The epidemiology and effects of video game addiction: A systematic review and meta-analysis.

With the increasing popularity and accessibility of video games, the public concern about their effects - positive and negative - has also increased. In this regard, this systematic review sought to identify and thematically analyze recent studies (in the last five years) and report on video games' epidemiological characteristics and outcomes. A systematic database search was done on ScienceDirect, APA PsycINFO, Emerald, and Scopus databases for articles published from January 1, 2017, to April 1, 2022. The Meta XL software - an add-in for Microsoft Excel - was used to calculate the pooled prevalence level of video game addiction. The database search yielded a total of 693 non-duplicate articles. After applying the inclusion and exclusion criteria, 27 articles were selected to be included in the systematic review. Along with this, 12 articles were considered for the final meta-analysis. The pooled prevalence level of gaming addiction was 5.0 % (95 % CI, 2.1-8.8 %). The I2 value was 99.297 with a p-value of 0.000. The factors that accompanied addictive video gaming were psychological, social, and personal. An addictive gaming behavior was characterized by spending an above-average time on gaming, doing most of the gaming online, and gaming activities interfering with sleep patterns. Some predictors of addictive gaming were emotional dependence, social detachment, increased gaming time, preference for playing online than offline, and increased emotional and psychological stress. Engaging in addictive gaming led to adverse outcomes such as lower academic scores, depression, and anxiety, as well as decreased self-esteem, life satisfaction, and social support. From the collected findings it could be concluded that extreme playing of video games can be classified as addictive. Following the identification of risk factors, appropriate corrective or interventional measures should be developed and applied coherently to newer statistical data.

Resilience, Positivity and Social Support as Perceived Stress Predictors among University Students.

Since the COVID-19 pandemic, researchers have been trying to identify which personal resources can contribute to minimizing the mental health costs in students incurred due to the restrictions that disrupted safety and predictability in their academic lives. The aim of the study was to verify if and how individual factors (resilience and positivity) and socio-environmental factors (social support and nationality) allow prediction of the level of perceived stress. University students (n = 559) from Poland, Serbia, and Italy were surveyed using the Perceived Stress Scale (PSS-10), the Brief Resilience Scale (BRS), the Positivity Scale (PS), and the Interpersonal Support Evaluation List (ISEL-12). Personal resources-positivity, resilience, and support-were found to be positively interrelated and significantly associated with stress levels. Additionally, gender and nationality differentiated stress levels. A general linear model (GLM) showed that levels of perceived stress are best explained by resilience, positivity, tangible support, and gender. The results obtained can strengthen students' awareness of personal resources and their protective role in maintaining mental health, as well as contribute to the creation of prevention-oriented educational activities. Nationality was not a significant predictor of the level of perceived stress, which highlights the universality of examined predictors among university students from different countries and suggests that interventions aimed at enhancing these resources could benefit students across different cultural contexts.

The Italian version of the "tool to measure parental self-efficacy-short form": psychometric properties of the measure and initial validation.

BACKGROUND AND AIM: Parental self-efficacy is recognized as a core element of the transition to parenthood process. It affects parental mental health, as well as children's psychosocial, neurodevelopmental and health outcomes since early infancy. Parents with higher parenting self-efficacy have a higher likelihood of engaging in quality parenting practices that support optimal self-regulation development in children. Our study evaluated the psychometric properties of the Italian TOPSE-Short Form (I-TOPSE-SF) questionnaire. METHODS: 673 Italian mothers (Mage=37.5; SD=5.7) of children aging 0 to 6 years (Mage=3.9; SD=1.7) were involved in this study. RESULTS: Initial results of Confirmatory Factor Analysis highlighted that the fit indices of the hypothesized 6-factor structure of the TOPSE weren't satisfactory. Acceptable internal consistencies for the total score and the six dimensions of the measure were observed. Evidence for convergent and divergent validity were provided. CONCLUSIONS: The I-TOPSE-SF could be a valuable tool to assess parental self-efficacy up to school age, but it is in need of further considerations about its measurement properties.

Language Delay in Patients with CLN2 Disease: Could It Support Earlier Diagnosis?

Neuronal ceroid lipofuscinosis type 2 (CLN2 disease) is a rare pediatric disorder associated with rapid neurodegeneration, and premature death in adolescence. An effective enzyme replacement therapy (cerliponase alfa) has been approved that can reduce this predictable neurological decline. The nonspecific early symptoms of CLN2 disease frequently delay diagnosis and appropriate management. Seizures are generally recognized as the first presenting symptom of CLN2 disease, but emerging data show that language delay may precede this. An improved understanding of language deficits in the earliest stage of CLN2 disease may support the early identification of patients. In this article, CLN2 disease experts examine how language development is affected by CLN2 disease in their clinical practices. The authors' experiences highlighted the timings of first words and first use of sentences, and language stagnation as key features of language deficits in CLN2 disease, and how deficits in language may be an earlier sign of the disease than seizures. Potential challenges in identifying early language deficits include assessing patients with other complex needs, and recognizing that a child's language abilities are not within normal parameters given the variability of language development in young children. CLN2 disease should be considered in children presenting with language delay and/or seizures to facilitate earlier diagnosis and access to treatment that can significantly reduce morbidity.

Validation of the self-compassion scale in a sample of Italian special needs teacher.

Introduction: Special needs teachers deliver crucial care to their students by showing a particular attitude toward them. However, they usually face stressful situations that negatively impact their capacity to support their students, often reporting higher levels of burnout compared to teachers from mainstream education. Self-compassion has been seen to function as a protective factor against teacher stress, enhancing their resilience and coping abilities. Methods: The current study aimed to evaluate the factorial structure, reliability, and validity of the Self-compassion Scale (SCS) in a sample of Italian special needs teachers (R1). In addition, it was investigated whether the satisfactory internal reliability of the SCS is confirmed (R2). Finally, the validity of the SCS criterion was assessed, assuming that each of its subscales would be related to anxiety, measured with GAD-7, and with resilience, measured with the BRS (R3). A sample of 629 teachers was enrolled in this study and completed an online questionnaire. Results: Overall, the confirmatory factor analysis showed good or acceptable indices of fit to the data supporting the use of SCS to measure self-compassion in Italian special needs teachers. Discussion: The tool could be helpful for future research to start exploring the self-compassion dimension at school as a protective factor that may foster teachers' and, consequently, students' well-being.

The Efficacy of Parent Training Interventions with Parents of Children with Developmental Disabilities.

Parenting children with developmental disabilities (DD) can be generally characterized by a considerable psychological burden. The effects on parental and familial psychological well-being and, consequently, on children's developmental outcomes should not be underestimated, especially in early childhood. The current review aims to advance our understanding of the key factors (e.g., formats, sample characteristics, research design) that characterize parent training interventions, and that could be related to their outcomes, to guide researchers and clinical practitioners to develop and provide efficient programs. Studies were identified via an Internet search from three electronic databases, following PRIMSA guidelines. Studies published until November 2021 were taken into account. The initial search yielded a total of 2475 studies. Among them, 101 studies were fully reviewed. Finally, ten of the studies, which met all the inclusion criteria, formed the basis for this review. Participants' characteristics, main features of the interventions (i.e., study design, structure, and contents), outcome variables and treatment efficacy were deeply examined and discussed. Key factors of parent training interventions with parents of children affected by DD are enlightened, to guide researchers and clinicians in the design and implementation of tailored specific programs, aimed to sustain parenting and foster children's developmental outcomes, from early stages of life.

Health-related quality of life in Italian children and adolescents with congenital heart diseases.

BACKGROUND: Congenital heart disease (CHD) is the most common congenital anomaly at birth, affecting approximately 1% of live births. In recent decades great medical and surgical advances have significantly increased life expectancy, shifting healthcare professionals' and researchers' interests in patients' Quality of Life (QoL). The main aims of our study were to evaluate generic and condition-specific QoL in a group of Italian children and adolescents with CHD and their parents and examine the level of agreement and directional disagreement between child/adolescent and parents reports on generic and condition-specific QoL. METHODS: A cross-sectional study was designed with CHD children and adolescents and their parents referred to the Cardiology Department of "Bambino Gesù" Children's Hospital. The PedsQL scale was used, including generic (PedsQL 4.0) and cardiac-specific modules (PedsQL 3.0) were administered to patients and caregivers. A Kruskal-Wallis test was used to compare generic and cardiac module scores between patients with different ages, CHD diagnoses, and between patients who underwent surgery interventions and/or are currently taking cardiac medications. RESULTS: 498 families were enrolled in this study. On average, patients reported a good level of generic and condition-specific QoL, as well as their mothers and fathers. Children aged between 5-7 years old reported lower generic and cardiac-specific total QoL levels than children aged 8-12 years and adolescents (13-18 years). With regard to the agreement, patient-parent agreement on condition-specific QoL ranged from 25 to 75% while on generic QoL, it ranged from 19 to 76%. The highest percentage of disagreement between parents and children was found in patients aged 5-7 years old, both for condition-specific and generic QoL rates. CONCLUSIONS: Our study contributed to the growing body of knowledge on QoL in CHD, emphasizing the need for these families to receive support from multidisciplinary standardized care, including psychological consultations and support.

Intervention Programs to Promote the Quality of Caregiver-Child Interactions in Childcare: A Systematic Literature Review.

Sensitive caregiver-child interactions appear fundamental throughout childhood, supporting infants' wellbeing and development not only in a familial context but in professional caregiving as well. The main aim of this review was to examine the existing literature about Early Childhood Education Context (ECEC) intervention studies dedicated to caregiver-child interaction, fostering children's socioemotional developmental pathways. Studies published between January 2007 and July 2021 were identified in four electronic databases following PRIMSA guidelines. The initial search yielded a total of 342 records. Among them, 48 studies were fully reviewed. Finally, 18 of them met all inclusion criteria and formed the basis for this review. Main factors characterizing implemented programs were recorded (e.g., intervention and sample characteristics, dimensions of the teacher-child interaction targeted by the intervention, outcome variables, main results) in order to frame key elements of ECE intervention programs. Our review points to a range of fundamental issues that should consider to enhance ECEC interventions' efficacy, supporting children's socioemotional development and caregiver-child interaction. Reflections and considerations for future research are provided.

Pediatric medical traumatic stress (PMTS) in parents of newborns with a congenital anomaly requiring surgery at birth.

BACKGROUND: Pediatric medical traumatic stress (PMTS) is a psychological and physiological response of children and their families to pain, serious illness, and invasive medical procedures. We aimed to apply the PMTS model to parents of newborns operated at birth for a congenital malformation and to identify clinical and sociodemographic risk factors associated with PMTS symptoms at 6 months. METHODS: We designed a cross-sectional study to assess PMTS symptoms (avoidance, arousal, reexperiencing) in parents of six months children operated on for a congenital anomaly, with the Italian version of the Impact of Event Scale - Revised (IES-R). RESULTS: One-hundred-seventy parents form the object of the study. Eighty-two parents (48.2%) fell over the clinical cut-off. Ventilatory time (p = 0.0001), length of hospital stay (p = 0.0001), associated anomalies (p = 0.0002), medical devices at discharge (p = 0.0001) and Bayley motor scale (p = 0.0002) were significantly correlated with IES-R Total and Subscale Scores. Multivariate linear regression showed length of hospital stay and number of associated anomalies as significant predictors of IES-R Scores. CONCLUSIONS: Regardless the type of anomaly and sociodemographic factors, it is the clinical history of the child which seems to predict the severity of PMTS symptoms in this population of parents. PMTS represents a useful model to describe the psychological reactions of parents of newborns operated at birth for a congenital malformation. NICU and outpatient pediatric staff should be aware of risk factors to identify families who may request early multidisciplinary interventions since the first admission. LEVEL OF EVIDENCE: Prognosis study, level II.

Parental Involvement in Children's Sleep Care and Nocturnal Awakenings in Infants and Toddlers.

BACKGROUND: Sleep regulation and consolidation represent critical developmental processes that occur in the first years of life. Recent studies have highlighted the contribution of caregivers to sleep development. However, the majority of them have primarily focused on maternal behaviors, overlooking fathers. The main goal of the present study was to investigate the associations between paternal and maternal involvement in children's sleep care and the number of night awakenings reported by both parents in infants and toddlers. METHODS: One-hundred-and-one families of infants aged 8 to 12 months and 54 families of toddlers aged 18 to 36 months filled out the following self-report questionnaires: The Brief Infant Sleep Questionnaire and an ad hoc questionnaire to assess parental involvement in sleep care for children. A moderate actor-partner interdependence (APIM) with path analysis was performed to test the predictive role of parental involvement on the children's sleep (no. of nocturnal awakenings) and the moderation role of age on these relationships. RESULTS: Paternal involvement in children's sleep care was associated with the number of night awakenings reported by both parents. Moreover, a significant interaction effect emerged between the children's age and paternal involvement in children's sleep care for predicting nocturnal awakenings. CONCLUSIONS: The main outcomes of this study point to the protective role of paternal involvement in children's sleep during the first years of life.

The Interplay of Compassion, Subjective Happiness and Proactive Strategies on Kindergarten Teachers' Work Engagement and Perceived Working Environment Fit.

BACKGROUND: The current cross-sectional study examines a model that was designed to advance understanding of the interplay between compassion towards teachers expressed by teaching colleagues, subjective happiness, proactive strategies and kindergarten teachers' levels of work engagement, and perceived working environment fit. METHODS: The research was conducted with a sample of 319 full-time in-service kindergarten teachers at Italian public preschools-a context in which a few previous studies have been carried out. Self-report questionnaires were administered: The Subjective Happiness Scale, the Santa Clara Brief Compassion Scale, the Utrecht Work Engagement Scale, the Proactive Strategy Scale, and the Teacher-working environment fit scale. Data were analyzed by using the structural equation modelling (SEM) approach. RESULTS: Results show that compassion and subjective happiness have a direct positive total effect on work engagement, whereas the effects of compassion and subjective happiness on experienced working environment fit suggest that the association among constructs is mediated by the role of proactive strategies. CONCLUSIONS: Based on these findings, we strongly advocate that educational policy makers and head teachers' pay close attention to the areas of personal and collective resources and work-related well-being, with a view to effectively address the promotion of early childhood teachers' work engagement and working environment fit.

Predictive Factors of Toddlers' Sleep and Parental Stress.

BACKGROUND: Although most infants consolidate their sleep habits during the first year of life, for many children, sleep is described as disrupted during toddlerhood. Along with individual child variables such as temperamental characteristics, parenting behaviors play a key role in determining children's sleep-wake patterns. The aims of the current study were to evaluate the relationship among toddlers' sleep quality, emotion regulation, bedtime routines, parental bedtime involvement, parental perceived social support and stress, and to integrate a novel combination of the aforementioned dimensions into predictive models of toddlers' sleep quality and parental stress. METHODS: One hundred and sixty parents with 2-3-year-old children filled out the following self-report questionnaires: the Parent-Child Sleep Interaction Scale; the Emotion Regulation Checklist; the Social Provisions Scale; and an ad-hoc questionnaire to assess parental involvement in everyday and bedtime care for children. Three multiple regression analyses were conducted by regressing maternal and paternal parenting stress and infant's quality sleep onto the independent variables described above. RESULTS: Toddlers' emotion regulation and parental psychosocial functioning were related to parental stress. Toddlers' night awakenings and the time required by toddlers to fall asleep were related to parental distress. CONCLUSIONS: The findings evidenced the bidirectional associations among the studied variables, highlighting the protective role of social support in reducing parenting stress and of paternal bedtime involvement in improving toddlers' sleep quality.

Fixed the gap, solved the problem? Eating skills in esophageal atresia patients at 3 years.

Although eating problems have been described as long-term morbidities of esophageal atresia (EA), there have been few studies exploring eating outcomes in children born with EA as primary aim. Parents of children operated on for EA in our Institution from January 2012 to January 2016, answered a telephone structured interview developed specifically to conduct the present study, assessing eating skills at 3 years of age. Clinical data were collected from children's medical records. Parents (45 mothers and 6 fathers) of 51 children (male = 34; female = 17) with a median age of 3.5 years form the object of the study. Considering eating problems, parents reported that 23 children (45%) still have episodes of choking during meals at 3 years of age, 9 (45%) of these have more than one episode a week, and 19 parents (39%) reported higher levels of anxiety during mealtimes. Forty-four children (86%) were described by their parents as able to eat alone, 32 (65%) accepted all food textures and 45 (90%) was described as curious about food (3 years). Forty-three (86%) parents let their children eat with other people. Correlations showed that weaning age was significantly associated with number of dilatations (rs = 0.35, P = 0.012), days of mechanical ventilation (rs = 0.40, P < 0.001), and presence of gastrostomy tube at discharge (rs = 0.45, P < 0.001). Chewing age resulted associated with number of dilatations (rs = 0.34, P < 0.01) and days of mechanical ventilation (rs = 0.38, P < 0.01). Presence of choking episodes was associated with curiosity about food (rs = 0.29, P < 0.05), while frequent choking episodes were associated with higher parental anxiety during mealtimes (rs = 0.45, P < 0.05). In order to prevent delay in the achievement of eating developmental milestones in children operated on of EA, we advocate a dedicated preventive intervention from birth to follow-up.

Fathers and Sleep: A Systematic Literature Review of Bidirectional Links Between Paternal Factors and Children's Sleep in the First Three Years of Life.

OBJECTIVE: During childhood, sleep problems are a common concern for parents and families. The literature on children's sleep documents a strong association between parental factors and infant sleep quality. However, most studies have only examined maternal attitudes and behaviors. To systematically identify and assess the existing literature on the role of fathers in children's sleep over the first three years of life. METHOD: Studies were identified from January 1993 to July 2020 in four electronic databases, following PRIMSA guidelines. RESULTS: The initial search yielded a total of 657 records. Fifty-nine studies were full review, and 26 studies met all inclusion criteria and formed the basis for the review. Studies were divided into thematic groups as a function of the paternal variables they investigated: Extrinsic Parenting factors, Parent-child Interaction Context, and Distal Environmental Influences. CONCLUSIONS: This review points up a range of paternal variables that can represent risk or protective factors for child sleep. Our results may help parents and healthcare practitioners to identify evidence-based knowledge about sleep. Furthermore, identifying paternal factors that contribute to sleep problems can usefully inform the design of individualized interventions.

Subjective Happiness and Compassion Are Enough to Increase Teachers' Work Engagement?

The present quantitative multi-trait cross-sectional study aims to gain a better understanding of the network of relationship between subjective happiness, compassion, levels of work engagement, and proactive strategies (self- and co-regulation) in a sample of teachers. Participants were 187 full-time in-service teachers (89% female; age M = 48.5; SD = 7.88) from Rome, Italy. We hypothesized that subjective happiness and compassion of early childhood teachers would be related with work engagement in such a way that subjective happiness would promote the engagement of teachers. In a similar fashion, we theorized that subjective happiness would be positively related to self- and co-regulation strategies and that proactive strategies would be in turn associated to work engagement. As expected, the results revealed that subjective happiness and compassion showed effects on work engagement and that this association among constructs was mediated by the role of proactive strategies (ß = 0.22, p < 0.001; ß = 0.37, p < 0.001, respectively). Proactive strategies also have a significant direct effect on work engagement (ß = 0.56, p < 0.001). The study's findings suggest the importance of investing in the quality of the working environment.

Effect of Teachers' Happiness on Teachers' Health. The Mediating Role of Happiness at Work.

The present study aims to expand the understanding of the effects of dispositional happiness and self-esteem, as dispositional traits, on the health of teachers, as well as to understand the role played by the working environment in generating positive affection, thus mediating between the dispositional traits and teachers' health. Two hundred and eighty-two full-time in-service teachers (93.6% female) from Rome (Italy) took part in this study. Their ages ranged from 26 to 55 (M = 40.49 years, SD = 5.93). Participants' teaching experience ranged from 1 to 31 years (M = 9.95 years, SD = 5.65). 30.6% of participants taught in kindergarten (for children aged 0-5 years), 42.6% in primary schools (for children aged 6-11 years), 15.8% in middle schools and 10.9% in high schools. A questionnaire was administered, containing: the Subjective Happiness Scale (SHS); the Rosenberg Self-Esteem Scale (RSES); The adapted version for teachers of the School Children Happiness Inventory (Ivens, 2007); the Physical and Mental Health Scales (SF12). The data were analyzed using the MPLUS software, version 8. Our results showed that teacher happiness at work partially mediates the relationship between dispositional happiness and teacher health, and fully mediates the relationship between self-esteem and teacher health. To the best of our knowledge, the mediational role of teacher happiness has not been addressed before, concerning these dimensions. At the same time, our findings confirmed the role of self-esteem in endorsing health-related behaviors, thus promoting physical and mental health. Moreover, according to our study findings, when teachers acknowledge their workplace as a context in which they feel happy, the impact of dispositional happiness and self-esteem on health conditions is higher. Effective measures to promote teachers' well-being are discussed.

Parental Mental Health, Fathers' Involvement and Bedtime Resistance in Infants.

BACKGROUND: Around the age of 6 months, difficulties in settling to sleep and frequent night awakenings are generally occurring in 20 to 30% of infants. According to the transactional model parental factors can play a significant role in influencing infant sleep development. The purpose of the current study was to explore the combined effect of infants' factors (temperament and sleep onset problems), and parental factors (parental mental health in terms of post-partum affective disorders, consistent bedtime routines and fathers' involvement at bedtime), on infant bedtime difficulties (e.g. fussing, crying or protesting), including both maternal and paternal perspectives. METHODS: Sixty Italian intact two-parent families of infants (34 boys and 26 girls) ageing from 8 to 12 months (M = 10.73, SD = 2.54) were enrolled in the study. The parents filled out self-report questionnaires to measure the aforementioned variables. To investigate which infant and parental factors predicted infants' bedtime difficulties, two multiple linear regressions (MR), one for fathers and one for mothers, and relative weight analyses (RWA) were conducted. RESULTS: With regard to infants' bedtime difficulties reported by fathers (R2 = .35) they were explained by infant involvement in constant bedtime routines (ß = -.35, p = .030) and paternal involvement at bedtime (ß = -.45, p = .007). Instead infants' bedtime difficulties reported by mothers (R2 = .32) were explained by minutes the child taken to fall asleep (ß = .24, p = .04), infant involvement in constant bedtime routines (ß = -.31, p = .01) and bedtime paternal involvement (ß = -.27, p = .05). CONCLUSIONS: The main results of this study emphasized the protective role of consistent bedtime routines and bedtime paternal involvement in reducing infants' bedtime difficulties perceived both from mothers and fathers. Future research could help to raise awareness and improve understanding of the familial influences on children's sleep, providing recommendations for educating families, school professionals, healthcare providers, and the general public on risk and protective factors that could play a meaningful role in infants and children's developing sleep patterns.

Psycho-educational preparation of children for anaesthesia: A review of intervention methods.

OBJECTIVE: To systematically review the different methods available for the psycho-educational preparation of children for anaesthesia induction. METHODS: Articles were searched in Academic Search Premier, OvidSP, Web of Science, and PsycINFO. Inclusion criteria were psychological and educational preparation of children for anaesthesia and anxiety reduction. The titles of papers and abstracts were reviewed and full copies of selected papers were scrutinized. RESULTS: Forty-four empirical studies were identified. Twenty-one articles described preoperative preparation programmes, twelve examined the effects of distractive techniques and eleven reported the effect of parental presence during anaesthesia's induction. Some general characteristics of the different interventions are discussed together with some key psychological and educational factors mediating anxiety in children undergoing anaesthesia. CONCLUSION: The effectiveness of interventions were linked to several factors. Psychological and contextual aspects are discussed. Psycho-educational activities should be better described when reporting their effectiveness in children's preparation for an anaesthesia. PRACTICE IMPLICATIONS: Patient and family characteristics together with organizational and systemic aspects are described in order to guide the choice of the most appropriate preparation method for diverse health care setting.

Bridge Over Troubled Water: Perspective Connections between Coping and Play in Children.

We propose that children's play and coping strategies are connected. However, this connection has often been overlooked in the literature. To prove our hypothesis, the principal developmental functions of play are reviewed and compared with the different stages of the coping process. Our results show that coping and play are essential elements in child development, and indicate the presence of several overlapping areas where play and coping intersect. In spite of this, their interrelationship has seldom been examined. We explore the possible reasons for this omission with reference to the different natures of play and coping constructs, and also to the definitive psychometric and cognitive characteristics of most common coping measurement instruments. We conclude by proposing that play should be considered an elective form of coping in most aspects of children's lives. We also propose that methods to measure coping in children should be improved and a more analogical approach should be adopted toward play to enable accurate recognition of coping.