The Relationship Between Perceived Stress and Subjective Cognitive Decline During the COVID-19 Epidemic.

During the outbreak of the COVID-19 epidemic, fear of disease and its consequences, recommended lifestyle changes, and severe restrictions set by governments acted as stressors and affected people's mood, emotions, mental health, and wellbeing. Many studies conducted during this crisis focused on affective and physiological responses to stress, but few studies examined how the crisis affected cognition. The present cross-sectional study examined the relationship between physiological, affective, and cognitive responses to the epidemic. In an online survey conducted at the height of the first wave of the epidemic in Slovenia (April 15-25, 2020), 830 Slovenian residents aged 18-85 years reported the effects of stressors (confinement, problems at home, problems at work, lack of necessities, and increased workload), experienced emotions, generalized anxiety, perceived stress, changes in health, fatigue and sleep quality, and perceived changes in cognition during the epidemic. Risk factors for stress (neuroticism, vulnerability, general health, gender, and age) were also recorded. We hypothesized that stressors and stress risk factors will be related to subjective cognitive decline, with negative emotions, generalized anxiety, perceived stress, and physical symptoms acting as mediator variables. On average, the results showed a mild subjective cognitive decline during the epidemic. In structural equation modeling, 34% of its variance was predicted by the mediator variables, with negative emotions and physical symptoms having the largest contribution. Stress risk factors were predictably related to the four mediator variables. Among the stressors, confinement showed the strongest effect on the four mediator variables, implying the importance of thoughtful communication about necessary restrictive measures during emergency circumstances. The results of this study indicate that the possibility of altered cognitive function should be considered when planning work and study activities during the epidemic.

Slovenian Validation of the Children's Perceived Use of Self-Regulated Learning Inventory.

The importance of self-regulated learning (SRL) has increased during the COVID-19 pandemic and measures for assessing students' self-regulation skills and knowledge are greatly needed. We present the results of the first thorough adaptation of the Children's Perceived use of Self-Regulated Learning Inventory (CP-SRLI). The inventory, consisting of 15 scales measuring nine components of SRL, was administered to a sample of 541 Slovenian ninth graders. Confirmatory factor analyses supported internal structure validity of most components, but two components required some structural modifications. Internal consistency coefficients were acceptable for the majority of scale scores and were highly comparable to the original ones. While metric invariance across gender was confirmed, the scalar invariance of some scales needs further examination. Meaningful correlations with relevant externally assessed and self-reported self-regulation and school performance variables indicated good criterion validity of the inventory. The Slovenian version of the CP-SRLI thus proved to be a sufficiently valid and reliable instrument for assessing pupils' learning self-regulation.

Comparison of Polymeric Clips and Endoscopic Staplers for Laparoscopic Appendectomy.

INTRODUCTION: Appendectomy is the most common pediatric surgical procedure. To decrease the cost and environmental impact of single incision pediatric endosurgery (SIPES) appendectomy, we switched from using endoscopic staplers to polymeric clips placed with nondisposable laparoscopic appliers. The aim of this study was to compare the resulting reduction in cost and amount of waste generated per case, as well as to compare the perioperative variables and outcomes in patients in whom clips were used, with those of historical patients in whom staplers were used. MATERIALS AND METHODS: Retrospective chart review of SIPES appendectomies was performed and patients in whom clips were used were compared with patients in whom staplers were used. Demographic, operative, and clinical data were collected. t-Test, Mann-Whitney test, and chi squared test were used to analyze the data as appropriate. The cost to the hospital of the clips and staplers was compared. The disposable waste generated from clips and the staplers was weighed. RESULTS: A total of 246 patients were included: 111 in stapler group and 135 in clip group. There were no statistically significant differences between the groups in operative time, estimated blood loss, length of stay, and complications. There were no complications related to use of clips. In the clip group, staplers were used in 10% because base of appendix was too large, gangrenous, or perforated and could not be clipped. Use of polymeric clips was less expensive and generated less waste. CONCLUSIONS: Use of polymeric clips for appendectomy is safe and effective, and results are comparable with those of stapling. Based on our data, in 90% of appendectomies, the base of appendix is amenable to clipping. This study supports use of clips over staplers to decrease cost and environmental impact.

Factorial Validity and Measurement Invariance of the Slovene Version of the Cultural Intelligence Scale.

This study examined the factorial validity of the Slovene version of the cultural intelligence scale (CQS) in a representative sample of 1,000 Slovenian participants (49% were female). The results of confirmatory factor analysis supported the factorial validity of the Slovene CQS and the existence of a general (second-order) cultural intelligence factor. The four scales and the overall (general) CQS scale showed satisfactory internal consistency. The results of multiple-group confirmatory factor analyses supported the hypotheses of partial measurement invariance across gender, and full measurement invariance across type of settlement (urban vs. rural).

Individuation in relation to parents as a predictor of career goals and career optimism in emerging adults.

The aim of this study was to examine the associations of Slovenian emerging adults' individuation characteristics (in relation to mother and father) with career goals and career optimism. We were interested in contributions of age, gender, certainty of study choice, and individuation dimensions when predicting intrinsic/extrinsic career goals and career optimism. The participants provided self-reports on the Individuation Test for Emerging Adults, the Career Goals Scale and the Career Futures Inventory. The results showed that age did not relate to emerging adults' career goals; however, older students reported lower career optimism than their younger counterparts. Furthermore, certainty of study choice was the most important predictor of career optimism, and, along with gender, of intrinsic career goals. Emerging adults who reported higher connectedness with both parents and self-reliance in relation to mother had higher intrinsic career goals, while self-reliance in relation to mother was positively associated with stronger optimism about an individual's future career. Fear of disappointing both parents significantly contributed to the prediction of extrinsic career goals and optimism, while parental intrusiveness did not add significantly to the prediction of the two measured career outcomes. The study confirmed the correlational effects of positive and negative aspects of individuation on career outcomes in emerging adulthood.

Maternal pre-eclampsia as a risk factor for necrotizing enterocolitis.

OBJECTIVE: Similar pro-inflammatory responses are present in pre-eclampsia (PE) and necrotizing enterocolitis (NEC). We hypothesized that maternal PE is an independent risk factor for the development of NEC. METHODS: A retrospective database of all live births (2008-2011) at a tertiary center was constructed. Infant and maternal characteristics were gathered. Babies born to mothers with or without PE were compared. Data were analyzed using Mann-Whitney U, Pearson's χ(2), binary logistic regression and relative risks. RESULTS: Incidence of NEC was 1.5% in non-PE and 4.6% in the PE group (p < 0.001), but once controlled for gestational age and birth weight, the difference lost statistical significance. PE babies were more frequently preterm (41.4% versus 14.5%, p < 0.001) and had intrauterine growth restriction (IUGR) (10.2% versus 6.3%, p < 0.001). Within preterm babies, 9.0% of non-PE and 10.8% of PE babies developed NEC (p = 0.25). Effect of PE was significant in sub-group of IUGR babies, with NEC in 1.5% of non-PE and 13.6% in PE babies (p < 0.001). CONCLUSIONS: Maternal PE is an independent risk factor for the development of NEC in some sub-groups of babies, most notably with IUGR. Fetal hypoxia caused by abnormal placentation in PE leads to restricted growth, and may be the underlying mechanism that predisposes the newborn to NEC.

Development of the Short Version of the Individuation Test for Emerging Adults (ITEA-S) and Its Measurement Invariance Across Slovene and U.S. Emerging Adults.

In this study we developed a short version of the Individuation Test for Emerging Adults (ITEA-S) and tested its measurement invariance across Slovene and U.S. samples of emerging adults. The item reduction process resulted in retaining 21 out of 36 items. The content analysis of the retained and discarded items revealed that the ITEA-S adequately measures the 5 individuation domains (support seeking, connectedness, intrusiveness, self-reliance, and fear of disappointing the parent). In our samples, the ITEA-S demonstrated evidence for construct validity and its 5 scales showed adequate internal consistency. The scale scores were also meaningfully associated with the relevant demographic variables in both countries, as well as the three scales of the Psychological Separation Inventory (Hoffman, 1984 ; the Slovene sample), and the scales of the Differentiation of Self-Revised questionnaire (Skowron & Schmitt, 2003 ; the U.S. sample). The results of multiple group confirmatory factor analyses supported the hypothesis of full metric and partial scalar invariance for both ITEA-S forms (in relation to mother and father) across the 2 country groups.

Individuation in Slovene emerging adults: its associations with demographics, transitional markers, achieved criteria for adulthood, and life satisfaction.

The study investigated associations of Slovene emerging adults' age, gender, living situation, romantic relationship, and employment status with aspects of individuation in relation to mother and father. Controlling for demographic variables and transitional markers of adulthood, we further explored the contribution of individuation measures to individuals' perceptions of achieved criteria for adulthood and life satisfaction. The participants provided self-reports on the Individuation Test for Emerging Adults, the Satisfaction With Life Scale, and the list of Achieved Criteria for Adulthood. Age and living out of parental home were positively associated with self-reliance in relation to both parents, whereas female gender was related to higher levels of connectedness and seeking parental support. Along with age and involvement in a romantic relationship, connectedness and self-reliance predicted adulthood criteria attainment and life satisfaction. The results support the models of individuation that emphasize growing autonomy and retaining connectedness to parents as pathways towards personal adjustments.

Development and construct validation of the Individuation Test for Emerging Adults (ITEA).

This article presents the construction, exploratory dimensionality analysis (Study 1), and validation (Study 2) of the self-report and 36-item Individuation Test for Emerging Adults (ITEA). It is the first instrument to measure different aspects of individuation (in relation to mother and father) specifically in emerging adulthood. The construct validity of the final 5-factor structure (Support Seeking, Connectedness, Intrusiveness, Self-Reliance, and Fear of Disappointing the Parent) was satisfactory. The results of multigroup analyses demonstrated that the factor structure is stable across male and female emerging adults for ITEA assessments in relation to both mother and father. The ITEA scales also show good internal consistency and concurrent validity against Emotional, Conflictual, and Functional Dependence scales of the Psychological Separation Inventory.

Self-reported adherence behavior in adolescent hypertensive patients: the role of illness representations and personality.

OBJECTIVE: This exploratory study examined the role that illness representations and personality play in the various adherence behaviors of adolescents diagnosed with essential hypertension. METHODS: The participants were 97 hypertensive adolescents. They completed self-report questionnaires pertaining to (1) demographic and medical data, (2) adherence, (3) illness representations, and (4) personality. Medical charts were also assessed. RESULTS: The hierarchical regression analyses indicated that: (1) conscientiousness, agreeableness, and perception of treatment effectiveness account for a significant amount of variance in general adherence; (2) perception of treatment effectiveness is predictive of overall specific adherence; and (3) for adherence to most of the individual specific regimen recommendations, illness representations are more predictive compared to personality dimensions. CONCLUSIONS: The personality domains of conscientiousness, extraversion, agreeableness, and illness representation dimensions (treatment control, concern, and emotional burden) were shown to predict adherence behaviors in adolescent hypertensive patients differentially. Study implications and limitations are discussed.

Impact of surgical approach on outcome in 622 consecutive pyloromyotomies at a pediatric teaching institution.

PURPOSE: The aim of this study is to compare the outcome of 3 different approaches to pyloromyotomy in a large single institution series. METHODS: Records of consecutive patients undergoing pyloromyotomy for an 8-year period were reviewed. Patients' age, sex, weight, operating time, length of stay, number of emeses, and complications were recorded. Variables were compared between right upper quadrant (RUQ), umbilical (UMB), and laparoscopic (LAP) approaches. RESULTS: Six hundred twenty-two patients were included in the study. Operating time was significantly shorter for LAP and RUQ compared to UMB. Length of stay did not differ between the groups. There were fewer episodes of emesis in the LAP group. There was a trend toward a higher rate of complications in UMB group. CONCLUSION: Outcomes after pyloromyotomy are institution dependent and cannot be generalized. Patient safety is the first concern, followed by patient comfort and cosmesis. Laparoscopic pyloromyotomy can be as fast and efficient as open, without an increased rate of complications, with excellent cosmetic results, and less analgesic requirement. If skill and experience to replicate good outcomes of laparoscopy are not available, open pyloromyotomy is a safer technique. The UMB approach is an alternative method to achieve good cosmesis without laparoscopy in the hands of a surgeon proficient in this method.