Data on the effective burden of the SARS-CoV-2 pandemic in the pediatric population are limited. We aimed at assessing the prevalence of SARS-CoV-2 IgG antibodies in children at three subsequent time-points. The study was conducted between January 2021 and July 2021 among children referring to the Research Institute for Maternal and Child Health “Burlo Garofolo” in Trieste, a referral regional hospital in Friuli Venezia Giulia, Italy. A multivariate analysis was conducted to assess factors independently associated with seroconversion. A total of 594 children were included. Anti-SARS-CoV-2 trimeric Spike protein IgG antibodies were found in 32 (15.4%) children tested in April-May and in 20 (11.8%) in June–July 2021, compared with 24 (11.1%) of those tested in January–February 2021 (p = 0.37, Armitage exact test for trend over time p = 0.76). A subgroup analysis and a multivariate logistic regression analysis were performed considering sociodemographic, clinical, and historical variables. Three categories of children showed statistically significant increased odds of positive anti-SARS-CoV-2 IgG antibodies: children previously positive to a nasopharyngeal swab (AdjOR 15.41, 95%CI 3.44–69.04, p < 0.001), cohabitant with a person with an history of a previous positive nasopharyngeal swab (AdjOR 9.95, 95%CI 5.35–18.52, p < 0.001), and children with a foreign citizenship (AdjOR 2.4, 95%CI 1.05–5.70, p = 0.002). The study suggests that seroprevalence studies may be of limited help in estimating the prevalence of the COVID-19 pandemic in children. Further studies are needed to identify other markers of previous SARS-CoV-2 infection in children, such as CD4+ T cells or memory B-cells.

Background/Objectives: The use of physical restraints in adult and pediatric intensive care units (ICUs) is common yet controversial. While restraints are intended to prevent treatment interference or self-harm, they pose significant physical, psychological, and ethical risks. Nurses in intensive care units play a key role in decisions about restraint application, but there is a global lack of validated tools to assess their knowledge, attitudes, and practices, particularly in non-English-speaking contexts. Aim of this study was to develop and validate a questionnaire for assessing knowledge, attitudes, and practices (KAP) of ICU nurses regarding restraint use in adult and pediatric settings. Materials and Methods: A multi-method psychometric validation study was conducted across both adult and pediatric ICU settings at two hospitals in northern Italy. Questionnaire development included literature review, expert consultation, and iterative content and face validity assessments. Reliability was tested using test–retest methods, and construct validity was explored through exploratory factor analysis. The study followed COSMIN guidelines. Results: The final CON-Ti-IT questionnaire comprised 29 items across three subscales: Practices, Attitudes, and Knowledge. It demonstrated strong content validity (CVI = 0.96) and good internal consistency for the Practices subscale (Cronbach’s α = 0.89). Internal consistency for the Attitudes (α = 0.51) and Knowledge (α = 0.47) subscales was lower, reflecting the broader conceptual variability of these domains. Exploratory factor analysis confirmed the structural validity of the tool and led to the removal of three items with low factor loadings. Conclusions: This study presents the first validated tool specifically designed to evaluate ICU nurses’ KAP on restraint in adult and pediatric settings. While developed and validated in Italy, it could undergo cross-cultural adaptation and translation for use in other languages and healthcare systems. Its strong psychometric properties support its application in future research, and the data collected through its use can serve both to improve patient care and to provide a foundation for targeted educational initiatives.

Background/Objectives: Few studies focus on essential information and training for responsible caregivers in the operating theatre (OT). Our study explored challenges, opportunities and critical information for caregivers close to the child until induction, drawing on the experiences of nurses and caregivers. Methods: A mixed-method exploratory sequential design was adopted in the OT and surgery wards of a maternal and child health hospital in Italy (2021–2023). Results: Twelve nurses were involved in 2 focus groups. The content analysis yielded 3 themes and 6 subthemes. Two questionnaires were developed for nurses and caregivers based on qualitative findings. The quantitative phase included 25 nurses and 140 caregivers. Results from the quantitative strand confirm findings from the qualitative strand. However, discrepancies in information needs highlight gaps. Conclusions: Optimizing family comfort and workflows in the OT depends on caregivers’ awareness of their role near the child, emphasizing mindful presence and awareness of their body movements—watching, touching and fidgeting.

Background: Pediatric ear, nose, and throat (ENT) surgery is common, but generates perioperative anxiety for caregivers and distress in children. Limited time for perioperative education and reliance on unverified online information can reduce family preparedness and increase stress. Few studies have evaluated co-designed mobile health (mHealth) apps to support and engage families in the perioperative ENT journey. Objective: This study aimed to compare caregiver anxiety between an mHealth app-supported care pathway and standard supportive and educational care alone in the perioperative ENT context. Secondary objectives explored between-group differences in caregiver anxiety at follow-up, family preparation, child distress, and social-impact indicators. Methods: A 2-arm, parallel-group, open-label randomized controlled trial (RCT) enrolled caregivers of children undergoing ENT surgery (tonsillectomy, adenoidectomy, tympanostomy tube insertion). The intervention was an mHealth app co-designed through a user-centered participatory approach and developed following Schnall and colleagues’ Information Systems Research Framework, with content based on caregivers’ informational needs. RCT participants were recruited at the hospital during their presurgery visit, when a health care provider introduced the study and provided instructions on how to use the app. No additional human support was scheduled thereafter. A sample size of 180 participants (90 per group) was estimated to detect the expected between-group difference in caregiver anxiety. Participants were randomly assigned in a 1:1 ratio to app use or standard care alone. The primary outcome was the between-group difference in caregiver state anxiety (State-Trait Anxiety Inventory [STAI-Y]). Secondary outcomes included between-group differences in child distress (modified version of the Yale Preoperative Anxiety Scale [mYPAS]), child preparation for surgery, family preparation for hospital admission and surgery, and social impact indicators. Outcomes were assessed online through questionnaires, which included both self-reported measures and evaluations completed by a nurse on the day of surgery. App engagement metrics were also collected. Reporting followed the CONSORT-EHEALTH (Consolidated Standards of Reporting Trials of Electronic and Mobile Health Applications and Online Telehealth) guidelines. Results: The study enrolled 227 caregivers, with 111 allocated to the control group (CG) and 116 to the experimental group (EG), achieving the target sample size. No statistically significant differences were observed between the groups for the primary or secondary outcomes (all P >.05). In the EG, 75% (n=87) of the participants accessed at least 1 item of in-app content. Higher baseline anxiety was linked to lower app use (ρ=–0.22, 95% CI –0.39 to –0.04; P =.02), while greater use was linked to lower child distress (ρ=–0.23, 95% CI –0.40 to –0.04; P =.02). Conclusions: Although the hypotheses were not confirmed, these findings provide valuable insights for future perioperative mHealth research. The lack of effectiveness may reflect limited exposure to the intervention, outcome selection and timing, and contextual factors such as caregivers’ independent information-seeking. These findings support a greater focus on implementation processes and on identifying the caregivers most likely to benefit from mHealth-supported education.