Understanding the potential effects of the COVID-19 pandemic on the developing parent-infant relationship is a priority, especially for medically-fragile infants and their caregivers who face distinct challenges and stressors. Observational assessments can provide important insights into parent-child behaviors and relational risk; however, stay-at-home directives and physical distancing measures associated with COVID-19 have significantly limited opportunities for in-person observational parent-infant assessment. To maintain momentum in our research program during the pandemic, we rapidly pivoted to remote, technology-assisted parent-infant observational assessments. In this commentary, we offer a series of strategies and recommendations to assist researchers in adapting observational parent-infant paradigms. We also discuss the benefits, challenges, and limitations of distance-delivered assessments, and offer considerations for clinical service provision and future research during and post the COVID-19 pandemic.
We sought to characterise patients with POS related to PFO without pulmonary hypertension. We retrospectively reviewed databases at three tertiary referral hospitals in New South Wales, Australia from 2000 to 2019. Fourteen patients with a mean age of 69614 years of age had a PFO with wide tunnel separation. Median NYHA Class was II and 7 inpatients had been confined to bed (from postural symptoms). It was 30633 days from onset of POS to diagnosis. Baseline oxygen saturations supine were 9365% and 8466% upright. 2 patients had a minor congenital heart Platypneaorthodeoxia Syndromedefect and 4 had mild parenchymal lung disease with preserved lung function. The mean aortic root diameter was 3766mm and distance between aortic root and posterior atrial wall was 1662mm. POS was preceded by surgery in 5 patients and 1 patient had mild pneumonia. Successful closure of the PFO using an Amplatzer device was performed in 11 of 14 patients. Post-closure, NYHA Class improved by 260.9 (p,0.001, n=11) and supine oxygen saturations increased by 1368% (p,0.001, n=10). POS is a debilitating condition, curable by PFO closure. Anatomical distortion of the atrial septum related to a dilated aortic root or shortening of the distance between the aortic root and posterior atrial wall may contribute to the syndrome.
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