The alarm distress baby scale in a longitudinal Portuguese study reanalyzed with attachment data

Article first published online: 13 NOV 2013

Estudo de validação da versão portuguesa da Alarm Distress Baby Scale (ADBB)

Contexto. O comportamento de retraimento social prolongado da criança é um importante sinal de alarme, quer tenha origem orgânica, psicológica e/ou social. A. Guédeney construiu a Alarm Distress Baby Scale (ADBB), para identificar este comportamento no contexto da consulta pediátrica ou da observação psicológica. Objectivos. Validação da versão portuguesa da ADBB destinada a avaliar o comportamento de retraimento social de crianças com idades compreendidas entre 2 e 24 meses. Metodologia A ADBB e as Bayley Scales of Infant Development (BSID) foram administradas a uma amostra de 130 lactentes com 3 meses de idade, cujas mães preencheram a versão portuguesa da Edinburgh Postnatal Depression Scale (EPDS); 51 bebés foram novamente avaliados aos 12 meses de idade. Resultados. Os itens da ADBB organizam-se satisfatoriamente em duas sub-escalas. A consistência interna do instrumento é razoável (alpha de Cronbach = .587). A validade externa é elevada: a correlação entre os resultados na ADBB e nas BSID é muito significativa - os bebés que aos 3 meses apresentam um resultado igual ou superior a 5 na ADBB evidenciam menor desenvolvimento nas BSID. Os resultados testemunham ainda que bebés de mães deprimidas (EPDS ≥ 12) mostram mais sinais de retraimento social do que os bebés das mães não deprimidas. Conclusão. A escala permite detectar crianças a necessitar de ajuda no sentido de contrariar o retraimento social que encetaram em relação ao meio. Desenhada para sinalizar tão precocemente quanto possível o retraimento social do lactente, e na medida em que este é um comprovado sinal da perturbação do desenvolvimento, a ADBB pode estimular os clínicos na procura das suas causas e na intervenção junto das mesmas. Estudos em amostras de crianças com mais idade são necessários. No entanto, os resultados obtidos apontam que a Versão portuguesa da ADBB é robusta e válida.

Desenvolvimento de sistema de alarmes para incontinentes

Dissertação de mestrado em redes e serviços telemáticos

Infants’ behavioral and physiological profile and mother–infant interaction

This study aims to (a) identify and profile groups of infants according to their behavioral and physiological characteristics, considering their neurobehavioral organization, social withdrawal behavior, and endocrine reactivity to stress, and to (b) analyze group differences in the quality of mother–infant interaction. Ninety seven 8-week-old infants were examined using the Neonatal Behavioral Assessment Scale and the Alarm Distress Baby Scale. Cortisol levels were measured both before and after routine inoculation between 8 and 12 weeks. At 12 to 16 weeks mother–infant interaction was assessed using the Global Rating Scales of Mother–Infant Interaction. Three groups of infants were identified: (a) ‘‘withdrawn’’; (b) ‘‘extroverted’’; (c) ‘‘underaroused.’’ Differences between them were found regarding both infant and mother behaviors in the interaction and the overall quality of mother–infant interaction. The identification of behavioral and physiological profiles in infants is an important step in the study of developmental pathways.

Infant’s psychophysiological profile and temperament at 3 and 12 months

This study is intended to analyze (1) differences in infant temperament at 3 and 12 months according to infants' psychophysiological profiles: "withdrawn" "extroverted", and "underaroused" and (2) changes in infant temperament from 3 to 12 months, namely according to the infant psychophysiological profile and the quality of mother-infant interaction. Ninety-four 8-week-old infants were assessed using the Neonatal Behavioral Assessment Scale (NBAS, Brazelton & Nugent, 1995) and the Alarm Distress Baby Scale (ADBB, Guedeney & Fermanian, 2001). Saliva samples were collected at 8-12 weeks old, both before and after a routine inoculation for cortisol reactivity measurement. Mother-infant interaction was evaluated at 12-16 weeks, using the Global Rating Scales (GRS, Murray, Fiori-Cowley, Hooper, & Cooper, 1996). Mothers' reports on infant temperament at 3 and 12 months were collected using the Infant Behavior Questionnaire (IBQ, Rothbart, 1981). Significant differences in mothers' perception of infant temperament were found at both 3 and 12 months in infants with distinct psychophysiological profiles. Stability was observed in most of the temperament's dimensions from 3 to 12 months old; still, there were changes in mothers' perception of infant temperament in terms of level of distress, cuddliness, sadness and approach. Infant psychophysiological profile and mother-infant interaction both influence with the pattern of those changes. The results corroborate that infant's characteristics early in life as well as contextual factors influence with mothers' perception of infant temperament and with changes across the 1st year of life.

Critical events in mechanically ventilated patients

Mechanical Ventilation is an artificial way to help a Patient to breathe. This procedure is used to support patients with respiratory diseases however in many cases it can provoke lung damages, Acute Respiratory Diseases or organ failure. With the goal to early detect possible patient breath problems a set of limit values was defined to some variables monitored by the ventilator (Average Ventilation Pressure, Compliance Dynamic, Flow, Peak, Plateau and Support Pressure, Positive end-expiratory pressure, Respiratory Rate) in order to create critical events. A critical event is verified when a patient has a value higher or lower than the normal range defined for a certain period of time. The values were defined after elaborate a literature review and meeting with physicians specialized in the area. This work uses data streaming and intelligent agents to process the values collected in real-time and classify them as critical or not. Real data provided by an Intensive Care Unit were used to design and test the solution. In this study it was possible to understand the importance of introduce critical events for Mechanically Ventilated Patients. In some cases a value is considered critical (can trigger an alarm) however it is a single event (instantaneous) and it has not a clinical significance for the patient. The introduction of critical events which crosses a range of values and a pre-defined duration contributes to improve the decision-making process by decreasing the number of false positives and having a better comprehension of the patient condition.