The illness experiences of African Americans residing in an inner city community, Houston, Texas

This dissertation documents health and illness in the context of daily life circumstances and structural conditions faced by African American families living in Clover Heights (pseudonym), an inner city public housing project in the Third Ward, Houston, Texas. Drawing from Kleinman's (1980) model of culturally defined health care systems and using the holistic-content approach to narrative analysis (Lieblich, Tuval- Mashiach, & Zilber, 1998) the purpose of this research was to explore the ways in which social and health policy, economic mobility, the inner city environment, and cultural beliefs intertwined with African American families' health related ideas, behaviors, and practices. I recruited six families using a convenience sampling method (Schensul, Schensul, & LeCompte, 1999) and followed them for fourteen months (2010–2011). Family was defined as a household unit, or those living in the same residence, short or long-term. Single, African American women ranging in age from 29–80 years headed all families. All but one family included children or grandchildren 18 years of age and younger, or children or other relative 18 years of age and older. I also recruited six residents with who I became acquainted over the course of the project. I collected data using traditional ethnographic methods including participant-observation, archive review, field notes, mapping, free-listing, in-depth interviews, and life history interviews. ^ Doing ethnography afforded the families who participated in this project the freedom to construct their own experiences of health and illness. My role centered on listening to, learning from, and interpreting participants' narratives, exploring similarities and differences within and across families' experiences. As the research progressed, a pattern concerning diagnosis and pharmacotherapy for children's behavioral and emotional problems, particularly attention-deficit hyperactivity disorder (ADHD) and pediatric bipolar disorder (PBD), emerged from my formal interactions with participants and my informal interactions with residents. The findings presented in this dissertation document this pattern, focusing on how mothers and families interpreted, organized, and ascribed meaning to their experiences of ADHD and PBD. ^ In the first manuscript presented here, I documented three mothers' narrative constructions of a child's diagnosis with and pharmacotherapy for ADHD or PBD. Using Gergen's (1997) relational perspective I argued that mothers' knowledge and experiences of ADHD and PBD were not individually constructed, but were linguistically and discursively constituted through various social interactions and relationships, including family, spirituality and faith, community norms, and expert systems of knowledge. Mothers' narratives revealed the complexity of children's behavioral and emotional problems, the daily trials of living through these problems, how they coped with adversity and developed survival strategies, and how they interacted with various institutional authorities involved in evaluating, diagnosing, and encouraging pharmaceutical intervention for children's behavior. The findings highlight the ways in which mothers' social interactions and relationships introduced a scientific language and discourse for explaining children's behavior as mental illness, the discordances between expert systems of knowledge and mothers' understandings, and how discordances reflected mothers' ‘microsources of power’ for producing their own stories and experiences. ^ In the second manuscript presented here, I documented the ways in which structural factors, including gender, race/ethnicity, and socioeconomic status, coupled with a unique cultural and social standpoint (Collins, 1990/2009) influenced the strategies this group of African American mothers employed to understand and respond to ADHD or PBD. The most salient themes related to mother-child relationships coalesced around mothers' beliefs about the etiology of ADHD and PBD, ‘conceptualizing responsibility,’ and ‘protection-survival.’ The findings suggest that even though mothers' strategies varied, they were in pursuit of a common goal. Mothers' challenged the status quo, addressing children's behavioral and emotional problems in the ways that made the most sense to them, specifically protecting their children from further marginalization in society more so than believing these were the best options for their children.^

L’abilità di perspective taking : un training per bambini in età prescolare in differenti contesti

Elemento centrale della presente tesi dottorale è il costrutto di perspective taking, definibile come l’abilità, emergente nei bambini intorno a 4-5 anni, di assumere la prospettiva altrui secondo tre differenti dimensioni: emotiva, cognitiva e percettiva (Bonino, Lo Coco, Tani, 1998; Moll e Meltzoff, 2011). Dalla letteratura emerge come il perspective taking, in quanto abilità di comprensione sociale, rivesta un ruolo adattivo e sia fondamentale per lo sviluppo, non solo intellettivo, ma anche per la formazione di adeguate capacità relazionali e sociali (Jenkins e Astington, 2000; Weil et al., 2011). Sulla base di tali considerazioni, alcuni ricercatori si sono interrogati sulla possibilità di insegnare questa abilità, elaborando specifiche e differenti procedure di intervento finalizzate ad incrementare l’abilità di perspective taking sia in bambini a sviluppo normativo (Cigala e Mori, 2015), sia in gruppi di bambini a sviluppo atipico (Fisher e Happé, 2005; Heagle e Rehfeldt, 2006; Paynter e Peterson, 2012). A partire da una prospettiva teorica socio-costruzionista, secondo cui l’acquisizione del perspective taking si configura come un’impresa di co-costruzione continua, all’interno di interazioni quotidiane con figure significative per il bambino, si è deciso di analizzare il perspective taking non solo in relazione a variabili individuali (genere, età del bambino, regolazione emotiva, abilità sociali) ma anche e soprattutto a variabili contestuali quali le caratteristiche del contesto familiare (caratteristiche disposizionali e stili genitoriali di socializzazione emotiva, presenza di fratelli). Sono stati in particolare indagati un contesto familiare normativo ed uno caratterizzato da maltrattamento psicologico, contrassegnato dalla reiterazione di comportamenti inadeguati (critiche svalutanti, denigrazione, umiliazione, minacce verbali, indifferenza) nei confronti del minore, che convogliano sul bambino l’idea di non essere amato e di avere poco valore. Con i termini “a sviluppo tipico” si intendono i bambini per i quali non sussista una diagnosi clinica e con quelli di “famiglie normative” ci si riferisce a nuclei per i quali non ci siano state segnalazioni da parte dei Servizi Educativi e Sociali di riferimento, indipendentemente dalle caratteristiche della composizione del nucleo familiare (nucleare, estesa, multipla, ricostituita o ricomposta). Tale studio rientra in un ampio progetto di ricerca e formazione che ha coinvolto più di 250 prescolari frequentanti 8 scuole dell’infanzia e 15 comunità terapeutiche e di accoglienza mamma-bambino, situate in differenti province del Nord Italia. Il gruppo dei partecipanti alla ricerca si è composto di 256 bambini in età prescolare, compresa quindi tra 3 e 5 anni (M=54,39; DS=5,705): 128 maschi (M=54,08; DS=5,551) e 128 femmine (M=54,70; DS=5,860). In particolare, 213 bambini appartenevano a famiglie normative e 43 a nuclei familiari caratterizzati dalla presenza di maltrattamento psicologico. Oltre ai bambini, la ricerca ha previsto il coinvolgimento di 155 coppie di genitori, 43 madri ospitate in comunità, 18 insegnanti e 30 operatori. Obiettivo centrale è stato l’indagine della possibilità di poter promuovere il perspective taking in bambini di età prescolare a sviluppo tipico appartenenti a due differenti tipologie di contesto familiare (normativo e psicologicamente maltrattante), attraverso l’applicazione di uno specifico percorso di training di natura “ecologica” all’interno della scuola dell’infanzia e della comunità, assimilabile a quelli di tipo evidence based. In particolare è stata prevista una procedura quasi sperimentale di tipo pre-test, training, post-test e follow-up. Dopo una preliminare valutazione dello sviluppo del perspective taking nelle sue tre componenti, in bambini appartenenti ad entrambi i contesti, si è voluto verificare l’esistenza di eventuali relazioni tra questa abilità ed alcune capacità socio-emotive dei bambini, con particolare riferimento alla disposizione prosociale, rilevate nel contesto scolastico attraverso differenti metodologie (osservazioni dirette non partecipanti, questionari self report compilati dalle insegnanti). Inoltre, data l’importanza del contesto familiare per lo sviluppo di tale abilità, la ricerca ha avuto lo scopo di verificare l’esistenza di eventuali relazioni tra le abilità di perspective taking mostrate dai bambini e gli stili di socializzazione emotiva delle figure familiari, caratteristiche di entrambi i contesti (maltrattante e non maltrattante). È stato inoltre previsto uno studio di confronto tra i due campioni rispetto alle dimensioni indagate. I risultati ottenuti sono stati particolarmente interessanti. Innanzitutto, le esperienze di training hanno determinato, in entrambi i contesti, miglioramenti nell’abilità dei prescolari di mettersi nei panni altrui. Tale training ha inoltre dimostrato effetti positivi sulla competenza sociale dei bambini, che, a seguito del percorso, hanno manifestato un incremento dei comportamenti prosociali ed una diminuzione di quelli aggressivi. Per lo studio in contesto normativo, è stato inoltre dimostrato un mantenimento delle abilità acquisite a seguito del training attraverso un follow-up a distanza di 4 mesi dal termine dell’intervento. Il positivo esito di tale percorso sembra quindi rappresentare un’importante risorsa per i prescolari, soprattutto in caso di situazioni in cui l’abilità di perspective taking risulti deficitaria. Il confronto dei due gruppi a seguito del training ha evidenziato come non siano emerse differenze significative, rispetto al perspective taking, ad eccezione della dimensione emotiva, in cui le prestazioni dei prescolari maltrattati sono risultate inferiori, come già evidenziato prima del training. Tali risultati non giungono però inaspettati, poiché, sebbene il percorso abbia agito significativamente sull’abilità di comprensione delle emozioni altrui di questi bambini, non si configura come sufficiente a ristrutturare così profondamente le problematiche presentate. Interessanti sono stati altresì i risultati ottenuti dall’analisi degli stili di socializzazione emotiva, dei genitori (madri e padri) dei prescolari non maltrattati e delle mamme dei bambini residenti in comunità. In particolare è emerso come, stili accettanti e di tipo coaching nei confronti delle emozioni negative dei bambini, siano positivamente correlati con il perspective taking dei figli, e come all’opposto, stili rifiutanti rispetto alle espressioni emotive negative dei propri bambini, mostrino correlazioni negative con le abilità di perspective taking dei figli. Oltre ad interessi di ordine teorico e metodologico, è possibile quindi affermare come, il presente lavoro di tesi, sia stato guidato da fini applicativi, affinché la ricerca scientifica possa tradursi in pratiche educative quotidiane da applicare ai contesti di vita significativi per i bambini.

Processos e significados da experiência de pais, mães ou cuidador primário de crianças abusadas sexualmente

Introdução - O abuso sexual de crianças constitui um problema de saúde pública, com aproximadamente 73 milhões de casos de meninos e 150 milhões de meninas registrados anualmente no mundo. O abuso sexual gera consequências negativas e condutas de risco que contribuem com algumas das principais causas de morte, doença e deficiência nas vítimas do abuso. Pais ou cuidadores primários são fundamentais no processo de orientação e de cuidado das crianças abusadas, no sentido de prevenir as consequências cognitivas, comportamentais e emocionais evidenciadas no futuro dessas crianças. Entretanto, as habilidades das famílias de cuidadores para lidar com a problemática ainda são insuficientes. Objetivo - Descrever os processos e significados da experiência vivida pelos pais ou cuidadores primários de crianças abusadas sexualmente. Método - Os dados empíricos foram tratados utilizando-se o Discurso do Sujeito Coletivo (DSC), fundamentado na Teoria das Representações Sociais, que viabiliza a emergência das representações sociais por meio da construção dos discursos coletivos obtidos de depoimentos de um grupo específico. Foram avaliados 60 pais ou cuidadores primários não estupradores, que responderam à cinco situações-problema, cada uma com questões correspondentes, residentes nos municípios de Cajicá e Tabio de Bogotá, Colômbia. O processamento e a análise dos dados foram realizados no sofware Qualiquantisoft, associado à metodologia do DSC. Resultados - Na primeira situação-problema, que aborda o porquê do silêncio do filho sobre o abuso, os entrevistados enfatizaram que é fundamental o relacionamento pais e filhos (45,7 por cento , n = 43), bem como melhorar o papel de pais por meio da escuta, do diálogo e do confiar, dedicando mais tempo às crianças; também acham que o silêncio se deve ao medo por parte das crianças e a ameaças e intimidação por parte do abusador, Na situação-problema 2, relativa à identificação do abuso sexual como problema real, o significado atribuído configura cadeias que se repetem por transmissão intergeracional (26,9 por cento , n = 21). Na situação-problema 3, o que fazer no futuro, 53,3 por cento dos entrevistados (n = 32) acham que a criança está comprometida comportamentalmente e enfatizam a homossexualidade com perda da identidade como consequência da violência sexual. Na situação-problema 4, que enfatiza o papel da rede social quanto ao cuidado da criança, os entrevistados acreditam que a solução é dar proteção (29,1 por cento ; n = 32), com ações que visem a afastar a criança do ambiente agressor, dar orientação, apoio e segurança à criança e à família. A quinta situação-problema que diz respeito ao cuidado das crianças abusadas; 34,26 por cento dos entrevistados (n = 37) enfatizam o apoio e a ajuda com a interveniência da rede de apoio social e afetivo. Conclusão - Para os pais ou cuidadores primários de crianças abusadas sexualmente, os significados se expressam como afetivo, coragem, superação, não ter medo e saber reconhecer as falhas dos pais. Em função dos resultados, que identificam posturas tradicionais dos respondentes, recomenda-se programas inovadores com um alto componente educativo, onde se contextualize o abuso sexual por meio de situações reais em escolas, delegacias, nas famílias e na comunidade, com interveniência das redes de apoio social; enfatiza-se igualmente a necessidade de formação mais humanizada dos profissionais de apoio social.

Fostering Change: Toward Understanding, Valuing, and Informing the Therapeutic Role of Foster Parents

Foster parents have the potential to effect lasting therapeutic change through their role with the children they temporarily foster. Therapists working with foster parents can understand, support, and inform foster parents in their role based on a commonality that exists between the roles of therapists and foster parents. Similarities at different stages of both the therapeutic and foster parenting relationships are addressed, as well as the use of these relationships in a therapeutic manner. Advantages (for foster parents, foster children, therapists, and the foster care system) of articulating the foster parenting relationship through the lens of the therapeutic relationship are also discussed. Future research into the experience of foster parents in their role will be essential in creating an effective and sustainable system of care for vulnerable children.

Aplicación práctica de los modelos de Mercer y Beck en las especialidades de enfermería

El vínculo afectivo es la atracción que un individuo siente por otro. La conducta de apego busca la unión emocional y seguridad del bebé hacia su madre. Distintas especialidades de enfermería indican la importancia de trabajar el vínculo afectivo, las relaciones familiares y utilizar el proceso enfermero partiendo de modelos conceptuales. Los modelos conceptuales de Mercer y Beck estudian factores a considerar en la formación y desarrollo de vínculos afectivos entre madres e hijos. Este estudio pretende desarrollar conocimientos, habilidades y actitudes que permitan una atención óptima al bebé y su familia. Analizando los elementos comunes y diferenciadores de ambos modelos y justificando la necesidad de prestar especial atención a la formación y mantenimiento del vínculo maternofilial desde la perspectiva de las diferentes especialidades de enfermería, se utiliza el proceso enfermero para la detección y resolución de problemas que afecten al vínculo afectivo y a las relaciones familiares.

Increase of a Caribbean leatherback turtle Dermochelys coriacea nesting population linked to long-term nest protection

The leatherback turtle Dermochelys coriacea is considered to be at serious risk of global extinction, despite ongoing conservation efforts. Intensive long-term monitoring of a leatherback nesting population on Sandy Point (St. Croix, US Virgin Islands) offers a unique opportunity to quantify basic population parameters and evaluate effectiveness of nesting beach conservation practices. We report a significant increase in the number of females nesting annually from ca. 18-30 in the 1980s to 186 in 2001, with a corresponding increase in annual hatchling production from ca. 2000 to over 49,000. We then analyzed resighting data from 1991 to 2001 with an open robust-design capture-mark-recapture model to estimate annual nester survival and adult abundance for this population. The expected annual survival probability was estimated at ca. 0.893 (95% CL 0.87-0.92) and the population was estimated to be increasing ca. 13% pa since the early 1990s. Taken together with DNA fingerprinting that identify mother-daughter relations, our findings suggest that the increase in the size of the nesting population since 1991 was probably due to an aggressive program of beach protection and egg relocation initiated more than 20 years ago. Beach protection and egg relocation provide a simple and effective conservation strategy for this Northern Caribbean nesting population as long as adult survival at sea remains relatively high. (c) 2005 Elsevier Ltd. All rights reserved.

The use of non-verbal repair strategies by children with autism

This study examined possible links between the occurrence of prosodic changes to vocalizations and gestures and the use of problem behaviors by children with autism when attempting to repair communication breakdowns. The repair strategies of six children with autism aged 2-5 years and with fewer than 10 words or signs were analyzed. Mother-child dyads were videotaped at home interacting in naturally occurring contexts. Videotapes were analyzed and coded for communication breakdowns and repair attempts made by the child. Repairs were further analyzed according to the type of repair strategy used, changes in prosidy, and whether the repair mode involved problematic or non-problematic behavior. In most situations, this group of children attempted to repair breakdowns in communication that occurred while interacting with their mothers. Most children used both nonproblematic and problematic behaviors and were less likely to use augmentations as a repair strategy than repetitions and substitutions. Some repetitions and some augmentations involved the use of gestures or vocalizations with increased emphasis or prosidy. Possible links between repair strategies involving increased prosidy and the use of problem behaviors are discussed together with the implications and significance of these finding in relation to early intervention for children with significant communication impairments. (C) 2004 Elsevier Ltd. All rights reserved.

Sibling relationships in adolescence: Learning and growing together

fit this article, I discuss the reasons for my interest in sibling relationships, and showcase studies on sibling relationships in adolescence carried out with my colleagues and students, in the context of the broader literature on sibling relationships. Our studies have focused on a number of important issues concerned with sibling relationships. First, I report on the associations between sibling relationships and other family relationships and the ways that the various family relationships affect each other. Second, I report a study of sibling relationships in the context of parental separation and divorce and show that sibling relationships in these families are more likely to be high in both warmth and hostility than is true for relationships in 2-parent families. Third, I report on several data sets showing an association between the quality of sibling relationships and adolescent adjustment and the link between differential parenting, adolescent adjustment, and the quality of the sibling relationship. Fourth, I report on a study of comparison and competition in sibling relationships and the associations between sibling relationship quality and reactions to being outperformed by a sibling. Finally, I discuss possible future directions for research on sibling relationships, including the importance of multimethod studies and a longitudinal perspective.

An Algorithmic Approach to Inferring Cross-Ontology Links while Mapping Anatomical Ontologies

ACM Computing Classification System (1998): J.3.

Constructing literacy: Disadvantaged Irish mothers' attempts at developing literacy with their preschool children during storybook reading and jigsaw puzzle building

Early childhood research beginning in the 1960s has focused on the literacy experiences of preschool children in the home and the contribution of those experiences to later school success. Decades of research since then have investigated learning experiences of preschool children as they interacted with caregivers, siblings or peers prior to formal schooling (Durkin, 1966; Heath, 1983). ^ In this qualitative investigation into early literacy events that occur between disadvantaged Irish mothers and their children, four research questions were investigated. (1) How do disadvantaged Irish mothers engage their preschool children in literacy events such as storybook reading and jigsaw puzzle building? (2) How does the mother's previous school experience affect her role as the child's first teacher? (3) How does the culture of the neighborhood affect the child's developing literacy? (4) What risk factors inhibit literacy development in these Irish children? ^ This study examined the conversational exchanges between three disadvantaged Irish mothers and their preschool children living near Dublin, Ireland, as the mothers read a storybook to their children and assisted them in jigsaw puzzle building. Conversations were recorded, transcribed and analyzed into reading skill and teaching strategy categories for the purpose of determining the mothers' literacy intent during her turn. Journal notes, field notes and interviews with the mothers recorded other information and allowed for triangulation of data. ^ The results of this investigation indicated four findings. The first finding was that these disadvantaged mothers employed many of the same techniques that classroom teachers use during the reading lesson. They attempted high-level and low-level questions, teaching strategies, and other interactions that are so familiar in the classroom. The second finding was that jigsaw puzzle building produced a richer literacy interaction than storybook reading. The third finding was that the environment of the disadvantaged neighborhood posed many risks to children's literacy development. A final finding was that the mothers used thinking out loud behavior to vocalize their inner thoughts during literacy interactions. ^ Future research suggests studying mother/child dyads in other socio-economic environments and cultures to determine if other mothers practice the same skills and strategies as these mothers. ^

Atenção à criança no período neonatal: chamada neonatal, Rio Grande do Norte, 2010

The neonatal period, which includes the first 27 da ys postpartum, is a vulnerability phase in child health, making it necessary for a greater mon itoring by health professional through actions that add value to the binomial mother/child and comprehensive care to the newborn. To this end, this study aimed to evaluate the care actions the neonato from the strategies recommended by the Ministry of Health. This is a cr oss-sectional study carried out from the database of the national survey of population base entitled "Call Neonatal: evaluation of prenatal care and to children younger than one year old in the North and Northeast regions". It used as the sample unit the mothers and children yo unger than 1-year-old, costal residents of Rio Grande do Norte, Natal, Brazil, who attended th e vaccination campaign on June 12, 2010 in nine municipality’s priority for the Pact to Red uce Infant and Neonatal Mortality. To compose the study variables were selected issues/ac tions regarding the neonatal period and socio-demographic factors, followed by a descriptiv e and inferential analysis. A sample of 837 mother/child pairs was obtained, being 57.6% in capital and 42.4% in the whole from the interiors, which was weighted to represent the muni cipalities of the State. It was predominated by mothers aged between 20-29 years, complete high school, not entitled to income transfer program and male children (51.2%). The frequency of the actions of the hospital ranged from 35% to 96% and those performed at the Basic Health Unit (BHU) from 57% to 91.2%. Most actions had an association with hospitals and publi c nature of the state capital (p<0.05). The results for most of the actions are recommended in the care programs and policies for children, and reveal the regional inequities in hea lth and the need for the involvement of services and professionals in search of comprehensi ve care for enabling better care through humanized practices during this increased vulnerabi lity period.

A Longitudinal Investigation of Infant Gesture Use and Parent Speech: Unique and Dynamic Influences on Infant Vocabulary Acquisition

How do infants learn word meanings? Research has established the impact of both parent and child behaviors on vocabulary development, however the processes and mechanisms underlying these relationships are still not fully understood. Much existing literature focuses on direct paths to word learning, demonstrating that parent speech and child gesture use are powerful predictors of later vocabulary. However, an additional body of research indicates that these relationships don’t always replicate, particularly when assessed in different populations, contexts, or developmental periods.

The current study examines the relationships between infant gesture, parent speech, and infant vocabulary over the course of the second year (10-22 months of age). Through the use of detailed coding of dyadic mother-child play interactions and a combination of quantitative and qualitative data analytic methods, the process of communicative development was explored. Findings reveal non-linear patterns of growth in both parent speech content and child gesture use. Analyses of contingency in dyadic interactions reveal that children are active contributors to communicative engagement through their use of gestures, shaping the type of input they receive from parents, which in turn influences child vocabulary acquisition. Recommendations for future studies and the use of nuanced methodologies to assess changes in the dynamic system of dyadic communication are discussed.

Pratiques parentales coercitives, anxiété et traitement de la peur chez les jeunes en bonne santé: corrélats neuronaux, biologiques, physiologiques et comportementaux

L’adversité tôt dans la vie est associée au développement de symptômes anxieux pouvant perdurer jusqu’à l’âge adulte (Casey et el, 2010, Pine 2003). Des études chez l’adulte suggèrent que ces liens pourraient être associés à des altérations du « circuit de la peur » qui inclut l’amygdale, l’hippocampe antérieur, l’insula et le cortex préfrontal (Marek, 2013, Etkin & Wager, 2007). Ceci a cependant peu été étudié chez les jeunes. L’objectif principal de cette thèse était de définir les corrélats comportementaux, physiologiques, biologiques et neuronaux du traitement de la peur chez les jeunes en bonne santé, en lien ou non avec un historique d’adversité -- sous la forme de pratiques parentales coercitives -- et d’anxiété. D’abord, puisque nous nous intéressions aux pratiques parentales coercitives chroniques, nous avons examiné leur évolution et facteurs de risque, en nous concentrant sur la période de 17 à 72 mois. Un total de 2045 dyades mère-enfant ont été incluses dans une analyse de courbe de croissance latente. Nous avons démontré que la coercition maternelle suit une évolution non linéaire durant cette période et atteint un sommet à 42 mois. Les facteurs de risque relatifs à l’enfant et à la mère, mesurés à 17 mois, permettent de prédire les niveaux de coercition à 42 mois. Finalement, les prédicteurs relatifs à l’enfant et l’efficacité maternelle prédisent l’évolution des pratiques parentales coercitives entre 17 et 72 mois. Ensuite, afin de définir une méthodologie solide pour étudier le traitement de la peur chez des jeunes, nous avons adapté une tâche développée par Lau et ses collaborateurs (2008), employant des visages féminins comme stimuli. Le sexe des participants et des visages employés comme stimuli pouvant potentiellement moduler le traitement de la peur (Kret & de Gelder, 2012; McClure, 2000), nous avons étudié leurs influences respectives sur les réponses électrodermales et subjectives de peur durant le conditionnement et l’extinction de la peur chez 117 jeunes. Nous avons démontré que les stimuli féminins suscitent des réponses davantage comparables entre les garçons et les filles que les stimuli masculins. De plus, nous avons observé un effet du « même sexe », caractérisé par un conditionnement différentiel uniquement face aux stimuli du même sexe que le participant. Finalement, nous avons exploré les différences individuelles et conjointes associées aux différents niveaux de pratiques parentales coercitives et d’anxiété en termes de réponses de peur et d’activité cérébrale, durant le conditionnement et l’extinction de la peur chez 84 jeunes. Nous avons démontré que la coercition est spécifiquement associée au fonctionnement du lobe temporal médian et aux interactions entre l’amygdale et l’insula, durant le conditionnement. Durant l’extinction, les niveaux d’anxiété étaient associés à des différences spécifiques d’activation du gyrus cingulaire antérieur (GCA) dorsal. Enfin, les pratiques parentales coercitives et l’anxiété interagissent et viennent moduler la connectivité fonctionnelle amygdale - GCA rostral, l’activation d’une sous-région du GCA dorsal et les réponses subjectives de peur. Ces résultats ajoutent une pièce au casse-tête des neurosciences développementales et fournissent des pistes intéressantes pour le développement d’interventions futures.

Childhood Attention Problems and the Development of Comorbid Symptoms at the Transition to High School: The Mediating Role of Parent and Peer Relationships

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) are at increased risk for the development of depression and delinquent behavior. Children and adolescents with ADHD also experience difficulty creating/maintaining high quality friendships and parent-child relationships, and these difficulties may contribute to the development of co-morbid internalizing and externalizing symptoms in adolescence. However, there is limited research examining whether high quality friendships and parent-child relationships mediate the relation between ADHD and the emergence of these co-morbid symptoms at the transition to high school. This study examines the mediating role of relationship quality in the association between ADHD and depressive symptoms/delinquent behaviors at this developmentally significant transition point. Results revealed significant indirect effects of grade 6 attention problems on grade 9 depressive symptoms through friendship quality and quality of the mother-child relationship in grade 8. Interventions targeting parent and peer relationships may be valuable for youth with ADHD to promote successful transitions to high school.

Proposta de processo de enfermagem em unidade de internação obstétrica: históricos, diagnósticos e cuidados de enfermagem à luz de horta fundamentada em nanda

O presente estudo teve como objetivo geral elaborar uma proposta de processo de enfermagem contemplando históricos de enfermagem, diagnósticos de enfermagem, prescrição de cuidados de enfermagem para gestantes e puérperas em Unidade de Internação Obstétrica à luz de Horta, fundamentada em NANDA e, como objetivos específicos: identificar os dados clínico-obstétricos mais frequentes das gestantes em Unidade de Internação Obstétrica; identificar os dados clínico-obstétricos mais frequentes das puérperas em Unidade de Internação Obstétrica; identificar os diagnósticos de enfermagem a partir dos dados clínico-obstétricos mais frequentes das gestantes em Unidade de Internação Obstétrica; identificar os diagnósticos de enfermagem a partir dos dados clínico-obstétricos mais frequentes das puérperas em Unidade de Internação Obstétrica; elaborar modelos de histórico de enfermagem e de prescrição de cuidados de enfermagem para os diagnósticos de enfermagem identificados; e obter o consenso dos enfermeiros assistenciais da Unidade de Internação Obstétrica sobre a proposta construída. Trata-se de pesquisa qualitativa, descritiva e exploratória, realizada em uma Unidade de Internação Obstétrica de um hospital universitário do Sul do Brasil. Realizou-se uma consulta documental em 148 prontuários, com vistas à identificação dos diagnósticos e cuidados de enfermagem, baseados, respectivamente, na taxonomia II da North American Diagnosis Association 2009-2011 e da Nursing Intervention Classification. Desenvolveu-se um modelo de histórico de enfermagem para gestante/puérpera e outro para o recém-nascido. No total, identificaram-se 26 diagnósticos de enfermagem, assim distribuídos: nove direcionados às gestantes; nove, às puérperas; dois, ao binômio mãe/filho; seis, ao recém-nascido. A análise foi realizada por meio da apresentação da proposta construída e discussão com base em autores da área. Com isso, almeja-se contribuir para direcionar o cuidado de enfermagem às necessidades das gestantes, puérperas, binômios mãe/filho e recém-nascidos nesse microcenário, favorecendo a educação em saúde, a identificação precoce e a prevenção de complicações. Permanecem lacunas quanto às necessidades psicoespirituais, visto que elas não foram abordadas nos resultados. Assim, essa proposta de Processo de Enfermagem em Unidade Obstétrica contemplando históricos, diagnósticos e cuidados de enfermagem mantém em aberto o aperfeiçoamento do modelo, visando à inclusão de outros diagnósticos de enfermagem, de forma a aproximar-se de um cuidado mais holístico.