La fonction de Moi auxiliaire dans la prise en charge des douloureux chroniques [The role of the auxiliary ego in the care of the chronic pain patient]

La prise en charge des patients souffrant de douleurs chroniques, à l'interface entre corps et psyché, nécessite une approche globale et souvent un réseau de soins coordonnés, contenant et stable. La psychiatrie de liaison a naturellement trouvé sa place dans ce réseau de soins spécifiques auprès des différents soignants impliqués. Les réflexions issues de cette expérience ont pour objectif de mieux comprendre le rôle thérapeutique des soignants et font émerger la notion de Moi auxiliaire comme élément clé dans le traitement de ces patients. Dans cet article, nous reprendrons les fondements historiques et conceptuels de la fonction de Moi auxiliaire pour nous intéresser à ses différentes applications dans ces prises en charge : consultation médicale, psychothérapie individuelle ou de groupe, colloque interdisciplinaire. The management of the patient suffering from chronic pain, situated on the interface between body and psyche, necessitates a global approach and often a coordinated, stable and containing network of care. Liaison psychiatry has become part of this network, together with various health care professionals from somatic disciplines. Based on these experiences, this article aims to better understand the therapeutic role of those who take care of the chronic pain patient by identifying the auxiliary ego as a key element of care. The historical development and conceptual framework of the auxiliary ego are utilized to highlight its roles in the different aspects of care of these patients:in the medical consultation, individual psychotherapy, group psychotherapy and in the interdisciplinary meetings.

The rise and fall of icons of 'stolen childhood' since the adoption of the UN Convention on the Rights of the Child

In the past two decades, the iconography of victimhood mobilized by child rights advocates has changed significantly. In particular, the child victim of violence has replaced the street child as the dominant icon on the international agenda. Based on data from more than 300 documents produced between 1989 and 2009 and interviews with leading advocates, this article explores the diverging trajectories of iconic child victims. It follows the traces of the successive translations of the idea of âeuro~stolen childhoodâeuro? and locates them against the backdrop of evolutions in the childrenâeuro?s rights field.

Validity of the DSM-Oriented Scales of the Child Behavior Checklist and Youth Self-Report

Resumen tomado de la publicaci??n

General care of the older cancer patient.

With increasing age, there are greater numbers of older people who will be diagnosed with cancer. It must be remembered that such individuals have increased frailty and have a number of geriatric syndromes and conditions particularly pertinent to older age, including incontinence, poor cognition and impaired nutrition. It is often difficult to define the effects of cancer and its treatment or complications, and separate these from the effects of normal ageing and geriatric syndromes. The documentation of poor nutrition and its management must combine knowledge from both geriatric medicine and oncology. Nutrition serves to identify key healthcare professionals who are all essential in any patient at risk or suffering from malnutrition. Incontinence must be actively sought, its cause identified and efforts made to either 'cure' it or, in certain circumstances, 'manage' it. Older patients with cancer are cared for predominantly by older relations and informal care mechanisms and special consideration of their physical and practical needs are paramount. In this area, nurses, doctors, therapists and social workers should work to identify formal and informal mechanisms to support particularly the older carer.

The 'welfare of the child' in Shari'a law: an analysis of child custody law and practices in Bangladesh from a feminist perspective

The paper seeks to draw attention to some of the recent cases relating to child custody law in Bangladesh where, deviating from orthodox Shari’a rules, courts have looked to ‘the welfare’ of the child in determining which parent shall have custody. In studying the recent ‘welfare of child’ standard that has been advanced by the courts in Bangladesh, the paper aims to explore its implications for Muslim women from a feminist perspective.

NESTLING BEHAVIOR and PARENTAL CARE of THE COMMON POTOO (NYCTIBIUS GRISEUS) IN SOUTHEASTERN BRAZIL

We recorded and quantified the nocturnal activity and parental care of a brooding Common Potoo (Nyctibius griseus) using an infrared camera in southeastern Brazil. Parents alternated care of the nestling and decreased their presence as the nestling grew. Nestling feeding on passing insects while sitting on the nest, movements on the nest, wing exercising, preening, and defecating were recorded primarily while it was alone. The frequency of begging calls per hour was higher when the nestling was accompanied by one of the parents. Nocturnal recordings of this species on the nest revealed behaviors that were not cited in past studies, including: feedings bouts on passing flies performed by the nestling and adults, nestling defecation, and nestling plumage maintenance. The well-known plus newly quantified behaviors of the Common Potoo reinforce their value to survival during the long nestling period. Received 24 May 2010. Accepted 14 September 2010.

Argentina: Impacts of the child allowance programme on the labour-market behaviour of adults

In 2009 Argentina implemented the Universal Child Allowance for Social Protection (AUH), a cash transfer programme for households with children. Coverage provided by the contributory family allowance programme was extended to parents who are unemployed or who work in the informal sector (domestic workers, for example). This paper uses the difference-in-difference estimator and propensity score matching techniques to evaluate the short-term effects of the auh on adult labour participation and income generation. The results suggest that, during its first year of operation, no significant disincentives to work were generated by the programme, given that it did not discourage adults from working or lead to a reduction in the number of hours worked. These findings are highly relevant in the Latin American context where these kinds of cash transfers have become an important component of social protection systems.

Ethical Care of the Self and the Teacher in the Pedagogical Relationship: Reflections Based on the Latest Foucault

Our conception of education is that it is the responsible action whereby man becomes human, trains and faces the challenges that life and the world present, as man enters a larger, shared cultural tradition and thus joins the world. However such sharing implies that we must not just rely on tradition, but remain open to new ideas. It is essential for schooling to preserve a field where the art of living intersects with the world for which future generations are being prepared. It is in this field of intersection that this essay seeks to discuss Michel Foucault's thought, care of the self and the role played by others in the acquisition of ethical attitudes pertaining to one's conduct in life. Through reconstructing Foucault's ideas, we elaborate on the hypothesis that, before morally shaping students, teaching them values, or aiding in their skill acquisition in the sense prevailing in schooling today, it is important to understand the notion of care of the self (and how the notion implies interaction with others for effective care of the self). Care of the self is vital for thoroughly understanding the relationships between ethics and education in school. We particularly examine how Foucault's ideas and his analysis of the teacher's role in shaping the student's life conduct can help educators rethink pedagogical action in an ethical sense and find within it a certain openness to the formation of attitudes in educators and students

SOCIAL MONOGAMY AND BIPARENTAL CARE OF THE NEOTROPICAL SOUTHERN BAMBOO RAT (KANNABATEOMYS AMBLYONYX)

We analyzed social patterns indicative of the mating system and parental care in a population of the southern bamboo rat (Kannabateomys amblyonyx). This arboreal rodent feeds exclusively on bamboo stems and leaves. We conducted fieldwork from August 2003 to October 2004 in southern Brazil (30 degrees 20`-30 degrees 27`S, 50 degrees 50`-51 degrees 05`W), in patches of introduced Chinese bamboo (Bambusa tuldoides). We captured 18 individuals, 7 of which were adults that received radiotransmitters and were followed from 1 to 12 months. Another 5 animals (adults or subadults) received colored collars. We observed paternal care, delayed juvenile dispersal, and reduced degree of sexual dimorphism, all of which are traits typical of social monogamy. Mated males showed a direct parental behavioral repertoire similar to that of females (with the obvious exception of nursing), including grooming, huddling, and food provisioning. Potential monogamy in this species seems to be a flexible strategy linked to low density of bamboo patches. Females were confined to widely spaced., small home ranges, decreasing the possibility of male defense of and access to > 1 female. The arboreal habits of the species possibly increase the risk of inexperienced young falling from trees or else being depreciated when moving exposed through branches. This risk is probably reduced by the extensive biparental care observed, including the providing of low-energy plant food to young in the nest.

THE KNOWLEDGE ABOUT COMMUNICATION STRATEGIES WHEN TAKING CARE OF THE EMOTIONAL DIMENSION IN PALLIATIVE CARE

The aim of this qualitative study was to investigate existing knowledge and the use of communication strategies in emotional care for patients receiving palliative care in Brazil. It was performed from August, 2008, to July, 2009, with 303 health professionals who worked or had frequent contact with patients receiving palliative care, using a questionnaire. Data was submitted to descriptive and analytical statistical treatment. The professionals reported not knowing about communication strategies, showing a significant difference (p-value 0.0011) in comparing subjects with and without previous training in palliative care, showing that those who had received proper training know/use more communication strategies when providing care for their patients on an emotional level. The strategies most often cited were: careful listening, verbal reaffirmation of care, using open questions, and affective touch. We conclude that there is little knowledge and poor use of communication strategies among health professionals in towards the emotional care of patients receiving palliative care.

Teaching of the Integrated Management of Childhood Illness strategy in undergraduate nursing programs

Objective: To describe and analyze the teaching of the Integrated Management of hildhood Illness (IMCI) strategy on Brazilian undergraduate nursing programs. Method: Integrating an international multicentric study, a cross-sectional online survey was conducted between May and October 2010 with 571 undergraduate nursing programs in Brazil Results: Responses were received from 142 programs, 75% private and 25% public. 64% of them included the IMCI strategy in the theoretical content, and 50% of the programs included IMCI as part of the students’ practical experience. The locations most used for practical teaching were primary health care units. The ‘treatment’ module was taught by the fewest number of programs, and few programs had access to the IMCI instructional manuals. All programs used exams for evaluation, and private institutions were more likely to include class participation as part of the evaluation. Teaching staff in public institutions were more likely to have received training in teaching IMCI. Conclusion: In spite of the relevance of the IMCI strategy in care of the child, its content is not addressed in all undergraduate programs in Brazil, and many programs do not have access to the IMCI teaching manuals and have not provide training in IMCI to their teaching staff.

Vasopressin in vasodilatory shock: ensure organ blood flow, but take care of the heart!

Supplementary arginine vasopressin infusion in advanced vasodilatory shock may be accompanied by a decrease in cardiac index and systemic oxygen transport capacity in approximately 40% of patients. While a reduction of cardiac output most frequently occurs in patients with hyperdynamic circulation, it is less often observed in patients with low cardiac index. Infusion of inotropes, such as dobutamine, may be an effective strategy to restore systemic blood flow. However, when administering inotropic drugs, systemic blood flow should be increased to adequately meet systemic demands (assessed by central or mixed venous oxygen saturation) without putting an excessive beta-adrenergic stress on the heart. Overcorrection of cardiac index to hyperdynamic values with inotropes places myocardial oxygen supply at significant risk.

Care of the bariatric surgery patient in the emergency department

Obesity has reached epidemic proportions in the United States, with an estimated 50% of adults meeting the definition of being overweight. As this condition has become more prevalent, bariatric surgery has become an increasingly accepted form of treatment of the severely obese. Patients who have had bariatric surgery are presenting more commonly to Emergency Departments as a result. This article will review the most common bariatric surgery procedures, the complications that can arise post-operatively, and the approach to the assessment and management of the bariatric surgery patient in the Emergency Department.

Unaccompanied Refugee Youth in Switzerland and the 'Refugee Crisis': The Emergence of the Child Asylum Seeker

In this paper I will reflect on the emergence of the distinct figure of the child asylum seeker which has entered public and political debates in Switzerland within the last 2 years. It is a figure that is identified through certain attributes such as youth, trauma, lostness or need for protection, and it is a figure that is imbued with certain rights (namely children’s rights). While this has helped young people to receive special treatment, the question arises what the repercussions are for those who do not fit within these categories. What, for example, happens, when different notions of youth, childhood and adolescence clash and disrupt ideals of innocence and childhood? And given that negative public discourses are largely focussed on the apparent danger and uncontrollability of male, single asylum seekers, what happens when categories mix and mingle? In this paper I will shed light on the interplay of institutional expectations of what constitutes a 'proper' child refugee and the ways young people themselves play with, test and contest these norms.