Estudi de l'impacte de les activitats de moviment corporal en un infant amb TDA

Aquest treball consta d’una investigació amb una pràctica d’activitats basades en el moviment corporal amb un infant diagnosticat amb Trastorn de Dèficit D’Atenció (TDA), amb la intenció de tractar i treballar els problemes que pateix de concentració i atenció. Aquesta pràctica va tenir lloc a l’Escola Sant Jordi de Navàs. Es va analitzar a l’alumne/a en concret, però es van treballar totes les activitats amb tot el grup classe. Les activitats van ser dissenyades a partir dels aprenentatges a la universitat durant la carrera i també de diferents autors citats al marc teòric. Els instruments de recollida de dades que es van utilitzar són les tècniques d’observació i el diari de camp i la càmera de fotos i de vídeo per enregistrar moments en concret. Aquests instruments van donar lloc a l’anàlisi i a la valoració final de les sessions de la pràctica realitzada, en la que es va poder observar una millora en l’atenció, la concentració, l’ interès, la relació amb els companys, etc, aconseguint els objectius proposats al principi. Si el moviment corporal ajuda a millorar als infants que pateixen aquest trastorn i a tots els altres és aconsellable que a l’escola es busquin estratègies i formes de treballar-ho, en qualsevol àrea, per a motivar i fer créixer els aprenentatges de tots els alumnes.

Infant's triangular communication in "two for one" versus "two against one" family triangles: Case illustrations

Infants use their social competence very early to communicate not only in dyads but also in triads, in particular in the triangle they form with their mother and father. The development of this triangular communication is largely shaped by the ways the parents support or undermine each other in relation to their child. Whereas triangular communication is facilitated in "two for one" alliances, it is recruited in the service of regulating the parents' conflicts in "two against one" coalitions. These processes are manifest in toddlerhood and may be traced back to the coparenting alliance in formation during pregnancy.

Defoliation of strawberry mother plants for the production of runner tips

The objective of this work was to determine the sink-source relationships and their effects on the number and growth of runner tips of 'Camino Real' strawberry stock plants. Three types of sources were evaluated: one defoliation at 96 days after planting (DAP), two defoliations at 50 and 96 DAP, and mother plants without defoliation. Four types of sink were accessed: runner tips collected weekly and monthly, four stolons with rooted runner tips in pots, and four freely-grown stolons. A completely randomized experimental design was used in a split-plot arrangement, with four replicates. The source types were placed in the plots, and sink types in the subplots. The number of runner tips, the crown diameter, and the dry matter mass were determined. Number and growth of tips were higher on plants without defoliation, and decreased 44.7% on twice-defoliated mother plants. The two-defoliation management did not reduce runner tip dry matter mass only on plants with rooted stolons, which produced runner tips 50% heavier. Defoliation of mother plants bearing rooting stolons can be used to reduce their growth, without reducing the emission and growth of runner tips.

Reexamination of the relationship of resting metabolic rate to fat-free mass and to the metabolically active components of fat-free mass in humans.

The ratio of resting metabolic rate (RMR) to fat-free mass (FFM) is often used to compare individuals of different body sizes. Because RMR has not been well described over the full range of FFM, a literature review was conducted among groups with a wide range of FFM. It included 31 data sets comprising a total of 1111 subjects: 118 infants and preschoolers, 323 adolescents, and 670 adults; FFM ranged from 2.8 to 106 kg. The relationship of RMR to FFM was found to be nonlinear and average slopes of the regression equations of the three groups differed significantly (P less than 0.0001). For only the youngest group did the intercept approach zero. The lower slopes of RMR on FFM, at higher measures of FFM, corresponded to relatively greater proportions of less metabolically active muscle mass and to lesser proportions of more metabolically active nonmuscle organ mass. Because the contribution of FFM to RMR is not constant, an arithmetic error is introduced when the ratio of RMR to FFM is used. Hence, alternative methods should be used to compare individuals with markedly different FFM.

Expressive writing intervention for mothers following the birth of their premature baby.

The birth of a preterm infant is in most cases unexpected and can be a distressing experience for parents. Parents of premature babies report more stress, experience more adjustment difficulties and need for support during the first year after delivery compared to parents of infants born at term. It has been documented that parents may experience posttraumatic stress reactions, anxiety and depression following the premature birth of their baby, which subsequently may impact on the mother-baby-interactions, their attachment relationship and the cognitive, social and behavioural development of the baby. In this pilot study, we offered an expressive writing intervention to women who recently had a premature baby to alleviate their psychological distress and to improve their physical health. During the expressive writing intervention, women were asked to write down their deepest thoughts and feelings about the most traumatic aspect of their experience of having a premature baby for 15 min over three consecutive days. The aims of the study were as follows: (1) To evaluate the effect of expressive writing on psychological and physical health in women who recently had a premature baby. (2) To evaluate the effect of expressive writing on the use of healthcare services and medication in this population. (3) To evaluate the acceptability and feasibility of this intervention for this population. Forty participants were randomly allocated to either the expressive writing intervention group or a wait list control group. Pre- and post questionnaires to evaluate the effectiveness of the expressive writing intervention, as well as their acceptability and feasibility were completed. The intervention took place when the baby was 3 months of corrected age. Post-measures were completed at 1 and 3 months following the intervention. Results and their clinical implications will be discussed with regards to the implementation of this safe and cost-effective method as a preventative measure in the routine care of women who recently gave birth to a premature baby

Parent-adolescent relationship in youths with a chronic condition.

BACKGROUND: Suffering from a chronic disease or disability (CDD) during adolescence can be a burden for both the adolescents and their parents. The aim of the present study is to assess how living with a CDD during adolescence, the quality of parent-adolescent relationship (PAR) and the adolescent's psychosocial development interact with each other. METHODS: Using the Swiss Multicenter Adolescent Survey on Health 2002 (SMASH02) database, we compared adolescents aged 16-20 years with a CDD (n = 760) with their healthy peers (n = 6493) on sociodemographics, adolescents' general and psychosocial health, interparental relationship and PAR. RESULTS: Bivariate analyses showed that adolescents with a CDD had a poorer psychosocial health and a more difficult relationship with their parents. The log-linear model indirectly linked CDD and poor PAR through four variables: two of the adolescents' psychosocial health variables (suicide attempt and sensation seeking), the need for help regarding difficulties with parents and a highly educated mother that acted as a protective factor, allowing for a better parent-adolescent with a CDD relationship. CONCLUSION: It is essential for health professionals taking care of adolescents with a CDD to distinguish between issues in relation with the CDD from other psychosocial difficulties, in order to help these adolescents and their parents deal with them appropriately and thus maintain a healthy PAR.

An Infant with Food Allergy and Eczema in the Family – The Mental and Economic Burden of Caring

Allergic diseases including food allergy and eczema in an infant in combination with the everyday activities of caring for a family will pose challenges to parents. Only fragments of these challenges are revealed to health care professionals. Families have varying mental, social and economic resources to help them care for an allergic infant, and all such resources are important in determining how families succeed in meeting these challenges and the quality of the infant’s care. This study evaluated the whole burden to the family caused by an infant's allergic disease during the first 24 months of life. As the primary caregiver during this period is usually the mother, her perspective was considered important. Ecocultural theory, which considers families as capable of modifying the positive and negative forces facing them, was taken as the frame of reference. Data were collected as part of an ongoing prospective mother-infant study, and the methods included severity scoring of atopic dermatitis, dietary records, health-related quality of life measurements and assessments of the use of health care services and medications for treating the infant’s eczema, food allergy and asthma. Interviews with mothers were analysed by deductive content analysis on the basis of ecocultural theory and the family empowerment model. The theme “Living an ordinary family life” guided the organization of family activities essential for treating the infant's food allergy and eczema. These activities were sources of both strain and support for the mothers, the allergy-related supporting factors being the mother’s own knowledge of the allergy, hopes for an improvement in the infant’s condition, social support and work. An infant’s food allergy at the age of one year caused considerable strain for the mother in cases where the introduction of new foods into the child’s diet was delayed. This delay was still causing the mother additional strain when the child was 24 months of age. The infants waking at night at the ages of 12 and 24 months because of itching related to eczema caused strain for the mothers. The infants’ health-related quality of life was impaired at ages of 6 and 12 months compared with healthy infants. The principal reasons for impairments were itching, scratching and sleep disturbances at 6 and 12 months and treatment difficulties at 6 months. Problems with getting to sleep were reported at all stages irrespective of eczema and were also present in healthy infants. The economic impact of the treatment of allergic diseases on families during the first 24 months was 131 EUR (2006 value) in cases of eczema and 525 EUR in cases of food allergy. From the societal perspective, the costs of food allergy were a median of 3183 EUR (range 628–11 560 EUR) and of eczema a median of 275 EUR (range 94–1306 EUR). These large variations in costs in food allergy and eczema indicate that disease varies greatly . In conclusion, food allergy and eczema cause extra activities and costs to families which arrange these disease-related activities in such a way that they support the leading family theme “Living an ordinary family life”. Health care professionals should consider this thematic character of family life and disease-related activities in order to ensure that new treatments are sustainable, meaningful and tailored to daily activities. In addition, those mothers who are experiencing difficulties with food allergic infants or infants with eczema should be recognized early and provided with individual encouragement and support from health clinics. In the light of the present results, early detection of symptoms and effective parental guidance can contribute to the well-being and health-related quality of life of the child and family.

Behavioral characteristics of the offspring of adolescent rats

The aim of this study was to test the hypothesis that, during adulthood, the offspring of adolescent rats differ in emotionality, learning and memory from the offspring of adult rats. The behavior of the offspring of adolescent (age, 50-55 days) and adult rats (age, 90-95 days) was tested in the open field, activity cage, and passive and active avoidance apparatus. The latencies during training and testing in the passive avoidance apparatus of the offspring of adolescent parents were shorter than the latencies of control offspring (P<0.001 on both training and testing days). Offspring of adolescent parents showed shorter latency time in acquisition trials during active avoidance testing compared to control offspring (P<0.001). They also showed a higher number of active avoidance responses in the last four blocks of acquisition (P<0.001) and first two blocks of extinction trials (P<0.05 and P<0.001, respectively). The offspring of adolescent parents showed higher latency on the first day of testing in the open field (P<0.01) and a lower latency on the third day of testing (P<0.01). They also showed higher activity during all three days of testing (1st and 2nd day: P<0.01; 3rd day: P<0.05). The spontaneous activity of the offspring of adolescent parents in the activity cage was higher in the last three intervals of testing (P<0.001). In summary, the offspring of adolescent parents were less anxious and tended to be more active. The results of two learning and memory tests were opposite, but could be explained by a higher exploratory drive of the offspring of adolescent parents. This was probably due to chronic malnutrition stress and the disturbed mother-infant relationship in the litters of adolescent mothers.

The neurobiology of infant maternal odor learning

Infant rats must learn to identify their mother’s diet-dependent odor. Once learned, maternal odor controls pups’ approach to the mother, their social behavior and nipple attachment. Here we present a review of the research from four different laboratories, which suggests that neural and behavioral responses to the natural maternal odor and neonatal learned odors are similar. Together, these data indicate that pups have a unique learning circuit relying on the olfactory bulb for neural plasticity and on the hyperfunctioning noradrenergic locus coeruleus flooding the olfactory bulb with norepinephrine to support the neural changes. Another important factor making this system unique is the inability of the amygdala to become incorporated into the infant learning circuit. Thus, infant rats appear to be primed in early life to learn odors that will evoke approach responses supporting attachment to the caregiver.

Breastfeeding preterm infant from the delivery ward via nicu to home

The aim of this study was to examine how to support breastfeeding of preterm infants immediately after birth in the delivery ward, during their hospital stay in a neonatal intensive care unit (NICU), and at home after hospital discharge. Specifically, the role of early physical contact, maternal breastfeeding attitude, and an internet-based peer support group were investigated. The delivery ward practices concerning the implementation of early physical contact between a mother and her infant admitted to a NICU were examined by a structured survey in two hospitals. An Internet-based, breastfeeding peer-support intervention for the mothers of preterm infants was developed and tested in a randomized controlled design with one year follow-up. The main outcomes were the duration of exclusive and overall breastfeeding, expressing milk, and maternal attitude. In addition, the perceptions of mothers of preterm infants were investigated by analyzing the peer-support group discussions with a qualitative approach. The implementation of early physical contact was different between the two hospitals studied and was based more on hospital routines than the physiological condition of the infant. Preterm infants, who were born before a gestational age (GA) of 32 weeks, were hardly ever allowed to have early contact with their mothers. Both, a higher GA and early physical contact predicted earlier initiation and increased frequency of breastfeeding in the NICU. A maternal breastfeeding-favorable attitude predicted increased frequency of breastfeeding in the NICU and also a longer duration of overall breastfeeding. The actual duration of breastfeeding was, however, shorter than the mothers intended in advance. The internet-based, peer-support intervention had no effect on the duration of breastfeeding, expressing milk, or maternal attitude. The participating mothers enjoyed the possibility of sharing their experiences of preterm infants with other mothers in similar situations. Some of the mothers also experienced being given useful advice for breastfeeding. Based on the mothers’ discussions, a process of breastfeeding preterm infants was created. This included some paradoxical elements in the NICU where, for example, breast milk was emphasized over breastfeeding and support in the hospital varied. Hospital discharge was a critical point, when the mothers faced breastfeeding in reality. Over time, the mothers assimilated their breastfeeding experience into part of being a mother. The care practices related to early physical contact in delivery wards need to be re-evaluated to allow more infants to have a moment with the mother. Maternal attitude could be screened prenatally and attitude-focused interventions developed. Breastfeeding support in the NICU should be standardized. Internet-based breastfeeding peer-support intervention was feasible but additional research is needed.

Supporting fathering through infant massage

Developing a strong relationship is essential for optimal child development and it is possible for fathers to fully participate in developing this close bond. Men often develop this relationship through interactive play which usually occurs later in their child's development. As a result, fathers often feel dissatisfied with their ability to form a close attachment in the early post-partum period, which in turn may increase their stress level. However, men can be prepared for the transition to fatherhood if they develop the knowledge and skill necessary to create positive relationships with their infants. Infant massage appears to be a viable option for teaching fathers care-giving sensitivity. To build on the notion of teaching fathers attachment system behaviour in early infancy, a quasi-experimental, mixed methods study was employed. Twenty-four infant-father dyads were recruited for the study. The fathers were asked to fill out the Parent Stress Index and a facial cues rating scale at two times, one month apart. The experimental group also participated in an infant massage intervention taught by a Certified Infant Massage Instructor of the International Association of Infant Massage. A repeated measures MANOVA revealed infant massage decreased paternal stress. Qualitatively, the fathers provided rich descriptions of their experience in the baby massage class which provided useful insight into the efficacy of the intervention. Overall, the fathers enjoyed the experience but did not necessarily see the direct benefit of the intervention on their relationship. Recommendations for pre and postnatal education for fathers are made.

The relationship between parental practices and suicidal behaviors in Québec adolescents

Sommaire Cette thèse examine les liens entre la présence de risques suicidaires chez les adolescents et leur perception des pratiques de chacun de leurs parents. L’étude a examiné l’association entre le comportement suicidaire et différents aspects des pratiques parentales incluant l’affection, l’exercice du contrôle comportemental et psychologique ainsi que les conflits entre parent et adolescents. La thèse a également examiné l’effet du statut matrimonial des parents sur le comportement suicidaire chez les jeunes. Le dernier objectif de l’étude a été d’explorer le rôle du sexe de l’adolescent comme facteur de vulnérabilité face au suicide. L’échantillon de l’étude était composé 1096 adolescents Montréalais, âgés de 11 à 18 ans. L’échantillon était également réparti entre filles et garçons, fréquentant deux écoles secondaires de la région de Montréal, dans la province du Québec au Canada. Il y avait deux groupes à l’étude : le groupe suicidaire et le groupe non-suicidaire. Le premier groupe incluait les sujets présentant des idéations suicidaires et ceux ayant fait une ou plusieurs tentatives de suicide. Un questionnaire auto-rapporté fut administré à chaque sujet pour évaluer les dimensions suivantes auprès de la mère et du père : le niveau de proximité affective, le niveau de supervision parentale, le contrôle comportemental et le contrôle psychologique, la tolérance à l’égard des amis, ainsi que la fréquence et l’impact émotionnel des conflits. Une échelle a également évalué la présence éventuelle de comportements suicidaires chez les jeunes. Dans le but de tester l’hypothèse de base de l’étude, une série d’analyses descriptives et une MANCOVA ont été réalisées. L’hypothèse générale de la thèse postulant que les adolescents ayant des risques suicidaires présenteraient des relations plus problématiques avec leurs parents fut confirmée. En contrôlant l’effet de la détresse psychologique des adolescents, les analyses ont mené à la conclusion que, dans les familles biparentales, un faible niveau de proximité affective avec la mère, une fréquence plus élevée de conflits avec la mère, un excès du contrôle psychologique et un plus faible niveau de supervision maternelle, présentaient des liens significatifs avec le comportement suicidaire chez les adolescents. Indépendamment de la structure familiale, les caractéristiques suivantes du père étaient respectivement perçues par l’adolescent comme ayant des liens significatifs avec le comportement suicidaire des adolescents: faible proximité affective, impact émotionnel et fréquence élevée des conflits ainsi que le manque de supervision. Ces résultats ont été interprétés à la lumière des théories de la socialisation qui mettent l’accent sur le rôle central de la qualité des liens affectifs entre parents et adolescents, comme facteur de protection contre les risques suicidaires. Les résultats ont aussi révélé que les filles adolescentes sont plus exposées aux risques suicidaires tels que tentatives et idéations suicidaires. Les conclusions de cette étude soulignent le besoin urgent de recherches plus poussées sur le comportement suicidaire des adolescents et leurs liens avec les facteurs familiaux, en tenant compte du statut matrimonial des parents. La thèse met également l’accent sur la nécessité de mettre en place des programmes de prévention auprès des adolescents présentant des risques suicidaires élevés.

Les niveaux et les facteurs déterminants de la mortalité infantile en Nouvelle-France et au début du Régime Anglais (1621-1779)

A l’époque de la Nouvelle-France, il n’était pas rare que des enfants de moins d’un an décèdent. Les parents acceptaient avec sagesse et résignation le décès de leurs enfants. Telle était la volonté du Tout-Puissant. Grâce au Registre de la Population du Québec Ancien (R.P.Q.A.) élaboré par le Programme de Recherche en Démographie Historique (P.R.D.H), l’ampleur de la mortalité infantile a pu être mesurée selon plusieurs critères, quelques facteurs déterminants examinés ainsi qu’une composante intergénérationnelle identifiée. Couvrant pour la première fois la totalité de l’existence de la colonie, nos résultats confirment l’importance de la mortalité des enfants aux XVIIe et XVIIIe siècles (entre 140 et 260‰ avant correction pour le sous-enregistrement des décès). Des disparités tangibles ont été constatées entre les sexes, selon le lieu de naissance ainsi que selon la catégorie professionnelle à laquelle appartient le père de l’enfant. L’inégalité des probabilités de survie des tout-petits reflète l’iniquité physiologique entre les genres, avec une surmortalité masculine de l’ordre de 20%, et l’influence de l’environnement dans lequel vit la famille : les petits de la ville de Québec décédaient en moyenne 1,5 à 1,2 fois plus que les petits des campagnes. Montréal, véritable hécatombe pour l’instant inexpliquée, perdait 50% de ses enfants avant l’âge d’un an, ce qui représente 1,9 fois plus de décès infantiles que ceux des enfants de la campagne, qui jouissent malgré tout des bienfaits de leur environnement. Les effets délétères de l’usage de la mise en nourrice, qui touche plus de la moitié des enfants des classes aisées citadines, ravagent leur descendance de plus en plus profondément. L’examen de la mortalité infantile sous ses composantes endogène et exogène révèle que la mortalité de causes exogènes explique au moins 70% de tous les décès infantiles. La récurrence des maladies infectieuses, l’absence d’hygiène personnelle, l’insalubrité des villes constituaient autant de dangers pour les enfants. Dans une perspective davantage familiale et intergénérationnelle où l’enfant est partie intégrante d’une fratrie, des risques significatifs ont été obtenus pour plusieurs caractéristiques déterminantes. Les mères de moins de 20 ans ou de plus de 30 ans, les enfants de rang de naissance supérieur à 8, un intervalle intergénésique inférieur à 21 mois ou avoir son aîné décédé accroissent les risques de décéder avant le premier anniversaire de l’ordre de 10 à 70%, parce que le destin d’un enfant n’est pas indépendant des caractéristiques de sa mère ou de sa fratrie. Nous avons aussi constaté une relation positive entre la mortalité infantile expérimentée par une mère et celle de ses filles. La distribution observée des filles ayant perdu au moins 40% de leurs enfants au même titre que leur mère est 1,3 à 1,9 fois plus grande que celle attendue pour les filles ayant eu 9 enfants et moins ou 10 enfants et plus. Il existerait une transmission intergénérationnelle de la mortalité infantile même lorsqu’on contrôle pour la période et la taille de la famille.

Habileté de mentalisation chez les mères présentant un trouble de personnalité limite : orientation mentale maternelle lors d’interactions mère-bébé.

Contexte : Les personnes atteintes de trouble de personnalité limite (TPL) présenteraient un déficit de mentalisation, soit la capacité de percevoir et interpréter les états mentaux chez soi et chez l’autre. Dans le cadre de la relation mère-bébé, un tel déficit est susceptible d’entraîner des perturbations relationnelles ayant des conséquences néfastes sur le développement de l’enfant. L’orientation mentale se mesure par le biais des verbalisations du parent au sujet des états mentaux de son enfant et constitue donc un reflet de la mentalisation du parent durant cette interaction. Toutefois, aucune étude n’a encore investigué l’orientation mentale chez des mères avec TPL durant l’interaction avec leur bébé. Objectif : Le but de cette étude était d’évaluer l’orientation mentale de 38 mères en interaction avec leur enfant âgé de 12 mois, incluant 10 mères atteintes de TPL et 28 sans diagnostic psychiatrique. Méthode: L’orientation mentale maternelle fut évaluée à partir de vidéos d’interaction mère-enfant dans un contexte de jeu libre. Le TPL a été identifié à l’aide du Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II). Résultats: Les mères atteintes de TPL ne se sont pas distingué concernant la fréquence de commentaires faisant référence aux états mentaux de leur bébé. Toutefois, les commentaires mentaux des mères souffrant de TPL se sont avérés être 4.7 fois plus fréquemment jugés non-appropriés à l’état mental de l’enfant comparés à ceux des mères sans diagnostic psychiatrique. Conclusions : Les commentaires mentaux des mères atteintes de TPL semblent plus fréquemment empreints d’erreurs d’interprétation des états mentaux de leur enfant, ce qui pourrait poser un risque pour le développement de l’enfant.

La violence constituante

Dans le cadre de ce mémoire, nous tenterons de contribuer à la compréhension des processus qui régissent la relation entre le parent et l’infans, en nous intéressant plus spécifiquement au primat de l’autre en tant que constituant nécessaire de la psyché de l’infans, au sens ou l’entend la psychanalyse. Sachant que le développement de l’enfant dépend grandement de la qualité des soins psychiques et corporels qu’il reçoit, nous chercherons néanmoins à montrer comment la relation parent-enfant doit néanmoins prendre la forme d’une certaine violence. Nous baserons nos analyses sur les théories développées par Piera Aulagnier et Jean Laplanche. À partir des concepts de la violence primaire et secondaire développés par Aulagnier, ainsi que des notions d’implantation et d’intromission théorisées par Laplanche, nous tenterons de définir et déceler comment et sous quelles formes la violence décrite par les auteurs dans la relation mère/infans marque ou plutôt « signe » le développement psychique. À travers l’analyse comparative de ces théories, nous chercherons à voir les différences et les accords entre la pensée de ces deux auteurs, en vue d’en obtenir une compréhension plus riche.