Avances de un estudio psicoanalítico acerca de la distancia afectiva en la relación madre-bebé / Advances of a psychoanalytic study about the affective distance in the mother-baby relationship

Medir el empuje que transmite la voz materna es casi inconcebible, (Didier-Weill,1998) ya que la estructura de su discurso primordial incluye una paradoja. ¿De qué manera entonces medir un espacio de encuentro que está en construcción? Este estudio explora la distancia afectiva en la díada madre-bebé desde una perspectiva intersubjetiva, durante la emisión del fenómeno sonoro denominado "tono maternés". Como parte de los avances de la investigación en curso, se destaca el valor de la interdisciplina para la obtención de los datos y el modo en que su procesamiento conduce a una posible categorización de su objeto de estudio. La consulta a expertos (del campo de la fonoaudiología y la psicomotricidad) permitió abordar un "único cuerpo suficientemente complejo"(Bernardi,2000)y de este modo cercar la realidad compartida. Se acuerda con Winnicott (1989) en la idea de que, si distintos observadores llegan a conclusiones semejantes, probablemente signifique que se ocupan de cosas reales(AU)

Measuring the drive transmitted by the maternal voice is almost inconceivable (Didier-Weill 1998). This statement is based on the idea that the primordial discourse structure is paradoxical. How then, to measure a meeting space that is under construction. One of the objectives of this psychoanalytic thesisis to explore the affective distance present in the dyad, while she emits the sound phenomenon 'babytalk'. As part of the progress, the author presents some moments of the investigation. This paper highlights the value of interdisciplinary approach to obtain the data and presents a possible categorization of the affective distance present in the early relationship.To study the real movements for the psychical constitution, it was required the dialogue with experts (from the areas of phonology and psychomotricity) to border a shared reality and address a "single sufficiently complex body (Bernardi, 2000). In agreement with Winnicott (1989), if different observers arrive at a similar conclusion, it possibly implies that they are dealing with real things(AU)

Ancient genomes provide insights into family structure and the heredity of social status in the early Bronze Age of southeastern Europe.

Twenty-four palaeogenomes from Mokrin, a major Early Bronze Age necropolis in southeastern Europe, were sequenced to analyse kinship between individuals and to better understand prehistoric social organization. 15 investigated individuals were involved in genetic relationships of varying degrees. The Mokrin sample resembles a genetically unstructured population, suggesting that the community's social hierarchies were not accompanied by strict marriage barriers. We find evidence for female exogamy but no indications for strict patrilocality. Individual status differences at Mokrin, as indicated by grave goods, support the inference that females could inherit status, but could not transmit status to all their sons. We further show that sons had the possibility to acquire status during their lifetimes, but not necessarily to inherit it. Taken together, these findings suggest that Southeastern Europe in the Early Bronze Age had a significantly different family and social structure than Late Neolithic and Early Bronze Age societies of Central Europe.

Paleodemographic analysis of age at death for a population of Black Sea Scythians: An exploration by using Bayesian methods.

OBJECTIVES: Studies of the demography of past populations involving deterministic life tables can be criticized for ignoring the errors of estimation. Bayesian methods offer an alternative, by focusing on the uncertainty of the estimates, although their results are often sensitive to the choice of prior distributions. The aim of this study is to explore a range of Bayesian methods for estimating age at death for a population of nomadic warriors-Scythians from the Black Sea region. MATERIALS AND METHODS: In total, skeletons of 312 individuals (93 children and 219 adults) from Glinoe (Moldova), dated to the 5th-2nd century BCE, were examined. We unified the age categories corresponding to different aging methods, allowing an application of a probabilistic assessment of the age categorization. A hierarchical Bayesian multinomial-Dirichlet-Dirichlet model was applied, with a hypothetical, subjective reference population, a real reference population, and no reference. RESULTS: Stationary-population life expectancy was estimated as 27.7 years (95% CI: 25.1-30.3) for a newborn (e0 ), and 16.4 years (14.0-19.0) for 20-year-olds (e20 ), although with high uncertainty, and sensitive to the model specification. Slight differences in longevity between different social strata and between the Classical and Late chronological periods were found, although with high estimation errors. A more robust finding, confirming earlier studies, was a high probability of death in young adulthood, which could depend on Scythian lifestyle (conflicts, wars). DISCUSSION: Our study shows a way to overcome some limitations of broad age categorization by using the Bayesian approach with alternative model specifications, allowing to assess the impact of reference populations.

Code Stroke Patient Referral by Emergency Medical Services During the Public COVID-19 Pandemic Lockdown.

BACKGROUND: The COVID-19 pandemic caused public lockdowns around the world. We analyzed if the public lockdown altered the referral pattern of Code Stroke patients by Emergency Medical Services (EMS) to our Comprehensive Stroke Center. METHODS: Retrospective single-center study at a Bavarian Comprehensive Stroke Center. Patients who were directly referred to our stroke unit by EMS between the 1st of January 2020 and the 19th of April 2020 were identified and number of referrals, clinical characteristics and treatment strategies were analyzed during the public lockdown and before. The public lockdown started on 21st of March and ended on 19th April 2020. RESULTS: In total 241 patients were referred to our center during the study period, i.e. 171 before and 70 during the lockdown. The absolute daily number of Code Stroke referrals and the portion of patients with stroke mimics remained stable. The portion of female stroke patients decreased (55% to 33%; p = 0.03), and stroke severity as measured by the National Institutes of Health Stroke Scale (median 3 (IQR 0-7) versus 6 (IQR 1-15.5) points; p = 0.04) increased during the lockdown. There was no difference of daily numbers of patients receiving thrombolysis and thrombectomy. CONCLUSIONS: Referral of Code Stroke patients by EMS could be maintained sufficiently despite the COVID-19 pandemic lockdown. However, patients' health care utilization of the EMS may have changed within the public lockdown. EMS remains a useful tool for Code Stroke patient referral during lockdowns, but public education about stroke is required prior to further lockdowns.

Current Recommendations for the Management of Stroke Patients in the Middle East in the Era of COVID-19 Pandemic; Statement from the MENA SINO.

COVID-19 pandemic has led to a change in the way we manage acute medical illnesses. This pandemic had a negative impact on stroke care worldwide. The World Stroke Organization (WSO) has raised concerns due to the lack of available care and compromised acute stroke services globally. The numbers of thrombolysis and thrombectomy therapies are declining. As well as, the rates and door-to treatment times for thrombolysis and thrombectomy therapies are increasing. The stroke units are being reallocated to serve COVID-19 patients, and stroke teams are being redeployed to COVID-19 centers. Covid 19 confirmed cases and deaths are rising day by day. This pandemic clearly threatened and threatening all stroke care achievements regionally. Managing stroke patients during this pandemic is even more challenging at our region. The Middle East and North Africa Stroke and Interventional Neurotherapies Organization (MENA-SINO) is the main stroke organization regionally. MENA-SINO urges the need to developing new strategies and recommendations for stroke care during this pandemic. This will require multiple channels of interventions and create a protective code stroke with fast triaging path. Developing and expanding the tele-stroke programs are urgently required. There is an urgent need for enhancing collaboration and cooperation between stroke expertise regionally and internationally. Integrating such measures will inevitably lead to an improvement and upgrading of the services to a satisfactory level.

"There is a Balm in Gilead": Black Social Workers' Spiritual Counterstory on the COVID-19 Crisis.

The authors assert that art-based inquiry can serve as a powerful medium for understanding the connection between faith and resilience as perceived and understood by older African-Americans adults disproportionately affected by the COVID-19 pandemic. Utilizing the CRT method of counterstorytelling as our conduit to elucidate our culturally situated responses to the COVID-19 pandemic. We seek to explore the connections between faith and resilience in social work practice during this public health crisis. Drawing from our shared experiences as two Black social workers we discuss the role spirituality plays in mitigating loneliness and stress among socially isolated older African-American adults (i.e., social distancing). Finally, with physical contact limited (i.e., social distancing) because of COVID-19, implications and recommendations for using spiritual-based practices with older African-American adults and families are discussed.

Case Study: Using Electronic Medication Administration Record to Enhance Medication Safety and Improve Efficiency in Long-Term Care Facilities.

The electronic medication administration record (eMAR) has been used in hospitals and acute care facilities in Canada for over a decade. Unfortunately, the Canadian continuing care sector has been slow to adopt eMAR usage. Medication delivery in long-term care has traditionally been through paper-based orders and manual documentation in the paper medication administration record. The effectiveness of this manual system as it relates to medication incidents, patient safety and nursing efficiency is not well understood because most of the information is based on anecdotal evidence. Peer-reviewed scientific literature supports the premise that the eMAR, compared to the MAR, is more efficient, significantly reduces medication incidents, promotes patient safety and improves workflow efficiency. In April 2016, the Brenda Strafford Foundation committed to implementing the eMAR at each of our three long-term care facilities to improve medication delivery, reducing and eliminating medication incidents and evaluating the benefits of the electronic system. Under the direction of the clinical team, including nurses, physicians, pharmacists, and the software provider/vendor, an electronic system was developed and new processes for medication delivery were instituted within eight months of starting the project. Since the past year, the evaluation of the eMAR at the Brenda Strafford Foundation demonstrated a reduction in medication delivery time allowing for more time for direct care and a decrease in medication incidents, which directly affects resident health and safety. Nursing and the healthcare aides trained in medication management were surveyed and indicated that the eMAR provides a holistic view of the resident and provides important information readily available to improve the quality of resident care.

Social Ties and Suicidal Ideation Among Veterans Referred to a Primary Care-Mental Health Integration Program.

OBJECTIVE: This study examined associations between three indices of social ties (perceived social support, frequency of negative social exchanges, and degree of social integration) and suicidal ideation among veterans referred by their primary care provider for a behavioral health assessment. METHODS: The sample included 15,277 veterans who completed a mental health and substance use assessment on referral to a Primary Care-Mental Health Integration (PCMHI) program. Data on sociodemographic factors, mental health and substance use conditions (e.g., depression, anxiety, and substance use), perceived general health, the three indices of social ties, and suicidal ideation were extracted from clinical interviews. RESULTS: The mean±SD age of the sample was 51.3±15.9, most (89%) were men, and about half (48%) were white. Most met criteria for at least one mental health or substance use condition on PCMHI assessment, and 39% reported either low- or high-severity suicidal ideation, as measured by the Paykel Suicide Scale. Logistic regression analyses indicated that after adjustment for sociodemographic factors, perceived health, and comorbid mental health and substance use conditions, each of the three social tie indices was uniquely associated with higher odds of reporting suicidal ideation, compared with no ideation. CONCLUSIONS: Findings underscore the value of assessing multiple indices of social ties when examining suicidal ideation among high-risk veterans in primary care experiencing behavioral health issues. Incorporating an assessment of the quality of patients' social interactions and level of social integration into routine PCMHI practice has the potential to enhance screening and intervention efforts aimed at reducing suicidal ideation.

Stigma and Quality of Life in Patients With Advanced Lung Cancer.

OBJECTIVES: To identify groups of participants with high and low levels of stigma and to examine the influence of stigma on social support, social constraints, symptom severity, symptom interference, and quality of life (QOL). SAMPLE & SETTING: 62 individuals with lung cancer were identified and recruited from a comprehensive cancer center in the southeastern United States. METHODS & VARIABLES: Participants completed a questionnaire that included demographic information and measures of stigma, symptom severity and interference, social support, social constraints, and QOL. IBM SPSS Statistics TwoStep Cluster Analysis was used to identify high- and low-stigma groups. Independent sample t tests were used to compare differences between the groups. RESULTS: 22 participants had a high level of stigma; they had significantly higher symptom severity on feeling distressed, problems remembering things, and feeling sad, and greater symptom interference related to mood, relations with others, and enjoyment of life. Participants also had significantly higher levels of social support and lower social constraints. Stigma was significantly related to lower levels of QOL. IMPLICATIONS FOR NURSING: Nurses should be aware that stigma may influence various factors throughout the disease trajectory; they can privately assess individuals with lung cancer for access to social supports, feelings of stigma, and QOL, and make appropriate referrals as needed.

Nursing and Midwifery Students' Sense of Connectedness Within Their Learning Communities.

BACKGROUND: Recognition of the importance of a supportive academic and clinical learning environment for nursing and midwifery students enrolled in health care programs is not new. However, the factors that influence social connections within these environments and the consequences for students' learning are not well understood. METHOD: This study used a multisite mixed-methods design to examine students' learning experiences. RESULTS: Participants stated that to develop a sense of professional connectedness, opportunities are needed to develop meaningful relationships with academic staff and peers through increased face-to-face on-campus learning experiences, as well as through off-campus contexts. CONCLUSION: To enhance nursing and midwifery students' sense of connectedness, the balance between online and face-to-face learning experiences needs to be reexamined, and a renewed focus on the development of quality clinical learning experiences that foster a sense of belonging also is needed. [J Nurs Educ. 2019;58(1):47-52.].

Who Is Less Likely to Ostracize? Higher Trait Mindfulness Predicts More Inclusionary Behavior.

Despite the pain ostracism (being excluded and ignored) causes, researchers have minimally investigated factors related to reducing its occurrence. We investigated the association between higher trait mindfulness (the tendency to be attentive to the present moment) and lower engagement in ostracism. In Study 1, employed adults scoring higher on trait mindfulness reported ostracizing coworkers less. In Study 2, participants possessing higher levels of trait mindfulness demonstrated greater inclusion of a fellow group member being ostracized by others in the group. Results suggested that attention, rather than empathy, was the psychological process responsible for greater inclusion of an ostracized group member by mindful individuals. Study 3 supported this conclusion because participants responded similarly to those high in trait mindfulness when they were instructed to pay attention and ensure all players were included equally. Overall, we found that people with higher levels of trait mindfulness are more attentive to targets of ostracism.

The art of recovery: outcomes from participatory arts activities for people using mental health services.

BACKGROUND: There is a growing evidence base for the use of participatory arts for the purposes of health promotion. In recent years, recovery approaches in mental healthcare have become commonplace in English speaking countries amongst others. There are few studies that bring together these two fields of practice. AIMS: The two aims of this study were (a) to investigate the validity of the CHIME framework for characterising the experience of Participatory Arts and (b) to use the CHIME framework to investigate the relationship between participatory arts and mental health recovery. METHOD: The study employed a two-phase methodology: a rapid review of relevant literature followed by secondary analysis of qualitative data collected from 38 people who use mental health service who took part in participatory arts activities designed to improve mental health. RESULTS: Each of the recovery processes identified by CHIME are present in the qualitative research literature as well as in the data of the secondary analysis. CONCLUSIONS: Participatory arts activities produce outcomes which support recovery, specifically including enhancing connectedness and improving hope. They can be recommended to people living with mental health problems.

Recovery and creative practices in people with severe mental illness: evaluating well-being and social inclusion.

PURPOSE: This mixed (quantitative-qualitative) study evaluates the impact of an artistic workshop on a group of people with severe mental illness (SMI). This study focuses on the impact of creative practices on well-being and social inclusion outcomes. METHOD: After participating in a creative workshop, 31 people diagnosed with a SMI completed pre/post-intervention measures, namely, the Warwick-Edinburgh Mental Well-Being Scale and the Social Inclusion questionnaire. It was applied in two-way repeated measures analysis of variance. The statistic Wilcoxon and Kruskal-Wallis were applied for non-parametric data to measure pre/post-test effects and workshop experience effects, respectively. In addition to quantitative measures, one observer participated in each workshop that ran in parallel in order to deepen and triangulate quantitative outcomes. RESULTS: The qualitative and quantitative results show that social inclusion improved in a significant way with an important size effect. Psychological wellbeing increased significantly with a low size effect. CONCLUSIONS: In accordance with these results, creative practices with people diagnosed with SMI are recommended. In order to increase the impact of these interventions, it is recommended to utilize public space away from clinical environments and to include people without SMI in creative activities together with SMI patients. Implications for Rehabilitation: Creative practices can significantly improve social inclusions and well-being in people with severe mental illness. Participating in creative workshops helps to elaborate personal meanings and promote recovery. Creative practices in mental health services can challenge professional roles and institutional practices. Participation of people with and without severe mental illness engaged together in artistic activities can decrease public stigma.

Acceptance alone is a better predictor of psychopathology and well-being than emotional competence, emotion regulation and mindfulness.

Emotional competence, emotion regulation, mindfulness and acceptance have all been strongly associated to emotional disorders and psychological well-being in multiple studies. However little research has compared the unique predictive ability of these different constructs. We hypothesised that they will all share a large proportion of common variance and that when compared to the broader constructs emotional competence, emotion regulation and mindfulness, acceptance alone would predict a larger proportion of unique variance METHODS: 228 participants from a community sample completed anonymously measures of anxiety, depression, happiness, acceptance, mindfulness, emotional competence and emotion regulation. We then ran multiple regressions to assess and compare the predictive ability of these different constructs. RESULTS: For measures of psychological distress, the acceptance measure uniquely accounted for between 4 and 30 times the variance that the emotional competence, emotion regulation and mindfulness measures did. LIMITATIONS: These results are based on cross-sectional designs and non-clinical samples, longitudinal and experimental studies as clinical samples may be useful in order to assess the potential protective power of acceptance over time. Another limitation is the use of self-report questionnaires. CONCLUSIONS: Results confirmed our hypothesis, supporting the research on the importance of acceptance as a central factor in the understanding of the onset and maintenance of emotional disorders.

Effects of brief mindfulness and loving-kindness meditation inductions on emotional and behavioral responses to social rejection among individuals with high borderline personality traits.

Borderline personality disorder (BPD) is characterized by an enduring pattern of instability across affective, behavioral, cognitive, and interpersonal domains. Individuals with BPD are known to be particularly vulnerable to experiences of social rejection, but little work has examined strategies that may moderate their reactivity to social rejection. Using a laboratory experimental approach, this study investigated the effects of brief mindfulness and loving-kindness meditation (LKM) inductions on emotional and behavioral responses to social rejection in a sample of adults with high BPD traits. One hundred and eighteen participants were randomly assigned to receive 10 min of mindful breathing practice, LKM, or a no-instruction control condition, prior to exposure to a social rejection manipulation. Participants rated their emotions and completed a competitive reaction time task, which provided a proxy measure of aggression. Compared to the control condition, the mindfulness group demonstrated significantly quicker recovery in negative affect and feelings of rejection after social rejection. The mindfulness group also reported significantly quicker recovery in negative affect compared to the LKM group. Whereas baseline trait mindfulness negatively predicted aggressive behaviors across all participants, groups did not differ in immediate emotional reactivity or aggressive behavior following social rejection. The findings suggest that mindfulness training may be a promising strategy in alleviating negative emotional effects of social rejection among individuals with high borderline personality traits, and highlight the limited utility of brief LKM practice in buffering the effects of social rejection.

Acceptance lowers stress reactivity: Dismantling mindfulness training in a randomized controlled trial.

OBJECTIVE: Mindfulness interventions, which train practitioners to monitor their present-moment experience with a lens of acceptance, are known to buffer stress reactivity. Little is known about the active mechanisms driving these effects. We theorize that acceptance is a critical emotion regulation mechanism underlying mindfulness stress reduction effects. METHOD: In this three-arm parallel trial, mindfulness components were dismantled into three structurally equivalent 15-lesson smartphone-based interventions: (1) training in both monitoring and acceptance (Monitor+Accept), (2) training in monitoring only (Monitor Only), or (3) active control training (Coping control). 153 stressed adults (mean age=32years; 67% female; 53% white, 21.5% black, 21.5% Asian, 4% other race) were randomly assigned to complete one of three interventions. After the intervention, cortisol, blood pressure, and subjective stress reactivity were assessed using a modified Trier Social Stress Test. RESULTS: As predicted, Monitor+Accept training reduced cortisol and systolic blood pressure reactivity compared to Monitor Only and control trainings. Participants in all three conditions reported moderate levels of subjective stress. CONCLUSIONS: This study provides the first experimental evidence that brief smartphone mindfulness training can impact stress biology, and that acceptance training drives these effects. We discuss implications for basic and applied research in contemplative science, emotion regulation, stress and coping, health, and clinical interventions.

Humanizing folk devils using ethnography.

The sociological concepts of the "moral panic" and the deviant "folk devil" apply to the drug panics in the United States over methamphetamine, heroin, and crack cocaine. Mothers or pregnant women who smoke crack cocaine, and their babies, are assigned exaggerated "demonic" attributes that result in stigma and societal rejection. Otherwise, ethnographic studies of drug users demonstrate realities that are other than what might be considered were one to merely look at their use and the consequences. These considerations are examined with respect to the image of folk devils, methadone program attendees, smokers of "blunts," opium den habitués, and others grouped together as negative influences as a result of their drug habits.

Determining the relationship between body mass index, healthy lifestyle behaviors and social appearance anxiety.

The aim of this study was to describe the relationship between nutritional status, healthy lifestyle behaviors and social appearance anxiety of individuals aged 20-65 (n = 500). A significant, positive relationship was seen between body mass index and nutrition, and negative relationship between body mass index and spiritual development, interpersonal relations, stress management. There was a negative relationship between the ORTO-15 score and health responsibility, physical activity, nutrition, spiritual development, interpersonal relationships, stress management. There was also a negative relationship between the Social Appearance Anxiety Scale and spiritual development, interpersonal relationships.

A Brief Introduction to Mass Migration: Then and Now.

To provide a context, this introduction presents a bird's-eye view of migration history, of some differences between voluntary and forced motivation for leaving home territories, and the significance of large group relocations.(mass migrations). The challenges of adjustment and acculturation as well as the interactional effects on migrants and host populations, including mental health issues and facilities, are considered.