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1.
Phys Rev Lett ; 122(18): 183203, 2019 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-31144888

RESUMO

Using a model system, we demonstrate both experimentally and theoretically that coherent scattering of light can be robust in hot atomic vapors despite a significant Doppler effect. By operating in a linear regime of far-detuned light scattering, we also unveil the emergence of interference triggered by inelastic Stokes and anti-Stokes transitions involving the atomic hyperfine structure.

2.
Dev Psychobiol ; 60(6): 639-650, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29961271

RESUMO

The present longitudinal study is the first to investigate the association between human breast milk cortisol and infant crying over the first three months of life. Higher concentrations of breast milk cortisol were expected to be differentially associated with fussing and crying in boys and girls. At 2, 6, and 12 weeks of infant age, mothers (N = 70) collected a morning sample of their milk and kept a 3-day diary to measure infant fussing and crying. Cortisol was extracted and quantified from milk samples. Results showed that breast milk cortisol concentrations increased from 2 weeks through 12 weeks of infant age. Milk cortisol was unrelated to the total duration, frequency, and bout length of infant fussing and crying for both boys and girls. Directions for future research aiming to extend our knowledge on the biology of milk cortisol in relation to infant behavior and development are discussed.


Assuntos
Choro/fisiologia , Hidrocortisona/metabolismo , Comportamento do Lactente/fisiologia , Leite Humano/metabolismo , Aleitamento Materno , Feminino , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino
3.
J Appl Res Intellect Disabil ; 30(5): 872-884, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27554599

RESUMO

BACKGROUND: Recent studies have shown that it is possible to foster affective involvement between people with congenital deafblindness and their communication partners. Affective involvement is crucial for well-being, and it is important to know whether it can also be fostered with people who have congenital deafblindness and intellectual disabilities. METHODS: This study used a multiple-baseline design to examine whether an intervention based on the Intervention Model for Affective Involvement would (i) increase affective involvement between four participants with congenital deafblindness and intellectual disabilities and their 13 communication partners and (ii) increase the participants' positive emotions and decrease their negative emotions. RESULTS: In all cases, dyadic affective involvement increased, the participants' very positive emotions also increased and the participants' negative emotions decreased. CONCLUSION: The results indicate that communication partners of persons with congenital deafblindness and intellectual disabilities can be successfully trained to foster affective involvement.


Assuntos
Afeto , Comunicação , Surdocegueira/reabilitação , Deficiência Intelectual/reabilitação , Relações Interpessoais , Psicoterapia/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
4.
Stress ; 19(1): 8-17, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26455788

RESUMO

Cortisol concentrations of older children in childcare centers have been found to be higher than at home. This study focuses on infant cortisol in childcare centers throughout the first year of life, and aims to investigate whether inter-individual differences can be explained by temperament, the quality of maternal behavior, and the quality of center care. Sixty-four infants were followed for 9 months after entering care at 3 months of age. Salivary samples were taken at 10.00 h and 16.00 h in center care (in post-entry weeks 1, 2, 3, 4, 8, 12, 16, 24, and 36) and at home (in post-entry weeks 1, 24, and 36). Prior to entry, mothers completed a temperament questionnaire and the quality of maternal behavior (sensitivity and cooperation) was observed during routine bathing sessions. Subsequently, the infants were visited three times at center care to observe the quality of infant's interactive experiences with their professional caregiver. Longitudinal regression models showed that both morning and afternoon cortisol were higher in center care compared to home. Longitudinal regression models showed that infants receiving higher quality of maternal behavior displayed higher morning cortisol in center care, compared to infants receiving lower quality of maternal behavior. Higher quality of maternal behavior was also related to higher afternoon cortisol in center care, but only in infants high in negative emotionality. Center care quality was not related to cortisol. In sum, young infants show higher cortisol concentrations in center care that are related to infant temperament and quality of maternal behavior at home.


Assuntos
Creches , Hidrocortisona/metabolismo , Cuidado do Lactente , Comportamento Materno , Estresse Psicológico/metabolismo , Temperamento , Feminino , Humanos , Lactente , Estudos Longitudinais , Masculino , Relações Mãe-Filho , Análise de Regressão , Saliva/química , Inquéritos e Questionários
5.
Stress ; 17(4): 305-13, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24766316

RESUMO

We investigated whether children's performance on working memory (WM) and delayed retrieval (DR) tasks decreased after stress exposure, and how physiological stress responses related to performance under stress. About 158 children (83 girls; Mage = 10.61 years, SD = 0.52) performed two WM tasks (WM forward and WM backward) and a DR memory task first during a control condition, and 1 week later during a stress challenge. Salivary alpha-amylase (sAA) and cortisol were assessed during the challenge. Only WM backward performance declined over conditions. Correlations between physiological stress responses and performance within the stress challenge were present only for WM forward and DR. For WM forward, higher cortisol responses were related to better performance. For DR, there was an inverted U-shape relation between cortisol responses and performance, as well as a cortisol × sAA interaction, with concurrent high or low responses related to optimal performance. This emphasizes the importance of including curvilinear and interaction effects when relating physiology to memory.


Assuntos
Memória/fisiologia , Estresse Fisiológico/fisiologia , Estresse Psicológico/metabolismo , Criança , Feminino , Humanos , Hidrocortisona/metabolismo , Masculino , Saliva/metabolismo , alfa-Amilases Salivares/metabolismo , Análise e Desempenho de Tarefas
6.
Stress ; 17(5): 383-8, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24930802

RESUMO

Knowledge about children's stress reactivity and its correlates is mostly based on one stress task, making it hard to assess the generalizability of the results. The development of an additional stress paradigm for children, that also limits stress exposure and test time, could greatly advance this field of research. Research in adults may provide a starting point for the development of such an additional stress paradigm, as changes in salivary cortisol and alpha-amylase (sAA) over a 1-h pre-stress period in the laboratory correlated strongly with subsequent reactivity to stress task (Balodis et al., 2010, Psychoneuroendocrinology 35:1363-73). The present study examined whether such strong correlations could be replicated in 9- to 11-year-old children. Cortisol and sAA samples were collected from 158 children (83 girls) during a 2.5-h visit to the laboratory. This visit included a 1-h pre-stress period in which children performed some non-stressful tasks and relaxed before taking part in a psychosocial stress task (TSST-C). A higher cortisol arrival index was significantly and weakly correlated with a higher AUCg but unrelated to cortisol reactivity to the stressor. A higher sAA arrival index was significantly and moderately related to lower stress reactivity and to a lower AUCi. Children's personality and emotion regulation variables were unrelated to the cortisol and sAA arrival indices. The results of this study do not provide a basis for the development of an additional stress paradigm for children. Further replications in children and adults are needed to clarify the potential meaning of an arrival index.


Assuntos
Hidrocortisona/metabolismo , alfa-Amilases Salivares/metabolismo , Estresse Fisiológico , Estresse Psicológico/metabolismo , Criança , Emoções , Feminino , Humanos , Masculino , Personalidade , Saliva/química , Estresse Psicológico/psicologia
7.
Horm Behav ; 65(2): 173-8, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24370687

RESUMO

The present study sought to investigate the relation between ethological observations of children's gaze aversion during a psychosocial stress task and their cortisol reactivity to the task, and how this relation might be moderated by how stressful the children perceived the stress task to be. Videos of 140 children (74 girls; Mage=10.60years) performing a psychosocial stress task in front of a jury were coded for displays of the children's gaze aversion from the jury, and saliva samples were taken to determine their cortisol reactivity. A questionnaire assessed the children's level of perceived stress. Results showed higher cortisol reactivity in children who perceived the task as more stressful. Furthermore, a quadratic relation between gaze aversion and cortisol was found which depended on the level of perceived stress: for children with low levels of perceived stress, cortisol reactivity was lowest with intermediate levels of gaze aversion, whereas for children with high levels of perceived stress cortisol reactivity was highest at intermediate levels of gaze aversion. The results suggest a modest association between subjective and physiological stress responses in 9- to 11-year-olds, and indicate that gaze aversion may play only a minor role as a behavioural coping strategy at this age.


Assuntos
Adaptação Psicológica/fisiologia , Movimentos Oculares/fisiologia , Hidrocortisona/análise , Estresse Fisiológico/fisiologia , Estresse Psicológico/fisiopatologia , Afeto/fisiologia , Criança , Feminino , Humanos , Sistema Hipotálamo-Hipofisário/fisiopatologia , Masculino , Sistema Hipófise-Suprarrenal/fisiopatologia , Saliva/química , Inquéritos e Questionários
8.
Int Psychogeriatr ; 26(7): 1161-70, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24735803

RESUMO

BACKGROUND: Based on self-determination theory and adaptation theories, the study aim was to investigate the relationship between need fulfillment (of autonomy, relatedness, and competence), need importance, and depressive symptoms during the first months of living in a nursing home. METHODS: Eight-month longitudinal questionnaire study in which 75 persons newly admitted to units for physically frail residents participated at baseline. Twenty-three longitudinal participants were remaining at the third and final measurement wave. RESULTS: The results show a main effect of need fulfillment and an interaction effect of need fulfillment and need importance on depressive symptoms over time. A prototypical plot shows that residents with low need fulfillment had higher initial levels of depressive symptoms that decreased modestly over time, regardless of their need importance. Residents with high need fulfillment had lower initial levels of depressive symptoms, but their trajectories differed for participants with low and high need importance. Residents with low need importance started with lower levels of depressive symptoms but remained stable over time, whereas residents with high need importance had more depressive symptoms at T1 that decreased slightly over time. CONCLUSIONS: In general, depressive symptoms do not change over time. However, individual trajectories of depressive symptoms seem to depend on individual need fulfillment and need importance. The residents that consider need fulfillment to be highly important but experience low need fulfillment had higher initial levels of depressive symptoms that decreased modestly over time, although the level of depressive symptoms remained higher as compared to the other residents.


Assuntos
Depressão/epidemiologia , Necessidades e Demandas de Serviços de Saúde , Casas de Saúde , Idoso/psicologia , Idoso de 80 Anos ou mais , Depressão/etiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Casas de Saúde/estatística & dados numéricos , Autonomia Pessoal , Escalas de Graduação Psiquiátrica , Inquéritos e Questionários , Fatores de Tempo
9.
Stress ; 16(3): 267-77, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23116166

RESUMO

Experiences during early life are suggested to affect the physiological systems underlying stress responses, including the hypothalamic-pituitary-adrenal axis (HPA axis). While stressful early experiences have been associated with dysregulated HPA-axis functioning, positive early experiences, i.e. high maternal caregiving quality, contribute to more optimal HPA-axis functioning. Influences of other early caregiving factors, however, are less well documented. The goal of this study was to examine whether breastfeeding and co-sleeping during the first 6 months of life were associated with infant cortisol regulation, i.e. cortisol reactivity and recovery, to a stressor at 12 months of age. Participants were 193 infants and their mothers. Information on breastfeeding and co-sleeping was collected using weekly and daily sleep diaries, respectively, for the first 6 months of life. Co-sleeping was defined as sleeping in the parents' bed or sleeping in the parents' room. At 12 months of age, infants were subjected to a psychological stressor [Strange Situation Procedure (SSP); Ainsworth et al. 1978]. Salivary cortisol was measured prestressor and at 25, 40, and 60 min poststressor to measure reactivity and recovery. Regression analyses showed that after controlling for maternal sensitivity, infant attachment status, feeding, and sleeping arrangements at 12 months of age and other confounders, more weeks of co-sleeping predicted lower infant cortisol reactivity to the SSP. Also, more weeks of breastfeeding predicted quicker cortisol recovery. These results indicate that an early history of co-sleeping and breastfeeding contributes positively to cortisol regulation in 12-month-olds.


Assuntos
Leitos , Aleitamento Materno , Hidrocortisona/metabolismo , Sistema Hipotálamo-Hipofisário/metabolismo , Poder Familiar , Sistema Hipófise-Suprarrenal/metabolismo , Saliva/metabolismo , Sono , Estresse Psicológico/metabolismo , Adulto , Fatores Etários , Análise de Variância , Ansiedade de Separação/metabolismo , Ansiedade de Separação/psicologia , Biomarcadores/metabolismo , Meio Ambiente , Feminino , Humanos , Sistema Hipotálamo-Hipofisário/fisiopatologia , Lactente , Comportamento do Lactente , Estudos Longitudinais , Masculino , Sistema Hipófise-Suprarrenal/fisiopatologia , Estudos Prospectivos , Reconhecimento Psicológico , Análise de Regressão , Estresse Psicológico/fisiopatologia , Fatores de Tempo
10.
Child Psychiatry Hum Dev ; 43(2): 201-18, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22011810

RESUMO

Previous studies of the long-term effects of maternal postpartum depression (PPD) on child development have mostly focused on a limited set of outcomes, and have often not controlled for risk factors associated with maternal depression. The present study compared children of postpartum depressed mothers (n = 29) with children from a community sample (n = 113) in terms of a broad range of developmental outcomes in the early school period. Controlling for risk factors associated with maternal depression, we found that children of postpartum depressed mothers had lower ego-resiliency, lower peer social competence, and lower school adjustment than the community sample children. In addition, girls of postpartum depressed mothers showed lower verbal intelligence, and, unexpectedly, showed fewer externalizing problems than their counterparts in the community sample. Results show that children's capacities to deal with stress and interact with peers in the early school period may be particularly affected by their mothers' PPD.


Assuntos
Comportamento Infantil/psicologia , Filho de Pais com Deficiência/psicologia , Depressão Pós-Parto/psicologia , Inteligência , Resiliência Psicológica , Autoimagem , Comportamento Social , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Relações Mãe-Filho , Grupo Associado , Ajustamento Social , Estresse Psicológico/psicologia
11.
Front Oncol ; 12: 1003506, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36330470

RESUMO

Background: The probability of undergoing treatment with curative intent for esophagogastric cancer has been shown to vary considerately between hospitals of diagnosis. Little is known about the factors that attribute to this variation. Since clinical decision making (CDM) partially takes place during an MDTM, the aim of this qualitative study was to assess clinician's perspectives regarding facilitators and barriers associated with CDM during MDTM, and second, to identify factors associated with CDM during an MDTM that may potentially explain differences in hospital practice. Methods: A multiple case study design was conducted. The thematic content analysis of this qualitative study, focused on 16 MDTM observations, 30 semi-structured interviews with clinicians and seven focus groups with clinicians to complement the collected data. Interviews were transcribed ad verbatim and coded. Results: Factors regarding team dynamics that were raised as aspects attributing to CDM were clinician's personal characteristics such as ambition and the intention to be innovative. Clinician's convictions regarding a certain treatment and its outcomes and previous experiences with treatment outcomes, and team dynamics within the MDTM influenced CDM. In addition, a continuum was illustrated. At one end of the continuum, teams tended to be more conservative, following the guidelines more strictly, versus the opposite in which hospitals tended towards a more invasive approach maximizing the probability of curation. Conclusion: This study contributes to the awareness that variation in team dynamics influences CDM during an MDTM.

12.
Stress ; 14(1): 53-65, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20666659

RESUMO

Early life factors can shape the development of hypothalamic pituitary adrenal (HPA) axis. Maternal prenatal stress might constitute such an early environmental factor. As little is known about the relation between maternal prenatal stress and cortisol reactivity in human offspring, we performed a longitudinal study including four assessments of infant cortisol reactivity to stressful events in a non-clinical population. General and pregnancy-related feelings of stress and anxiety, as well as circadian cortisol levels, were measured in 173 mothers in the last trimester of pregnancy. Infant cortisol reactivity was measured at 5 weeks to a bathing session, at 8 weeks to a vaccination, at 5 months to a stressful mother-infant interaction (still face procedure), and at 12 months to a maternal separation (strange situation procedure). Maternal prenatal fear of bearing a handicapped child was a consistent predictor of infant cortisol reactivity. Although the effects were mild, higher fear was significantly related to higher salivary cortisol reactivity to the bathing session and to decreased cortisol reactivity to vaccination and maternal separation. Thus, pregnancy-specific anxieties predict infant cortisol reactivity in the first year of life, but the direction of the effect depends on infant age and/or the nature of the stressor. While this specific anxiety was a better predictor than stress experience or maternal cortisol concentrations, the underlying mechanisms of these associations remain unclear. Future studies should try to incorporate multiple measures of HPA-axis reactivity during development when studying the long-term consequences of maternal prenatal stress.


Assuntos
Hidrocortisona/sangue , Sistema Hipotálamo-Hipofisário , Efeitos Tardios da Exposição Pré-Natal , Estresse Psicológico , Adulto , Medo , Feminino , Humanos , Sistema Hipotálamo-Hipofisário/fisiologia , Lactente , Estudos Longitudinais , Masculino , Sistema Hipófise-Suprarrenal/fisiologia , Gravidez/psicologia , Terceiro Trimestre da Gravidez
13.
Child Dev ; 82(6): 1906-20, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22026414

RESUMO

Exclusion and victimization by classmates were related to levels and diurnal change in cortisol in 97 fourth graders (53% boys, M = 9.3 years). Number and quality of friendships were considered as moderators. Salivary cortisol was collected 5 times daily on 2 school days. Excluded children had elevated cortisol levels at school and a flattened diurnal cortisol curve, suggesting hypothalamic-pituitary-adrenocortical (HPA) axis dysregulation. This effect was weaker for children with more friends or better friendships. Victimization was not associated with cortisol level or change. The results demonstrate the role of HPA activity in peer group processes and indicate that group and dyadic factors interact in predicting stress in the peer group.


Assuntos
Nível de Alerta/fisiologia , Amigos/psicologia , Sistema Hipotálamo-Hipofisário/fisiologia , Grupo Associado , Sistema Hipófise-Suprarrenal/fisiologia , Rejeição em Psicologia , Adulto , Ritmo Circadiano/fisiologia , Vítimas de Crime/psicologia , Feminino , Humanos , Hidrocortisona/sangue , Controle Interno-Externo , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Países Baixos
14.
Infant Ment Health J ; 32(3): 362-376, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-28520142

RESUMO

Improving depressed mothers' sensitivity is assumed to be a key element in preventing adverse outcomes for children of such mothers. This meta-analysis examines the short-term effectiveness of preventive interventions in terms of enhancing depressed mothers' sensitivity toward their child and investigates what type of intervention is most effective. Thirteen interventions, reported in 10 controlled outcome studies, met the inclusion criteria (N = 918). Meta-analytic results showed a small to medium, significant mean effect size (g = 0.32) with large variation in individual effect sizes (-0.56-1.76). Interventions including baby massage were highly effective in improving maternal sensitivity (g = 0.85). In contrast, individual therapy for the mother proved ineffective in terms of improving maternal sensitivity (g = -0.00). Two other significant predictors of greater effect sizes were the inclusion of a support group and the use of a higher number of intervention methods; however, the significance of these results was largely accounted for by one single study. Our meta-analysis confirms that depressed mothers' sensitivity can be improved by preventive intervention and suggests that baby massage may be an effective intervention method to evoke short-term changes in maternal sensitivity. It is unclear whether these changes are maintained over time.

15.
Phys Rev Lett ; 104(5): 053202, 2010 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-20366760

RESUMO

We study the widths of interspecies Feshbach resonances in a mixture of the fermionic quantum gases 6Li and 40K. We develop a model to calculate the width and position of all available Feshbach resonances for a system. Using the model, we select the optimal resonance to study the {6}Li/{40}K mixture. Experimentally, we obtain the asymmetric Fano line shape of the interspecies elastic cross section by measuring the distillation rate of 6Li atoms from a potassium-rich 6Li/{40}K mixture as a function of magnetic field. This provides us with the first experimental determination of the width of a resonance in this mixture, DeltaB=1.5(5) G. Our results offer good perspectives for the observation of universal crossover physics using this mass-imbalanced fermionic mixture.

16.
J Child Psychol Psychiatry ; 51(10): 1160-70, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20707826

RESUMO

BACKGROUND: Whereas preventive interventions for depressed mothers and their infants have yielded positive short-term outcomes, few studies have examined their long-term effectiveness. The present follow-up of a randomised controlled trial (RCT) is one of the first to examine the longer-term effects of an intervention for mothers with postpartum depression and their infants at school-age. In early infancy, the intervention was found effective in improving mother-infant interaction and the child's attachment to its mother. METHODS: Twenty-nine mother-child pairs who completed the intervention are compared with 29 untreated mother-child dyads as to the quality of maternal interactive behaviour and the child outcomes of attachment security to the mother, self-esteem, ego-resiliency, verbal intelligence, prosocial behaviour, school adjustment, and behaviour problems at age 5 (M=68 months). RESULTS: In the total sample no lasting treatment benefits were found, but in families reporting a higher number of stressful life events, children in the intervention group had fewer externalising behaviour problems as rated by their mothers than children in the control group. CONCLUSIONS: In the context of multiple stressful life events the intervention served as a buffer by preventing the development of externalising problems in the child. The results warrant cautious interpretation because of the relatively small sample size and differential attrition revealing the mothers that completed the follow-up assessment to have improved less on maternal sensitivity following the intervention than the mothers who did not participate in the follow-up.


Assuntos
Comportamento Infantil/psicologia , Depressão Pós-Parto/terapia , Visita Domiciliar , Comportamento Materno/psicologia , Relações Mãe-Filho , Mães/psicologia , Adulto , Pré-Escolar , Depressão Pós-Parto/psicologia , Feminino , Seguimentos , Humanos , Lactente , Comportamento do Lactente/psicologia , Inteligência , Masculino , Autoimagem , Comportamento Social , Resultado do Tratamento
17.
Phys Rev Lett ; 103(15): 153202, 2009 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-19905636

RESUMO

We consider a heteronuclear fermionic mixture on the molecular side of an interspecies Feshbach resonance and discuss atom-dimer scattering properties in uniform space and in the presence of an external confining potential, restricting the system to a quasi-two-dimensional geometry. We find that there is a peculiar atom-dimer p-wave resonance which can be tuned by changing the frequency of the confinement. Our results have implications for the ongoing experiments on lithium-potassium mixtures, where this mechanism allows for switching the p-wave interaction between a K atom and Li-K dimer from attractive to repulsive, and forming a weakly bound trimer with unit angular momentum. We show that such trimers are long lived and the atom-dimer resonance does not enhance inelastic relaxation in the mixture, making it an outstanding candidate for studies of p-wave resonance effects in a many-body system.

18.
Science ; 155(3761): 463-5, 1967 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-6015695

RESUMO

Supersaturated greens seen after long-wavelength adaptation depend upon contrast from the continuing afterdischarge of bleached "red" receptors in the surround, rather than merely upon inactivation from bleaching of "red" receptors in the test spot area. When test spot and bleach field coincide spatially, supersaturated greens are not seen. Since color mixing but not contrast was found binocularly, color contrast must be a retinal phenomenon.


Assuntos
Adaptação Ocular/fisiologia , Pós-Imagem , Percepção de Cores , Retina/fisiologia , Humanos
19.
Infant Ment Health J ; 30(4): 366-383, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28636282

RESUMO

The predictive value of different infant attachment measures was examined in a community-based sample of 111 healthy children (59 boys, 52 girls). Two procedures to assess infant attachment, the Attachment Q-Set (applied on a relatively short observation period) and a shortened version of the Strange Situation Procedure (SSSP), were applied to the children at age 15 months and related to a comprehensive set of indicators of the children's socioemotional development at age 5 years. Three attachment measures were used as predictors: AQS security, SSSP security, and SSSP attachment disorganization. AQS security and SSSP security jointly predicted the security of the children's attachment representation at age 5. Apart from that, SSSP attachment disorganization was a better predictor of the children's later socioemotional development than were the other two early attachment measures. First, attachment disorganization was the only attachment measure to predict the children's later ego-resiliency, school adjustment, and dissociation. Second, as for the socioemotional measures at age 5 that also were related to AQS or SSSP security (i.e., peer social competence and externalizing problems), the attachment security measures did not explain any extra variance beyond what was explained by attachment disorganization.

20.
Eur J Cancer ; 121: 85-93, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31563730

RESUMO

INTRODUCTION: For optimal oncological care, it is recommended to discuss every patient with cancer in a multidisciplinary team meeting (MDTM). This is a time consuming and expensive practice, leading to a growing demand to change the current workflow. We aimed to investigate the number of patients discussed in MDTMs and to identify characteristics associated with not being discussed. METHODS: Data of patients with a newly diagnosed solid malignant tumour in 2015 and 2016 were analysed through the nationwide population-based Netherlands Cancer Registry (NCR). We clustered tumour types in groups that were frequently discussed within a tumour-specific MDTM. Tumour types without information about MDTMs in the NCR were excluded. Multivariable logistic regression analyses were used to analyse factors associated with not being discussed. RESULTS: Out of 105.305 patients with cancer, 91% were discussed in a MDTM, varying from 74% to 99% between the different tumour groups. Significantly less frequently discussed were patients aged ≥75 years (odds ratio [OR] = 0.7, 95% confidence interval [CI] = 0.6-0.7), patients diagnosed with disease stage I (OR = 0.5, 95% CI = 0.5-0.6), IV (OR = 0.4, 95% CI = 0.4-0.4) or unknown (OR = 0.2, 95% CI = 0.2-0.2) and patients who received no treatment (OR = 0.3, 95% CI = 0.3-0.3). Patients who received a multidisciplinary treatment were more likely to be discussed in contrary to a monodisciplinary treatment (OR = 4.6, 95% CI = 4.2-5.1). CONCLUSION: In general, most patients with cancer were actually discussed in a MDTM, although differences were observed between tumour groups. Factors associated with not being discussed may, at least partially, reflect the absence of a multidisciplinary question. These results form a starting point for debate on a more durable and efficient new MDTM strategy.


Assuntos
Comunicação Interdisciplinar , Neoplasias/epidemiologia , Neoplasias/terapia , Planejamento de Assistência ao Paciente/organização & administração , Equipe de Assistência ao Paciente/organização & administração , Padrões de Prática Médica/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Oncologia/métodos , Oncologia/organização & administração , Oncologia/normas , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias/patologia , Países Baixos/epidemiologia , Planejamento de Assistência ao Paciente/normas , Planejamento de Assistência ao Paciente/estatística & dados numéricos , Equipe de Assistência ao Paciente/normas , Equipe de Assistência ao Paciente/estatística & dados numéricos , Assistência Centrada no Paciente/organização & administração , Assistência Centrada no Paciente/normas , Padrões de Prática Médica/organização & administração , Padrões de Prática Médica/normas
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