Hyperactive child : a gestaltic view

A pesquisa objetivou investigar o funcionamento psicológico da criança hiperativa em base a teoria do ciclo do contato da abordagem gestáltica, proposta por Ribeiro (1997). O Transtorno de Déficit de Atenção/Hiperatividade (TDAH) caracteriza-se por distúrbios motores, perceptivos, emocionais e comportamentais. Segundo os critérios diagnósticos do DSM-IV (1994), esse transtorno reúne 18 sintomas básicos de desatenção, hiperatividade e impulsividade. A pesquisa adotou uma abordagem qualitativa. A amostra foi composta por 20 sujeitos: cinco casais, cinco professoras e cinco crianças entre oito e 11 anos de idade. Utilizaram-se a entrevista aberta e o Teste de Apercepção Infantil com figuras de animais (CAT-A), como instrumentos de coleta de dados. Concluímos que a criança hiperativa apresenta processos psicológicos específicos que formam a base de sua personalidade. A hiperatividade é a característica que define o transtorno. Não há propriamente um déficit de atenção. Propomos, portanto, uma terminologia diferente: Transtorno de Hiperatividade/Atenção.The study investigated the psychological functioning of the hyperactive child according to Contact Cycle Theory of Gestalt Approach, proposed by Ribeiro (1997). Attention Deficit/Hyperactivity Disorder (ADHD) is characterized by motor, perceptual, emotional and behavioral disturbances. According to DSM-IV (1994), the disorder comprises 18 basic symptoms of inattention, hyperactivity and impulsiveness. The research adopted a qualitative approach. The sample was composed by 20 subjects: five couples, five teachers and five children from eight to 11 years old. Non-structured interviews and children's apperception test using animal figures (CAT-A) were applied as instruments to collect data. We concluded that hyperactive child displays specific psychological processes forming the base of his personality, hyperactivity is the characteristic that defines the disorder, and that there is no attention deficit properly. Thus, we propose a different terminology: Hyperactivity/Attention Disorder

Gestalt approach and psychopedagogy : a comprehensive look to the child-school totality

O presente estudo visa estabelecer interface entre a abordagem gestáltica e a Psicopedagogia. Focalizam-se as teorias de base, a concepção de campo holístico-relacional a teoria do Ciclo do Contato, bem como as contribuições da Gestaltpedagogia para a compreensão do processo de aprendizagem e prática escolar. Da Psicopedagogia destaca-se sua conceituação, abrangência, processo de avaliação e intervenção junto à criança e instituição educativa; a convergência de suas bases teóricas e práticas abrangem os fenômenos aprendizagem, avaliação e intervenção na ótica gestáltica. Tal interface visa nova compreensão e ação interventiva do processo de aprendizagem, de modo a proporcionar o desenvolvimento da criança.The following study aims to establish an interface between gestalt approach and Psychopedagogy. Gestaltpedagogy base theories are focused, its conception of holistic-relational field, the Contact Cycle theory and the contributions for the learning process and school practices comprehension. From Psychopedagogy, its conception, amplitude and processes evaluation and intervention for the child and educative institution are pointed out; the convergence of their theoretical and practical bases enclose the learning phenomenon, the psychopedagogy evaluation and intervention from a gestaltic standpoint. The interface seeks a new comprehension and interventionist action to the learning process and school complaints, to collaborate to the child development

Longitudinal evaluation of peritoneal macrophage function and activation during CAPD: Maturity, cytokine synthesis and arachidonic acid metabolism

Longitudinal evaluation of peritoneal macrophage function and activation during CAPD: Maturity, cytokine synthesis and arachidonic acid metabolism. The release of cytokines and prostaglandins (PG) by peritoneal macrophages (PMØ) may influence the cytokine network controlling peritoneal inflammation and in the long-term the function of the peritoneum as a dialysis membrane. In the present study, an evaluation of the long-term effects of peritoneal dialysis on the release of cytokines and prostaglandins, and the expression of surface markers of cellular maturation on blood and mononuclear cells has been performed in patients during their first year on CAPD. Spontaneous release of tumour necrosis factor α (TNFα) and interleukin 6 (IL-6) by PMØ, after 4 or 24 hours in culture, increased significantly with time on CAPD, while there was a small but significant decrease in release of prostaglandin E2 (PGE2). Production of TNFα and IL-6 was enhanced following incubation of the cells with lipopolysaccharide (LPS), but the effect of LPS was proportionally greater on blood monocytes than on PMØ. There was a significant increase in the concentrations of PGE2 and 6-keto-prostaglandin F1α in overnight dwell peritoneal dialysis effluent with time on CAPD. The levels of TNFα and IL-6 in uninfected PDE were below the detection limit of the immunoassay over the whole time period studied. Expression of CD15, which correlates with immaturity, by PMØ and blood monocytes increased with time on CAPD, while expression of CD11c, a marker of maturation, decreased on blood monocytes, but did not change significantly on PMØ. There was also a slight increase in expression of transferrin receptor in both PMØ and monocytes, but this did not reach statistical significance. These findings suggest that peritoneal macrophages and blood monocytes isolated from CAPD patients over a one year period become increasingly immature with time, and this is accompanied by a significant modulation of their ability to secrete inflammatory cytokines. Dysregulation of macrophage function may have important consequences with respect to inflammatory processes and the long-term function of the peritoneal membrane in CAPD patients

Multiple Systems Estimation for Modern Slavery: Robustness of List Omission and Combination

Performing censuses on stigmatized or vulnerable populations is challenging, however, for such populations partial enumeration is often possible using different lists or sources. If the sources overlap then multiple systems estimation (MSE) methods can be applied to obtain an estimate of the total population. These are typically expressed by a log-linear model which permits positive/negative dependencies between lists. This paper considers issues that arise for the application of MSE to modern slavery where there is little to no overlap of individuals across lists. We investigate the robustness of MSE in terms of the importance of each list and the impact of combining lists on the estimation process. We undertake a simulation study and consider real national modern slavery data from the UK and Romania

Abordagem Gestáltica e Psicopedagogia: um olhar compreensivo para a totalidade criança-escola

The following study aims to establish an interface between gestalt approach and Psychopedagogy. Gestaltpedagogy base theories are focused, its conception of holistic-relational field, the Contact Cycle theory and the contributions for the learning process and school practices comprehension. From Psychopedagogy, its conception, amplitude and processes evaluation and intervention for the child and educative institution are pointed out; the convergence of their theoretical and practical bases enclose the learning phenomenon, the psychopedagogy evaluation and intervention from a gestaltic standpoint. The interface seeks a new comprehension and interventionist action to the learning process and school complaints, to collaborate to the child development.O presente estudo visa estabelecer interface entre a abordagem gestáltica e a Psicopedagogia. Focalizam-se as teorias de base, a concepção de campo holístico-relacional a teoria do Ciclo do Contato, bem como as contribuições da Gestaltpedagogia para a compreensão do processo de aprendizagem e prática escolar.Da Psicopedagogia destaca-se sua conceituação, abrangência, processo de avaliação e intervenção juntoà criança e instituição educativa; a convergência de suas bases teóricas e práticas abrangem os fenômenosaprendizagem, avaliação e intervenção na ótica gestáltica. Tal interface visa nova compreensão e açãointerventiva do processo de aprendizagem, de modo a proporcionar o desenvolvimento da criança

A patient safety toolkit for family practices

Objectives: Major gaps remain in our understanding of primary care patient safety. We describe a toolkit for measuring patient safety in family practices. Methods: Six tools were used in 46 practices. These tools were: NHS Education for Scotland Trigger Tool, NHS Education for Scotland Medicines Reconciliation Tool, Primary Care Safequest, Prescribing Safety Indicators, PREOS-PC, and Concise Safe Systems Checklist. Results: PC-Safequest showed that most practices had a well-developed safety climate. However, the Trigger Tool revealed that a quarter of events identified were associated with moderate or substantial harm, with a third originating in primary care and avoidable. Although medicines reconciliation was undertaken within 2 days in >70% of cases, necessary discussions with a patient/carer did not always occur. The prescribing safety indicators identified 1,435 instances of potentially hazardous prescribing or lack of recommended monitoring (from 92,649 patients). The Concise Safe Systems Checklist found that 25% of staff thought their practice provided inadequate follow-up for vulnerable patients discharged from hospital and inadequate monitoring of non-collection of prescriptions. Most patients had a positive perception of the safety of their practice although 45% identified at least one safety problem in the past year. Conclusions: Patient safety is complex and multidimensional. The Patient Safety Toolkit is easy to use and hosted on a single platform with a collection of tools generating practical and actionable information. It enables family practices to identify safety deficits that they can review and change procedures to improve their patient safety across a key sets of patient safety issues

What is different about living alone with cancer in older age? A qualitative study of experiences and preferences for care

Background: Increasing numbers of older patients with advanced cancer live alone but there is little research on how well health services meet their needs. The aim of this study was to compare the experiences and future preferences for care between two groups of older people with cancer in their last year of life; those who live alone, and those who live with co-resident carers. Methods: In-depth qualitative interviews were conducted with 32 people aged between 70 and 95 years who were living with cancer. They were recruited from general practices and hospice day care, when the responsible health professional answered no to the question, of whether they would be surprised if the patient died within twelve months. Twenty participants lived alone. Interviews were recorded and transcribed and the data analysed using a Framework approach, focussing on the differences and commonalities between the two groups. Results: Many experiences were common to all participants, but had broader consequences for people who lived alone. Five themes are presented from the data: a perception that it is a disadvantage to live alone as a patient, the importance of relational continuity with health professionals, informal appraisal of care, place of care and future plans. People who lived alone perceived emotional and practical barriers to accessing care, and many shared an anxiety that they would have to move into a care home. Participants were concerned with remaining life, and all who lived alone had made plans for death but not for dying. Uncertainty of timescales and a desire to wait until they knew that death was imminent were some of the reasons given for not planning for future care needs. Conclusions: Older people who live alone with cancer have emotional and practical concerns that are overlooked by their professional carers. Discussion and planning for the future, along with continuity in primary care may hold the key to enhancing end-of-life care for this group of patients

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Using surveillance data to determine treatment rates and outcomes for patients with chronic hepatitis C virus infection

The aim of this work was to develop and validate an algorithm to monitor rates of, and response to, treatment of patients infected with hepatitis C virus (HCV) across England using routine laboratory HCV RNA testing data. HCV testing activity between January 2002 and December 2011 was extracted from the local laboratory information systems of a sentinel network of 23 laboratories across England. An algorithm based on frequency of HCV RNA testing within a defined time period was designed to identify treated patients. Validation of the algorithm was undertaken for one center by comparison with treatment data recorded in a clinical database managed by the Trent HCV Study Group. In total, 267,887 HCV RNA test results from 100,640 individuals were extracted. Of these, 78.9% (79,360) tested positive for viral RNA, indicating an active infection, 20.8% (16,538) of whom had a repeat pattern of HCV RNA testing suggestive of treatment monitoring. Annual numbers of individuals treated increased rapidly from 468 in 2002 to 3,295 in 2009, but decreased to 3,110 in 2010. Approximately two thirds (63.3%; 10,468) of those treated had results consistent with a sustained virological response, including 55.3% and 67.1% of those with a genotype 1 and non-1 virus, respectively. Validation against the Trent clinical database demonstrated that the algorithm was 95% sensitive and 93% specific in detecting treatment and 100% sensitive and 93% specific for detecting treatment outcome. Conclusions: Laboratory testing activity, collected through a sentinel surveillance program, has enabled the first country-wide analysis of treatment and response among HCV-infected individuals. Our approach provides a sensitive, robust, and sustainable method for monitoring service provision across Englan