A proposal for a brief-term post-adoption intervention in the attachment-perspective. A single case study with a late-adopted child and his adoptive mother

A growing body of attachment literature has focused on bridging the gap between research and clinical applications, even in clinical work with adoptive families. A brief-term clinical intervention focused on a multi-method assessment of attachment relationships and representations was performed in the first year after placement. This single case study aimed at analysing the attachment outcomes, through a long-term follow-up, both for the adoptive mother and her late-adopted son. We assumed that this five-session attachment oriented intervention could help the mother enhance her sensitivity skills and her ability to understand both her own past attachment experiences and her child’s insecure attachment as a consequence of the failures of his previous experiences of care, supporting her six year old child in acquiring a positive image of himself and of others and the security of the caregiver’s availability up to adolescence

Qualitative research in adolescent psychotherapy: attachment and reflective functioning as psychotherapy's outcomes of an adolescent with anorexia nervosa

The aim of this study was to examine both the change in attachment state of mind and mentalization competencies as outcomes of a two-year weekly psychodynamic psychotherapy of a female adolescent with anorexia nervosa. The Attachment Interview for Childhood and Adolescence (AICA) was administered at pre and post-treatment, and coded both with the attachment coding system and the Reflective Functioning (RF) scale. At the pre-treatment, the anorexic adolescent was assessed as insecure dismissing with very low level of RF, while in the post-treatment a secure attachment model and higher RF were highlighted. The AICA can be considered a useful method to assess the outcomes in adolescent psychotherapy, like the AAI is useful in adult psychotherapy

Conductas preventivas frente a traumatismos bucodentales : 4ta parte

Introducción: Los traumatismos alveolodentales son lesiones causadas por fuerzas que actúan sobre el órgano dentario y tejidos de sostén siendo diagnosticados a simple vista o radiográficamente. Estas afecciones se dan fundamentalmente en los niños y adolescentes, e incluyen la pérdida de piezas dentarias temporales y permanentes. Provocan además una disfunción que altera, de manera conjunta, la psicología del niño, la fonética, la masticación y la estética. Es considerada la segunda causa de atención odontológica que afecta a nuestra población infantil y juvenil, motivo por el cual se debe intervenir con el fin de evitar o disminuir la incidencia y prevalencia de los traumatismos dentales. Objetivos: Fomentar la educación para la salud bucal y la prevención de los traumatismos orales frecuentes en niños y adolescentes en escuelas de La Plata.Facultad de Odontologí

Conductas preventivas frente a traumatismos bucodentales : Acciones y prevención frente a accidentes bucodentales

Los traumatismos bucodentales son uno de los principales accidentes que afectan a nuestra población en las edades infantiles. Dado el riesgo a que están expuestos los niños en edad escolar, se lo considera un problema de interés odontológico, motivo por el cual se debe intervenir a través de acciones de promoción y prevención para la salud, con el fin de disminuir y evitar la incidencia de los traumatismos dentales.Facultad de Odontologí

Conductas preventivas frente a traumatismos dentales : Etapa 4

Los traumatismos alveolodentales son lesiones causadas por fuerzas que actúan sobre el órgano dentario y los tejidos de sostén siendo diagnosticados a simple vista o radiográficamente. Estas afecciones se dan fundamentalmente en los niños y adolescentes, e incluyen la pérdida de piezas dentarias temporales y permanentes. Provocan además una disfunción que altera, de manera conjunta, la psicología del niño, la fonética, la masticación y la estética. Son considerados como una urgencia dentro de la asistencia odontológica y deben ser diagnosticados y tratados de forma certera e inmediata por el odontólogo.Facultad de Odontologí

Qualitative research in adolescent psychotherapy: Attachment and Reflective Functioning as psychotherapy outcomes of an adolescent with anorexia nervosa

The aim of this study was to examine both the change in attachment state of mind and mentalization competencies as outcomes of a two-year weekly psychodynam-ic psychotherapy of a female adolescent with anorexia nervosa. The Attachment Inter-view for Childhood and Adolescence (AICA) was administered at pre and post-treatment, and coded both with the attachment coding system and the Reflective Func-tioning (RF) scale. At the pre-treatment, the anorexic adolescent was assessed as inse-cure-dismissing with very low level of RF, while in the post-treatment a secure attach-ment model and higher RF were highlighted. The AICA can be considered a useful method to assess the outcomes in adolescent psychotherapy, like the AAI is useful in adult psychotherapy

EFFECT OF OUABAIN BINDING ON THE FLUORESCENT PROPERTIES OF THE NA+/K+-ATPASE

The influence of occupancy by ouabain of its specific binding site on the stability and conformation of the Na+/K+-ATPase has been investigated. When native Na+/K+-ATPase is exposed to guanidinium chloride or diluted acid, tryptophanyl fluorescence falls to 50% of the initial value. If ouabain is bound, higher concentrations of GdmCl or acidity are needed to reach the same decrease in fluorescence. The rotational diffusion coefficient (relaxation time), shows higher values for the Na+/K+-ATPase (ouabain) complex compared to the enzyme alone, suggesting an increase in molecular asymmetry. This observation is confirmed by the Stern-Volmer analysis that shows an increase in the accessibility of the fluorophores in the Na+/K+-ATPase (ouabain) (KSV = 15.6 M-1) with respect to the native enzyme (KSV = 12.5 M-1). Iodine perturbation of the enzyme labelled with FITC, demonstrates a decrease in the accessibility of the fluorescein probe in the Na+/K+-ATPase(ouabain) (KSV = 4 M-1) compared to the Na+/K+-ATPase (KSV = 7 M-1) indicating that after ouabain binding this site of the enzyme is less exposed to the solvent, These data, in agreement with other reports, suggest an allosteric effect of ouabain binding on the Na+/K+-ATPase conformation. © 1988

Validity and reliability of the interpersonal competence questionnaire: empirical evidence from an italian study

Interpersonal competence is crucial to human life, and poor social functioning is a typical feature of various psychopathological conditions. Given the relevance of the construct, increasing attention has recently been paid to the Interpersonal Competence Questionnaire (ICQ; Buhrmester et al. 1988), a 40-item self-report measuring five domains of interpersonal competence. To provide additional data on the cross-cultural adaptability of the ICQ, we developed an Italian version and investigated its psychometric properties with two independent student samples. Respondents were mostly women (about three quarters), ranging in age from 18 to 57. Study 1 (n=408) tested factor structure, internal consistency, and convergent validity. Study 2 (n=59) investigated test-retest reliability. Taken together, the results of both these studies provided support for the cross-cultural applicability of the ICQ, and revealed interesting associations between interpersonal competence and constructs such as well-being, emotion dysregulation and empathy

Nasopharyngeal cancer: the impact of guidelines and teaching on radiation target volume delineation

Target volume delineation in the radiation treatment of nasopharyngeal cancer is challenging due to several reasons such as the complex anatomy of the site, the need for the elective coverage of definite anatomical regions, the curative intent of treatment and the rarity of the disease, especially in non-endemic areas. We aimed to analyze the impact of educational interactive teaching courses on target volume delineation accuracy between Italian radiation oncology centers. Only one contour dataset per center was admitted. The educational course consisted in three parts: (1) The completely anonymized image dataset of a T4N1 nasopharyngeal cancer patient was shared between centers before the course with the request of target volume and organs at risk delineation; (2) the course was held online with dedicated multidisciplinary sessions on nasopharyngeal anatomy, nasopharyngeal cancer pattern of diffusion and on the description and explanation of international contouring guidelines. At the end of the course, the participating centers were asked to resubmit the contours with appropriate corrections; (3) the pre- and post-course contours were analyzed and quantitatively and qualitatively compared with the benchmark contours delineated by the panel of experts. The analysis of the 19 pre- and post-contours submitted by the participating centers revealed a significant improvement in the Dice similarity index in all the clinical target volumes (CTV1, CTV2 and CTV3) passing from 0.67, 0.51 and 0.48 to 0.69, 0.65 and 0.52, respectively. The organs at risk delineation was also improved. The qualitative analysis consisted in the evaluation of the inclusion of the proper anatomical regions in the target volumes; it was conducted following internationally validated guidelines of contouring for nasopharyngeal radiation treatment. All the sites were properly included in target volume delineation by >50% of the centers after correction. A significant improvement was registered for the skull base, the sphenoid sinus and the nodal levels. These results demonstrated the important role that educational courses with interactive sessions could have in such a challenging task as target volume delineation in modern radiation oncology

Results of surgical aortic valve replacement and transapical transcatheter aortic valve replacement in patients with previous coronary artery bypass grafting

OBJECTIVES To evaluate the results of aortic valve replacement through sternotomic approach in redo scenarios (RAVR) vs transapical transcatheter aortic valve replacement (TAVR), in patients in the eighth decade of life or older already undergone previous coronary artery bypass grafting (CABG). METHODS One hundred and twenty-six patients undergoing RAVR were compared with 113 patients undergoing TaTAVR in terms of 30-day mortality and Valve Academic Research Consortium-2 outcomes. The two groups were also analysed after propensity-matching. RESULTS TaTAVR patients demonstrated a higher incidence of 30-day mortality (P = 0.03), stroke (P = 0.04), major bleeding (P = 0.03), worse 'early safety' (P = 0.04) and lower permanent pacemaker implantation (P = 0.03). TaTAVR had higher follow-up hazard in all-cause mortality [hazard ratio (HR) 3.15, 95% confidence interval (CI) 1.28-6.62; P < 0.01] and cardiovascular mortality (HR 1.66, 95% CI 1.02-4.88; P = 0.04). Propensity-matched patients showed comparable 30-day outcome in terms of survival, major morbidity and early safety, with only a lower incidence of transfusions after TaTAVR (10.7% vs RAVR: 57.1%; P < 0.01). A trend towards lower Acute Kidney Injury Network Classification 2/3 (3.6% vs RAVR 21.4%; P = 0.05) and towards a lower freedom from all-cause mortality at follow-up (TaTAVR: 44.3 \ub1 21.3% vs RAVR: 86.6 \ub1 9.3%; P =. 08) was demonstrated after TaTAVR, although cardiovascular mortality was comparable (TaTAVR: 86.5 \ub1 9.7% vs RAVR: 95.2 \ub1 4.6%; P = 0.52). Follow-up freedom from stroke, acute heart failure, reintervention on AVR and thrombo-embolisms were comparable (P = NS). EuroSCORE II (P = 0.02), perioperative stroke (P = 0.01) and length of hospitalization (P = 0.02) were the determinants of all-cause mortality at follow-up, whereas perioperative stroke (P = 0.03) and length of hospitalization (P = 0.04) impacted cardiovascular mortality at follow-up. CONCLUSIONS Reported differences in mortality and morbidity after TaTAVR and RAVR reflect differences in baseline risk profiles. Given the lower trend for renal complications, patients at higher perioperative renal risk might be better served by TaTAVR