Behavior development of preterm infants in the first year of life

Este artigo apresenta uma investigação do comportamento de 21 bebês prematuros (de 33 a 36 semanas de gestação), de 1 a 12 meses, realizada no Hospital da Universidade de São Paulo, Brasil, utilizando a Escala de Desenvolvimento do Comportamento da Criança - EDCC. Os resultados mostraram que os prematuros, a partir do 3º mês apresentaram uma recuperação importante no rítmo de desenvolvimento do comportamento, reduzindo de modo estatisticamente significante a frequência de comportamentos com indicadores patológicos, mas mantendo um fator de risco de 23% de comportamentos não-normalizados aos 12 meses incompletos. Este estudo contribui com elementos que podem favorecer o acompanhamento do processo de desenvolvimento do comportamento destas crianças e na detecção precoce de atrasos ou possíveis distúrbios neste processoThis article presents a research about the behavior development of 21 preterm babies (between 33 and 36 weeks of pregnancy), from 1 to 12 months old, at the Hospital of the University of São Paulo, in Brazil, using the Child Behavior Development Scale - CBDS. The results showed that the preterm infants had an important improvement in the behavior development rhythm after the 3rd month of age, reducing in a statistically significant way the behaviors with pathological signs, but maintaining risk factors in 23% of non-normalized behaviors at 12 months of age. This study provides elements that can help the follow-up of the behavior development process of these children and the early detection of delays or possible disorders in that process

Development of a Clinical Attitude In Undergraduate Clinical Practice.

Neste artigo visamos destacar aspectos que consideramos fundamentais para o processo de ensino/aprendizagem em Psicologia Clínica, baseados na nossa experiência como supervisores da disciplina de psicodiagnóstico para estagiários da graduação em Psicologia. Delineamos nossa sistemática de trabalho na disciplina, que segue um referencial psicanalítico e enfocamos particularmente a questão da formação da atitude clínica do estagiário em relação ao cliente. Procuramos mostrar as inter-relações da mesma com o enquadramento de trabalho e com o processo de formação da identidade profissional do psicólogo, enfatizando o papel da supervisão. Apontamos a necessidade de novos estudos e pesquisas, bem como de discussões entre supervisores, psicólogos e estudantes, sobre assuntos tais como o processo de ensino/aprendizagem clínicos e a habilitação de psicólogos para o exercício clínico.In this paper, we highlight aspects we consider fundamental in the clinical teaching/learning process, according to our experience as supervisors of psychological assessment (we point out that in Brazil this clinical practice takes place during undergraduate studies). After presenting our outline of work, which follows a psychoanalytical approach, we focus particularly on the student's development of a clinical attitude toward the patient. We show its connections with the establishment o f the clinical setting and the process o f acquiring a professional identity. The ultimate role of the supervision, in these aspects, is also emphasised. Further research, as well as discussions among supervisors and psychologists, are necessary, regarding issues like the process of clinical teaching/learning and also the licensing of psychologists

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Search for dark matter produced in association with bottom or top quarks in √s = 13 TeV pp collisions with the ATLAS detector

A search for weakly interacting massive particle dark matter produced in association with bottom or top quarks is presented. Final states containing third-generation quarks and miss- ing transverse momentum are considered. The analysis uses 36.1 fb−1 of proton–proton collision data recorded by the ATLAS experiment at √s = 13 TeV in 2015 and 2016. No significant excess of events above the estimated backgrounds is observed. The results are in- terpreted in the framework of simplified models of spin-0 dark-matter mediators. For colour- neutral spin-0 mediators produced in association with top quarks and decaying into a pair of dark-matter particles, mediator masses below 50 GeV are excluded assuming a dark-matter candidate mass of 1 GeV and unitary couplings. For scalar and pseudoscalar mediators produced in association with bottom quarks, the search sets limits on the production cross- section of 300 times the predicted rate for mediators with masses between 10 and 50 GeV and assuming a dark-matter mass of 1 GeV and unitary coupling. Constraints on colour- charged scalar simplified models are also presented. Assuming a dark-matter particle mass of 35 GeV, mediator particles with mass below 1.1 TeV are excluded for couplings yielding a dark-matter relic density consistent with measurements