Negligência afetiva e parentalidade : contributo(s) de pais e crianças para a elaboração de um programa de prevenção do risco na infância

A família é o primeiro grupo social e a primeira forma de relação social da criança. Assim, delega-se nesta um papel central no desenvolvimento do menor visto que o relacionamento familiar tem o papel central de construir o autoconceito e a autoestima, além de ter um impacto muito significativo nos seus comportamentos sociais, éticos, morais e cívicos. Numa organização familiar saudável os pais devem apresentar estilos parentais baseados no uso de atitudes positivas, assegurando assim as condições ideais ao desenvolvimento dos filhos. Se estas condições não se observarem, isto é, se não forem proporcionados à criança cuidados básicos, equilíbrio emocional e amor e, havendo recursos e possibilidades dos pais para o fazerem, estamos então perante uma situação de negligência (Monteiro, 2010). Este projeto surgiu da necessidade de compreender quais as representações que pais e crianças têm acerca da relação paterno-filial que estabelecem entre si ao nível dos estilos e das práticas parentais através da Escala de Estilos Parentais (Arnold, O’Leary, Wolff & Acker, 1993). Para isso recorremos a um grupo de 24 encarregados de educação e respetivos filhos de 4/5 anos que foram entendidos como participantes ativos no processo de investigação. Houve ainda a oportunidade de desenvolver uma adaptação pictográfica e do vocabulário da subescala utilizada ajustando-a às idades das crianças em causa. Os resultados apontam para alguns desfasamentos entre as representações dos pais relativamente às dos filhos. Os contributos obtidos, sustentam, por sua vez, a elaboração de um programa de prevenção do risco na infância.The family is the first social group and the first form of social relationship of the child. It has a central role in their development since the family relationship has a big importance in building the self-concept and self-esteem, and have a very significant impact on their social, ethical, moral and civic behavior. In a healthy family organization parents must submit parenting styles using positive attitudes, like this ensuring the optimal conditions for the development of the children. If these conditions are not observed, ie, if the child were not provided basic care, emotional balance, love, and parents have resources and possibilities, then we are facing of a situation of negligence (Monteiro, 2010). This project arose from the need of understand what representations that parents and children have about paternal-filial relationships established between them in level of styles and parenting practices through Parenting Styles Scale (Arnold, O'Leary, Wolff & Acker, 1993). For this we turn to a group of 24 parents and their respective children of 4/5 years old that were seen as active participants in the investigation process. There was also the opportunity to develop a pictographic adaptation and vocabulary of the subscale used adjusting it to the ages of the children concerned. The results point to some discrepancies between the representations between parents regarding their children. The contributions were made to sustain the development of a program of risk prevention in childhood

Parental alienation: when parents and children need help

As transformações sociais que têm levado à modificação da estrutura familiar, também têm, entre outras, estado associadas ao aumento de divórcios e às dificuldades dos pais em exercerem as suas responsabilidades parentais. Neste contexto, surgem problemas específicos, como é o caso da alienação parental, onde um dos progenitores, através de estratégias e manobras manipuladoras, denegrindo a imagem do outro, o procura excluir da vida do filho, destruindo o vínculo entre este a criança. Estas ações culminam muitas vezes em denúncias falsas de maus-tratos que tornam ainda mais relevante a sensibilização para esta problemática. Neste artigo situar-se-á o conceito de alienação parental, bem como as causas, manifestações e efeitos associados à sua prática.The social changes that are contributing to modifications in family structure are also, among others associated with an increase in divorces and difficulties in parenting. In this context, there are specific problems that arise such as parental alienation, where one of the parents, through manipulative strategies and maneuvers, tries to tarnish the image of the other, seeking to exclude him of child's life, destroying their bonding. Often, these actions can turn on false allegations of child abuse. For this reason it becomes even more important raising awareness on this issue. This article will focus the concept of parental alienation, as well as its causes, manifestations and effects that are associated with their practice.info:eu-repo/semantics/publishedVersio

Alienação Parental:: Quando Pais e Crianças Necessitam de Ajuda

As transformações sociais que têm levado à modificação da estrutura familiar, também têm, entre outras, estado associadas ao aumento de divórcios e às dificuldades dos pais em exercerem as suas responsabilidades parentais. Neste contexto, surgem problemas específicos, como é o caso da alienação parental, onde um dos progenitores, através de estratégias e manobras manipuladoras, denegrindo a imagem do outro, o procura excluir da vida do filho, destruindo o vínculo entre este a criança. Estas ações culminam muitas vezes em denúncias falsas de maus-tratos que tornam ainda mais relevante a sensibilização para esta problemática. Neste artigo situar-se-á o conceito de alienação parental, bem como as causas, manifestações e efeitos associados à sua prática

Parental alienation: when parents and children need help

The social changes that are contributing to modifications in family structure are also, among others, associated with an increase in divorces and difficulties in parenting. In this context, there are specific problems that arise such as parental alienation, where one of the parents, through manipulative strategies and maneuvers, tries to tarnish the image of the other, seeking to exclude him of child's life, destroying their bonding. Often, these actions can turn on false allegations of child abuse. For this reason it becomes even more important raising awareness on this issue. This article will focus the concept of parental alienation, as well as its causes, manifestations and effects that are associated with their practice

How to choose the appropriate cannulation technique for vascular access in hemodialysis patients

The cannulation technique is important for the survival of the arteriovenous access. Choosing the appropriate technique is a complex decision. Such choice must be customized to patients, considering their characteristics, the type of arteriovenous access and the experience of the hemodialysis team. We describe seven items that can help nurses to identify the appropriate cannulation technique: type of arteriovenous access; drainage vein; hygienic self-care profile; experience of the nursing staff in the cannulation technique and nurse-to-patient ratio; hemodialysis treatment method; patient's condition; and patient's decision. Such items can help nurses in decision-making on the "ideal" cannulation technique for each patient.info:eu-repo/semantics/publishedVersio

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved

Proceedings Of The 23Rd Paediatric Rheumatology European Society Congress: Part Two

PubMe

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit