Analysis of the Psychometric Properties of a Parental Alienation Scale

The development of forensic evaluation scales is fundamental. This study's purpose was to explore the psychometric properties of a parental alienation scale. Forensic technicians completed 193 scales concerning parents involved in a lawsuit: 48 families with at least one parent indicated as the alienator (group A) and 48 families with no parental alienation claim (group B). The scale consisted of five categories and 69 items: denying access to the child; derogatory comparisons; emotional manipulation; behavior of parent and child during assessment. The results show Cronbach's alpha = .965 and split-half = .745; KMO = .884 and Bartlett's sphericity test ( p < .001). Concurrent criterion validity applied to data showed that the scale is able to distinguish between the alienator and target parent. The results showed significant and consistent standards in the instrument's psychometric characteristics.El desenvolvimiento de medidas de evaluación forense de alienación parental es fundamental. El objetivo de la investigación fue identificar propiedades psicométricas de una escala de alienación parental. Técnicos forenses (193) calificaron escalas de padres involucrados en demanda judicial: estos pertenecían a 48 familias con al menos uno de los padres identificado como alienador (grupo A) y 48 familias sin pretensión de alienación parental (grupo B). La escala consistió en cinco categorías y 69 ítems: evitar, difamar, manipulación emocional, padre e hijo en la evaluación. Los resultados mostraron un alfa de Cronbach = 0,965 y = 0,745 media de split; KMO = 0,884 y el teste de esfericidad de Bartlett ( p < 0,001). El análisis discriminante mostró que la escala es capaz de discriminar entre padres alienadores y alienados. Los resultados mostraron niveles significativos y consistentes en las características psicométricas del instrumento.O desenvolvimento de instrumentos de avaliação forense da alienação parental é fundamental. O objetivo da pesquisa foi investigar as propriedades psicométricas da escala de alienação parental. Foram respondidas 193 escalas sobre genitores em processo judicial por técnicos forenses: 48 famílias com ao menos um dos genitores apontados como alienador parental (grupo A) e 48 famílias sem alegação de alienação parental (grupo B). A escala foi composta por cinco categorias e 69 itens: impedir, difamar, manipulação emocional, genitor na avaliação e criança na avaliação. Os resultados mostraram alfa de Cronbach = 0,965 e split half = 0,745; KMO = 0,884 e o teste de esfericidade de Bartlett ( p < 0,001). A validade de critério concorrente aplicada aos dados mostrou que a escala é capaz de discriminar entre genitores alienadores e alvo. Os resultados apontaram padrões consistentes e significativos nas características psicométricas do instrumento

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Analysis of the Psychometric Properties of a Parental Alienation Scale

Abstract The development of forensic evaluation scales is fundamental. This study's purpose was to explore the psychometric properties of a parental alienation scale. Forensic technicians completed 193 scales concerning parents involved in a lawsuit: 48 families with at least one parent indicated as the alienator (group A) and 48 families with no parental alienation claim (group B). The scale consisted of five categories and 69 items: denying access to the child; derogatory comparisons; emotional manipulation; behavior of parent and child during assessment. The results show Cronbach's alpha = .965 and split-half = .745; KMO = .884 and Bartlett's sphericity test ( p < .001). Concurrent criterion validity applied to data showed that the scale is able to distinguish between the alienator and target parent. The results showed significant and consistent standards in the instrument's psychometric characteristics

Nursing teachers in clinical training areas: a phenomenological focus El docente de enfermería en los campos de práctica clínica: un enfoque fenomenológico O docente de enfermagem nos campos de prática clínica: um enfoque fenomenológico

During theoretical and practical activities in clinical training areas, nursing teachers provide the bases needed for the development of future professionals. The goal is to understand the experience of nursing teachers with nursing students in clinical training areas. Therefore, a phenomenological qualitative method was chosen, and Martin Heidegger&#39;s philosophical framework was used to support data analysis. Five faculty from a Chilean university participated in the study. The analysis permitted discovering the following themes: being a faculty at the hospital, contact with nurse practitioners and being a faculty in care teaching. The study demonstrated that teaching/care integration is a constructive element that facilitates the teaching and learning process, aiming to prepare nursing professionals who incorporate the bases of authentic care into their activities.<br>El docente de enfermería en el desarrollo de las actividades teórico-prácticas en los campos de práctica clínica proporciona las bases necesarias para el desarrollo del futuro profesional. El objetivo propuesto es comprender la vivencia de los docentes de enfermería junto a los estudiantes de enfermería, en los campos de práctica clínica. Para ello se optó por una metodología cualitativa fenomenológica, y para fundamentar el análisis de los datos, se utilizó el marco filosófico de Martín Heidegger. Cinco docentes de una universidad de Chile participaron del estudio. El análisis posibilitó descubrir los siguientes temas: ser docente en el hospital, la convivencia con enfermeras clínicas y ser docente en la enseñanza del cuidado. El estudio demostró que la integración docente/asistencial es un elemento constructivo y facilitador del proceso de enseñanza y aprendizaje, que busca la formación de profesionales de enfermería que incorporen en su actuación las bases de un cuidado auténtico.<br>No desenvolvimento das atividades teórico-práticas nos campos de prática clínica, o docente de enfermagem proporciona as bases necessárias para o desenvolvimento do futuro profissional. O objetivo proposto foi compreender a vivência dos docentes de enfermagem, junto aos estudantes de enfermagem, nos campos de prática clínica. Para isso, optou-se por metodologia qualitativa fenomenológica e, para fundamentar a análise dos dados, foi adotado o referencial filosófico de Martin Heidegger. Cinco docentes de uma universidade do Chile participaram do estudo. A análise possibilitou descobrir os seguintes temas: ser docente no hospital, a convivência com enfermeiras clínicas e ser docente no ensino do cuidado. O estudo demonstrou que a integração docente/assistencial é elemento construtivo e facilitador do processo ensino/aprendizagem, buscando a formação de profissionais da enfermagem que incorporem, na sua atuação, as bases de cuidado autêntico