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排序方式： 共有150条查询结果，搜索用时 48 毫秒
91.
Objective
Parental abandonment is part of trajectory discontinuity during the placement of foster children and adolescents. In addition to a deleterious experience suffered before placement, parental abandonment is considered as variable linked to emotional regulation (coping strategies and temperament dimensions) of children and adolescents in foster family.Population and methods
The population is made up of 232 children and adolescents aged 7 to 16 years. Among them, 115 without maltreatment and live in their family unit (control group) and 117 victims of maltreatment and live in foster family. Of these, 97 have regular contact with their parents (not abandoned group) and 20 have had no contact for at least one year (abandoned group). Each young people answered to a scale measuring the frequency of coping strategies (Kidcope) as well as a questionnaire of temperament (Questionnaire d’auto et d’hétéro-évaluation du tempérament en sept facteurs pour l’enfant d’âge scolaire et l’adolescent). The emotional regulation of children and adolescents belonging to “not abandoned” and “abandoned” groups has been examined from the angle of the frequency coping strategies and temperament. Scores comparison was made with children and adolescents of the same age who have not been maltreated (control group). They constitute a normative reference.Results
The results show that absence or presence of parent/child relation is linked to temperamental aspect but not to coping strategies. The comparison of abandoned and not abandoned groups with the control group shows that social avoidance is particularly increased among abandoned children. Fear of being judged by others seems to be exacerbated. However, a strong motor activity and compliance with adult rules and a low concentration characterize children in not abandoned group. These observations could be explained by the fact that abandoned children are more likely to benefit from the placement and are more likely to take advantage of the resources provided by the foster family. It may be assumed that because of their abandonment, abandoned children allow themselves to find a stability and emotional security in the family assistant, which helps them to recover psychically and thus to adjust the representation that they make of the authority of adults. This security base helps them to overcome this abandonment situation and they can raise more.Conclusion
In the light of the theory of attachment, this study highlights the importance of trajectories favoring resource persons as a point of reference and emotional anchoring of abandoned children. 相似文献92.
E. Toussaint A. Florin B. Schneider F. Bacro 《Neuropsychiatrie de l'enfance et de l'adolescence》2018,66(6):335-343
Introduction
Many studies show the high prevalence of behavioral problems in foster children (Bronsard et al., 2016). In the literature, various factors have been associated with behavioral problems, including disorganized attachment (Fearon et al., 2010) and placement disruptions (Barth et al., 2007). The objective of this research is to examine the relationships between these variables and to determine whether the disorganization of attachment representations mediates the relationship between behavior problems and placement courses.Methods
The study was conducted with children aged 4–10 years placed in child welfare institutions. Children's behavior problems were assessed by social workers using the CBCL Questionnaire (Achenbach et al., 1991) and their attachment representations were explored with the Attachment Story Completion Task (Bretherton et al., 1990).Results
The results confirm the mediating role of the disorganization of attachment representations in the relationship between externalizing problems and the number of foster places.Conclusion
These results bring a better understanding of relationships between child behavioral problems, attachment and placement pathways in child welfare, and consider implications for practice and research. 相似文献93.
目的评价超声引导下经颈内静脉穿刺置管术的成功率及可行性。方法将一次性中心静脉导管在超声引导下经颈内静脉穿刺留置于上腔静脉末端,共112例。结果一针穿刺置管成功率为100%。结论该方法提高了穿刺准确性,减少了反复穿刺给患者带来的痛苦,值得推广和应用。 相似文献
94.
95.
Alberto Repossini Lorenzo Di Bacco Bruno Passaretti Herko Grubitzsch Christina Schäfer Benjamin Claus Laura Giroletti Thierry Folliguet Gianluigi Bisleri Theodor Fischlein Giuseppe Santarpino Roberto Di Bartolomeo François Laborde Claudio Muneretto 《The Journal of thoracic and cardiovascular surgery》2017,153(3):549-558.e3
Objective
Stentless aortic valves have been developed to overcome obstructive limitations associated with stented bioprostheses. The aim of the current multi-institutional study was to compare hemodynamics of transcatheter (TAVR) and the Freedom SOLO Stentless (FS) valve in an intermediate risk population undergoing surgical aortic valve replacement.Methods
From 2010 to 2014, 420 consecutive patients underwent isolated surgical aortic valve replacement with FS and 375 patients underwent TAVR. Only patients with intermediate operative risk (Society of Thoracic Surgeons score 4-10) and small aortic annulus (≤23 mm) were included. After a propensity matched analysis 142 patients in each group were selected. Thirty-day postoperative clinical and echocardiographic parameters were evaluated.Results
Mean prosthesis diameter was 22.2 ± 0.9 mm for FS and 22.4 ± 1.0 mm for TAVR. In-hospital mortality was 2.1% for FS and 6.3% for TAVR (P = .02). Postoperative FS peak gradients were 19.1 ± 9.6 mm Hg (mean 10.8 ± 5.9 mm Hg); TAVR peak gradients were 20.2 ± 9.5 mm Hg (mean 10.7 ± 6.9 mm Hg) P = .57 (P = .88). Postoperative effective orifice area was 1.93 ± 0.52 cm2 for FS and 1.83 ± 0.3 cm2 for TAVR (P = .65). There was no prostheses-patient mismatch in either group. Postoperative grade 2-3 paravalvular leak was present in 3.5% for TAVR and 0.7% for FS. Postoperative permanent pacemaker implant rate was 12% for TAVR and only 1 case (0.7%) in the FS group (P < .001).Conclusions
In patients with small aortic annulus and intermediate risk, both FS and TAVR demonstrated similar excellent hemodynamic performance. TAVR demonstrated greater mortality and rates of pacemaker insertion. Further studies are warranted to validate TAVR indications in this subset of patients. 相似文献96.
Stent and leaflet stresses in a 26-mm first-generation balloon-expandable transcatheter aortic valve
Yue Xuan Kapil Krishnan Jian Ye Danny Dvir Julius M. Guccione Liang Ge Elaine E. Tseng 《The Journal of thoracic and cardiovascular surgery》2017,153(5):1065-1073
Objective
Transcatheter aortic valve replacement is established therapy for high-risk and inoperable patients with severe aortic stenosis, but questions remain regarding long-term durability. Valve design influences durability. Increased leaflet stresses in surgical bioprostheses have been correlated with degeneration; however, transcatheter valve leaflet stresses are unknown. From 2007 to 2014, a majority of US patients received first-generation balloon-expandable transcatheter valves. Our goal was to determine stent and leaflet stresses in this valve design using finite element analyses.Methods
A 26-mm Sapien Transcatheter Heart Valve (Edwards Lifesciences, Inc, Irvine, Calif) underwent high-resolution microcomputed tomography scanning to develop precise 3-dimensional geometry of the leaflets, the stent, and the polyethylene terephthalate elements. The stent was modeled using 3-dimensional elements and the leaflets were modeled using shell elements. Stent material properties were based on stainless steel, whereas those for leaflets were obtained from surgical bioprostheses. Noncylindrical Sapien valve geometry was also simulated. Pressure loading to 80 mm Hg and 120 mm Hg was performed using ABAQUS finite element software (Dassault Systèmes, Waltham, Mass).Results
At 80 mm Hg, maximum principal stresses on Sapien leaflets were 1.31 megaspascals (MPa). Peak leaflet stress was observed at commissural tips where leaflets connected to the stent. Maximum principal stresses for the stent were 188.91 MPa and located at stent tips where leaflet commissures were attached. Noncylindrical geometry increased peak principal leaflet stresses by 16%.Conclusions
Using exact geometry from high-resolution scans, the 26-mm Sapien Transcatheter Heart Valve showed that peak stresses for both stent and leaflets were present at commissural tips where leaflets were attached. These regions would be prone to leaflet degeneration. Understanding stresses in first-generation transcatheter valves allows comparison to future designs for relative durability. 相似文献97.
许静 《国际医药卫生导报》2017,23(9)
目的 探讨采用腹腔镜切除术联合左炔诺孕酮宫内缓释系统治疗子宫腺肌症的临床疗效.方法 在2014年9月至2016年5月期间本院收治的子宫腺肌症患者中选取84例,所有患者均采用腹腔镜切除术联合左炔诺孕酮宫内缓释系统进行治疗,同时根据左炔诺孕酮宫内缓释系统的放置时间不同将其分为同步组和延迟组,对所有患者治疗前其月经量、子宫体积、痛经等临床症状变化情况进行观察分析.结果 84例患者经治疗后,其子宫体积、痛经程度、月经量[分别为(75.6±27.9) cm3、(1.3±0.9分)(72.4±18.5)分]均较术前[(192.9±85.0) cm3、(7.2±1.5)分、(217.2±87.7)分]明显改善,差异均有统计学意义(均P＜ 0.05);同步组与延迟组在术后不同时期相关指标比较差异无统计学意义(P＞0.05),但前者节育器相关并发症发生率(33.33％)明显高于后者(11.90％),差异有统计学意义(P＜0.05).结论 采用腹腔镜切除术联合左炔诺孕酮宫内缓释系统治疗子宫腺肌病可有效促进患者临床症状的改善,在术后1个月左右延迟放置节育器可取得较好的稳定性,有助于减轻患者不必要的痛苦,促进左炔诺孕酮作用的稳定发挥. 相似文献
99.
目的探讨食管癌手术的患者置入胃管和鼻肠管的最佳时机。方法100例食管癌手术患者随机分为两组：麻醉后置管组、麻醉前置管组。麻醉后置管组均在全身麻醉气管插管后、摆置手术体位前留置胃管和鼻肠管,麻醉前置管组均在麻醉前留置胃管和鼻肠管。结果两组患者在舒适度、护理操作的难度和时间、置管首次的成功率、患者置管出现的各种并发症等方面差异有极显著性（P〈0．01）。结论食管癌手术患者留置胃管、鼻肠管置入的最佳时机在全身麻醉气管插管后、摆置手术体位前。 相似文献
100.
A survey of 246 pre-registration nursing students in a University in the South West of England was carried out to explore the impact of course related travel on the student experience. Results from the survey indicated that students’ main mode of transport to practice placements was by car which reflects the rural nature of the South West and the relative paucity of public transport. Long distances that many students travel to their study centre and to placements, and the concurrent financial strain that this creates, impacted negatively on the student experience. Students recognised the need to travel to a place of study and clinical placements and suggestions of minimising the negative impact of travel were offered. These included the increased use of electronic delivery of lectures, attendance at local university premises, the provision of shared transport to placements and placements closer to the student’s home. Few students, however, considered the environmental impact of travel. Higher Education Institutions need to address issues of sustainability through promoting student wellbeing and taking steps to reduce greenhouse gas emissions. It is therefore important that student awareness of sustainability related issues is increased as well as focusing on reducing the environmental impact through organisational change. 相似文献