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Marion Feldman Mayssa’ El Husseini Elisabetta Dozio Elise Drain Rahmeth Radjack Marie Rose Moro 《Child Care in Practice》2019,25(2):215-226
ABSTRACTClose observation of the interactions between a traumatised mother and her infant son provides information on the modes of transmission of psychic trauma in the mother–infant dyad. Following the presentation of a current literature review on the theme, the subject of “radioactive residue” and counter-transference in the transmission of psychic trauma from mother to infant will be illustrated through a clinical case study that focuses on a Haitian mother and her two-year-old infant son who has been referred to a “transitional care nursery” in urban Paris. The encounter with this mother–infant dyad is analysed through observing the quality of the interactions that take place between the mother and infant in order to determine how a particularly traumatic narrative impacts the mother–infant relationship, in addition to relations with the clinician. Mother and infant respond to one another through the emission and reception of “radioactive residues” as hypothesized by Gampel. This clinical case study shows that there is a need to consider transcultural factors and collective experience and history when analysing traumatic events. Additionally, the case study shows that counter-transference can be an effective clinical tool for gaining access to an infant's experience as the recipient of a traumatic narrative. 相似文献
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动脉导管未闭(PDA)是早产儿常见疾病,目前早产儿PDA的自然发展过程仍未完全明确,PDA发生的有些高危因素仍存在争议,对PDA是否进行药物、手术干预,以及何时进行药物、手术干预仍存在争议。尽管已经有相当多的证据证实动脉导管持续开放可能有害,但目前尚缺乏关闭导管治疗方案的远期益处或害处的相关证据。大多数临床试验旨在评估短期导管开放对患儿的影响。目前尚无评估动脉导管持续开放对早产儿死亡率及并发症影响的临床试验。近年来PDA治疗上最大的变化是减少对PDA的治疗。该文重点总结胎龄28周早产儿PDA的治疗策略。 相似文献
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Very preterm children are at increased risk of reduced processing speed at 5 years of age,predicted by typical complications of prematurity and prenatal smoking
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《Health & place》2019
The objective of this paper was to assess the link between premature mortality and a combination of neighbourhood contextual (environmental and health) and compositional (socioeconomic and demographic) characteristics. We statistically and spatially examined six environmental variables (ultrafine particles, carcinogenic and non-carcinogenic pollutants, pollution released to air, tree cover, and walkability index), six health service indicators (number health providers, breast, colorectal and cervical cancer screening uptake rates, student nutrition program uptake rates, and healthy food index), and eight socioeconomic indicators (total income, Gini coefficient, two age categories – below and above 40 years, proportion of females to males, visible minorities, Indigenous peoples, education, less than grade 9) among 140 neighbourhoods of the City of Toronto in Ontario (Canada). We applied principal component analysis to identify patterns and to reduce the number of explanatory variables into combined component axes that represent unique variation in these confounded and overlapping factors. We then applied regression analysis to model the relationship between the indices of enviro-health and socioeconomics and their potential relationship with premature mortality. Residual spatial analysis was used to investigate any remaining spatial structure (such as neighbourhoods with higher residual premature mortality rates). Neighbourhood Equity Index was correlated with our enviro-health and socioeconomic indices. Premature mortality within neighbourhoods was predicted by poor cancer screenings, pollution, lack of tree canopy, increased uptake of student nutrition programs and high walkability index. A negative association between premature mortality and pollution was associated low walkability index and presence of visible minorities within neighbourhoods. There was some unexplained residual spatial variation in our model of premature mortality - especially along the shores of Lake Ontario and in neighbourhoods with major highways or road corridors: premature mortality in Toronto neighbourhoods was higher than expected along highway-corridor neighbourhoods and shorelines. Our analysis revealed a significant relationship between neighbourhood contextual features – both environmental and health – and premature mortality, suggesting that these contextual components of neighbourhoods can predict rates of urban premature mortality in Toronto. 相似文献
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目的 探讨新生儿肺部超声在早产儿肺部感染评价中的价值。
方法 选取肺部感染早产儿80例为观察组,无肺部感染的早产儿80例为对照组,均给予新生儿肺部超声检查,比较2组肺部超声评分、氧合指数、呼吸指数,比较观察组不同病情、预后患儿肺部超声评分、氧合指数、呼吸指数,分析肺部超声评分和氧合指数、呼吸指数的相关性。
结果 观察组肺部超声评分、氧合指数低于对照组,呼吸指数高于对照组,差异有统计学意义(P<0.05)。观察组极危重患儿肺部超声评分、氧合指数低于危重和非危重患儿,呼吸指数高于危重和非危重患儿,危重患儿肺部超声评分、氧合指数低于非危重患儿,呼吸指数高于非危重患儿,差异有统计学意义(P<0.05)。肺部超声评分与呼吸指数呈负相关(r=-0.455,P<0.05),与氧合指数呈正相关(r=0.470,P<0.05)。观察组死亡患儿肺部超声评分、氧合指数低于存活患儿,呼吸指数高于存活患儿,差异有统计学意义(P<0.05)。肺部超声评分预测患儿预后的ROC曲线下面积为0.874,高于呼吸指数和氧合指数(P<0.05),其截断值为20分时,敏感度和特异度为88.50%和75.00%。
结论 新生儿肺部超声在早产儿肺部感染评价中有较好的效果,值得临床使用。 相似文献
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《Heart, lung & circulation》2019,28(10):1463-1471
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目的 研究胎膜早破孕妇生殖道感染情况及对妊娠结局的影响。方法 选择2014年5月至2015年1月住院分娩的胎膜早破孕妇70例为早破组,同期无胎膜早破70例为对照组,检测两组生殖道病原微生物感染情况,并比较两组的妊娠结局。结果 早破组生殖道感染阳性率高于对照组,且剖宫产率,母体发生产后出血,绒毛膜羊膜炎,胎儿窘迫及新生儿窒息发生率均高于对照组,差异均有统计学意义(P<0.05)。结论 生殖道感染是胎膜早破最常见的诱因,积极筛查及治疗孕妇生殖道感染可以减少相关产科并发症的发生。 相似文献