Mode of Delivery and Maternal Sensitivity: Effects on the Socioemotional Development of Children at One Year of Age / Tipo de parto y sensibilidad materna: Efectos en el desarrollo socioemocional de niños y niñas al año de edad

Abstract Early childhood is a period of high relevance in children's socioemotional development, establishing the basis for future development. Acquisitions during the first year of life are significant predictors of future social and emotional skills. During this period, maternal sensitivity is also essential, and there is evidence regarding its effects on the socioemotional development of the child. Considering the relevance of this competence, together with the global and national increase in cesarean rates and the possible risks associated with the type of delivery experienced, the influence of the type of delivery and the maternal sensitivity in child's socioemotional development at one year of age was analyzed. For this, an intentional non-probabilistic sample of 91 mothers with their respective children of different socioeconomic levels, who attended public or private nurseries in the city of Santiago, Chile, was studied. The instruments used were the Adult Sensitivity Scale (ESA) and the Functional Emotional Assessment Scale (FEAS). The results showed no differences in the children's socioemotional development according to the type of delivery. However, it was possible to observe an association between a higher maternal sensitivity and a more significant socioemotional development on children at one year of age. The implications of promoting maternal sensitivity are discussed to support optimal socioemotional development in infants.

Resumen La infancia temprana es un periodo de gran relevancia en el desarrollo socioemocional infantil; de hecho, es donde se sientan las bases del desarrollo futuro. En este sentido, las adquisiciones durante el primer año de vida son predictores importantes de las habilidades sociales y emocionales futuras, de modo que la sensibilidad materna, según evidencia respecto a sus efectos en el desarrollo socioemocional del niño, ha demostrado ser un aspecto fundamental durante este periodo. Teniendo esto en cuenta, y considerando la relevancia de dicha competencia, así como el alza mundial y nacional en las tasas de cesárea y los posibles riesgos asociados al tipo de parto vivenciado, el presente estudio tuvo como objetivo analizar la influencia de la sensibilidad materna y del tipo de parto en el desarrollo socioemocional infantil al año de edad. Para ello, se estudió una muestra no probabilística intencionada de 91 madres con sus respectivos hijos o hijas -de distinto nivel socioeconómico- que asistían a salas cuna públicas o privadas en la ciudad de Santiago, Chile, por medio de dos instrumentos: la escala de sensibilidad del adulto (ESA) y la functional emotional assessment scale (FEAS). En general, los resultados no mostraron diferencias en el desarrollo socioemocional de los niños según el tipo de parto, aunque sí se pudo apreciar una relación entre una mayor sensibilidad materna y un mayor desarrollo socioemocional de los niños al año de edad. Al final se discuten las implicaciones de promover la sensibilidad materna con el fin de apoyar un óptimo desarrollo socioemocional en los infantes.

Patrones de apego en la infancia temprana en muestras normativas, contextos de cuidado alternativo, e infancia de alto riesgo / Patterns of attachment in early infancy in normative samples, alternative caregiving systems, and high risk infants

INTRODUCCIÓN: La evidencia de las últimas décadas ha demostrado que el apego temprano es un proceso vital para la comprensión, prevención e intervención de la salud mental y física de las personas. Sin embar go, es escasa la información sobre el comportamiento del sistema de apego en la realidad chilena. OBJETIVO: Describir la distribución de los estilos de apego en poblaciones de niños bajo diferentes tipos de cuidado. SUJETOS Y MÉTODO: A través de un método descriptivo retrospectivo, se evaluaron 714 díadas madre-bebé (de 1 a 36 meses) seleccionadas al azar y de modo intencionado, a través de los procedimientos de la Situación Extraña, Escala de Apego durante Stress (ADS), y la Escala de Relación Profesor-Alumno. Las muestras provinieron de familias normativas seleccionadas al azar, infantes de salas de cuna y jardines infantiles JUNJI, e infantes de los centros CONIN y en condiciones de privación de libertad junto a sus madres. RESULTADOS: Las 6 muestras provenien tes de 6 estudios demuestran el espectro del comportamiento de los estilos de apego en diversas condiciones: un 70% seguro y 30% inseguro, y un 51,1% seguro y 48.9% inseguro en muestras normativas; un 48,5% de seguridad y un 51,5% de inseguridad en cuidado alternativo y; un 39,6% de seguridad y 60,4% inseguridad, y 25% de estilos seguros y 75% inseguros en muestras de alto riesgo. CONCLUSIÓN: El estudio presenta interesantes evidencias sobre las distribuciones de apego en la infancia, que permiten reflexionar sobre la dispar realidad de la situación chilena en lo que a desarrollo socio-afectivo temprano.

INTRODUCTION: Scientific evidence gathered over the last decades has demonstrated that early attachment is a vital process for the understanding, prevention, and intervention of people's mental and physical health. However, information about the attachment system functioning in Chile is scarce. OBJECTIVE: To des cribe attachment styles distribution in populations of children under different types of care. SUBJECTS AND METHOD: Through a retrospective descriptive method, 714 mother-child pairs (1 to 36 months- old) selected at random and purposefully, were assessed using the Strange Situation Procedure, Atta chment during Stress Scale (ADS), and Student-Teacher Relationship Scale. The samples were collec ted from randomly selected normative families, infants attending JUNJI nurseries and kindergartens, and infants from CONIN centers and who live in prison with their mothers. RESULTS: The samples from six studies show the spectrum of the attachment system functioning in diverse conditions: 70% secure and 30% insecure, and 51.1% secure and 48.9% insecure in normative samples; 48.5% secure and 51.5% in secure in alternative care; 39.6% secure and 60.4% insecure, and 25% secure and 75% in secure styles in high-risk samples. CONCLUSION: the study presents interesting evidence on the atta chment distributions in childhood, which allow reflecting on the uneven Chilean reality with regard to early social and emotional development.

La imitación reconsiderada: Su función social en la infancia temprana / Imitation reconsidered: Its social function in early infancy

En el ámbito de la Psicología del Desarrollo, la imitación infantil ha sido un tema ampliamente estudiado, fundamentalmente, por su vinculación con la capacidad simbólica. Sin embargo, en los últimos 50 años su abordaje teórico y metodológico se ha diversificado profundamente. Se ha provocado un giro en cómo conceptualizar la imitación, desde un enfoque individual que destaca su valor en el desarrollo cognitivo y simbólico, hasta uno que entiende que la imitación infantil y los efectos de ser imitado están estrechamente vinculados con el desarrollo de las habilidades sociales y de la comunicación. El presente artículo recorre este giro partiendo de una breve presentación de la perspectiva de la imitación en la teoría piagetiana, la cual destaca el valor epigenético de esta capacidad en la formación simbólica del niño. Luego, se sintetizan los resultados obtenidos en los estudios sobre imitación neonatal, imitación en interacciones espontáneas adulto-bebé, interacciones entre pares y los efectos de ser imitado. En conjunto, estos datos permitieron reconceptualizar la capacidad de imitación, destacando su aspecto social y su función en el establecimiento de las primeras conexiones interpersonales entre el bebé y sus congéneres. Con vistas a construir una teoría integradora, se propone concebir a ambos enfoques como complementarios y entender a la imitación como una actividad que permite establecer coincidencias interpersonales, las cuales generan algún tipo de encuentro intersubjetivo que sirve para vehiculizar distintas funciones de acuerdo al contexto de interacción.

Infant imitation is a controversial topic that has been widely studied in the field of developmental psychology. In the last decades, since Piagetian theory of infant imitation, the research on it has been revolutionized. This article intends to review a set of studies on imitation in early infancy that have caused a change in the understanding of this phenomenon. In this review, Piaget's description of the development of imitation and its relationship to symbolic formation are set as a starting point. Piaget's theory has made an essential contribution to the study of imitation: it highlights its importance in development of symbolic function; it stimulated the realization of numerous longitudinal studies, promoted the development of techniques and observation systems for its evaluation in psychology labs, and led to the generation of different assessment scales of psycho-motor child development. However, experimental studies that demonstrated the ability of imitation in newborns have questioned Piagetian developmental theory of imitation and they revolutionized the understanding of the phenomenon. Data on neonatal imitation, which have received different theoretical interpretations, bring out that certain intra and intersensory coordination exist from the first month of life; that the capacity for imitation is selective; that its sequence of development is different from that proposed by Piaget and shows different evolutionary paths depending on the act in question. Beyond experimental studies, early imitation has also been studied in natural contexts. The data show that during the first two years of life, imitation is a frequent pattern of social interaction between adult and baby, providing a pleasant experience to both participants. In that context, imitation is not only bi-directional, but it is the adult who imitated more frequently. Such data suggest that the ability to imitate actions does not appear in development as a product of an exclusively individual process; but, on the contrary, is a capacity that gradually emerges in the context of social patterns of baby-adult reciprocity as a result of the communicative intentions of the latter. Also, imitation is an important relationship tool when the participants interacting are similar in age. There are several studies showing that young children use imitation as a basic way to interact and develop social and communication links between them, as well as to coordinate playful actions. Finally, experimental studies on the effects of being imitated indicate that adult imitation facilitates social interaction with the baby during the first two years of life. It causes greater visual attention from the baby, and more frequent smiles than a spontaneous interaction. Even it has been observed that babies are able to monitor adult imitation, testing it by modulating their behavior (for example, sudden stops or sudden changes in the direction of their behavior). Data from studies on neonatal imitation, spontaneous imitation in adult-baby interactions, peer interactions and the effects of being imitated have allowed reconceptualizing imitation, highlighting the social aspect and its role in the establishment of the first interpersonal connections between the baby and its congeners. All these new empirical evidence highlights the value of imitation in the establishment of social interactions in the early years of a child´s life, beyond their cognitive function of accommodation. In order to construct an integrative theory of imitation, it is proposed to conceive imitation as a matching activity through which emerges a social engagement that might serve to convey different functions according to the context of social interaction. It is suggested to carry out new longitudinal studies that investigate the contexts of interaction in which imitation events emerge, as well as the integration of the results of neurocognitive studies and Comparative Psychology.

Análisis de la representación de emociones en niños de 30 meses de edad: Relación con el temperamento y sexo del niño y capacidad de representar en los padres / Analysis of the ability to represent emotions in 30 months old children: Relationship with child's sex and temperament and parental ability to represent emotions

Resumen: La capacidad de representar emociones se comprende como la habilidad para producir movimientos faciales y corporales intencionalmente, para hacer "cómo si" se estuviera experienciando un determinado tipo de emoción. La presente investigación tuvo como objetivo describir la capacidad de representar emociones en niños de 30 meses de edad, y analizar cómo se relacionaba con el temperamento y sexo de los niños, así como con la capacidad de representar emociones en los padres. En el estudio participaron 80 niños junto a sus padres, con un diseño descriptivo, transversal y correlacional. Se aplicó el Early Childhood Behavior Questionnaire (ECBQ-VSF) para evaluar temperamento infantil, y una situación diseñada en el estudio para evaluar las representaciones de 6 emociones en adultos y niños; alegría, pena, rabia, miedo, orgullo y vergüenza. Los resultados mostraron que la capacidad de representar emociones en los niños a los 30 meses se relacionó solo con la dimensión de afecto negativo del temperamento, y la intensidad facial de la representación en los padres, más no así con el sexo de los niños.

Abstract: The ability to represent emotions is understood as the ability to produce facial and corporal movements intentionally, to do "as if" the person is experiencing a certain kind of emotion. The aim of this research was to describe the ability to represent.t emotions in 30 months old children, and analyze how this ability was related to the children's temperament and gender, as well as the ability to represent emotions in their parents. In the study participated 80 children with their parents, and the design was descriptive, transversal and correlational. The procedure included the Early Childhood Behavior Questionnaire (ECBQ-VSF) to assess children's temperament, and an experimental situation designed to assess the representation of 6 emotions in adults and children; happiness, sadness, anger, scare, pride and shame. The results showed that the ability to represent emotions in 30 months old children was related only with the negative affect dimension of temperament, and facial intensity to represent emotions on parents, but no relation was observed with children's gender.

Relación de la autorregulación infantil con sensibilidad materna y contexto familiar a los 12 y 30 meses de edad / Relationship between children self-regulation, maternal sensitivity and family context at 12 and 30 months of age

La autorregulación se refiere a la capacidad del niño/a para modificar su conducta según las demandas del entorno. Esta presenta una gran influencia en el desarrollo infantil, especialmente en el ámbito social. Desde una mirada evolutiva, la autorregulación, como característica temperamental, depende de factores tanto biológicos como contextuales, donde las figuras parentales juegan un rol determinante. En el siguiente estudio se analizó la relación entre la sensibilidad de la madre cuando el niño/a tenía 12 meses y la autorregulación de este tanto a los 12 como a los 30 meses de edad, para examinar si la sensibilidad materna predice la autorregulación infantil a los 30 meses. Además se incluyeron variables del contexto familiar, como tipo de familia, tipo de hijo/a y NSE. La muestra incluyó 72 diadas madre-hijo/a, con un diseño descriptivo, longitudinal, comparativo y correlacional. Se aplicó la Escala de Sensibilidad del Adulto (E.S.A.), un cuestionario sociodemográfico y los cuestionarios de temperamento IBQ-R-VSF y ECBQ-VSF. Los resultados muestran una relación significativa entre la autorregulación de los infantes a los 12 meses, con el tipo de hijo/a que son, y la interacción entre NSE y sensibilidad de las madres. A los 30 meses, en cambio, además de la autorregulación a los 12 meses, solo resulta ser un predictor significativo el tipo de hijo/a. Se discuten las implicancias de los resultados.

Self-regulation refers to the capacity of a child to modify his or her behavior according to environmental demands. It strongly influences child's development, especially in the social sphere. From an evolutionary point of view, self-regulation, viewed as a temperamental characteristic, depends on biological and environmental factors, where the parental figures of the child play a crucial role. In the following study, an analysis of the relationship between mother's sensitivity when her child was 12 months old and the child's self-regulation at 12 months and 30 months of age was made. This was done to analyze if mother's sensitivity predicts child's self-regulation at 30 months of age. Also variables related to the family context were included, considering type of family, type of child and SES. The sample included 72 mother-child dyads, with a descriptive, longitudinal, comparative and correlational design. The Adult Sensitivity Scale, a socio-demographic questionnaire and the temperament questionnaires IBQ-R-VSF and ECBQ-VSF were used to obtain the data. The results show that there is a significant relationship between infants' self-regulation at 12 months, the type of child, and the interaction between SES and maternal sensitivity. At 30 months of age instead, additionally to the self-regulation at 12 months, only the type of child is a significant predictor. Further implications of these results are discussed

Percepción materna del desarrollo socioemocional infantil: relación con temperamento infantil y sensibilidad materna / Maternal perception of infant socio-emotional development: Relationship with infant temperament and maternal sensitivity

Resumen Debido al rápido crecimiento en las habilidades sociales y emocionales tempranas, variaciones significativas en el desarrollo socioemocional comienzan tempranamente y pueden hacerse más fuertes a través del tiempo. Además, variables individuales y familiares pueden contribuir a incrementar estas diferencias entre niños de una misma edad. Este estudio examina la relación entre la percepción materna del desarrollo socioemocional infantil a los 12 meses de edad con la sensibilidad materna, el sexo y temperamento infantil, y el nivel socioeconómico familiar, y analiza cuál de estas variables predice dicha percepción. Un total de 90 niños y niñas fueron evaluados con sus madres al año de edad, con la Escala Social Emocional (Bayley), el Infant Behavior Questionnaire (IBQ-R-VSF), la Evaluación de Sensibilidad del Adulto (ESA) y un cuestionario sociodemográfico. Los resultados mostraron que el mejor predictor de la percepción materna del desarrollo socioemocional infantil a esta edad era el temperamento del niño, específicamente la dimensión de extraversión.

Abstract Because of the rapid growth in early social and emotional skills, significant variations in socioemotional development begin early and may become stronger over time. In adittion, individual and family variables may contribute to increase these differences among children of the same age. This study examined the relationship between maternal perception of infants' social-emotional development at 12 months of age, maternal sensitivity, child's gender and temperament, and family's socioeconomic status, and analyzes which of these variables predict such perception. 90 boys and girls were assessed with their mothers at 1 year old with Bayley Social Emotional Scale, Infant Behavior Questionnaire (IBQ-R-VSF), Adult's Sensitivity Assessment (ESA), and a socio-demographic questionnaire. Results showed that the best predictor of maternal perception of infant socio-emotional develop-ment at this age was the child's temperament, specifically the dimension of extraversion.

¿Afectan las complicaciones perinatales la respuesta sensible de las madres hacia sus hijos/as de 12 meses? / Do adverse pregnancy outcome affect mothers’ sensitive response to their 12 month children?

La respuesta sensible es una competencia materna ampliamente estudiada por su influencia en el desarrollo infantil y su asociación con las características de la madre, pero en menor medida se ha investigado su relación con las dificultades durante la gestación y el parto. El presente estudio busca identificar la influencia de las complicaciones perinatales sobre la sensibilidad materna en 90 diadas madre-hijo/a entre diez y catorce meses de edad de nivel socioeconómico alto, medio y bajo, residentes en Santiago de Chile. Se aplicó un cuestionario sociodemográfico y las diadas fueron filmadas en una situación de juego libre, la cual fue codificada con la Escala de Sensibilidad del adulto (E.S.A.). Los resultados muestran que la ausencia de complicaciones en el embarazo de la madre y la presencia de complicaciones en el parto, explican una mayor sensibilidad materna un año después. Se observa, además, una influencia significativa del nivel socioeconómico sobre la sensibilidad materna. Se discuten estos resultados y sus implicancias.

Sensitive response is a maternal competence widely studied for its influence in child development, and for its relationship with mother features, however, there is fewer research on its relationship to the difficulties of pregnancy and childbirth. This study seeks to identify the influence of adverse pregnancy outcome on maternal sensitivity in 90 dyads mother-child between ten and fourteen months age, of high, medium and low socioeconomic status, residents in Santiago, Chile. A sociodemographic questionnaire was taken to mothers, and dyads were filmed in a free play situation, which was coded with the Sensitivity Adult Scale (ESA). Results show that absence of difficulties during pregnancy on the mother, as well as presence of them during labor, explain a higher maternal sensitivity one year later. In addition, a significant influence of socioeconomic status on maternal sensitivity had been observed. These results and their implications are discussed.

Primera infancia y discapacidad en Chile: revisión y enfoque actual a los programas de gobierno / Early childhood and disability in Chile: review and current approach to government programs

En el presente artículo se realiza una revisión acerca de la Primera Infancia en situación de discapacidad en Chile, se abordarán los programas de gobierno que existen, su actual enfoque y se analizará si las soluciones que ofrecen son pertinentes y eficientes para este importante grupo de niños y niñas. El trabajo toma como marco de referencia la Convención sobre los Derechos del Niño y la Convención sobre los Derechos de las Personas en Situación de Discapacidad, con el fin de evaluar el estado de los derechos de estos niños y si los programas de gobierno garantizan lo convenido en ambas convenciones.

In this article we review the current Chilean government programs about early childhood with disability. The current focus of these programs will be addressed in order to analyze whether the solutions they provide are relevant and efficient for this significant group of children. This article takes as a reference the Convention on the Rights of the Child and the Convention on the Rights of Persons with disability, to assess the state of the rights of these children and whether government programs guarantee what is enshrined in both conventions.

Clínica dos primórdios e processos de simbolização primários / Clinic of the early infancy and the primary processes of symbolization / Clínica de los comienzos y los procesos de simbolización primarios

A reflexão sobre a clínica dos primórdios nos permite revisitar as concepções psicanalíticas sobre a constituição do sujeito e ressaltar a importância das relações intersubjetivas na constituição do psiquismo, apontando para uma articulação entre a dimensão pulsional e a qualidade das relações entre sujeito e objeto no início da vida. Neste texto, procuramos ampliar a noção de representação para nela incluir as experiências sensoriais e não verbais do bebê, visto que a subjetividade se constrói ao longo de um processo cujo elemento fundamental é a experiência compartilhada com o outro. As contribuições de R. Roussillon e A. Green apontam para dois elementos que devem se articular para favorecer os processos de simbolização primários: a qualidade de presença continente e sensível do objeto, assim como a importância da constituição do negativo, resultante do apagamento do objeto primário e de sua transformação em estrutura enquadrante. Assim, se a presença do objeto é imprescindível para possibilitar a representação de sua ausência, o trabalho do negativo é igualmente fundamental para permitir a instauração dos limites entre interno/externo e entre as instâncias psíquicas.

The discussion on the clinic of the early infancy makes it possible to review classical psychoanalytic conceptions about the constitution of the subject and to emphasize the importance of the intersubjective relations in the beginning of the psychic life, indicating an important relationship between the drive theory and the early object relations. The paper aims to broaden the notion of representation to include the sensory and non-verbal communication between the baby and his primary objects, based on the fact that the process of subjectivation is constructed through the experiences that are shared between the infant and his primary others. The contributions of R. Roussillon and A. Green indicate that the quality of early interactions are extremely important to facilitate the representation of the absence of the object. Thus, the symbolizing function of the object is at the same time the constitution of its affective presence as well as its capacity to become a containing structure through the work of the negative.

La reflexión sobre los primeros días nos permite revisitar los puntos de vista del psicoanálisis en la constitución del sujeto y destacamos la importancia de las relaciones interpersonales en la constitución de la psique, que apunta a una relación entre la dimensión de la unidad de calidad e de las relaciones entre sujeto y objeto a temprana edad. En este trabajo se busca ampliar la noción de representación a fin de incluir las experiencias sensoriales y no verbales del bebé, ya que la subjetividad se construye sobre un proceso cuyo elemento clave es la experiencia compartida con los demás. Las contribuciones de R. Roussillon y A. Green a dos elementos que deben ser articulados para favorecer los procesos de simbolización tempranos: la calidad del continente y la presencia sensible del objeto, así como la importancia de la constitución de lo apagamiento del objeto que resulta do trabajo del negativo y su transformación en la estructura encuadrante. Por lo tanto, la presencia del objeto es esencial para permitir la representación de su ausencia, el trabajo del negativo es también esencial para permitir el establecimiento de límites entre interior / exterior y entre instancias psíquicas.

Febrile Urinary Tract Infection in Infants Less than Two Months of Age : Characteristics and Factors Related to the Recurrence

PURPOSE: The aim of this study is to characterize and to investigate the factors related to the recurrence of febrile urinary tract infection (UTI) in infants less than 2 months of age. METHODS: We performed a retrospective study in 60 infants, who were treated for the first febrile UTI. Among them, 27 infants were followed for 12 months, and were reviewed concerning the factors related to the recurrence. The factors compared for the recurrence included sex, age at diagnosis, laboratory and radiologic findings like degree of the reflux and renal cortical defect. RESULTS: Among the 60 infants studied, 52 were male (86.7%). Age at diagnosis was 39+/-13 days. The most common pathogen was E.coli (71.7%). The infants underwent an ultrasonography (n=59), DMSA scan (n=55), and voiding cystourethrography (VCUG). Further hydronephrosis, renal cortical defect, vesicoureteral reflux (VUR) were found in 28 (47.4%), 12 (21.8%) and 11 (20.4%) infants, respectively. The hydronephrosis was found frequently in the recurrent UTI group (P=0.012). The VUR was found frequently, but not significantly, in therecurrent UTI group (44.4%) than that of the non-recurrent UTI group (16.7%). CONCLUSION: During the 12 months after the first febrile UTI, hydronephrosis increased the risk of recurrent UTI. The ultrasonography is needed during the follow up of UTI in infants less than two months of age.

A retrospective study on group B beta haemolytic streptococcal sepsis in early infancy.

Objectives To determine the incidence, clinical presentation and outcome of group B haemolytic streptococcal (GBS) sepsis Design, setting and method This was a two year retrospective observational analysis at Colombo South Teaching hospital. All clinically suspected and bacteriologically confirmed cases of GBS sepsis in infants up to three month of age were analysed. Data was obtained from individual clinical notes and records at the Department of Microbiology. Results There were 21 cases, an incidence of 1.06 per 1000 live births. Thirteen (62%) were male. Seven (33%) were premature. Thirteen (62%) were early onset and 08 (38%) were late onset. Main presenting features on admission were respiratory 11 (52%), poor activity/feeding 09 (43%) and fever 08 (38%). Complications were mainly neurological (48%) Mortality was 4.7 %.

Escala de evaluación parental (EEP): desarrollo, propiedades psicométricas y aplicaciones / Parental evaluation scale (EEP): development, psychometric properties and applications

La Escala de Evaluación Parental (EEP) es una medición autoadministrada para evaluar la satisfacción y sentimientos de autoeficacia respecto a la maternidad en mujeres con niños entre 0 y 2 años de edad. La EEP se compuso inicialmente de 20 ítems, los cuales fueron chequeados en 100 madres chilenas con hijos menores a 2 años. Se realizaron análisis de la validez de contenido de la escala y análisis discriminativo de los ítems. Los análisis demostraron una adecuada consistencia interna y el análisis factorial arrojó dos factores, que explican el 635 de la varianza. La versión final de la EEP considera 10 ítems y entrega un puntaje global de la autoeficacia materna en madres de infantes. Las evaluaciones preliminares de las propiedades psicométricas de la escala resultaron satisfactorias, pero requiere de posteriores análisis.

The Parental Evaluation Scale is a self-administered measure to assess satisfaction and self-efficacy feelings about motherhood in women with children aged 0-2 years. The EEP was initially composed of 20 items and was tested on 100 Chilean mothers with infants less that 12 months old. Contentvalidity analysis and discriminative analysis of the items was performed.The test demonstrated adequate internal consistency and factor analysisshowed two factors that explain the 63% of variance. The final version ofthe EEP has 10 items and gives a global score of the maternal self-efficacyin infants’ mothers. This preliminary test for the psychometric properties was acceptable; however, further analysis is suggested.

Clinical Features of Eosinophilic Colitis Developed in Early Infancy / 대한소아소화기영양학회지

PURPOSE: Eosinophilic colitis is a disease characterized by gastrointestinal symptoms, peripheral eosinophilia, eosinophilic infiltration of the colonic wall. The etiology and pathogenesis of this disease is not clear and it is considered to be idiopathic. This study aimed to ascertain the clinical features, treatment and prognosis of eosinophilic colitis in early infancy. METHODS: We reviewed 6 infants retrospectively, presented with bloody stool in early infancy, who were diagnosed with eosinophilic colitis in Pusan National University Hospital between August 2002 and February 2004. RESULTS: Five males and one female were included. The mean age when bloody stool was identified was 79.2+/-56.1 days (10~145 days). All but one infant with atopic dermatitis did not have other allergic diseases. Nobody had a family history of allergic disease. No specific dietary history in infants and their mothers related to food allergy was identified. Peripheral eosinophilia (total WBC count 11,763+/-3,498/mm3, eosinophils 17.0+/-4.3%, absolute eosinophil count 2,044+/-996/mm3) was observed in all infants. Colonoscopy in six infants revealed diffuse erythema, congestion and granulation pattern of mucosa in the rectosigmoid colon. Histopathologic findings of colononic biopsies showed chronic inflammation with severe eosinophilic infiltration in the mucosa. Two infants were treated with hydrolyzed casein-based formula and four infants with prednisolone. Gastrointestinal symptoms and peripheral eosinophilia resolved completely with prednisolone and partially with a hydrolyzed casein-based formula. Relapse was not observed during the follow-up period. CONCLUSION: Our study demonstrated that there is no evidence of a definite relationship between eosinophilic colitis and food-allergic disorders. Clinical course and prognosis of infantile form of eosinophilic colitis is very favorable and treatment with prednisone was effective.

Characteristics and Recurrence Risk Factors of Urinary Tract Infection in Early Infancy

PURPOSE AND METHODS: Urinary tract infection(UTI) is one of the most important diseases of childhood, especially for young infants. To characterize the patients diagnosed with febrile UTI in their first 6 months of life and to explore the risk factors of recurrent UTI, a retrospective study was performed. RESULTS: Among the 90 patients studied, 77 were boys(86%). First episodes of UTI were diagnosed at the age of 2.5+/-1.4 months. These patients underwent ultrasonographic evaluation of urinary tract(n=90) and voiding cystourethrography(n=81) where 53 and 35 studies showed abnormal findings respectively, and a total of 45 cases of urinary tract anomaly including vesicoureteral reflux(VUR, n=35) were diagnosed. Normal findings on ultrasonography indicated decreased risk of VUR in boys of 1-3 months of age(n=30). 53 patients were followed up more than 6 months and 45 episodes of subsequent UTI developed in 29 patients during the first 6-month period. Patients with relapse were older than patients without relapse at the diagnosis of first UTI, but other clinical parameters including abnormal findings on the imaging studies and prophylactic antibiotics prescription were not different between the two groups. CONCLUSION: UTI in early infancy occurred mainly in male infants and half of the patients had structural anomalies. USG was of clinical value in detecting anomalies requiring surgical intervention, and to rule out high grade VUR in 1-3 months old boys. Results of the imaging study or prophylactic antibiotics could not modify the risk of recurrent UTI.