ABSTRACT
OBJECTIVES: Traumatic amputation of the ear constitutes a great aesthetic deformity that can have a tremendous negative impact. Reports describing the survival of near-complete ear amputation using non-microsurgical replantation are scarce. We aimed to study the surgical outcome of patients with near-complete ear amputations supplied by small pedicle bridges that were treated with primary reattachment. METHODS: We retrospectively studied patients with near-complete ear amputation who were admitted at Al Ain Hospital from January 2016 to December 2019. RESULTS: Five patients were studied. The most common mechanism of injury was motor vehicle injury, followed by cutting injury. The skin pedicle was inferior in 3 (60%) patients of patients. The median width of the skin pedicles was 8.5 mm. The median interval between the injury and the surgical management was 4 hours. All patients underwent primary reattachment of the ear without microsurgery. One patient developed a small area of necrosis of the ear lobe. All patients recovered with a completely healed pinna and satisfactory overall appearance. CONCLUSIONS: Primary reattachment without microsurgery of the near-complete ear amputation can be safely performed in the presence of an intact skin pedicle. It can achieve an aesthetically satisfactory outcome without severe complications.
Subject(s)
Amputation, Traumatic , Humans , Retrospective Studies , Amputation, Traumatic/surgery , Replantation , Ear, External/injuries , Microsurgery , Amputation, SurgicalABSTRACT
OBJECTIVES: Research into adolescent mental health has tended to focus on primary attachment relationships. However, the effect of secondary attachment relationships and the role of culture remain under-explored. This study examined the associations between primary attachment, secondary attachment, and coping strategies (task-focused, emotion-focused, and avoidant coping) with psychological well-being and psychological distress in adolescents across two cultural settings. DESIGN: A cross-sectional study. METHOD: An identical test battery was used across two geographic sites in Pakistan (N = 510; 12-18 years; 51.5% male; mean age = 14.50) and Scotland (N = 610; 12-18 years; 53.6% male; mean age = 13.97). Associations were tested separately in each sample using moderated mediation modelling for the outcome variables: psychological well-being and psychological distress. RESULTS: For psychological well-being, all three coping strategies were significant partial mediators and secondary attachment was a significant moderator in both samples. Secondary attachment moderated the association between emotion-focused coping and psychological well-being in the Pakistani sample only. For psychological distress, task-focused coping was a significant full mediator in the Pakistani sample only. In contrast, for the Scottish sample, task-focused coping and emotion-focused coping were significant partial mediators. Secondary attachment's direct effect on psychological distress was significant in both samples. Secondary attachment also moderated the association between emotion-focused coping and psychological distress in the Pakistani sample only. CONCLUSIONS: The cross-cultural evidence suggests that alongside primary attachment, it is important to target secondary attachment through coping strategies, in order to enhance psychological well-being and lessen psychological distress in adolescents. PRACTITIONER POINTS: Secondary attachment plays a different role from primary attachment in adolescents. Therefore, it is important to target both primary attachment and secondary attachment security to enhance psychological well-being and lessen psychological distress. Cross-cultural differences in coping suggest that differential strategies to target different coping dimensions may enhance adolescent well-being across cultures. These cross-cultural differences highlight the ethical importance of cultural sensitivity among clinicians working with adolescents globally.
Subject(s)
Adaptation, Psychological , Mental Health , Adolescent , Cross-Sectional Studies , Female , Humans , Male , Pakistan , Scotland , Surveys and QuestionnairesABSTRACT
O presente artigo buscou: 1) descrever e comparar: a) a qualidade do vínculo entre o bebê-mãe e bebê-educadora, aos nove e aos doze meses de idade; b) a percepção do temperamento do bebê pelas mães e pelas educadoras e, 2) correlacionar os indicadores de vinculação com os escores obtidos nas escalas de temperamento. Participaram nove bebês e suas respectivas mães e duas educadoras. Mães e educadoras responderam a escala de temperamento e foram filmadas individualmente com os respectivos bebês, aos nove e aos doze meses. Os resultados indicaram a presença de vinculação primária com a mãe e secundária com a educadora, ambas satisfatórias. Houve correlações negativas entre temperamento difícil do bebê e comportamentos interativos maternos. Embora o vínculo mãe-bebê seja mais forte, a qualidade estabelecida com as educadoras sugere que a transição para a educação infantil pode ser positiva.
This paper aims: 1) to describe and to compare: a) the quality of the bond between a baby-mother and a baby-educator, at nine and twelve months old; b) the perception of the babies' temperament by mothers and by educators and, 2) c) to correlate the bonding indicators with scores in temperament scales. Participated nine babies, their mothers and two teachers. Mothers and educators answered the temperament scale and were filmed individually with their respective babies, at nine and twelve months. The results indicated the presence of a primary bond with the mother and a secondary bond with the educator, both satisfactory. There were negative correlations between the baby's difficult temperament and maternal interactive behaviors. Although the mother-baby bond is stronger, the quality established with the educators suggests that the transition to early childhood education can be positive.
El presente artículo buscó: 1) describir y comparar: la calidad del vínculo entre el bebé y su madre y su educadora, a los nueve y doce meses de vida; b) la percepción del temperamento del bebé según las madres y según las educadoras y, c) correlacionar las categorías de conductas de vinculación a los resultados obtenidos en las escalas de temperamento. Participaron nueve bebés y sus respectivas madres y dos educadores. Madres y educadores respondieron a la escala de temperamento y fueron filmadas individualmente con sus respectivos bebés, a los nueve y doce meses. Los resultados indicaron la presencia de vinculación primaria con la madre y secundaria con la educadora, ambas satisfactorias. Hubo correlaciones negativas entre el temperamento difícil del bebé y los comportamientos interactivos maternos. Aunque el vínculo madre-bebé es más fuerte, la calidad establecida con los educadores sugiere que la transición a la educación de la primera infancia puede ser positiva
Subject(s)
Psychology, Child , Infant, Newborn , Mothers/psychologyABSTRACT
Staphylococcus epidermidis is a usually harmless commensal bacterium highly abundant on the human skin. Under defined predisposing conditions, most importantly implantation of a medical device, S. epidermidis, however, can switch from a colonizing to an invasive life style. The emergence of S. epidermidis as an opportunistic pathogen is closely linked to the biofilm forming capability of the species. During the past decades, tremendous advance regarding our understanding of molecular mechanisms contributing to surface colonization has been made, and detailed information is available for several factors active during the primary attachment, accumulative or dispersal phase of biofilm formation. A picture evolved in which distinct factors, though appearing to be redundantly organized, take over specific and exclusive functions during biofilm development. In this review, these mechanisms are described in molecular detail, with a highlight on recent insights into multi-functional S. epidermidis cell surface proteins contributing to surface adherence and intercellular adhesion. The integration of distinct biofilm-promoting factors into regulatory networks is summarized, with an emphasis on mechanism that could allow S. epidermidis to flexibly adapt to changing environmental conditions present during colonizing or invasive life-styles.
