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1.
Infancy ; 25(1): 84-109, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32632344

RESUMO

Infants adopted domestically from foster care often present with prenatal substance exposure and risky birth outcomes such as prematurity and low birth weight. Because few longitudinal studies of foster-adoptive infants exist, it is unclear how these preplacement risk factors influence development over time. The present study examined associations between perinatal risk factors and developmental outcomes among an ethnically/racially-diverse sample of 97 infants in foster-care (56% boys) placed into adoptive homes at ages 0-19 months. Relative to population-norms, foster-adoptive infants showed comparable cognitive but lower language and motor functioning at baseline and one-year follow-up. Age-adjusted language scores significantly improved one year following placement, consistent with a developmental "catch-up" effect. Low birth weight uniquely predicted lower language scores at baseline, but this association was no longer significant at follow-up. Prenatal substance exposure was associated with lower baseline cognitive scores, but only for infants placed after six months of age. In contrast, infants with low birth weight and later placement age (>12 months) showed the most accelerated motor development. Sex differences emerged at follow-up when predicting motor and language outcomes, suggesting potential sex-specific pathways of risk. Overall, results support adoption as an early intervention that may buffer vulnerability to perinatal risk on development.


Assuntos
Adoção , Desenvolvimento Infantil , Deficiências do Desenvolvimento , Cuidados no Lar de Adoção , Fatores Etários , Intervenção Educacional Precoce , Feminino , Humanos , Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Desenvolvimento da Linguagem , Estudos Longitudinais , Homens , Fatores de Risco , Fatores Sexuais
2.
Child Abuse Negl ; 110(Pt 3): 104437, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32151429

RESUMO

BACKGROUND: School-based trauma-informed care (TIC) represents a novel way of supporting children with trauma histories. However, minimal research has focused on how TIC impacts teacher wellbeing, which is concerning given the relationship between occupational stress and turnover from education. OBJECTIVE: This study investigated teacher characteristics associated with perceived effectiveness of TIC and intent to leave education. PARTICIPANTS AND SETTING: The study included 163 teachers in underserved elementary schools serving a high percentage of low-income, English-language learner Latinx students. METHODS: Teachers completed a survey regarding an ongoing TIC program and quality of life for helping professionals. RESULTS: Higher compassion satisfaction and secondary traumatic stress (STS), as well as lower burnout, were associated with perceived effectiveness of TIC. Older teachers, and those with lower compassion satisfaction and higher burnout, were more likely to report intentions to leave education. STS and perceived effectiveness of TIC were not associated with turnover intent. CONCLUSIONS: Results suggest that teacher occupational wellbeing, particularly compassion satisfaction, plays a role in buy-in to TIC and retention among teachers.


Assuntos
Esgotamento Profissional/epidemiologia , Fadiga de Compaixão/epidemiologia , Empatia , Intenção , Satisfação Pessoal , Professores Escolares/psicologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reorganização de Recursos Humanos , Pobreza/etnologia , Avaliação de Programas e Projetos de Saúde , Qualidade de Vida , Inquéritos e Questionários , Capacitação de Professores
3.
Am J Community Psychol ; 64(3-4): 389-404, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31617588

RESUMO

Pediatric medical traumatic stress (PMTS) is common among injured/ill children and is associated with elevated distress, treatment non-adherence, and poor health outcomes. As survivorship of life-threatening pediatric injury and illness continues to increase alongside rapid medical advancements, rates of PMTS and negative sequelae are expected to grow; however, research on prevention and treatment of PMTS is limited. The current study sought to systematically review the literature using a developmental framework to highlight research gaps. Sixteen peer-reviewed studies were identified via a systematic literature search. Consistent with best practices for treatment of childhood trauma, caregiver involvement and CBT principles served as the foundation for most interventions. All studies reported improvements in PMTS; however, among the most methodologically rigorous, few found statistically superior reductions in PMTS between intervention and control groups. While many studies focused on a specific developmental stage and discussed developmental considerations, others took a "one-size-fits" approach. Interventions that demonstrated the most promising findings were online, self-guided, or time-limited. Future research would benefit from expanding diversity of participants, continuing to evaluate novel delivery methods, and integrating developmental considerations along with trauma-informed care (TIC) approaches, given their useful framework for understanding child traumatic stress responses and avenues for prevention and treatment.


Assuntos
Pediatria , Ferimentos e Lesões/terapia , Terapia Cognitivo-Comportamental , Pesquisa Empírica , Prática Clínica Baseada em Evidências , Humanos
5.
Schizophr Bull ; 43(3): 620-632, 2017 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-27539951

RESUMO

Metabolic dysfunction and microvascular abnormality may contribute to the pathogenesis of schizophrenia. Most previous studies of cerebral perfusion in schizophrenia measured total cerebral blood volume (CBV) and cerebral blood flow (CBF) in the brain, which reflect the ensemble signal from the arteriolar, capillary, and venular compartments of the microvasculature. As the arterioles are the most actively regulated blood vessels among these compartments, they may be the most sensitive component of the microvasculature to metabolic disturbances. In this study, we adopted the inflow-based vascular-space-occupancy (iVASO) MRI approach to investigate alterations in the volume of small arterial (pial) and arteriolar vessels (arteriolar cerebral blood volume [CBVa]) in the brain of schizophrenia patients. The iVASO approach was extended to 3-dimensional (3D) whole brain coverage, and CBVa was measured in the brains of 12 schizophrenia patients and 12 matched controls at ultra-high magnetic field (7T). Significant reduction in grey matter (GM) CBVa was found in multiple areas across the whole brain in patients (relative changes of 14%-51% and effect sizes of 0.7-2.3). GM CBVa values in several regions in the temporal cortex showed significant negative correlations with disease duration in patients. GM CBVa increase was also found in a few brain regions. Our results imply that microvascular abnormality may play a role in schizophrenia, and suggest GM CBVa as a potential marker for the disease. Further investigation is needed to elucidate whether such effects are due to primary vascular impairment or secondary to other causes, such as metabolic dysfunction.


Assuntos
Arteríolas/diagnóstico por imagem , Volume Sanguíneo Cerebral/fisiologia , Substância Cinzenta/irrigação sanguínea , Substância Cinzenta/diagnóstico por imagem , Transtornos Psicóticos/diagnóstico por imagem , Esquizofrenia/diagnóstico por imagem , Adulto , Biomarcadores , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade
6.
Schizophr Res ; 172(1-3): 101-5, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26925800

RESUMO

The extent of age-related changes in glutamate and other neurometabolites in the anterior cingulate cortex (ACC) in individuals with schizophrenia remain unclear. Magnetic resonance spectroscopy (MRS) at 7 T, which yields precise measurements of various metabolites and can distinguish glutamate from glutamine, was used to determine levels of ACC glutamate and other metabolites in 24 individuals with schizophrenia and 24 matched controls. Multiple regression analysis revealed that ACC glutamate decreased with age in patients but not controls. No changes were detected in levels of glutamine, N-acetylaspartate, N-acetylaspartylglutamic acid, myo-inositol, GABA, glutathione, total creatine, and total choline. These results suggest that age may be an important modifier of ACC glutamate in schizophrenia.


Assuntos
Envelhecimento/metabolismo , Ácido Glutâmico/metabolismo , Giro do Cíngulo/metabolismo , Transtornos Psicóticos/metabolismo , Esquizofrenia/metabolismo , Adulto , Antipsicóticos/uso terapêutico , Ácido Aspártico/análogos & derivados , Ácido Aspártico/metabolismo , Colina/metabolismo , Creatina/metabolismo , Dipeptídeos/metabolismo , Feminino , Glutamina/metabolismo , Glutationa/metabolismo , Humanos , Inositol/metabolismo , Masculino , Espectroscopia de Prótons por Ressonância Magnética/instrumentação , Transtornos Psicóticos/tratamento farmacológico , Esquizofrenia/tratamento farmacológico , Ácido gama-Aminobutírico/metabolismo
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