In this study the stability over the first 13 months of life of measures of infant cardiac activity (heart period and heart-period variability), their relations with each other, and their relations with a continuous-variable index of infant-mother attachment were investigated. The indexes of cardiac activity changed in an orderly way with development (increasing heart-rate variability, decreasing heart rate). There were moderate to high intercorrelations among the cardiac measures, particularly those indexing heart-rate variability (i.e., vagal tone, heart-period variance, and heart-period range). Regression analyses showed that the measures of heart-rate variability at 3,6, and 9 months were significant predictors of the continuous-variable index of security. The higher the infants' heart-rate variability, the higher were their attachment insecurity scores. Analyses of whether the conventional secure/insecure classification was related to the early infant cardiac measures indicated that measures of heart-rate variability were significantly higher in the insecure children.Recently, researchers have investigated the relation between attachment classification and measures of temperament (Belsky & Rovine, 1987; Bretherton, CConnell, &Tracey, 1980;Miyake, Chen, & Campos, 1985). This research has demonstrated a relation between concurrent measures of temperament and attachment and suggests that temperament, assessed during early infancy, may be a reliable predictor of attachment classification. For example, Miyake et al. (1985) reported that infant irritability measured at 3 months of age was predictive of patterns of resistant behavior during reunion in the strange situation at 1 year. These findings suggest that temperament may contribute significantly to the prediction of the quality of attachment.Neurophysiological processes may underlie the construct of temperament and mediate aspects of the relation between temperament and attachment. Contemporary theoretical perspectives have conceptualized temperament as a psychobiological construct (e.g., Goldsmith & Campos, 1982;Rothbart & Derryberry, 1981;Thomas & Chess, 1977). For example, Rothbart and Derryberry defined temperament in terms of constitutional differences in physiological reactivity and self-regulation of reactivity. Thus, children's approach and avoidant behaviors, observed in the strange-situation procedure (Ainsworth, Ble-
Within the framework of sound research, the utmost flexibility and creativity is needed to keep or even increase the number of renal transplants when faced with a quantitatively stagnating but qualitatively deteriorating donor pool. Both the non-heart-beating donor protocol and the ESP have proven to be quite successful in achieving this goal without compromising the outcome for the individual end-stage renal disease patient.
Bloom Syndrome (BSyn) is an autosomal recessive disorder that causes growth deficiency, endocrine abnormalities, photosensitive skin rash, immune abnormalities, and predisposition to early-onset cancer. The available treatments for BSyn are symptomatic, and early identification of complications has the potential to improve outcomes. To accomplish this, standardized recommendations for health supervision are needed for early diagnosis and treatment. The purpose of this report is to use information from the BSyn Registry, published literature, and expertise from clinicians and researchers with experience in BSyn to develop recommendations for diagnosis, screening, and treatment of the clinical manifestations in people with BSyn. These health supervision recommendations can be incorporated into the routine clinical care of people with BSyn and can be revised as more knowledge is gained regarding their clinical utility.
Summary To investigate on the impact of Critical Care (CC) staffs’ attitudes to donation, their acceptance of the brain death (BD) concept, their confidence with donation‐related tasks and educational needs on national donation rates. Donor Action (DA) Hospital Attitude Survey (HAS) data were collected from 19 537 CC staff in 11 countries, including personal attitudes to donation, self‐reported knowledge, involvement and comfort levels with donation‐related tasks and educational requirements. Countries’ donation performance was expressed as Procurement Efficiency Index (PEI) (organs procured and transplanted/deaths from eligible causes). National PEI rates correlated well with CC staffs’ average support to donation (R = 0.700, P = 0.014), acceptance of the BD concept (R = 0.742, P = 0.007), confidence levels (R = 0.796, P = 0.002) and average educational requirements with donation‐related tasks (R = −0.661, P = 0.025). Nurses reported significantly lower positive attitudes (P < 0.0001), acceptance of the BD concept (P < 0.0001), comfort levels (P < 0.0001) and requested more education (P = 0.0025) than medical staff members. DA’s HAS is a powerful, standardized tool to assess CC staffs’ attitudes and donation‐related skills in different environments. Measures to improve countries’ donation performance should focus on guidance and education of CC staff so as to ensure that all practitioners have sufficient knowledge and feel comfortable with donation‐related issues.
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