Should Extremely Premature Babies Get Ventilators During the COVID-19 Crisis?

Abstract

In a crisis, societal needs take precedence over a patient’s best interests. Triage guidelines, however, differ on whether limited resources should focus on maximizing lives or life-years. Choosing between these two approaches has implications for neonatology. Neonatal units have ventilators, some adaptable for adults. This raises the question of whether, in crisis conditions, guidelines for treating extremely premature babies should be altered to free-up ventilators. Some adults who need ventilators will have a survival rate higher than some extremely premature babies. But surviving babies will likely live longer, maximizing life-years. Empiric evidence demonstrates that these babies can derive significant survival benefits from ventilation when compared to adults. When “triaging” or choosing between patients, justice demands fair guidelines. Premature babies do not deserve special consideration; they deserve equal consideration. Solidarity is crucial but must consider needs specific to patient populations and avoid biases against people with disabilities and extremely premature babies.     

Expulsion prevention: Framework for the role of infant and early childhood mental health consultation in addressing implicit biases

Young children of color—especially boys—are at disproportionate risk for suspension and expulsion from early care and education settings. Infant and Early Childhood Mental Health Consultation (IECMHC) is an approach associated with lower than expected expulsion rates, but the mechanisms through which it may influence preschool expulsion are unknown. This paper reflects on the parallels between IECMHC and interventions created to reduce implicit bias. Based on interviews with leaders in IECMHC practice, implementation, and evaluation, a theoretical framework was created to articulate how IECMHC is hypothesized to affect expulsion by first reducing the influence of implicit bias on disciplinary decisions. Implications for practice and research are provided.     

Understanding Information Selection and Encoding from a Dynamic,Energy Saving,Evolved, Embodied,Embedded Perspective

This article uses the Dynamic Human Centric Communication Systems Theory to reconceptualize 4 selected attributes of attention from a human‐centric point of view. Information is defined with respect to its relationship in the environment to the human in terms of time and space. The 4 attributes considered are stability, imminence, motivational relevance, and task relevance. An experiment was conducted in which encoding was assessed using a signal detection analysis of a change detection task. Results supported the prediction that story and motivational relevance would have opposite effects on the encoding of stable information as a function of imminence. Differences in memory predictions made by traditional theoretical approaches and the DHCCST are discussed in light of the results of the experiment.     

Learnability of Pregroup Grammars

This paper investigates the learnability by positive examples in the sense of Gold of Pregroup Grammars. In a first part, Pregroup Grammars are presented and a new parsing strategy is proposed. Then, theoretical learnability and non-learnability results for subclasses of Pregroup Grammars are proved. In the last two parts, we focus on learning Pregroup Grammars from a special kind of input called feature-tagged examples. A learning algorithm based on the parsing strategy presented in the first part is given. Its validity is proved and its properties are examplified.     

People are not cabbages: reflections on patient and analyst change

The author describes how her own internal change was a vital part of transformation between herself and two patients. She draws on Loewald's work as she discusses how change in her own internal relationship with her father was part of a lifelong emotional reorganization of Oedipal relations. She describes a process of mutual change whereby her and her patients' unconscious growth each stimulated the other. She suggests that the analyst's own emotional growth is a vital, not an incidental, part of psychoanalysis, as it brings new life to the work for patients as well as analysts themselves.     

Die Wahrnehmung von Bewegungen in der Gegend des blinden Flecks

Ohne Zusammenfassung Mit 9 Abbildungen im Text.     

Digging beneath the surface: Results from stage one of a qualitative analysis of factors influencing the well-being of trans youth in Quebec

ABSTRACT

Background: The literature on trans youth has been dominated by etiological studies interested in trans experience as a medical phenomenon. An emerging body of literature has begun to document that trans youth are a diverse, vulnerable, yet resilient population, and to investigate the role of various sites of support such as the family, peer groups, institutions, and community spaces in contributing to or impeding trans youth's well-being.

Method: This article presents the results of Stage One of interviews (n = 24) conducted for a Community-Based Participatory Action Research (CBPAR) qualitative research project based in Quebec. It studies the factors that enhance trans youth's well-being as well as the factors of oppression that negatively affect it. This paper offers a brief overview of the anti-oppressive methodology used for this project, emphasizing how CBPAR was combined with Grounded Theory (GT) methods to encourage the direct involvement of communities and the translation of knowledge into action.

Results: We present preliminary categories emerging through the ongoing axial coding process. These categories address trans youth's experiences in and perceptions of various “sites”: 1) healthcare services both for gender-related and general care, 2) other institutional spaces, 3) the family and other social circles, and 4) community spaces.

Conclusion: While much of this study's results support existing evidence on trans youth's experiences, they also provide a more nuanced portrayal of the complex ways in which recognition, as well as non-, mis-, or mal-recognition, influence trans youth's well-being at different sites. We also argue that recognition itself must be considered through the lens of intersectionality.     

Psychological,endocrine, and neural correlates of attentional bias in subclinical depression

Background: Our knowledge with respect to psychological, endocrine, and neural correlates of attentional bias in individuals with high vulnerability to developing depression – the subclinically depressed, still remains limited. Design: The study used a 2?×?2 mixed design. Methods: Attentional bias toward happy and sad faces in healthy (N?=?26) and subclinically depressed individuals (N?=?22) was assessed via a neuroimaging dot-probe attention task. Participants also completed trait and state psychological measures and provided saliva samples for cortisol analysis. Results: The subclinical group showed attentional bias toward happy faces; past use of problem-focused coping strategies when dealing with a personally relevant stressor as well as state levels of anxiety, together, contributed to this bias. In the control group, the happy attentional bias was positively correlated with activity in the right caudate. In the subclinical group, the bias was negatively associated with the left fusiform gyrus and positively with the left inferior parietal lobule and bilateral putamen. We observed group differences in association between cortisol levels during the task and neural activity during happy attentional bias processing within the key regions involved in attention. Conclusions: The attentional bias toward happy faces may reflect an active coping attempt by the subclinical participants.