Care,play and lifelong learning

In this paper, links between the concepts of long-term care and lifelong learning are suggested, and notions of care and the author’s construction of the Pedagogic Third will be proposed. The psychoanalysis of children stresses the importance of symbolic play, during which the child uses games to master internal conflicts. Analogous results might emerge from play that engages adult learners. However, where play helps children define roles and accept rule-regulated behaviour, we consider to what extent an adult learner is addressing desires which cannot be satisfied because they are too threatening, or desires which cannot be satisfied in reality and which are represented symbolically in play as an alternative. In order to work through these ideas, we consider a comedic representation of a hospital ward and an extract from the diary of a midwife who was also a long-term patient. The author’s contribution to the conference was a workshop and not the presentation of a paper. As such, this paper has been written in retrospect and is consequently reflective in stance. Much of the work described in this paper is connected to a larger piece of work, a monograph in progress, due to be published in 2019.     

我国妇幼保健机构公共卫生属性淡化的机制研究

妇幼卫生是公共卫生体系的重要组成部分,妇幼保健机构是妇幼卫生工作的实现主体,为了促进我国妇幼保健机构的健康和可持续发展,提高妇女、儿童健康水平,通过对妇幼保健机构的社会功能、行为动因和行为特征的系统分析,构建出妇幼保健机构公共卫生属性淡化的作用机制模型.公共卫生的实质是公共政策,建议政府要实现市场机制与政府宏观调控的有机结合,促进妇幼保健事业健康发展.     

Ce que soigner veut dire. Le peintre,le patient et le bon samaritain

The hyper-medicalization of our societies and our absolute confidence in curative medicine have made us gradually lose the deep meaning of the words of ailments. Many are now calling on the public authorities to promote a “policy of Care”. The use of anglicisms is certainly “trendy” but opposing “cure” and “care” does not make sense. We invite our readers to try to recover the meaning and the value of the verb to treat and the word care(s), plural and yet so singular. To carry out this quest, we will focus our attention on a few works of art which will perhaps allow us, in three stages, to (re)discover the deep meaning of the care relationship.     

Mindfulness‐based cognitive therapy is effective as relapse prevention for patients with recurrent depression in Scandinavian primary health care

This study examined the effectiveness of mindfulness‐based cognitive therapy (MBCT) in primary care for patients with recurrent depression (major depressive disorder: MDD). According to the World Health Organization (WHO), MDD is now the leading cause of disease burden in middle‐ and high‐income countries. Patients (N = 45) with three or more previous depressive episodes were recruited to participate in MBCT as a preventative intervention. Using a benchmarking approach, outcome data was compared with data from a recent efficacy study. The methodology is a rigorous approach to assessing effectiveness when evidence‐based UK protocols are transferred into the existing Scandinavian service delivery. Additionally, a person‐centred methodological approach was used to assess clinical significance on the Reliable Change Index (RCI). The analysis revealed comparable or larger effects from pre‐test to post‐test in reduced psychiatric symptoms, increased quality of life and level of mindfulness, and the effects were maintained over 14 months. Analysis of the relapse rate in the current study (16%) compared to the TAU in the efficacy study (68%) yielded an h value of 0.78, a moderate effect size. Only 13% dropped out of the treatment. According to the RCI findings, 65% to 67% of participants in the clinical group improved, no individual worsened, and women showed a significantly greater improvement of depression and anxiety than men. Therapeutic alliance and motivation had no impact on the outcome. The overall result suggests that MBCT can be implemented successfully in Scandinavian primary health care as a preventive intervention for patients with recurrent depression.     

Characteristics of residential care for adolescent offenders: A comparison of assumptions and practices in two models

Staff assumptions and program practices in two models of residential care for male adolescent offenders were compared. Group care settings had from 6 to 15 youths in residence and used peer-mediated treatments. Treatment Foster Care settings had one youngster placed in each home and treatments were adult-mediated. Results showed that group care and Treatment Foster Care program models differed on staff assumptions about therapeutic mechanisms of change, and different patterns of daily program practices were found.     

Training program in psychosocial intervention for high-risk infants and their families

A multidisciplinary training program for psychosocial intervention in the Neonatal Intensive Care Unit (NICU) was developed. The purpose of the program was to train mental health and health care professionals in a psychosocial preventive intervention model for high-risk infants and their families throughout the infants' hospital course in the NICU. The program was divided into modules that include assessment and intervention with the infant, parents, family, and larger caregiving environment. Over a 3-year period 40 trainees from 9 disciplines were trained. A randomized clinical trial was conducted which showed the positive effects of the intervention. A clinical service including inpatient and outpatient follow-up has been established in the NICU based on the psychosocial model developed from the training program.     

Parent's report of stress and articulation oscillation as factors in a preschooler's dysfluencies

Recently, one focus of research on dysfluency and stuttering seems to be on the preschooler. One goal of such research should be to determine what factors in the child's language system and what factors in the social environment may put the child at risk for developing dysfluencies and stuttering. The following is a parent's account of the occurrence of dysfluencies in a preschooler. Emphasis is on a language phenomenon that might be labeled “articulation oscillation” and on apparent social environmental stress.     

Music therapy enhances preterm infant’s signs of engagement and sustains maternal singing in the NICU

Hospitalized preterm infants are exposed to stressful stimuli and early parental separation, which can undermine their long-term development and mother-infant bonding. Family-centered music therapy can enable positive mother-infant interactions, mediated by maternal infant-directed singing. This study aimed to investigate the effects of music therapy on preterm infant’s signs of engagement, namely Eye Opening (EO) and Smiling (SM), and maternal vocalizations. Participants were 30 mother-preterm infant dyads in a Brazilian Neonatal Intensive Care Unit (NICU), divided into a Music Therapy Group (MTG) and a Comparison Group (CG). The MTG participated in 6 sessions of the Music Therapy Intervention for the Mother-Preterm Infant Dyad (MUSIP), with the aim of supporting maternal singing with the infant. Prior to discharge, all mothers were filmed during a Non-singing (NS) and Singing (S) interactional condition; in the S condition, mothers were explicitly asked to address their infants by singing. Results of video and audio analysis showed that infants in the MTG displayed greater Eye Opening (EO) frequency compared to CG, but only when they were in an initial awake state at test, suggesting that music therapy can potentialize infants’ alertness, by increasing their disposition and chances of being engaged in the interaction with the mother. Non-religious mothers appeared to sing significantly more in the MTG than in the CG. These preliminary findings indicate that music therapy in the NICU could promote infant’s signs of engagement during interactions and can sustain maternal singing, especially with non-religious mothers in Brazil.     

Assembling human empathy towards care robots: The human labor of robot sociality

This paper conceptualizes human to robot empathy as empathetic arrangements configured in caring spaces. Analyzing empathy towards care robots as arrangements comprising robots, spaces, discourses, bodies and institutions enables recognition of the way empathy is about self-other relationships while eschewing an understanding of empathy in terms of a reciprocal relationship between human and robot. Situating the therapeutic, zoomorphic robot, Paro and the health care support robot, Care-O-Bot as part of empathetic arrangements draws attention to how the cultivation of empathy towards robots governs and regulates patient sociality. In particular, it shows that these robots do not function as substitutes for human carers but instead are dependent on human labor if they are to deliver therapy ethically and effectively. They rely on the affective labor of the patient and the labor of carers and others in the arrangement.     

Multilevel Analysis of a Measure of Community Prevention Collaboration

This study assesses a measure of community-wide collaboration on prevention-specific activities (i.e., prevention collaboration) in context of the theory of community change used in the Communities That Care prevention system. Using data from a sample of 599 community leaders across 41 communities, we examined the measure with regard to its factor structure, associations with other concurrent community-level measures, and prediction by individual- and community-level characteristics. Results of multilevel confirmatory factor analysis provide evidence for the construct validity of the measure and indicate significant (p < .05) associations with concurrent validity criteria. Female community leaders reported significantly higher levels of prevention collaboration and community leaders sampled from religious organizations reported lower levels of prevention collaboration than did their respective counterparts. Although no community-level characteristics were associated significantly with prevention collaboration, community clustering accounted for 20-28% of the total variation in the measure. Findings support the use of this measure in assessing the importance of collaboration in community-based prevention initiatives.