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Studies of families with adopted children are of special interest to attachment theorists because they afford opportunities to probe assumptions of attachment theory with regard to the developmental timing of interactions necessary to form primary attachments and also with regard to effects of shared genes on child attachment quality. In Bowlby's model, attachment-relevant behaviors and interactions are observable from the moment of birth, but for adoptive families, these interactions cannot begin until the child enters the family, sometimes several months or even years post-partum. Furthermore, because adoptive parents and adopted children do not usually share genes by common descent, any correspondence between attachment representations of the parent and secure base behavior of the child must arise as a consequence of dyadic interaction histories. The objectives of this study were to evaluate whether the child's age at the time of adoption or at the time of attachment assessment predicted child attachment security in adoptive families and also whether the adoptive mother's internal attachment representation predicted the child's attachment security. The participants were 106 mother - child dyads selected from the 406 adoptions carried out through the Lisbon Department of Adoption Services over a period of 3 years. The Attachment Behavior Q-Set (AQS; Waters, 1995) was used to assess secure base behavior and an attachment script representation task was used to assess the maternal attachment representations. Neither child's age at the time of adoption, nor age of the child at assessment significantly predicted the AQS security score; however, scores reflecting the presence and quality of maternal secure base scripts did predict AQS security. These findings support the notion that the transmission of attachment security across generations involves mutual exchanges and learning by the child and that the exchanges leading to secure attachment need not begin at birth. These results complement the findings and conceptual arguments offered by Bowlby and Ainsworth concerning the critical influence of maternal representations of attachment to the quality of attachment security in children. [ABSTRACT FROM AUTHOR]

Background: To validate the accuracy of SAPS II, APACHE III and TRISS for the prediction of mortality in Intensive Care Unit (ICU) at polytrauma patients admission. The outcome of multiple trauma patients is often linked to the degree of physiologic dysfunction and to the extension of anatomic lesions, the age of the patient and the lesion mechanism., Methods: The study population consisted of 93 cases of multiple injured patients hospitalised at the ICU of the Padua hospital from October 1998 to October 1999; the term polytraumatized patient is referred to patients who have multiple lesions of which at least one potentially endangers, immediately or in a short term, their life. These cases were evaluated with the APACHE III, SAPS II, Revised Trauma Score and Injury Severity Score. The predictive power of each system was evaluated by using decision matrix analysis to compare observed and predicted outcome with a decision criterion of 0.50 and 0.40 for risk of hospital death., Results: All trauma score systems under study showed high accuracy rates, above all if they are used with a 40% positive test., Conclusions: The prognostic scales used in this study showed a good correlation between expected and observed cases, particularly with TRISS and APACHE III systems. The APACHE III system seems to be the most reliable of the different methods analysed. These prognostic systems are seldom or occasionally used in the ICU, in Padua and in the whole of Italy, so Italian data are not suitable to be compared to international ones. Due to urgency, the importance of the evaluation scales is often underestimated, but even if they require time and attention, they surely can be useful in the evaluation of the treatment, and not only of a polytraumatized patient.