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Schistosomiasis in Brazil: Does social development suffice?

Up to 15 years ago, when asked to identify the major public health problems of Brazil, there would be no hesitation in naming infant diarrhoea, Chagas disease and Schistosoma mansoni. While most field workers have now eliminated schistosomiasis from the list, now certainly headed by malaria, in academic and bureaucratic circles the old priorities are still maintained.

Journal Article↗

Characterisation of health and social development.

The relative performance of less developed countries in their health, demographic and economic sectors was assessed by means of comparative indices constructed with the help of a factor analysis. This approach reduces the problems usually associated with such indices, like the arbitrary weighting of their components.

Developing Countries↗

Experiencing self and others: contributions from studies of autism to the psychoanalytic theory of social development.

Psychoanalysts have long been interested in autism as a disorder in which the development of a sense of self and other is altered dramatically. This paper outlines how our psychoanalytic understanding of the process of emergence and maintenance of the self and of inner world may be informed by recent findings from developmental psychology about how normal and autistic children develop the capacity to attribute mental states such as desires, feelings, and beliefs to others. Because autistic individuals frequently fail to develop an understanding of the relation between feelings or beliefs and the behaviors of themselves or others, studies of autism provide a clinical model for how these neurocognitively based functions, related to acquiring a so-called theory of mind, are involved in the elaboration of an inner world and in the ongoing definition of self. Understanding how both autistic and normal children develop, or fail to develop, the capacity to attribute meaning to others' actions, beliefs, and feelings speaks to psychoanalytic notions of internalization, identification, and introjection and provides a neurocognitive frame for how representations of self and others are created in the inner world. Conversely, the psychoanalytic view that the infant's emerging sense of self is also shaped by the infant's desire for mother underscores that affective precursors are absolutely necessary for a theory of mind to emerge.

Autistic Disorder↗

Ototoxicity in children receiving platinum chemotherapy: underestimating a commonly occurring toxicity that may influence academic and social development.

PURPOSE: To describe the frequency and severity of ototoxicity in a series of pediatric patients treated with platinum-based chemotherapy. PATIENTS AND METHODS: Serial audiologic evaluations were conducted for 67 patients aged 8 months to 23 years who received platinum-based chemotherapy. Audiologic data was analyzed to determine time to hearing-loss using American Speech-Language-Hearing Association (ASHA) criteria, and the effects of treatment and patient characteristics on the incidence and severity of ototoxicity. RESULTS: Bilateral decreases in hearing were seen in 61% of patients (median time to hearing loss, 135 days). Children treated for medulloblastoma, osteosarcoma, and neuroblastoma had greater incidence and severity of hearing loss. Agreement between the usually reported National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) and ASHA criteria was inadequate. CONCLUSION: Traditional reporting of toxicity data (CTCAE) has under-reported ototoxicity and minimized the significance of hearing loss in children. As pediatric patients experience improved survival, the effects and implications of high-frequency hearing loss with regard to academic achievement and speech and language development are important considerations, especially in patients younger than 5 years.

Adolescent↗