Transition to adult care: another view.
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The predominant structural orientation of divorce research which either ignores or under represents to a great extent the child's perspective and his/her agency is criticized. As a consequence of these methodological shortcomings not only the production of scientific knowledge but also professional practice working with children from divorced families might be negatively affected--especially the regulation of custody and visiting issues. Therefore, the aim of this article is to give children a voice in describing their own experiences of visits and relationships with the non-residential father or mother during childhood and adolescence (sometimes until adulthood). By presenting numerous detailed autobiographical narratives from children of divorced parents, the study revealed a great diversity of visiting patterns as well as different relationship qualities ranging from loving to negative. In addition, visiting patterns and relationship qualities were not always static but were dynamic and changed over time, whereby the child's personality and agency contributed to this diversity and these processes. Finally, methodological recommendations are offered and it is suggested that the child's perspective and agency should be included in research about children of divorce.
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A letter from Prof. Celâl Saraç - His life story and scientific contributions.
I. Csapody was ophthalmologist, professor of eye surgery, Academic Doctor of Medical Sciences. He was born in Budapest in 1892, finished his studies in Budapest, had been at the front for years during World War I. As a young man he became Head of Department of Ophthalmology and worked in several institutes, later in St. John's Hospital for 30 years. In his well-organized institute of high level many specialists had been trained. In 1929 he published his procedure to make individual contact glasses with moulding of living eye. However, he was not concerned with industrial relations of his invention. His method was taken over by Zeiss Works and, in London Mr. Dallos based manufacturing on that. His operation for reconstruction of contracted orbital cavity due to an accident or chemical inquiry, making possible wearing ocular-prothese with use of free skin-graft, can be found in great monographs on surgery, too: Arruga, Blaskovics, Thiel, Mackensen- Neubauer. His book entitled "Látás-próbák" (Test Types for Near and Test Tables for Distant) was revised and published in three successive editions. Among his other publications in Hungarian and world-wide languages there are 7 books, 14 chapters in other books and approx. 160 papers. He retired in 1960 and died in 1970.
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The author describes his evacuation to the East at the beginning of the Second World War, his return to Cracow and efforts to be employed in a hospital. He recalls people with whom he worked during the occupation in the Department of Ophthalmology at Bonifraters' Hospital, and then from January 1945 in the Department of Ophthalmology at St. Lazarus Hospital in Cracow. As a motto of his memoirs the author chose the definition of medicine by Władysław Biegański.
OBJECTIVE: In this study, we explore the onset of psychotic episodes in schizophrenia. Patients with schizophrenia have sometimes reported specific life-events at the period of onset. For example: "It started on my 22nd birthday. From that day onward, my life was colored with extremes of happiness and tragedies", or "It was when I was playing with a cat in the park of S temple that I realized suddenly that my 'I'-ness had completely changed." In each case, patients referred to a specific event as a critical moment when the meaning of selfness and the surrounding world had changed. Interestingly, these moments were reported repeatedly throughout the history of their illnesses. We termed these clinical phenomena "Recurrent retrieval of the core episode referred to as the onset of schizophrenia" and investigated their psychopathologic implication. METHOD: The autobiographical memory of nine schizophrenic patients with "Recurrent retrieval of the core episode referred to as the onset of schizophrenia" was investigated. Four representative cases are described in detail. Samples of subjective statements were collected from medical records and analyzed. RESULTS: 1) Form and content of the statement: Patients clearly referred to a specific moment in their life. They usually reported that their image of self or the world had completely changed. The content of their reports were always about the same theme. 2) Chronological pattern of the repetition: Although the reported life event occurred just before onset, the reminiscence usually occurred not only at the beginning of the refractory period but also at the beginning of the recovery period. Patients did not report such events when they were stable. In the refractory period, distinct symptoms of schizophrenia were observed after the reminiscence. In the recovery period, the reminiscence was accompanied by minor physical symptoms, such as fever elevation or gastrointestinal dysfunction. 3) Subjective characteristics of repetitive reminiscence: In the refractory period, patients relived the onset of schizophrenia by reporting it reminiscently. They were excited, in a state of high-tension, or feeling oppressed. In contrast, in the recovery period, they reported the critical moment in an emotionally stable state, and even recollected it with humor. They were able to maintain some emotional distance from the reminiscence. 4) Predictive factor on prognosis: Reminiscence in the recovery period predicted a good prognosis. Seven of nine such cases were in remission. Two patients with whom the reminiscence was observed only in the refractory period were chronically ill. Therefore, two patterns of repetitive reminiscence of the critical moment should be discriminated. DISCUSSION: 1. The statements of patients were developed on the possibility that the critical event had not happened. Therefore, it can be postulated that their statements reconstructed a temporality open to any possible future: the moment just before the critical event might not have happened. The proper temporality associated with repetitive reminiscence should be distinguished from that of repetition of a traumatic memory in post-traumatic stress disorder. 2. From a therapeutic viewpoint, it is important to know to whom the discourse of the patient was addressed. In the refractory period, patients reported the repetitive reminiscence to anyone in a non-discriminating fashion. In contrast, in the recovery period, their discourse on the reminiscence was directed to a particular person with whom they were in close contact. The structure of the latter discourse was similar to that of neurotic patients in that they both demand acceptance from others. That is, the discourse structure of our patients was drastically changed in the recovery period. Reconstruction of the critical moment found in the recovery period was accomplished by the patient's discourse directed to another person, one from whom they could realize self-acceptance.
This manuscript outlines the lifelong battle with severe stuttering and describes a new modality of effective amelioration of the disorder from the standpoint of a university professor and researcher in the field of stuttering. Childhood reactions to stuttering are discussed, along with the educational and vocational impact of stuttering. Ongoing therapy was received throughout the formative years and into adulthood, emphasizing reduced rates of speech. The use of Delayed Auditory Feedback (DAF) was found to induce fluent speech, but was considered only as a tool for decreasing the speech rate to achieve fluency. When fluency under DAF was discovered to be possible at faster speech rates, the possibility that the use of DAF and other forms of altered auditory feedback could themselves have an inhibitory effect on stuttering, without concomitant rate reduction was investigated. An In-The-Canal (ITC) fluency-enhancing device was used that provided DAF and Frequency Altered Feedback (FAF) to produce more fluent speech. After 10 months of use, the author was relatively free from stuttering. Speech was natural sounding, relatively spontaneous and unlaboured with an absence of fear. However, further testing (that is currently underway at various centres) is necessary before generalizations can be made.
The lost autobiography of the famous Halle medical professor Friedrich Hoffmann (1660-1742) was recently located in the Manuscripta borussica collection of the Berlin State Library Manuscript Department (Handschriftenabteilung der Staatsbibliothek zu Berlin). The autobiography shows new details about his life and work as well as his strategy to shape the picture of his personality for posterity.
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A physical doctor with a PhD in Pathology, Euzenir Nunes Sarno studies the immunology factors of Hansen's disease, one of the oldest chronic infections and that is an exclusively human disease. Staff member of an ambulatory that has become a reference on the disease in Brazil with 220 to 250 new patients per year, Euzenir emphasizes that the fact one cannot cultivate Mycobacterium leprae brings about some everlasting questions in relation to the transmission of and the sensitivity to the disease. There are also many epidemiology questions that remain unanswered. Estimates show that, among those who have contact with multi-bacilli patients, 90% are infected but only about 8% get sick. The high infection rate of those who live with multi-bacilli patients but never fall sick shows that just a small number of individuals are sensitive to Mycobacterium leprae. This is one of the questions immunology has not been able to answer. Why do some people resist to it and some don't? The figures are even lower when compared to those who are in contact with patients that are paucibacillus-infected, i.e. a manifestation of the disease with few bacilli. Hansen's disease is known as a skin malady. But, according to the specialist, its first damage is to the nerve, when the area becomes insensitive. Besides damaging the sensitive skin nerves, the disease can lead to motor disability and irreversible deformities, which sometimes lead to the amputation of limbs and protruded parts of the body. Mycobacterium leprae was one of the first pathogenic bacteria whose genome sequence has been entirely mapped. Only now we have the capacity to have more precise assessments. The disease is not inherited, and only in 1986 health services in Brazil began to take the responsibility for both the disease and its patients. During the twenty-year military dictatorship the country underwent, the health system was dismantled. In 1991, the one-year treatment with three drugs - Dapsone, Rifanpicine and Clofazimine- was introduced in our country. Just 30% of the cases get to negative results after the treatment. according to the interviewee, whereas tuberculosis is a highly virulent multi-bacilli disease, leprosy bacillus is not virulent, is a 'lazy' germ at the end of its evolutional process. One third of its genome does not work.