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Massive fetomaternal hemorrhage: how long should children with good evolution be controlled? A case report.

We report on a term infant with a severe fetomaternal hemorrhage that caused a serious anemia that was surmounted after several transfusions. After the initial complications, such as persistent pulmonary circulation, severe anemia and thrombocytopenia, the outcome was good. We discuss the importance of a long-term follow-up of affected children, as well as their mothers. No clear parameters for a real prognosis are available. A follow-up is needed in order to detect possible complications in neurological development.

Adult↗

Preschoolers' knowledge about strategies in coping with other's disgust evoked by immoral actions.

40 preschoolers in Exp. 1 and 22 in Exp. 2 (mean ages were both 5:11) were shown short stories presented as colored videotaped pictures with explanatory narrations. In each story a recipient felt disgusted by an agent's action. In Exp. 1 the agent's action was immoral. The participants were asked to tell how the agent would behave, supposing they were the agent themselves. About 80% of their answers were prosocial. In Exp. 2, two kinds of story were shown. In one, the agent hurt the recipient intentionally; in the other, by accident. Almost all answers in both kinds of story were prosocial. Furthermore, over a third of the participants told the reasons for their answers, considering the recipient's emotion, even when the agent's action was intentional and immoral. These findings show that the preschoolers had suitable knowledge about the agent's strategies in coping with the recipient's disgust.

Adaptation, Psychological↗

The power of mercy.

Throughout history heads of state have reserved for themselves the prerogative to exercise mercy and pardon not only for serious crimes but for lesser ones as well. The newly emerging state of Papua New Guinea is no exception. My experience as the psychiatrist member of the advisory committee on such executive clemency since its inception twelve years ago will be discussed.

Capital Punishment↗

Why we should not legalize euthanasia. The foundational ethical principle obliging us to protect life must be translated into a concrete norm.

The euthanasia debate is really the backdrop for a discussion within our society about the very nature of human life and meaning. Because the origin of life is in God, human beings do not have dominion over life but are stewards of life. The powerful combination of sanctity and stewardship is expressed in the foundational ethical principle. This principle says that no person has the right to directly take innocent human life and in fact there is a positive obligation to nurture and protect life. In our secular society there is a need to develop a "natural" metaphysic of sacredness. Such a metaphysic can serve as bedrock from which a foundational principle can be developed and then applied in concrete moral norms. It can show that life contributes to the full dignity of the human person. For this perspective to be effective in countering the movement to legalize euthanasia, this sense of integral wholeness of human personhood must be demonstrated in a convincing manner. It can be because a dualistic philosophical bias has been found wanting by Western culture. We must arrive at what ethicists would call concrete norms that guide individual choices. At issue is how we translate our foundational principle--Do not directly attack innocent human life--into a concrete norm when confronted with the possibility of death. Some persons question whether the concrete norm opposing euthanasia should be a matter of public morality. To answer this question, we must turn to our foundational principle.(ABSTRACT TRUNCATED AT 250 WORDS)

Catholicism↗

Student adjustment problems in two dental schools in Thailand.

Adjustment problems and academic achievement among dental students at two universities, one located in Thailand's capital city (Mahidol University) and the other in southern Thailand (Prince of Songkla University), were studied. All first- to sixth-year students at each university completed the Mooney Problem Checklist Thai version, by Supapan, which covers eleven areas of adjustment problems. The most severe adjustment problems at both schools were related to adjustment to college work. Problems relating to health and physical development, social and recreational activities, and moral and religious adjustment of MU dental students were significantly higher than those of PSU dental students. The checklist showed that, in both universities, the most important adjustment problem was the need for advice from staff concerning clinical experience. Stepwise regression indicated that four variables--adjustment to college work, sex, secondary education system and university (MU or PSU)--were associated with the academic achievement of dental students.

Adaptation, Psychological↗

Optic neuritis in children.

PURPOSE: To describe the clinical characteristics of optic neuritis in children, including final visual acuity and development of multiple sclerosis (MS). METHODS: Charts were reviewed of all patients < 15 years of age who presented with optic neuritis to the Bascom Palmer Eye Institute or the Miami Children's Hospital between 1986 and 1998. RESULTS: Fifteen patients were identified. There was a slight female predilection in the study group (60%), with a mean age of 9.8 years at presentation. A preceding febrile illness within 2 weeks of visual symptoms was reported in 66% of patients. Initial visual acuity ranged from 20/15 to no light perception. Involvement was bilateral in 66% of patients, and disc swelling was present in 64% of involved eyes. Of the patients who underwent magnetic resonance imaging, 33% had focal demyelinating lesions in the brain, and 63% of affected nerves were enlarged or enhanced with gadolinium. Eleven patients were treated with intravenous steroids. Final visual acuity was > or = 20/40 in 58.3% of eyes. Thirty percent of the patients had vision of finger counting or worse. Four (26%) patients developed MS. The mean age of patients with MS was 12 years, compared with 9 years in children who did not develop MS. Patients with unilateral involvement had an excellent visual prognosis (100% > 20/40), but a higher rate of development of MS (75%). Two patients had positive serology for Lyme disease. CONCLUSIONS: Optic neuritis presents differently in children than in adults. Children typically have bilateral involvement with papillitis following an antecedent viral illness. Although visual prognosis is poorer in children than adults, the development of MS is less common in children. Children who present with unilateral involvement have a better visual prognosis; however, they also develop MS at a greater frequency than children with bilateral involvement. Patients who developed MS were, on average, older at presentation with optic neuritis than those who did not develop MS.

Adolescent↗

[Not Available].

An important scientific problem is discussed--the formation of human ideas about health as a national property. Based on positions of class differentiation and party, the authors attempt to elucidate the meaning and essence of this basic notion, equally from the standpoint of medicine and history, and from the standpoint of science in general. Man's health is not merely personal, individual or familial concern. It is conditioned, first and foremost, on a social ground. In this case, the social-economical conditions play a decisive role. The health of people is socially substantiated--attainable by all. On its part, it exerts effect upon the social conditions and society. In socialism and communism only are really human conditions created for the proper development of mankind, not merely in moral and cultural respect, but also in terms of improving vital functions and health state.

Communism↗

Just-world reasoning in children's immanent justice judgements.

The present study investigated the belief by Piaget that immanent justice responses occur when fairness judgments override conceptions of physical causality in young (6-8 years) children's understanding of a certain type of story. The structure of Piaget's stimulus stories was analyzed, and they were found to involve 3 narrative elements: motive valence, outcome valence, and causal connection. These 3 factors were crossed to create 8 types of stories, one of which (e.g., a character with a bad motive receives a negative outcome which is noncausally related to the previous motive) was the type used by Piaget. It was predicted that 2 types of stories would yield immanent justice responses: good motive/positive outcome/noncausal and bad motive/negative outcome/noncausal. Subjects received 4 stories and answered the Piagetian immanent justice questions and rated outcome fairness. Subjects were 48 each of children in grades 1, 3, and 5 and 38 college students. Results supported the prediction that children use the belief in a just world in immanent justice judgements.

Adult↗

A unitary health service for South Africa.

Medicine throughout the world is facing many critical challenges. In South Africa these are exacerbated by the effects apartheid has had on the structure, funding, distribution and delivery of health care. The demographic, economic, political, ethical and management problems facing our health services and the arguments in favour of privatisation are briefly reviewed. The case against privatisation of health care is buttressed by moral, economic and sociological justification for developing a unitary national health service/insurance system. In a rapidly changing South Africa medical care could become the leading edge of an enlightened social policy, which may facilitate peaceful progress towards a better future for all in our country and sub-continent.

Economics↗

Personal responsibility antecedents of anger and blame reactions in children.

The potential cognitive basis for anger in children was investigated by having 5-, 6-, 9-, 11-, and 15-year-old children offer moral evaluations and anger judgments about 8 incidents of property damage that differed in terms of the perpetrator's personal responsibility. Personal responsibility was manipulated by varying the events in terms of 3 dimensions: avoidability, intentionality, and motive acceptability. Results showed that these dimensions similarly affected children's moral- and anger-related judgments. Children's use of the personal responsibility dimensions was also associated with giving lower anger judgments, which suggests that anger instigation to property damage is moderated by the ability to take a normative perspective on transgressions.

Adaptation, Psychological↗

Development terminable and interminable. II. Recent psychoanalytic theory and therapeutic considerations.

This is the second part of a paper previously published in the Journal. It reviews how the formulations proposed in Part 1 are not only consistent with interdisciplinary research findings from developmental psychobiology and from infant observations, but are also consistent with a range of clinical theories of psychoanalysis. The basic motives of infancy and the motivational structures arising from early relationship development are the subject of increasing attention in psychoanalytic treatment. Aspects of the working alliance, both in the beginning and termination phases include considerations of emotional availability, the use of positive emotions, as well as the relationship 'match' between patient and analyst. These may determine outcome and are deemed worthy of further inquiry.

Child Development↗