This paper investigates the impact of kin on child survival in a matrilineal society in Malawi. Women usually live in close proximity to their matrilineal kin in this agricultural community, allowing opportunities for helping behavior between matrilineal relatives. However, there is little evidence that matrilineal kin are beneficial to children. On the contrary, child mortality rates appear to be higher in the presence of maternal grandmothers and maternal aunts. These effects are modified by the sex of (...) class='Hi'>child and resource ownership: female children and children in households where women, rather than men, own land suffer higher mortality rates in the presence of maternal kin. These modifiers suggest the detrimental effects of matrilineal kin may result from competition between such kin for resources. There are some positive effects of kin on child survival: the presence of elder siblings of both sexes is correlated with higher survival rates, and there is some weak evidence that paternal grandmothers may be beneficial to a child’s survival chances. There is little evidence that any male kin, whether matrilineal or patrilineal, and including fathers, affect child mortality rates. This study highlights the importance of taking social and ecological context into account when investigating relationships between kin. (shrink)

The aim of this paper is to account for the effect of mother's death on child survival in a historical population. Using comprehensive data on the early French Canadian population of Quebec, evidence is provided for a higher risk of dying for motherless children that remains significant over all childhood and long after the death of the mother. The specific effect of the loss of maternal care was estimated by comparing mortality before and after mother's death, furnishing a (...) means to control for family heterogeneity. No differential in investment between genders was detected before age 3, but older girls suffered a three-fold higher susceptibility to mother's death than their male counterparts. This suggests that grown-up girls assuming the responsibilities of the missing mother had a lower chance of survival. (shrink)

Retrospective and prospective data collected in Cameroon were used to reassess hypotheses about how infant and early childhood mortality is affected by birth spacing and breast-feeding. These data show that: (a) a short preceding birth interval is detrimental for child survival in the first 4 months of life; (b) full and partial breast-feeding have direct protective effects on child survival in the first 4-6 months of life, with the effects of the former stronger than those of (...) the latter; (c) early subsequent conception significantly increases mortality risks in the first 16 months of life of the index child. These findings are robust to various controls, e.g. study design, data defects, child's health conditions at/around birth, postnatal maternal and child recurrent illnesses, patterns of utilisation of health care services, and immunisation status of the child. (shrink)

Volume 24, Issue 6, September 2019, Page 680-682.

Denunciations of child sexual abuse in the sport context have been increasing in the last decades. Studies estimate that between 14 and 29% of athletes have been victim of at least one form of sexual violence in sport before the age of 18. However, studies suggest that many do not disclose their experience of CSA during childhood. This finding is alarming since studies have shown that the healing process usually starts with disclosure. Moreover, little is known about the healing (...) process of CSA experienced in the sport context. The aim of the study is to present a single case study of a CSA in sport to better understand the global experience over time from the perspective of the athlete. A narrative inquiry approach was adopted. Three non-structured interviews were conducted with the participant. Three pathways in the survivor journey have been identified through inductive thematic analysis: pathway to understanding, pathway to disclosure, and pathway to healing. These pathways represent distinct processes but are intertwined as they are dynamic and iterative. Indeed, the survivor explained how she had been, and is still, going back and forth between them. Results are consistent with those found in the literature on CSA in the general population. It suggests that theoretical models of CSA in the general population could be applied to CSA in sport. Practical implications include a need for education and clearer boundaries in the coach-athlete relationship. Sport stakeholders also need to be better equipped to recognize the signs of sexual violence in sport. Our results indicate that qualitative research could be a potential avenue to help victims heal from CSA. It gives them the chance to talk about and make sense of their abuse in a safe space. Finally, our results demonstrate the importance of reviewing the current justice system for victims. It should be based on a trauma-informed approach that places the victim at the center of the judicial process. (shrink)

In the summer of 1985 my children, Laura and Aurélien, then seven and five, knelt before a Barbie doll standing at the foot of a Ken doll on an imaginary cross. I remember vividly the scene because I took a picture of it. We were vacationing in Ticino and visiting the local churches, so I assumed that this play imitated the iconography to which they were being exposed. After reading Moshenska's Iconoclasm as Child's Play, however—whose cover shows “Josh McBig,” (...) a bearded version of Ken with outstretched arms and severed legs, photographed by the Jackson sisters as part of their “Doll Games” project—I have to wonder: was there not in this play an element of parody or blasphemy, of iconoclasm even, prompted perhaps by my working at the time on contemporary “vandalism”? Or, on the contrary, was there an element of devotion, of faith produced by mimicking the ritual? I am now faced with the conundrum of “the adult's imagination of the child's imagination,” to borrow a phrase (from Michael Taussig) that resonates through Moshenska's strange and fascinating book.Sometime in the 1530s, in Redcliffe Cross in Bristol, in the west of England, a preacher named Roger Edgeworth denounced what he regarded as a current upsurge of impiety and singled out as evidence that “many Images” taken from the dissolved monasteries “haue bene caryed abrod, and gyuen to children to playe wyth all,” so that when their parents ask them what it is that they are playing with, they make them laugh by answering: “I haue here myne ydoll.” “Ydoll” is a portmanteau word—as Lewis Carroll would have said—combining “doll” and “idol,” and Moshenska finds “scattered but definite evidence... that holy things were made into playthings with sufficient frequency for it to be considered an established and recognized part of iconoclastic practice in the early modern period.” He analyzes a few other examples, but Edgeworth's sermon supplies him with the primal scene of his book: he admits to “having been seduced by this passage..., caught up in its folds, brought back to it time and again,” so that Iconoclasm as Child's Play bears some structural resemblance to Henry James's novella The Turn of the Screw. Consistently—and at times obtrusively—self-reflective, it also wonders whether its approach can be regarded as “a kind of iconoclasm” or is intended “as a form of play”—lusus serius, naturally.Iconoclasm as Child's Play explores with great ingenuity the complex relationships between the Christian rite, iconoclasm, and child's play: a Byzantine empress enables her icons to survive the Quarrel of Images by calling them her “dolls”; Protestants trivialize the Roman Catholic ritual by comparing it to “trifles” and the “mere playing of children”; in The Praise of Folly, Erasmus embraces the “foolishness” of Christianity, centered on the figure of a broken body that renders attacks against its images and iconoclastic theory itself—as Bruno Latour has shown—deeply equivocal. A further turn of the screw takes place in the missionary and mercantile context of Malacca, where the Dutch settlers impute childishness both to the Portuguese Jesuits who preceded them and to the local religions. The notions of “fetish” and “fetishism,” as Moshenska shows, charge their targets with a misattribution to objects of agency, responsibility, and desires.The object of Moshenska's inquiry, which he claims less convincingly to include “art-things,” is “polysemic and polychronic,” and a leitmotif of the interpretations he proposes is the instability of the status and meaning of what is interpreted, be it a thing, an action, or a word. Among the many epistemic virtues he attributes to iconoclasm as child's play is the questioning of “the sharp... divisions between modern and premodern” implied by historical narratives such as Max Weber's account of the Reformation as the “expulsion of play” and “disenchantment” of the world. A long meditation on the temporality of play concludes by pointing out the “toy potential of all things” and referring to James Gibson's notion of “affordance.” Indeed, child's play, whatever adults want to do with it, often consists in multiplying and inventing affordances, and it is capable of turning not only “idols” into “dolls,” but also “dolls” into “idols.”. (shrink)

This study examines whether mortality of two adjacent siblings in families is age-specific and is modified by the MCH78, 198590 in the treatment (MCH–FP) and comparison areas. Logistic regression was used to estimate the net effects of survival status of elder siblings on mortality of younger siblings in the neonatal, postneonatal and toddler periods, controlling for birth order, previous birth interval, maternal age, education and religion, household possession of valuable items and sex of the child.

Background: Confidentiality lies at the core of medical ethics and is the cornerstone for developing and keeping a trusting relationship between nurses and patients. In the wake of the HIV epidemic, there has been a heightened focus on confidentiality in healthcare contexts. Nurses’ follow-up of HIV-positive women and their susceptible HIV-exposed children has proved to be challenging in this regard, but the ethical dilemmas concerning confidentiality that emerge in the process of ensuring HIV-free survival of the third party – (...) the child – have attracted limited attention. Objective: The study explores challenges of confidentiality linked to a third party in nurse–patient relationships in a rural Tanzanian HIV/AIDS context. Study context: The study was carried out in rural and semi-urban settings of Tanzania where the population is largely agro-pastoral, the formal educational level is low and poverty is rife. The HIV prevalence of 1.5% is low compared to the national prevalence of 5.1%. Methods: Data were collected during 9 months of ethnographic fieldwork and consisted of participant observation in clinical settings and during home visits combined with in-depth interviews. The main categories of informants were nurses employed in prevention of mother-to-child transmission of HIV programmes and HIV-positive women enrolled in these programmes. Ethical considerations: Based on information about the study aims, all informants consented to participate. Ethical approval was granted by ethics review boards in Tanzania and Norway. Findings and discussion: The material indicates a delicate balance between the nurses’ attempt to secure the HIV-free survival of the babies and the mothers’ desire to preserve confidentiality. Profound confidentiality-related dilemmas emerged in actual practice, and indications of a lack of thorough consideration of the implication of a patient’s restricted disclosure came to light during follow-up of the HIV-positive women and the third party – the child who is at risk of HIV infection through mother’s milk. World Health Organization’s substantial focus on infant survival (Millennium Development Goal-4) and the strong calls for disclosure among the HIV-positive are reflected on in the discussion. (shrink)

The effects of grandparent survival on child survival and mean interbirth interval, both independent of and relative to parent survival, were investigated in a historical population. Families for the data set were reconstituted from the parish and census records of Cambridgeshire, 1770–1861. In a logistic regression analysis, only the mother’s and the maternal grandmother’s survival were found to be significant predictors of child survival. Maternal grandmother’s survival was found to influence child (...) survival both via maternal survival and independent of maternal survival. Grandparent survival was not found to influence mean interbirth interval. These findings are reviewed with respect to other studies of grandmothering, the Grandmother Hypothesis, and the evolutionary significance of human female postreproductive lifespan. (shrink)

Introducción: El maltrato infantil se define como el abuso y la desatención de que son objeto los menores de 18 años; incluye el maltrato físico o psicológico, abuso sexual, desatención, negligencia y explotación comercial o de otro tipo que puedan causar un daño a la salud, al desarrollo o la dignidad del niño, y poner en peligro su supervivencia, en el contexto de una relación de responsabilidad, confianza o poder. Método: Se realizó un estudio prospectivo, con enfoque cuali-cuantitativo, modalidad de (...) campo, descriptivo, analítico y longitudinal en la escuela Manuela Espejo del cantón Ambato, provincia Tungurahua, Ecuador, durante el periodo 2013-2015 con el objetivo de determinar la incidencia de maltrato infantil y brindarle la atención o tratamiento adecuado. Resultados: El 7,67 % de los niños eran maltratados, predominó el sexo masculino con un 74 %, fundamentalmente en el medio familiar con un 52,17 % en la modalidad de maltrato psicológico en un 62,16 %. Conclusiones: La violencia infantil, continúa siendo un problema a nivel internacional. La asistencia continua a las víctimas del maltrato y a sus familias puede ayudar a reducirlo y a paliar sus consecuencias. Introduction: Child abuse is defined as mistreatment and neglect of children who are under 18. It includes physical or psychological abuse, sexual abuse, neglect, negligence and commercial exploitation or any other kind of exploitation that may cause damage to children´s health, physical development or dignity, and may endanger their survival in the context of a relationship of responsibility, trust or power. Method: A prospective, descriptive, analytical, longitudinal study was conducted using qualitative and quantitative approaches at Manuela Espejo School in Canton Ambato, Tungurahua province, Ecuador, during the period of 2013-2015 in order to determine the incidence of child abuse and provide adequate care or treatment. Results: 7.67% of children were abused; of those, males predominated at 74%. The abuse took place mainly in the family environment in the form of psychological maltreatment. Conclusions: Child abuse remains a problem internationally. Continuous assistance to victims of abuse and their families can help reduce and mitigate its consequences. (shrink)

From the data of the 1989 Bangladesh Fertility Survey, aggregate deaths reported at ages 0-12 and 13-60 months are used to estimate infant and child mortality. Multivariate analysis shows that preceding birth interval length, followed by survival status of the immediately preceding child, are the most important factors associated with differential infant and child mortality risks; sex of the index child and mother's and father's education are also significant. Demographic factors are influential during infancy as (...) well as childhood, but social factors, particularly mother's and father's education, now emerge as significant predictors of infant mortality risks. This indicates a change in the role of socioeconomic factors, since the earlier Bangladesh Fertility Survey in 1975. (shrink)

The age-old adage "Give a man a fish; he'll eat for a day. Teach a man to fish he'll eat for the rest of his days", has truly manifested itself in Nicholas Negroponte's One Laptop per Child program. His organization seeks "To create educational opportunities for the world's poorest children by providing each child with a rugged, low-cost, low-power, connected laptop with content and software designed for collaborative, joyful, self-empowered learning". While it is seemingly a noble humanitarian effort (...) for the enhancement of education, support for the "$100 laptop" has fallen short of its stated goal with only twenty-eight participating countries. The fact that only a limited number of countries are willing to enter the program demonstrates that it does not address the majority of problems faced by developing nations. Inadequate education is one of many pressing social concerns, but its necessity should not be placed above the immediate needs of developing nations. And for an organization devoted to a non-survival-essential cause to pursue such an ambitious objective brings its social significance and ethics under question. (shrink)

Trisomy 13 and 18 are rare chromosomal abnormalities associated with high morbidity and mortality. Improved survival rates and increased prevalence of aggressive medical intervention have resulted in families and physicians holding different perspectives regarding the appropriate management of children with T 13/18. Families were invited for open-ended interviews regarding their experiences with the medical care of a child with T 13/18 over the past 5 years. Seven of 33 invited families were surveyed; those who had spent more than (...) 40 days in the hospital were most likely to accept the invitation. Grounded theory technique was used to analyze the interviews. This method elicited four key themes regarding family perspectives on children with T 13/18: they are unique and significant, they transform the lives of others, their families can feel overwhelmed and powerless in the medical setting, their families are motivated to “carry the torch” and tell their story. Families also emphasized ways in which Internet support groups can provide both positive and negative perspectives. The ensuing discussion explores the difficulties of parents and physicians in forecasting the impact that T 13/18 will have on families and emphasizes a narrative approach to elicit a map of the things that matter to them. The paper concludes that while over-reliance on dire prognostic data can alienate families, examining the voice, character and plot of patient stories can be a powerful way for physicians to foster shared decision-making with families. (shrink)

Considerable research on helpers-at-the-nest demonstrates the positive effects of firstborn daughters on a mother’s reproductive success and the survival of her children compared with women who have firstborn sons. This research is largely restricted to agricultural settings. In the present study we ask: “Does ‘daughter first’ improve mothers’ reproductive success in a hunting and gathering context?” Through an analysis of 84 postreproductive women in this population we find that the sex of the first- or second-born child has no (...) effect on a mother’s fertility or the survival of her offspring. We conclude that specific environmental and economic factors underlay the helpers-at-the-nest phenomenon. (shrink)

This paper argues that children as members of a perennial psychoclass represent one potential vanguard of an emergent shift in Western subjectivity, and that adult–child dialogue, especially in the context of schooling, is a key locus for the epistemological change that implies. I argue from Herbert Marcuse’s prophetic invocation of a “new sensibility,” which is characterized by an increase in instinctual revulsion towards violence, domination and exploitation and, correspondingly, a greater sensitivity to all forms of life. As the embodiment (...) of a form of philosophical “post-animism” or hylozoism, it represents the evolutionary shift that, it could be argued, our species requires for survival at this historical moment. I suggest that the evolutionary phenomenon of neoteny—the long formative period of human childhood and the pedomorphic character of humans across the life cycle—makes of the adult-collective of school a primary site for the reconstruction of belief. After exploring child–adult dialogue more broadly as a form of dialectical interaction between what John Dewey called “impulse” and “habit,” I argue for a form, or archetype of schooling first articulated in ancient Greece called skholé, a space that functions, according to Jan Masschelein and Maarten Simons, as a “meeting place,” a “form of gathering and action” dedicated to inquiry, and not to the production of calculated, preordained outcomes—a space removed from the world of production, and characterized by a form of temporality associated with childhood: aion, or “timeless time,” as opposed to kronos, or linear time. Skholé is dedicated to emergence and cultural reconstruction, which follows from an educative relationship between adults and children based on understanding the latter as bearers of the “novel,” and on a faith in the “reorganizing potentialities” of childhood impulse, or interest—that is, on natality as a fundamental principle of cultural evolution. (shrink)

According to an almost axiomatic standard in bioethics, moral commitment should ground parents’ relationship with their children, rather than biogenetic relatedness. This standard has been used lately to express skepticism about extending existing assisted reproductive treatments (ARTs) to same‐sex couples and to research into novel fertility interventions for those couples, but this skepticism is misplaced on several grounds. As a matter of access and equity, same‐sex couples seem presumptively entitled to genetic relatedness to their children as far as possible both (...) in regard to existing ARTs and to novel ARTs under investigation. For those worried about the effects of trying to secure biogenetic relatedness for same‐sex couples, it may be noted that same‐sex couples will only ever be a fraction of the parents implicated in propping up “biologism,” as the expectation of biogenetic relatedness it is sometimes called. The cultural force of biologism would survive almost intact even if no same‐sex couples were ever to have genetically related children. It is therefore hard to see why same‐sex couples should forfeit aspirations to biogenetic relationships with their children or enjoy less subsidy for ARTs than the subsidy given to different‐sex couples. As matter of moral consistency, the full implications of the biologism critique have yet to be evaluated relative to different‐sex couples. (shrink)

This paper aims to argue for the thesis that it is not a priori morally justified that the first phase of space colonisation is based on sexual reproduction. We ground this position on the argument that, at least in the first colonisation settlements, those born in space may not have a good chance of having a good life. This problem does not depend on the fact that life on another planet would have to deal with issues such as solar radiation (...) or with the decrease or entire absence of the force of gravity. These issues could plausibly be addressed given that the planets or settlements we will feasibly colonise could be completely transformed through geoengineering processes. Likewise, the ability of humans to live in space could be enhanced through genetic modification interventions. Even if, however, the problems concerning survival in space were solved, we think that, at least in the first period of colonisation of space or other planets, giving birth to children in space could be a morally irresponsible choice since we argue, the life we ​​could give them might not be good enough. We contend that this is the case since when we decide to have a baby. We argue that it is not morally right to be content that our children have a minimally sufficient life worth living; before we give birth to children in space, we should make sure we can give them a reasonable chance of having a good life. This principle applies both on Earth - at least where you can choose - and for space travel. (shrink)

This article proposes a situated reading of maternal love, loss and lovelessness in Donna Hemans’ novel River Woman, locating her text in relation to other contemporary Caribbean women writers and to the early fiction of Toni Morrison. I argue that the complex affects that her representation of ‘child-shifting’ produces, can be articulated both in relation to literary texts that re-imagine historical and contemporary practices leaving a child in order to save her, and in the context of the plantation, (...) where ruptured ties at the level of community and culture continue to be reproduced in the personal, emotional and family spheres. I use the concept of marronage, developed in the work of Glissant and Depestre, to define strategies of survival that necessitated actual and imaginative flight or escape, to contextualise the complex affects of the plantation that are repeated and reproduced in the novel's present—the late twentieth-century Caribbean. (shrink)

This article examines an enigma at the heart of Freud's work on trauma: the surprising emergence, from within the theory of the death drive, of the drive to life, a form of survival that both witnesses and turns away from the trauma in which it originates. I analyse in particular the striking juxtaposition, in Freud's founding work Beyond the Pleasure Principle, of his two primary examples of trauma: the repetitive nightmares of battle suffered by the soldiers of World War (...) I, and the game of the child, faced with the loss of its mother, who plays fort and da with his spool. My own understanding of Freud's insight did not emerge, however, simply through a reading of his text but began, in fact, in my encounter with a real child in Atlanta, a child whose best friend was murdered in the street and who is interviewed by the friend's mother. I thus read together the language of the nightmare and the language of the child in Freud's text, and then attempt to understand how Freud's text and the language of the real child shed light upon each other. (shrink)

The aim of this research is to illuminate (a) how religiosity can be manifest in a coping process associated with parenting a child with Down syndrome and (b) the complexity of this coping process in terms of the interdependence of identity, context, religion and coping. Following methods previously used in qualitative psychology of religious studies on religious people coping with cancer, religiosity is mapped out regarding how it is, and has been, manifest during the life before and after becoming (...) a parent to a child with Down syndrome. An in-depth analysis is conducted on how the various manifestations of religiosity play out, and intervene with identity and context, in the process of coping with various challenges associated with parenting a child with Down syndrome. The results show experiences of personal growth regarding identity as well as experiences of spiritual growth. The most dominant religious manifestation associated to the analysed coping processes is the faith community’s various roles. The results are compared with methodologically, and conceptually, similar studies. In comparison with studies on religious people coping with cancer, the role of the faith community is much more dominant in the presented case. It is argued that this might have to do with the differences in nature between stressors associated with the own health/survival and parenting a child with Down syndrome, and it is suggested that the nature of stressors might play an important role when understanding the varieties of religious manifestations in religious coping. (shrink)

The world’s first living donor liver transplant from an HIV-positive mother to her HIV-negative child, performed by our team in Johannesburg, South Africa (SA) in 2017, was necessitated by disease profile and health system challenges. In our country, we have a major shortage of donor organs, which compels us to consider innovative solutions to save lives. Simultaneously, the transition of the HIV pandemic, from a death sentence to a chronic illness with excellent survival on treatment required us to (...) rethink our policies regarding HIV infection and living donor liver transplantation. Although HIV infection in the donor is internationally considered an absolute contraindication for transplant to an HIV-negative recipient, there have been a very small number of unintentional transplants from HIV-positive deceased donors to HIV-negative recipients. These transplant recipients do well on antiretroviral medication and their graft survival is not compromised. We have had a number of HIV-positive parents in our setting express a desire to be living liver donors for their critically ill children. Declining these parents as living donors has become increasingly unjustifiable given the very small deceased donor pool in SA; and because many of these parents are virally suppressed and would otherwise fulfil our eligibility criteria as living donors. This paper discusses the evolution of HIV and transplantation in SA, highlights some of the primary ethical considerations for us when embarking on this case and considers the new ethical issues that have arisen since we undertook this transplant. (shrink)

In this article, James Joshua Coleman and Jon Wargo interrogate the (queer) child as a concept and specter that haunts civic life in the United States. Whereas scholars across a range of fields and standpoints have questioned the value of LGBTQ+ inclusion in public school curricula, and society more broadly, together Coleman and Wargo wonder at the capacity of civics education to include queer (as opposed to LGBTQ+) citizens within the cis-straight nation-state. To explore this possibility, they read across (...) two bills: (1) H.R. 9197 (Stop the Sexualization of Children Act), and (2) Illinois House Bill 246 (Inclusive Curriculum Law). In so doing, they highlight how the (Queer) Child operates as an organizing binary logic within these bills and examine how hermeneutical injustice impedes the formation of a truly queer civics education. Specifically, Coleman and Wargo demonstrate how hermeneutical injustice limits the nature of inclusion for LGBTQ+ citizens, both for exclusionary, anti-LGBTQ+ policy and for seemingly inclusive legislation. Pointing to scenes that demonstrate hermeneutical justice and queer survivance, they conclude by suggesting the construction of a queer civics education that stands outside the binary logics of the cis-straight nation-state. (shrink)

Medical researchers must continue to develop and test non-blood oxygen-transport products. Resources provided by the Jehovah's Witness Hospital Assistance Line must be consulted. Sickle cell researchers must continue to test non-blood treatment. Information about non-blood treatments must be disbursed. Ways to enhance parental comport as the laws further and further support children's best interest must be provided. Information regarding cultural diversity must be disseminated. Hospitals and healthcare agencies that have not done so must institute the use of ethics consulting or (...) ethics committees. Nurse ethicists must continue development of the role of educating staff; mediation, arbitration and negotiation; problem solving; obtaining legal opinion; providing patient, family, or staff advocacy; and helping to reduce suffering on the part of the providers. Difficult ethical decisions should continue to be debated.Were the staff at X Med Center correct in overriding parental wishes and breaking tenets of their faith? In the doctor's, nurse's lawyer's, and judge's view they were. The child, now eight years old, is alive and well. The stroke resolved, and imminent death averted. The parents' and child's views are not presently available. Whether the family is suffering from the child's loss of his relationship with God, or are secretly relieved in their hearts that they are not, like Rita Swan, mourning their dead son, is unknown. What is known, is that this was a difficult case for all involved, and that such cases will continue to present themselves in the future. (shrink)

Tomasello's moral psychology of obligation would be developmentally deepened by greater attention to early experiences of cooperation and shared social agency between parents and infants, evolved to promote infant survival. They provide a foundation for developing understanding of the mutual obligations of close relationships that contribute (alongside peer experiences) to growing collaborative skills, fairness expectations, and fidelity to social norms.

This study examines child survival and growth in a patrilineal Ethiopian community as a function of father absence and sex. In line with evolutionary predictions for sex-biased parental investment, the absence of a father and associated constraints on household resources is more detrimental for sons’ than daughters’ survival in infancy. Father absence doubles a son’s risk of dying in infancy but has a positive influence on the well-being of female members of the household, improving daughter survival, (...) growth, and maternal nutritional status. Lack of paternal investment may be compensated for by other matrilateral kin through increased reciprocity between mother, daughter, and sister. (shrink)

We conducted a meta-analysis of 17 studies that tested for an association between grandparental survival and grandchild survival in patrilineal populations. Using two different methodologies, we found that the survival of the maternal grandmother and grandfather, but not the paternal grandmother and grandfather, was associated with decreased grandoffspring mortality. These results are consistent with the findings of psychological studies in developed countries (Coall and Hertwig Behavioral and Brain Sciences 33:1-59, 2010). When tested against the predictions of five (...) hypotheses (confidence of paternity; grandmothering, kin proximity, grandparental senescence, and local resource competition), our meta-analysis results are most in line with the local resource competition hypothesis. In patrilineal and predominantly patrilocal societies, the grandparents who are most likely to live with the grandchildren have a less beneficial association than those who do not. We consider the extent to which these results may be influenced by the methodological limitations of the source studies, including the use of retrospective designs and inadequate controls for confounding variables such as wealth. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Grieving One More TimeNeethi Pinto"The deeper sorrow carves into your being, the more joy you can contain."—Kahlil GibranI take care of very sick children in the pediatric intensive care unit (PICU). When a child dies, grief strikes in three distinct waves. First, I grieve for the child we couldn't heal, the unfairness, and the complete and utter sadness of a life cut too short. Then, I grieve (...) for the survivors—the families whose lives will be changed forever and who must find the strength to go on. It's not until later, in solitude, that I am able to grieve a third time—this time by and for myself.As clinicians, we are also survivors. Yet, our culture in medicine rarely affords us the permission or the grace to unpack the depth of the sorrow and grief we regularly witness and suffer. Instead, we must summon up the fortitude to take care of the child in the next room before we can pause and process our grief. As a field, we have been more intentional about having "hot" (soon after the event) and "cold" (days to weeks later) debriefings, but these short conversations about our shared experience are limited. The sheer reality of our day-to-day lives in the PICU is that the next critically ill patient is waiting.My processing of grief happens when I replay the events leading up to the patient's death over and over and over again. Was there something I missed? Could I have done better? In fact, I teach my medical students, pediatric residents, and PICU fellows that this very questioning makes us better physicians—as long as we don't let our second-guessing or fear of making a mistake paralyze our actions in the future.Little did I know I would grieve a fourth time …"How would you feel if this was your daughter?" These words were harshly spoken by my patient's father, a former police officer, the day his daughter died of respiratory failure. I had cared for her on many occasions during her prolonged admission, including that very sad last day. Undoubtedly, he was grieving, but I could feel his anger when he interrogated me. I wondered if he remembered how he profusely thanked me for caring for his daughter when we first met or the many times our team had resuscitated her, saving her life. I spent countless hours at her bedside, during the day, in the middle of the night, away from my own young family. Sure, these hours—nights, weekends, and holidays—are "part of the job," but I chose a career in pediatric critical care because of a commitment to caring for the most medically vulnerable children—the sickest of the sick—despite these hours. As pediatric intensivists, we have a unique opportunity to help children and their families at the most harrowing times in their lives—when they face the possibility of death. Although we know at the outset that some children will not survive, the grief we experience when a child dies still runs deep. It hurts every single time. In this case, my profound grief was exacerbated by the father's hostility. One year later, my sorrow deepened when I answered my doorbell at home to find a police officer handing me a subpoena for a malpractice lawsuit regarding this child's death—a delivery intended to intimidate me. I found myself grieving a fourth time—grieving for the loss of joy—joy that had been central to my identity as a physician. [End Page 72]Then, the feeling of shame crept in and haunted me. I always understood that I entered a high-risk/high-stakes field where children die because of the severity of their illness despite state-of-the-art medicine and technology. Over the years, I've learned that not only is it rewarding to help a child survive critical illness but it is incredibly moving to forge an intense human connection with families when their children are dying. So, my shame was not due to a sense of failure in preventing this child's death but rather due to the... (shrink)

Background While prenatal surgery historically was performed exclusively for lethal conditions, today intrauterine surgery is also performed to decrease postnatal disabilities for non-lethal conditions. We sought to describe physicians' attitudes about prenatal surgery for lethal and non-lethal conditions and to elucidate characteristics associated with these attitudes. Methods Survey of 1200 paediatric surgeons, neonatologists and maternal–fetal medicine specialists. Results Of 1176 eligible physicians, 670 responded. In the setting of a lethal condition for which prenatal surgery would likely result in the (...) class='Hi'>child surviving with a severe disability, most respondents either disagreed or strongly disagreed that they would recommend the surgery. Male physicians were twice as likely to recommend surgery for the lethal condition, as were physicians who believe that abortion is morally wrong. Older physicians were less likely to recommend surgery. For non-lethal conditions, most respondents agreed that they would recommend prenatal surgery, even if the surgery increases the risk of prematurity or fetal death. Compared with MFMs, surgeons were less likely to recommend such surgery, as were physicians not affiliated with a fetal centre, and physicians who were religious. Conclusion Physician’s attitudes about prenatal surgery relate to physicians’ beliefs about disability as well as demographic, cultural and religious characteristics. Given the variety of views, parents are likely to receive different recommendations from their doctors about the preferable treatment choice. (shrink)

SummaryThe influence of religion on health remains a subject of considerable debate both in developed and developing settings. This study examines the connection between the religious affiliation of the mother and under-five mortality in Mozambique. It uses unique retrospective survey data collected in a predominantly Christian area in Mozambique to compare under-five mortality between children of women affiliated to organized religion and children of non-affiliated women. It finds that mother's affiliation to any religious organization, as compared with non-affiliation, has a (...) significant positive effect on child survival net of education and other socio-demographic factors. When the effects of affiliation to specific denominational groups are examined, only affiliation to the Catholic or mainstream Protestant churches and affiliation to Apostolic churches are significantly associated with improved child survival. It is argued that the advantages of these groups may be achieved through different mechanisms: the favourable effect on child survival of having mothers affiliated to the Catholic or mainstream Protestant churches is probably due to these churches' stronger connections to the health sector, while the beneficial effect of having an Apostolic mother is probably related to strong social ties and mutual support in Apostolic congregations. The findings thus shed light on multiple pathways through which organized religion can affect child health and survival in sub-Saharan Africa and similar developing settings. (shrink)

SummaryMalaria is a major cause of under-five mortality in Mali and many other developing countries. Malaria control programmes rely on households to identify sick children and either care for them in the home or seek treatment at a health facility in the case of severe illness. This study examines the involvement of mothers and other household members in identifying and treating severely ill children through case studies of 25 rural Malian households. A wide range of intra-household responses to severe illness (...) were observed among household members, both exemplifying and contravening stated social norms about household roles. Given their close contact with children, mothers were frequently the first to identify illness symptoms. However, decisions about care-seeking were often taken by fathers and senior members of the household. As stewards of the family resources, fathers usually paid for care and thus significantly determined when and where treatment was sought. Grandparents were frequently involved in diagnosing illnesses and directing care towards traditional healers or health facilities. Relationships between household members during the illness episode were found to vary from highly collaborative to highly conflictive, with critical effects on how quickly and from where treatment for sick children was sought. These findings have implications for the design and targeting of malaria and child survival programming in the greater West African region. (shrink)

Cross-cultural studies have revealed broad quantitative associations between subsistence practice and demographic parameters for preindustrial populations. One explanation is that variationin the availability of suitable weaning foods influenced the frequency and duration of breastfeeding and thus the length of interbirth intervals and the probability of child survival (the “weaning food availability” hypothesis). We examine the available data on weaning age variation in preindustrial populations and report results of a cross-cultural test of the predictions that weaning occurred earlier in (...) agricultural and pastoral populations because dairy and cereal production increased the availability of easily digestible, nutrientrich foods appropriate for weaning. We found that, contrary to predictions, supplementation with liquid foods other than breast milk was delayed in agricultural populations relative to less agriculturally dependent ones and complementary feeding with solid foods was delayed in pastoral populations relative to those less dependent on herding. Although the duration of breastfeeding was longer in populations dependent on hunting, there was no qualitative evidence that such populations lacked foods appropriate for weaning. The patterns observed suggest that the relationships between demography and subsistence observed among preindustrial societies cannot be explained by the “weaning food availability” hypothesis. We discuss the implications for understanding the mechanisms underlying prehistoric human demography, subsistence shifts, allocation to parenting and mating effort, and the evolutionary implications of tradeoffs between diet and disease. (shrink)

Background: It is not known how neonatologists address the affective and cognitive loads on parents deciding whether to resuscitate infants born extremely preterm. This study explores expert neonatologists' views on these decision-making processes and their own roles in counseling parents. Methods: Semistructured interviews asked internationally recognized experts to share their perspectives on perinatal consultations. Their responses were subjected to thematic analysis. Results: Eighteen of 22 invited experts participated. Approximately equal numbers reported employing a physician-driven approach, a parent-driven approach, and a (...) combined approach during these consultations. Those who followed a physician-driven approach typically focused on conveying standard information about adverse outcomes. Those who followed a parent-driven approach typically focused on addressing parents' information requests, guiding their decision making, and providing affective support. Nearly all experts, in each group, endorsed addressing the child's quality of life, in terms of functionality, when discussing long-term outcomes. Although many believed that families adjusted to life with a disabled child, few discussed the topic during prenatal consultations. Most, in each group, reported trying to alleviate future “decisional regret” for parents whose premature infants subsequently became disabled. None spoke to parents about possible decisional regret after deciding to forgo resuscitation. Conclusions: Expert neonatologists are deeply concerned that parents understand the decision facing them. However, they differ on what information they offer and how they balance parents' need for cognitive and affective support. They expressed more concern about parents' decisional regret should their child survive resuscitation, but have severe disability, than about decisional regret after foregoing resuscitation. (shrink)

Lactation constitutes a major focus for research in international health because of its dramatic impact on child survival; evolutionary biology has investigated lactation as an important aspect of parenting strategy, with implications for understanding parent-offspring conflict. These perspectives are brought together in an attempt to develop integrated models for an issue of key international health concern: the duration of exclusive breast-feeding and the timing of weaning. This analysis highlights the relevance of evolutionary theory for practical problems in public (...) health, and it suggests the utility of public health outcomes for addressing evolutionary questions. (shrink)

In discussing the effects of grandparents on child survival in natural fertility populations, Coall & Hertwig (C&H) rely extensively on the review by Sear and Mace (2008). We conducted a more detailed summary of the same literature and found that the evidence in favor of beneficial associations between grandparenting and child survival is generally weak or absent. The present state of the data on human alloparenting supports a more restricted use of the term Human stem family (...) situations with celibate helpers-at-the-nest can be described as cooperatively breeding, but the term is a poor fit to many human family systems. (shrink)

This paper examines the effects of three different types of father absence on the timing of life history events among women in rural Bangladesh. Age at marriage and age at first birth are compared across women who experienced different father presence/absence conditions as children. Survival analyses show that daughters of fathers who divorced their mothers or deserted their families have consistently younger ages at marriage and first birth than other women. In contrast, daughters whose fathers were labor migrants have (...) consistently older ages at marriage and first birth. Daughters whose fathers died when they were children show older ages at marriage and first birth than women with divorced/deserted fathers and women with fathers present. These effects may be mediated by high socioeconomic status and high levels of parental investment among the children of labor migrants, and a combination of low investment, high psychosocial stress, and low alloparental investment among women with divorced/deserted fathers. Our findings are most consistent with the Child Development Theory model of female life history strategies, though the Paternal Investment and Psychosocial Acceleration models also help explain differences between women in low paternal investment situations (e.g., father divorced/abandoned vs. father dead). Father absence in and of itself seems to have little effect on the life history strategies of Bangladeshi women once key reasons for or correlates of absence are controlled, and none of the models is a good predictor of why women with deceased fathers have delayed life histories compared with women whose fathers are present. (shrink)

Child mortality differentials according to water supply and sanitation in many urban areas of developing countries suggest that access to piped water and toilet facilities can improve the survival chances of children. The central question in this study is whether access to piped water and a flush toilet affects the survival chance of children under five in urban areas of Eritrea. The study uses data collected by the Demographic and Health Survey (DHS) project in Eritrea in 1995. (...) The results show that while the unadjusted effect of household environment (water supply and toilet facility) is large and statistically significant during the post[hyphen]neonatal and child periods, it is relatively small and statistically insignificant during the neonatal period. The effect of household environment remains substantial during the post[hyphen]neonatal and child periods, even when other socioeconomic variables are held constant. However, the household environment effect totally disappears during the neonatal period when the socioeconomic factors are controlled for. (shrink)

This paper discusses children's right to play and its bioethical importance for children affected by war. Against the background of the current military conflicts, it analyses physical, psychological, and institutional factors that limit children's right to play in a situation involving armed conflict. Considering that the lack of institutional support of play for children affected by war constitutes a failure to fulfil our societal and political obligation under Article 31 of the United Nations Convention on the Rights of the (...) class='Hi'>Child, this paper analyses the understanding of play adopted in this legal instrument. In line with the distinctions made in the Convention, it discusses the importance of play for children's life and survival, for their health and well‐being, as well as for the recovery of trauma experienced by children affected by armed conflict. It thereby aims to contribute to the recognition and protection of this right on the grounds of bioethics and healthcare. (shrink)

In the USA, one child in 285 children is diagnosed with cancer every year, but thanks to improvements in medicine, the survival rate has reached 80%. However, cancer treatments, such as chemotherapy and radiation, are likely to affect their fertility later in life, limiting their ability to conceive. To reduce this risk, ovarian tissue cryopreservation is a surgical procedure that allows the ovarian tissue to be retrieved and cryopreserved in order to be reimplanted back into the abdomen and (...) restore ovarian function in children who become infertile due to gonadotoxic treatments. A case study published in 2014 offered recommendations to help assess whether such a procedure should be offered to female patients who have not yet entered puberty. This paper will investigate whether, in light of more recent and updated literature, their recommendations may need to be revised. (shrink)

The only hope of survival for children with a number of life-threatening illnesses is a successful bone marrow transplant (BMT). Unlike the treatment source for most therapies, the raw material for transplant therapy comes from a human being. Although, many BMTs are autologous, utilizing the patient's own bone marrow, a large percentage of childhood BMTs rely on bone marrow from children or adolescents who are biological siblings to the sick child. Medical and legal systems are confronted with a (...) dilemma when healthy children are needed to undergo minimally risky, yet somewhat painful, procedures for the benefit of their critically ill siblings. This article reviews legal issues involved in sibling bone marrow donation and psychological research that is relevant to those issues. The article concludes with proposed directions for future psycholegal research and a discussion of ethical issues that are not amenable to empirical investigation. (shrink)

Many people hold that there is an important moral distinction between passive euthanasia and active euthanasia. Thus, while the AMA maintains that people have a right quote to die with dignity, quote so that it is morally permissible for a doctor to allow someone to die if that person wants to and is suffering from an incurable illness causing pain that cannot be sufficiently alleviated, the MA is unwilling to countenance active euthanasia for a person who is in similar straits, (...) but who has the misfortune not to be suffering from an illness that will result in a speedy death. -/- A similar distinction with respect to infanticide has become a commonplace of medical thinking and practice. If an infant is a mongoloid or a microcephalic, and happens also to have some other defect requiring corrective surgery if the infant is to live, many doctors and hospitals believe that the parents have the right to decide whether the surgery will be performed, and thus whether the infant will survive. But if the child does not have any other defect, it is believed that the parents do not have the right to terminate its life. -/- The rationale underlying these distinctions between active and passive euthanasia, and between active and passive infanticide, is the same: the idea that there is a crucial moral difference between intentionally killing and intentionally letting die. This idea is admittedly very common. But I believe that it can be shown to reflect either confused thinking or a moral point of view unrelated to the interests of individuals. (shrink)

We analyze expressive small clauses like you fool (and their counterparts in other languages) as contributors of expressive content. Independently known restrictions on expressive content in turn allow us to derive their limited distribution. The theory has ramifications for child language. It correctly predicts which root-level small clauses will survive into adult grammar and which will be blocked by the acquisition of higher functional projections. It also opens the way to an analysis of children’s one- and two-word utterances as (...) denoting expressive, rather than straightforwardly propositional, content. (shrink)