Association between parental guilt and oral health problems in preschool children

Parents may feel guilty about their children's oral problems, which can affect their quality of life. The aim of this study was to assess the presence of parental guilt and its association with early childhood caries (EGG), traumatic dental injuries (TDI) and malocclusion (AMT) in preschool children. All 2 to 5 year-old children (N = 305), and their parents, seeking dental care at the University of Sao Paulo Dental School one-week Screening Programme, were asked to participate in the study, and 260 agreed. Children were examined by two calibrated dentists, and their parents answered a socioeconomic and ECOHIS questionnaire; the question on guilt was used as the dependent variable. Regression analyses examined the association between parental guilt and EGG, TDI, AMT and socioeconomic factors. A total of 35.8% of parents felt guilty. This was only associated with caries severity. No association was found between guilt and TDI, AMT or socioeconomic factors. EGG was present in 63.8% of the children; the mean (+/-sd) dmf-t score was 7.29 (+/-2.78). Thus, the number of parents feeling guilty increases with the increase of their children's dental caries severity. Parental guilt is related to caries but is not associated with TDI or AMT.

Tragedy on grade crossing: driver failure or systemic fragility?

In 2010, an accident occurred in Americana-SP, Brazil, involving two trains and one bus on a Grade Crossing, when 10 people died and 17 were injured including workers. This paper aims to analyze the accident using the Model of Analysis and Prevention of Work Accidents (MAPA). The method provides observation of work, interviews and analysis of documents to understand precedents of the event in the following stages: to understand the usual work from the involved people, the changes occurred in the system, the operation of barriers, managerial and organizational aspects. By the end, measures are suggested to avoid new occurrences. The accident took place at night in a site with insufficient lighting. The working conditions of bus drivers, train operators and watchmen are inadequate. There were only symbolic barriers (visual and acoustic signals) triggered manually by watchman upon train operator radio communication. The fragility of the barrier system associated to poor lighting and short time to trigger the signaling seem to play a critical role in the event. Contrary to the official report which resulted in guilt of the bus driver, the conclusion of the paper emphasizes the fragility of the safety system and the need of level crossing reproject.

Spiritual support for people living with HIV/AIDS: A Brazilian explorative, descriptive study

y In this exploratory and descriptive research, we identified the meaning of religion and spirituality in the experience of patients at a public health service for treatment of HIV/AIDS in a Brazilian upcountry town. Eight participants were selected through theoretical sampling. Data were collected through semistructured interviews, and analyzed by means of qualitative content analysis. The emerging themes were religion: a path to support, and God is everything. Religion, as a path that leads patients to different sources of support, included exploration of different churches, acknowledgment of guilt, and finding strength to cope with the disease, rationalization of the disease process, meeting other churchgoers, and finding God and faith. God, an important source of support, was present in prayers, in the belief in healing through faith, and in the feeling of comfort and relief. Because spirituality and religion were seen as important sources of support, in this study we that health professionals include these aspects in care planning.

Feelings of women regarding end-of-life decision making after ultrasound diagnosis of a lethal fetal malformation

Objective: this study investigated the feelings of women regarding end-of-life decision making after ultrasound diagnosis of a lethal fetal malformation. The aim of this study was to present the decision making process of women that chose for pregnancy termination and to present selected speeches of women about their feelings. Design: open psychological interviews conducted by a psychologist immediately after the diagnosis of fetal malformation by ultrasound. Analysis of the results was performed through a content analysis technique. Setting: the study was carried out at a public university hospital in Brazil. Participants: 249 pregnant women who had received the diagnosis of a severe lethal fetal malformation. Findings: fetal anencephaly was the most frequent anomaly detected in 135 cases (54.3%). Termination of pregnancy was decided by 172 (69.1%) patients and legally authorised by the judiciary (66%). The reason for asking for termination was to reduce suffering in all of them. In the 77 women who chose not to terminate pregnancy (30.9%), the reasons were related to feelings of guilt (74%). Key conclusions: the results support the importance of psychological counselling for couples when lethal fetal malformation is diagnosed. The act of reviewing moral and cultural values and elements of the unconscious provides assurance in the decision-making process and mitigates the risk of emotional trauma and guilt that can continue long after the pregnancy is terminated. (C) 2011 Elsevier Ltd. All rights reserved.

Climate Change and "historical responsibilities"

The historical responsibility of countries listed in the Annex I of the Convention on Climate Change has been used extensively as a justification for the lack of action of countries not included in Annex I to reduce their greenhouse gas emissions. We analyzed the contribution of non-Annex I countries to the CO2 emissions in the period 1850 - 2006 to assess their relative contribution to total CO2 emissions. In the period 1980 - 2006 non-Annex I countries represented 44% of the total but this contribution increased in the period 1990 - 2006 to 48%. If we extrapolate present trends to 2020 they will represent 56% in the period 1990 - 2020. The "historical responsibility" of Annex I countries is therefore decreasing. If we take 1990 as the starting year in which the Climate Convention recognized clearly that greenhouse gases are interfering dangerously with the climate system, it becomes very difficult to attribute "blame" and "guilt" to Annex I for their historical contributions. It becomes also quite clear the need of non-Annex I countries to engage with Annex I countries in the effort to reduce emissions. The Copenhagen Accord has no mention of "historical responsibilities".

Pungente vislumbre: a triste infalibilidade da culpa

O crime do professor de Matemática, de Clarice Lispector, aborda a necessidade inconsciente de punição advinda do sentimento de culpa, que constitui elemento inexorável da psique humana. O espelhamento do homem em seu animal o conduz à aproximação de uma possível consciência deste transtorno, fato que culmina no irremissível abandono do cão. Com base nos ensaios O estranho e O mal-estar na civilização, de Sigmund Freud, almeja-se entender a origem da dolente identificação entre estes dois personagens narrada no conto, bem como o corolário da cultura, responsável pela tristeza humana com a qual o professor irremediavelmente se coaduna.