Death of a Child and the Risk of Stroke: A Binational Cohort Study From Denmark and Sweden

Background and Objectives:The death of a child is an extreme life event with potentially long-term health consequences. Accumulating evidence suggests that parents who lost a child have increased risks of cardiovascular diseases, including ischemic heart disease and atrial fibrillation. Whether bereaved parents have an increased risk of stroke is unclear and was investigated in this study.Methods:We conducted a population-based cohort study including parents who had a child born during 1973-2016 or 1973-2014 and recorded in the Danish and the Swedish Medical Birth Registers, respectively. We obtained information on child’s death, parent’s stroke and socioeconomic and health-related characteristics through linkage between several population-based registers. We used Poisson regression to examine the association between the death of a child and the risk of stroke.Results:Of the 6,711,955 study participants, 128,744 (1.9%) experienced the death of a child and 141,840 (2.1%) had a stroke during the follow-up. Bereaved parents had an increased risk of stroke; the corresponding incidence rate ratio (95% confidence intervals) was 1.23 (1.19-1.27). The association was present for all analyzed categories of causes of child death (cardiovascular, other natural and unnatural death), did not differ substantially according to the age of the deceased child, but was stronger if the parent had no or ≥3 than 1-2 live children at the time of the loss. The association was similar for ischemic and hemorrhagic stroke. The risk for hemorrhagic stroke was highest immediately after the death of a child and decreased afterwards. In contrast, there was no clear pattern over time in case of ischemic stroke.Discussion:The death of a child was associated with a modestly increased risk of stroke. The finding that an association was observed in case of unnatural deaths is suggestive of the explanation that bereavement-related stress may contribute to the development of stroke. Though the death of a child can often not be avoided, an understanding of its health-related consequences may highlight the need for improved support and attention from family members and healthcare professionals.

FUNCTIONS OF REMINISENCES IN CHRISTMAS STORIES OF MODERN RUSSIAN WRITERS (ON THE EXAMPLE OF THE WORKS OF Yu. BUIDA AND D. BYKOV)

The Little Match Girl by H.Ch. Andersen is a fairy tale that tells a tragic story about a child's death at Christmas night. Famous Russian authors Yu. Buida and D. Bykov have written stories with the same names (The Little Match Girl and The Little Match Girl Gives a Light). The authors deliberately used these names to show the relation with the famous work. In both stories, the action is set within the timeline defined by the canons of religious calendarial prose. There are miracles in the stories; the Christmas characters are archetypes, as they are kind, merciful and compassionate. The stories written by the contemporary authors are examples of a kind of a palimpsest. They show the socio-historical collisions and moral problems of the post-Soviet time. The article uses the comparative method which allows us to consider the types of characters, to find literary traditions and innovations in the prose of the writers. It is important to take an intertextual approach during (when) examining the stories. It helps identify and analyze how certain motifs and images relate in the 19th century literature and fiction texts of modern writers. This approach reveals the deep connection between the works and the texts of world and Russian literary classics.

Water and sanitation influence on child health in Namibia: using demographic and health surveys

Important milestones in reducing child mortality rates have been achieved internationally and in Africa. With 76 deaths per 1,000 live births, sub-Saharan Africa (SSA) continues to have the world's highest under-five mortality (U5M) rate. In SSA, one child in every 13 dies from preventable causes before reaching their fifth birthday. This study sought to determine the impact of demographic, socio-economic, and environmental determinants on child health in Namibia, using the Namibian demographic and health surveys (NDHS) from 2006 and 2013. A logistic regression model was used to determine the association between improved sanitary facilities and water sources and U5M in Namibia. Improved access to sanitation facilities in Namibia is associated with less U5M rate, according to the 2013 survey. No significant association was observed between improved access to safe water and child's death. In 2013, the greater the mother's level of education, the lower the chance of child death. Finally, the findings demonstrate that mothers with HIV-positive are more likely to experience under-five death. Hence, the Namibian government should increase sanitation facilities and promote maternal healthcare services for less fortunate households to lower the U5M rate.

Stevenson, Olive

Olive Stevenson (1930–2013) was an internationally recognized social work practitioner, educator, scholar, public servant, and consultant. She is particularly remembered for her contribution to the Maria Colwell Enquiry Report in 1974, which investigated a child’s death at the hands of her stepfather. The report was the first of what later became known as Serious Case Reviews. Stevenson authored a minority report, expressing dissent from some of the main report’s conclusions and strongly supporting social workers. This was much appreciated by practitioner social workers and leaders of Social Service departments at the time. She is also regarded by many in the United Kingdom as the leading social work academic of her generation over a 50-year career during a period of considerable change and challenge for the social work profession.

Exploring the Grieving Process and Coping Strategies of Meranao Mothers over their Children’s Death

Death of one’s child is an unfathomable painful situation that a mother may feel. While literature reports different coping strategies across cultures, there has no research yet that explored the grieving process that Meranao mothers go through when they lost a child. Hence, this study explored the grieving process of the bereaved Meranao mothers from the Southern Philippines over the loss of their children and the strategies they used to cope with the feelings of grief. The study was conducted at different barangays located in Marawi City, Lanao del Sur, Philippines. The participants lost children with age range of 18-30 years old. It was discovered that these bereaved mothers ask several questions to themselves emerging after the death of their children. Nonetheless, it was found that after the mothers had worked through their grief brought by their child’s death, they were able to restore their life and become stronger and resilient individuals. This paper concludes that bereaved mothers go through a tedious journey wherein the existence of pain, longing, sadness, guilt and anger were felt, but these emotions only strengthen them as mothers.

Síndrome do jaleco branco em crianças na emergência: estudo descritivo

O momento na hospitalização da criança gera uma mudança brusca na vida de uma família, pois envolvem circunstâncias, como a interrupção do cotidiano, onde ela se vê longe de seus irmãos, do pai e amigos; de seu lar e de seus hábitos. É um evento social que mobiliza todos, tem seu caráter segregante, pois afasta a criança e sua família da vida em sociedade, mas por outro lado, tem-se o desafio de conhecer novos ambientes, outras pessoas e por que não dizer, a possibilidade de fazer amizades e de retornar ao lar com a saúde restaurada. A criança hospitalizada passa por todo este processo e precisa do suporte familiar e educativo, a fim de que entenda aos poucos o processo no qual está inserida. Objetivos: descrever o fenômeno de extremo medo apresentado pela criança quando está na presença do jaleco branco. Visa também, apontar contribuições na minimização de manifestações de medo extremo e da síndrome do jaleco branco em crianças. Método: Estudo descritivo, com abordagem qualitativa e adotando conceitos da visão fenomenológica desenvolvido no setor de emergência pediátrica de um hospital universitário. Utilizou-se a técnica da entrevista semiestruturada, evocações livres e observação participante com treze familiares, a fim de produzir dados acerca da cultura do medo reproduzida pela família nas crianças hospitalizadas. Resultados: Os dados foram submetidos à análise de Bardin, onde se estabeleceram cinco categorias: Profissionais de saúde; objetos estranhos; evento indesejável; infecções e bactérias hospitalares e medo da morte da criança. Detectou-se o fenômeno de intenso medo pela criança comparado à “síndrome do jaleco branco em adultos” no qual foi interpretado sob o ponto de vista fenomenológico. Conclusão: Concluiu-se que a articulação de estratégias terapêuticas, é ferramenta indispensável tanto na prevenção da síndrome do jaleco branco em crianças, quanto no fortalecimento do estado de resiliência e no enfrentamento do medo pela criança e família. The moment a child is hospitalized generates an abrupt change in the life of a family, because it involves circumstances, such as the interruption of daily life, where the child is far from his/her siblings, father and friends; from his/her home and habits. It is a social event that mobilizes everyone; it has its segregating character, as it distances the child and his family from life in society, but on the other hand, there is the challenge of getting to know new environments, other people, and why not say, the possibility of making friends and returning home with his health restored. The hospitalized child goes through this whole process and needs family and educational support, so that he/she can gradually understand the process in which he/she is inserted. Objectives: to describe the phenomenon of extreme fear presented by the child when in the presence of the white coat. It also aims to point out contributions to minimize manifestations of extreme fear and the white coat syndrome in children. Method: A descriptive study, with a qualitative approach and adopting concepts from the phenomenological view, developed in the pediatric emergency department of a university hospital. We used the technique of semi-structured interview, free evocations and participant observation with thirteen family members, in order to produce data about the culture of fear reproduced by the family in hospitalized children. Results: The data were submitted to Bardin analysis, where five categories were established: health professionals; foreign objects; undesirable event; hospital infections and bacteria and fear of the child's death. The phenomenon of intense fear for the child was detected, compared to the "white coat syndrome in adults", which was interpreted from a phenomenological point of view. Conclusion: It was concluded that the articulation of therapeutic strategies is an indispensable tool both in the prevention of white coat syndrome in children and in the strengthening of the state of resilience and coping with fear by the child and the family.

Parental experiences of the liminal period of a child’s fatal illness

The article offers a description of parents’ experiences of their child’s ultimately fatal illness as it unfolds over the successive stages of medical treatment, in the context of the liminality theory. The parents ( N = 23) were interviewed 1–4 years after their child’s death. The research method involved conducting narrative interviews with parents in order to obtain a spontaneous narration of the child’s illness as it unfolded. The grounded theory approach, including the narrative and performative aspects of such parental utterances, was applied as the main research strategy. The results provide insight into the main areas and processes of common parental experiences, such as the pervasive sense of becoming trapped in timelessness and ambiguity. Further states reported by parents included oscillating between a distancing stance and involvement, and a dualistic relationship with medical staff and the medical system: between alignment and disharmony. The study indicates the importance of treating delivery of such a diagnosis as a process rather than as a one-time event. The sense of ambiguity is treated as a kind of necessary parental coping mechanism, whilst the sense of timelessness gives parents a unique sense of time in which they do not have to think about the child’s potentially imminent death.

“Parenting Beyond the Veil”: The Continued Parenting Relationship After a Child's Death Due to Cancer

Background: Childhood cancer is the leading cause of illness-related death, leaving thousands of parents to experience bereavement. This article presents select findings about the nature of the continued parenting relationship, which is an essential theme of the parental bereavement experience. Method: Heideggerian phenomenology provided the philosophical underpinnings of this study, which aimed to describe the lived experience of bereaved parents who experienced the death of a child due to cancer. Van Manen’s (1997) method guided data collection and analysis. Six parents participated in interviews to share what it has been like for them since their child's death. The researcher wrote analytic memos, documented detailed field notes, and used a member checking process to ensure trustworthiness of findings. Results: A structure of the lived experience of parental bereavement emerged, which included the essential theme of the continued parenting relationship. The parenting relationship continues throughout a parent's lifetime in spite of the child's physical absence, albeit in a different manner. This different nature of parenting is known as parenting beyond the veil. Bereaved parents continue to parent beyond the veil by engaging in meaningful activities, seeking activities that strengthen a deep connection with the child, and being open to comforting signs that enhance their continued relationship. Discussion: Parents believe sharing their experience can help nurses and other professionals understand the importance of their continued parenting relationship and their need to parent beyond the veil so that they can provide high quality care to bereaved parents in the future.

Parental bereavement – impact of death of neonates and children under 12 years on personhood of parents: a systematic scoping review

Background Losing a child tragically impacts the well-being and functioning of parents. With these effects extending beyond emotional, physical morbidity and compromising self-perceptions, appropriate, longitudinal, timely and personalised support is key to effective care of bereaved parents. However, in the absence of a comprehensive understanding of parental bereavement, effective support of bereaved parents remains suboptimal. To address this gap, we scrutinise prevailing data on the effects of a child’s death, aged 0–12 years, through the lens of the Ring Theory of Personhood (RToP). Methods To study prevailing accounts of bereaved parents following the death of a child, we adopt Krishna’s Systematic Evidence Based Approach (SEBA) to structure our Systematic Scoping Review (SSR in SEBA). Results Three thousand seventy-four abstracts were reviewed, 160 full text articles were evaluated, and 111 articles were included and analysed using thematic and content analysis. Four themes/categories were identified relating to the four rings of the RToP. Findings reveal that static concepts of protective and risk factors for grief are misplaced and that the support of healthcare professionals is key to assisting bereaved parents. Conclusion In the absence of consistent support of bereaved parents, this study highlights the need for effective training of healthcare professionals, beginning with an appreciation that every aspect of an individual parent’s personhood is impacted by the loss of their child. Acknowledging grief as a complex, evolving and personalised process subjected to parental characteristics, settings, context and available support, this SSR in SEBA calls attention to effective nurturing of the relationship between parents and healthcare professionals, and suggests use of the RToP to assess and direct personalised, timely, specific support of parents in evolving conditions. We believe the findings of this review also call for further studies to support healthcare professionals as they journey with bereaved parents.