Parent development

Today's parents tend to be overwhelmed with advice from many sources. In his role as family counselor, the pediatrician must understand and consider the emotional development of parents in relation to their child's development; otherwise, his advice and counsel do not "take" and he becomes tired and frustrated and angry. PARENTS PROGRESS THROUGH DEFINITE STAGES OF DEVELOPMENT: Stage 1: Learning the cues-the struggle of the parents to interpret the infant's needs. Stage 2: Learning to accept growth and development-the parent learning to accept some loss of control of the toddler. Stage 3: Learning to separate-the parent learning to allow the child to develop independently. Stage 4: Learning to accept rejection, without deserting-the struggle of the parents not to intrude and yet to be there when needed. Stage 5: Learning to build a new life having been thoroughly discredited by one's teenager-the parent learning to live independently while the teenager struggles to develop his own identity.The pediatrician who is accepting, sensitive and a good listener and who keeps in mind that parents as well as children have capacities for growth and development, will be a potent factor in promoting good parent-child relationships and many times more effective in dealing with the child in health and disease.     

Adrenalectomy for control of cancer of the breast

Bilateral oophorectomy and adrenalectomy were used in the treatment of ten patients with advanced metastatic carcinoma of the breast, and particular attention was given to preoperative and postoperative management by a team of specialists including surgeons, endocrinologist, radiologist and pathologist. Objective and gratifying clinical remissions were achieved in three of the ten patients in this series following total oophorectomy and adrenalectomy. The remaining seven patients all subsequently died of metastatic disease. There were no operative deaths. Known cerebral or hepatic metastasis contraindicates adrenalectomy for metastatic cancer of the breast. Five of the seven patients not benefited by the operation had either cerebral or hepatic metastasis. The best candidates for adrenalectomy are premenopausal women who have previously had a clinical remission following oophorectomy and who have subsequently relapsed. The indications for adrenalectomy in the postmenopausal woman are not clear.     

What do tadpoles really eat? Assessing the trophic status of an understudied and imperiled group of consumers in freshwater habitats

1. Understanding the trophic status of consumers in freshwater habitats is central to understanding their ecological roles and significance. Tadpoles are a diverse and abundant component of many freshwater habitats, yet we know relatively little about their feeding ecology and true trophic status compared with many other consumer groups. While many tadpole species are labelled herbivores or detritivores, there is surprisingly little evidence to support these trophic assignments. 2. Here we discuss shortcomings in our knowledge of the feeding ecology and trophic status of tadpoles and provide suggestions and examples of how we can more accurately quantify their trophic status and ecological significance. 3. Given the catastrophic amphibian declines that are ongoing in many regions of the planet, there is a sense of urgency regarding this information. Understanding the varied ecological roles of tadpoles will allow for more effective conservation of remaining populations, benefit captive breeding programmes, and allow for more accurate predictions of the ecological consequences of their losses.