[Living donors in kidney transplantation. Renaissance by non-related donors?]. / Lebendspende bei Nierentransplantation. Renaissance durch nicht verwandte Spender?

Renal Transplantation is hampered worldwide by the continuing lack of cadaveric organs. The discrepancy between the number of patients on the waiting list and the number of organs available is further compounded by the still unresolved problem of chronic transplant failure. Against this background, the arguments for increasing acceptance of the use of kidneys from living donors, both related and unrelated, are discussed. Initial reports on appreciably improved transplant survival rates of organs from unrelated living donors (85% survival after 3 years [19]) have since been confirmed by more recent studies. Our own results, in part obtained during a prospective study involving 103 patients (53 related, 50 unrelated) done between October 1994 and April 1999, with strict psychological care/evaluation prior to and after transplantation, revealed a four-year transplant survival rate of 98% in both groups. So far, the higher rejection rate of 34% in unrelated, vs. 13.2% in related, donors has not led to any earlier chronic dysfunction of the transplant. The expanded use of living kidney donors is not only ethically justifiable, but also improves the outcome.

Causes and consequences of harsh parental punishment. An empirical investigation in a representative sample of 570 German families.

This article examines a multifactorial model of causes and consequences of harsh parental punishment. The social-psychological model as developed by Gelles was extended to also include the antecedent conditions leading to rigid assertion of parental power relating to the child. Furthermore, personality problems of the child observable as consequences of harsh parental punishment were included in our model. The conditions which predict harsh parental punishment are--in the rank order of their importance: a child perceived as difficult to handle, i.e., a "problem child"; parental anger-proneness; the rigid assertion of parental power; and intra-familial problems and conflicts. As consequences of harsh parental punishment and rejection as perceived by the child, two types of personality problems were observed: a syndrome named "Conduct Disorder" and a syndrome including personality problems such as anxiety and helplessness.