Self-socialization: a case study of a parachute child.

The theoretical concept of self-socialization suggests that an individual is able to reflect on the self, formulate a vision of a future self, set goals, and take actions that create or alter the developmental trajectory. This case study of a parachute child illustrates how a person constructs her life from a very young age, drawing on a profound capacity for personal agency to overcome obstacles, identify resources, and internalize values to build a life structure. A model of the psychosocial process of self-socialization emerges from this case. Following the disruption of a well-defined trajectory, self-socialization is observed as a sequence of actions, reflection, correction, and new actions. Self-socialization is possible when a strong sense of self-efficacy is applied to attaining internalized values and goals.

The relationship of social support to depressive symptoms during the transition to high school.

The transition to high school is studied as a time when students may experience disruptions in their social support systems. Peer support, family support, and school belonging were hypothesized to be associated with adolescent adjustment, specifically depressive symptoms. Participants included 104 eighth graders and 101 ninth graders from a middle- to high-income, predominantly white community in southern Rhode Island. In year 2, 60 of the original 8th graders were surveyed as 9th graders. Three hypotheses were examined: Social support declines from 8th to 9th grade; depressive symptoms increase from 8th to 9th grade; and social support is significantly associated with depressive symptoms. The hypotheses were tested using cross-sectional and longitudinal analyses. Results indicated that 9th graders experienced more depressive symptoms and lower levels of school belonging as compared to the 8th graders. Changes in parent support and peer support were significantly associated with depressive symptoms in the transition to high school. Implications for increasing school belonging in the 9th grade are discussed.

Peer group membership and a sense of belonging: their relationship to adolescent behavior problems.

This study explored three aspects of peer group membership in adolescence: peer group affiliation, the importance of group membership, and a sense of peer group belonging. Each is considered in relationship to adolescents' behavior problems as measured by the Achenbach Youth Self-Report. Participants included an ethnically and socioeconomically diverse sample of 733 adolescents ranging in age from 11 to 18 years. Girls reported more internalizing problems and boys reported more externalizing problems. Girls also reported a higher sense of peer group belonging than boys. When controlling for adolescent age, gender, ethnicity, parent's educational level, and family structure, a sense of peer group belonging was negatively related to internalizing and externalizing behavior problems. Adolescents who viewed peer group membership as very important to them and had a positive sense of peer group belonging had significantly fewer behavior problems than those who viewed peer group membership as very important but did not have a positive sense of peer group belonging.

Dengue hemorrhagic fever with fulminant hepatic failure in an immigrant returning to Bangladesh.

An immigrant from Bangladesh living in the United Kingdom presented with a nonspecific febrile illness after visiting his homeland and subsequently developed fulminant hepatic failure accompanied by hypotension, ascites, a generalized coagulopathy, and thrombocytopenia. Serology and detection of dengue virus serotype 3 by PCR established a postmortem diagnosis of hepatic failure secondary to dengue hemorrhagic fever.

A randomised, controlled trial of the pulmonary artery catheter in critically ill patients.

OBJECTIVE: To compare the survival and clinical outcomes of critically ill patients treated with the use of a pulmonary artery catheter (PAC) to those treated without the use of a PAC. DESIGN: Prospective, randomised, controlled, clinical trial from October 1997 to February 1999. SETTING: Adult intensive care unit at a large teaching hospital. PATIENTS: Two hundred one critically ill patients were randomised either to a PAC group ( n=95) or the control group ( n=106). One patient in the control group was withdrawn from the study and five patients in the PAC group did not receive a PAC. All participants were available for follow-up. INTERVENTIONS: Participants were assigned to be managed either with the use of a PAC (PAC group) or without the use of a PAC (control group). MAIN OUTCOME MEASURES: Survival to 28 days, intensive care and hospital length of stay and organ dysfunction were compared on an intention-to-treat basis and also on a subgroup basis for those participants who successfully received a PAC. RESULTS There was no significant difference in mortality between the PAC group [46/95 (47.9%)] and the control group [50/106 (47.6)] (95% confidence intervals for the difference -13 to 14%, p>0.99). The mortality for participants who had management decisions based on information derived from a PAC was 41/91 (45%, 95% confidence intervals -11 to 16%, p=0.77). The PAC group had significantly more fluids in the first 24 h (4953 (3140, 7000) versus 4292 (2535, 6049) ml) and an increased incidence of renal failure (35 versus 20% of patients at day 3 post randomisation p<0.05) and thrombocytopenia ( p<0.03). CONCLUSIONS: These results suggest that the PAC is not associated with an increased mortality.