Lupus Vanishes (Jubilee A Good News Publication Book 49)

Therapeutic strategies for clinical trials targeting renal recovery. Raising awareness of acute kidney injury: The contrasting characteristics of acute kidney injury in developed and developing countries. Nat Clin Pract Nephrol. Epidemiology of acute kidney injury in children worldwide, including developing countries [e-pub ahead of print] Pediatr Nephrol.

Accessed May 29, Recognition and management of acute kidney injury in the International Society of Nephrology 0by25 Global Snapshot: Nephrology in Africa—not yet uhuru. The first international consensus conference on continuous renal replacement therapy. Detection and management of AKI in the developing world: Epidemiology of acute kidney injury in Africa. Outcomes of acute kidney injury in children and adults in sub-Saharan Africa: Nephrology in South East Asia: Evaluation and initial management of acute kidney injury.

Community-acquired acute kidney injury in tropical countries. The evolution of our knowledge of HIV-associated kidney disease in Africa. Am J Kidney Dis. Biopsy proven acute tubular necrosis due to rhabdomyolysis in a dengue fever patient: Acute renal failure associated with malaria in children. Saudi J Kidney Dis Transpl. Acute renal failure in Congolese children: Malarial acute renal failure. Acute kidney injury in tropical acute febrile illness in a tertiary care centre—RIFLE criteria validation.

Acute kidney injury is common in pediatric severe malaria and is associated with increased mortality. Open Forum Infect Dis. Renal failure in malaria. Clinical profile and hospital outcome of children with severe acute kidney injury in a developing country. Paediatric acute kidney injury in a tertiary hospital in Nigeria: Acute kidney injury in Pediatric Intensive Care Unit: Incidence, risk factors, and outcome. Indian J Critical Care Med. Acute kidney injury and its association with in-hospital mortality among children with acute infections.

Malarial acute kidney injury in a paediatric intensive care unit. Spectrum of community-acquired acute kidney injury in India: Incidence and etiology of acute kidney injury in southern India. Clinical profile of acute kidney injury in a pediatric intensive care unit from Southern India: Indian J Crit Care Med.

Influence of acute renal failure in patients with cerebral malaria - a hospital-based study from India. Changing epidemiology of community-acquired acute kidney injury in developing countries: Risk factors and outcomes stratified by severity of acute kidney injury in malaria.

Malarial nephropathy in a tertiary care setup—an observational study. Nepal Med Coll J. Outcome of malaria-associated acute kidney injury: Acute renal failure in a patient with severe malaria and dengue shock syndrome. Mortality after fluid bolus in African children with severe infection.

Intravenous fluids—getting the balance right. Acute renal failure in pregnancy: Acute kidney injury is independently associated with mortality in very low birthweight infants: Acute renal failure and pregnancy: Obstetric acute kidney injury: Postpartum acute kidney injury: RIFLE classification and mortality in obstetric patients admitted to the intensive care unit with acute kidney injury: Acute kidney injury in late pregnancy in developing countries.

Changing picture of acute kidney injury in pregnancy: Diagnosing drug-induced AIN in the hospitalized patient: Drug-induced acute interstitial nephritis. Epidemiology and clinical correlates of AKI in Chinese hospitalized adults. Acute renal cortical necrosis—a study of patients. Renal cortical necrosis is a disappearing entity in obstetric acute kidney injury in developing countries: Snakebite nephrotoxicity in Asia. Snakebite-induced acute kidney injury in Latin America.

Acute renal failure associated with the use of traditional folk remedies in South Africa. Phenotype standardization for drug-induced kidney disease. Drug-induced acute kidney injury. Curr Opin Crit Care. Nephrology Carlton ; The acute, the chronic and the news of HIV-related renal disease in Africa. Dengue haemorrhagic fever in children: Episodes and duration of oliguria affect outcomes in critically-ill patients. Oliguria and biomarkers of acute kidney injury: Understanding oliguria in the critically ill [epub ahead of print] Intensive Care Med.

Does this critically ill patient with oliguria need more fluids, a vasopressor, or neither? Targeting urine output and day mortality in goal-directed therapy: Incidence and risk factors of acute kidney injury among the critically ill neonates. Acute kidney injury in the pediatric population. Outcome of acute kidney injury in pediatric patients admitted to the intensive care unit. Diagnosis and treatment of acute tubular necrosis. Urinary biochemistry and microscopy in septic acute renal failure: Urinary biochemistry in experimental septic acute renal failure.

Increased fractional excretion of sodium in prerenal azotemia: Significance of the fractional excretion of urea in the differential diagnosis of acute renal failure. Diagnostic performance of fractional excretion of urea and fractional excretion of sodium in the evaluations of patients with acute kidney injury with or without diuretic treatment.

Comprehensive Clinical Nephrology , 4th ed. Elsevier Saunders; , pp. The urine sediment as a biomarker of kidney disease. Urinary bile casts in bile cast nephropathy secondary to severe falciparum malaria. Urinary sediment cast scoring index for acute kidney injury: Utility of urine eosinophils in the diagnosis of acute interstitial nephritis. Urinary eosinophils in AIN: Urine biochemistry in septic and non-septic acute kidney injury: Diagnostic performance of fractional excretion of urea and sodium in acute kidney injury.

Measuring acute kidney injury around the world: Creatinine kinetics and the definition of acute kidney injury. Kidney disease improving global outcomes or creatinine kinetics criteria in acute kidney injury: False-positive rate of AKI using consensus creatinine—based criteria.

Biomarkers of acute kidney injury: Calibration and random variation of the serum creatinine assay as critical elements of using equations to estimate glomerular filtration rate.

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Factors influencing the production of creatinine: Enhanced creatinine and estimated glomerular filtration rate reporting to facilitate detection of acute kidney injury. Am J Clin Pathol. In severe acute kidney injury, a higher serum creatinine is paradoxically associated with better patient survival.

Diagnosis of acute kidney injury: Let us therefore place these intentions and these promises under the patronage of Saint Aloysius Gonzaga, in the certainty that through his intercession they will be a source of goodness and grace. This document - long-awaited, and the result of a long process of work - has been welcomed with great interest. On the basis of the very process that generated it, however, this is a document destined to sow its seeds very extensively, to fertilize the soil of the building of society over long periods of time, to motivate and guide the presence of Catholics in history, and not merely in some extemporaneous manner.

The destiny of the Compendium will be measured by the conviction with which it is received and by the use that is made of it for the relaunching of general pastoral activity in society and, above all, in bringing about a reflective, aware, coherent and community presence of lay Catholics involved in society and in politics. Structure and Purpose of the Compendium. The Compendium of the Social Doctrine of the Church offers a complete summary of the fundamental framework of the doctrinal corpus of Catholic social teaching.

The Compendium has a simple and straight-forward structure. After an Introduction, there follow three parts: The Conclusion, entitled "For a Civilization of Love", is an expression of the underlying purpose of the entire document. The Compendium has a specific purpose and is characterized by certain objectives that are well spelled out in the Introduction. In fact, the document "is presented as an instrument for the moral and pastoral discernment of the complex events that mark our time; as a guide to inspire, at the individual and community levels, attitudes and choices that will permit all people to look to the future with greater trust and hope; as an aid for the faithful concerning the Church's teaching in the area of social morality".

It is moreover an instrument put together for the precise purpose of promoting "new strategies suited to the demands of our time and in keeping with human needs and resources. But above all there can arise the motivation to rediscover the vocation proper to the different charisms within the Church that are destined to the evangelization of the social order, because 'all the members of the Church are sharers in this secular dimension' " Compendium, A fact that we do well to emphasize, because it is found in various parts of the document, is the following: In fact, the statement is made in No.

Social doctrine, indeed, is intended for a universal audience, in addition to those to whom it is primarily and specifically addressed, the sons and daughters of the Church. The light of the Gospel, which social doctrine brings to shine on society, illuminates every person: Social doctrine also implies responsibility regarding the construction, organization and functioning of society: By means of this responsibility, the laity put social doctrine into practice and fulfil the Church's secular mission.

The Compendium and the Church's Mission. The Compendium places the Church's social doctrine at the heart of the Church's mission. It shows, above all in Chapter Two, the ecclesiological aspect of this social doctrine, that is, how this doctrine is intimately connected with the mission of the Church, with evangelization and the proclamation of Christian salvation in temporal realities. In fact, among the instruments of the Church's particular mission of service to the world, which consists in being a sign of the unity of all the human race and a sacrament of salvation, there is found also her social doctrine.

The fact that the Compendium places social doctrine within the mission proper to the Church prompts us on the one hand not to consider it as something added or peripheral to the Christian life and, on the other hand, helps us to understand it as belonging to a community subject. In fact, the only subject properly suited to the nature of social doctrine is the entire ecclesial community.

The Compendium, in no. It is not a prerogative of a certain component of the ecclesial body but of the entire community: The whole of the Church community -- priests, religious and laity -- participates in the formulation of this social doctrine, each according to the different tasks, charisms and ministries found within her". The Church is one body with many members who, "though many, are one body" 1 Cor The action of the Church is likewise one, it is the action of a sole subject, but it is carried out according to a variety of gifts through which the whole richness of the entire body passes.

In this perspective, I wish to offer a reflection concerning the contribution of these different ecclesial components. The Compendium is put into the hands of priests. The priest, "by virtue of the consecration which he receives in the Sacrament of Orders, is sent forth by the Father through the mediatorship of Jesus Christ, to whom he is configured in a special way as Head and Shepherd of his people, in order to live and work by the power of the Holy Spirit in service of the Church and for the salvation of the world".

Priestly service to the world takes place according to the specific character proper to the priest. He is a missionary, but not independently of his liturgical service, of his making Christ present in his preaching and in his very life, of his being a shepherd to his flock, of his value as an instrument of dialogue among Christians and between Christians and all men and women.

The priest serves the Church's social doctrine not when he becomes involved directly in social or economic activities, but by preaching the social Gospel from the altar, by proclaiming in his preaching the freedom of Christ and condemning the denial of human rights and the disregard for the dignity of the person, by showing the uncontainable force of the love and justice that issue forth from the Word, teaching the social value of the Christian faith, by promoting a catechesis -- especially among young people and adults -- that draws its inspiration also from social doctrine, by prompting the Christian community and the laity, both as individuals and in associations, to open their minds and hearts to the human needs found in their own territory as well as to the needs of the larger world community.

Moreover, to the priest belongs the mission of promoting the "different roles, charisms and ministries present within the ecclesial community" , in relation also to the assimilation and proclamation of the Church's social doctrine. He has the first responsibility, within his community, of fostering and strengthening the awareness that all subjects of the community must have concerning their role in the evangelization of society: Consecrated Life and the Compendium. The Compendium is put into the hands of men and women religious.

Those who have responded to Christ's call to a form of life that already in this world can anticipate the perfection of the Kingdom of God have a special place in the Christian community and, by virtue of their charism, have a unique role in the evangelization of society. Theirs is not a detachment from the world, it is a different way of being within the world. It is a particularly profound and non-evasive way, in that those in consecrated life see social relationships and economic questions not only as they are, but also and above all as they will be and therefore as they should be.

Men and women religious leave everything behind cf. Consecrated life focuses its gaze prophetically on the Resurrection, when men and women will be "like angels in heaven" Mt By their witness to the Gospel beatitudes in their personal and community lives and by their total openness -- with their vows of obedience, poverty and chastity -- to living with the Lord for the salvation of the world, consecrated persons imbue social, political and economic relations with the radicality of the Gospel. Consecrated life offers a Gospel-based model of coexistence based on gift and keeps alive the ability of the entire Christian community and of all people to discern in the "already" the "not yet", to seek communion and charity, in order to provide human relations with a heart even in today's society.

In concluding these reflections on the Compendium of the Social Doctrine of the Church, I would like to emphasize the necessity of building a civilization of love. And you, priests and religious men and women, are called to offer your precious contribution for the achievement of this civilization of love. In this regard, the Compendium of the Social Doctrine of the Church affirms in number Human relationships cannot be governed solely according to the measure of justice. Christians know that love is the reason for God's entering into relationship with man.

And it is love which he awaits as man's response. Consequently, love is also the loftiest and most noble form of relationship possible between human beings. Love must thus enliven every sector of human life and extend to the international order. The Compendium has been long-awaited and is the result of a long process of elaboration. It has been received with great interest, judging from the vast number of copies published and translations made. However, it remains a document that, in keeping with the very ideals that brought it into being, is intended to sow its seeds for a long time and to provide for the long-term fertilization of the ground on which society is built.

The Compendium presents in a broad and systematic manner the principles, assessments and guidelines that the Church has placed before Catholics and before men and women of good will, above all starting with Leo XIII's Encyclical Rerum Novarum, in order that they might face the difficult social questions of our modern age. The text is divided into three parts: In this first part, the great principles of social doctrine are illustrated: The second part of the document deals with a whole series of issues that touch on social life: As you can easily see, these are issues that are of utmost concern for us: The Compendium ends with a rather short section in which certain guidelines are suggested, especially for the lay faithful, regarding the best way to make use of the extraordinary patrimony of human and Christian knowledge represented by social doctrine.

The lay faithful - both as individuals and in associations - are the Compendium's privileged partners; this document is meant to represent for them a precious instrument for formation and a constant source of inspiration. The lay faithful, by virtue of their baptism, are placed within the mystery of God's love for the world that Christ has revealed and of which the Church is a continuation in history. They therefore participate in the mystery, the communion and the mission found within the Church, but they do so according to their particular nature, their secular dimension.

They live directly where social life is secularly organized: The laity are not in the world to a greater degree than other ecclesial subjects, but they are in the world in a different way: The lay faithful, by means of their competence and professional character, and by means of their responsibility for working in particular contexts, in some way complete the Church's social doctrine, as far as practice is concerned, and mediate its necessary impact on reality.

Social doctrine is not mere theoretical knowledge, but is meant to be put into action, it is oriented to life and is to be applied creatively and actively practised. The lay faithful have a very particular role in this area, even if it is not a role that belongs exclusively to them. Since social doctrine is the meeting between the truth of the Gospel and human problems, the lay faithful - both as individuals and in associations - must actively guide the directives for action found in social doctrine towards operative results that are concrete and effective.

They are people who take risks and who are open to new experiences. The lay faithful, coming up with concrete, historical solutions to humanity's problems, are not - in a manner of speaking - an addendum to the Church's social doctrine, rather they are the very heart of this doctrine, because social doctrine has an intimate "experiential" dimension.

The lay faithful are men and women who are the intermediaries between, on the one hand, the principles of reflection, the criteria of judgment and the directives for action found in social doctrine and, on the other hand, the concrete and unique situations in which they act and make decisions.

This role of mediation does not imply an absence of courage, and it is not merely a capacity to bring about moderation or effective compromises. The lay faithful, if they are to be salt, light and leaven in the world , must work to make ever more evident those things that are authentically human in social relations, without fear and with openness to and hopefulness for the future. It is my ardent wish that the Compendium of the Social Doctrine of the Church will also help to bring to maturity here in the local Church of Singapore important personalities who are authentic believers, inspiring them to bear credible witness, making them leaders capable of bringing about change in the mechanisms of contemporary society by their thought and action.

There is always a need for witnesses, for martyrs and saints, also in the area of society. The Compendium is undoubtedly a complex and articulate text that does not allow us, in the context of this meeting, to consider all its various themes in their vastness. Allow me, therefore, to make a few brief comments that may be of some usefulness and relevance for your witness as lay Christians involved in the world.

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The Compendium affirms that the theme of life, of defending life from conception to natural death and promoting it in all its stages, is of fundamental importance for Christian action in the area of society. The right to life is the first right without which all other rights would lack their foundation. As the right of rights, the right to life should be the basis of all social planning. Moreover, the right to life makes available to society a dimension that is not attainable in politics, the dimension of what is owed to the human person simply by virtue of his being a person: The right to life is of fundamental importance for giving politics its proper humanistic purpose.

The natural family - based on monogamy and stability, as it was conceived in the divine plan and sanctified by Christianity - is today facing a difficult moment because of the multiple attacks made on it from different fronts. A concrete way of promoting the family consists in recognizing, respecting and promoting its rights.

This has been a constant reminder found in Christian social teaching. The history of political thought demonstrates that if social planning overlooks the subjectivity of the family, it fails also to respect the rights of individuals. Recognizing the pre-eminence of the family, moreover, is an incentive for overcoming purely utilitarian perspectives in favour of a culture of selflessness, which society so urgently needs.

Such a culture promotes the quest for adequate criteria for solving other social problems, such as those connected with work, the home, health, education, and so forth. In our society also, the family must therefore remain what God has made it to be: The economy and economic institutions are concerned with that dimension of the social-relational life of men and women that seeks to meet the primary needs arising from human existence in the world.

Within this perspective is found the intrinsically ethical dimension of the economy, considered both as a practical aspect of human life and as a science. In fact, the human person is at the centre of economic quests and economic praxis, as has been repeated many times by the Church's social magisterium, which teaches that man is to be seen as "the source, the centre, and the purpose of all economic and social life" Gaudium et Spes, It is within this perspective that we are to place the question - of great current interest and the subject of heated debate - of the value to be given to the market, or, to be more precise, of the regulation of the market and by whom it should be regulated.

The Compendium repeats the teaching that the market must be regulated, in the first place because it is not right that all goods should pass by way of the market. The human person cannot be an object of the market. In the second place, because there are needs that the market is not able to satisfy. In the fourth place, because there are goods that belong to everyone and that do well to remain the common property of all cf. We come then to the second question: I believe that by now we are all convinced that the market must be regulated by different subjects.

The market must first of all be regulated by its own rules: Second, the market is regulated by the ethics of business owners and of those who work in the economic sector cf. Third, a people's culture and tradition contribute to regulating the market. This obviously includes religion. The market always exists within a culture, it does not exist in a pure state as a mere technical fact; social bonds of solidarity, models of behaviour are of vital importance for giving the market a soul cf. Fourth, the market is also regulated by legitimate divergences between the different sectors of society, by associations of people in various work categories and by labour unions that democratically demand respect for the rights of workers.

Healthy clashes of social opinion have never been condemned by the Church, provided that they never give rise to violent or ideological conflicts cf. Fifth, the market is regulated by civil society: Last, economic organizations and international financial organizations are factors of regulation for the market when they succeed in their aim of providing the market with equitable rules, fostering economic democracy cf. All these factors together with the political authorities contribute to the regulation of the market cf. As can readily be seen, the issue of the market is an issue of governance, that is, of dynamic and regulated orientation on the part of various subjects that must be integrated among themselves according to the principle of subsidiarity.

I believe I can affirm that in our globalized era these factors are being imposed as if with new force and that the urgent need to coordinate them, with a view to an economic order ethically oriented to the service of the person, can no longer be avoided. The Compendium states that the first contribution that the Church offers the political community is of a religious type and corresponds to her mission: As declared in No. In the message of Christ, the human community can find the strength that will enable people to love their neighbour as another self, to combat all that is contrary to life, to accept the fundamental equality of all, to fight against every form of discrimination, to overcome a purely individualistic ethic in the perspective of civil friendship cf.

The Compendium speaks also of democracy, the political system that, better than any other, fosters participation and therefore mutual solidarity and cooperation within the political community. For this reason, the Compendium understands and proposes democracy as a political system for the protection and development of the human person. In the perspective of the Compendium, democracy is understood not only as political and electoral freedom, but above all as protection and development of the person, understood as a being subject to no conditions. The Christian vision of the person is distinguished by the absolute character recognized in the person deriving from the fact of men and women being the imago Dei: Instead, this vision requires that the person be understood in his horizontal and transcendental openness, and in his capacity to relate to others and to God in truth and goodness.

A true democracy needs this soul cf. We can understand the Compendium's reflection on peace if we make a distinction between peace understood as life that is fully human and peace understood as the absence of war. This, in fact, is the "fullness" of peace, which includes truth, freedom and justice, and which alone makes it possible to arrive firmly at peace as the absence of war and to be firmly rooted in this kind of peace.

I do not believe I am in error in saying that the Compendium speaks of peace always, even when it does not use this word; it speaks of peace also when it speaks of justice or solidarity, of the unity of the human family, of God's plan for humanity, of the human rights of every person and the corresponding duties, of the dignity of the human person, peoples and cultures. In the Compendium, therefore, peace also takes on a powerful cultural significance that is very relevant today. The sense of mutual respect for religious and cultural traditions, dialogue between religions, international cooperation, a culture of openness and reconciliation: According to the Compendium, at play here is the ultimate meaning of the building up of human society and, consequently, of peace cf.

In fact, at the heart of Deus Caritas Est - especially in paragraphs - is found a reflection on the Church's social doctrine, and in paragraph 27 an historical sketch of this doctrine from Rerum Novarum to Centesimus Annus is made. In the same place, moreover, reference is made to the publication of the Compendium of the Social Teaching of the Church, which has made a "comprehensive presentation" of the entire social teaching of the Church. We can therefore say that the Encyclical takes to itself not only certain aspects of social doctrine but the whole of the Church's modern social magisterium.

Our Holy Father Pope Benedict XVI declares that the Church's task, with her social doctrine, in building a just social order is that of reawakening spiritual and moral forces. What are the forces that the Holy Father is referring to? Let us listen to his words: As citizens of the State, they are called to take part in public life in a personal capacity. In compliance with the different requirements of their particular area of commitment, the lay faithful express the truth of their faith and, at the same time, the truth of the Church's social doctrine, which finds its fullest realization when it is lived out concretely as a solution to social problems.

In fact, the very credibility of social doctrine is found in the witness of works more so than in its internal coherence and logic. We should also note the constant reference and appeal made by Benedict XVI to the Saints, put forth as examples to be imitated by the lay faithful through the cultivation of an authentic lay spirituality inspired by love that will regenerate them as new men and women immersed in the mystery of God and inserted into society, as those who are holy and those who make holy.

This kind of spirituality builds up the world according to the Spirit of Jesus: It is no coincidence that the Compendium of the Social Doctrine of the Church begins with a first chapter entitled "God's Plan of Love for Humanity" and ends with a concluding chapter entitled "For a Civilization of Love". We are regular readers of CatholicNews. Because it lets us know about the church from the homeland we love. It makes us feel connected. Our brothers love it too - Filipino, Spanish, Mexican And it's easy reading and attractive.

Non-religious also read it, including the youth in our apostolate. So, please, keep up the good work! It's contributing a lot to our lives here and nourishes our love for the mission to people. The book has given me a clear insight of the works of early missionaries and also of the present invaluable services of various churches and organizations.

It has strengthened my faith and I am proud to be Catholic. The Belgian professional as mentioned in your article was only able to render minor repairs but much work was still required. Robert Navaratnam completed the repairs to the organ and even added the two organ cases flanking the central one.

Besides that, he even helped build the north transept nine-rank choir organ in to bring the number of organs in the cathedral to two. The Belgian has long gone but Robert Navaratnam still plays at services in the cathedral. He has toiled for the cathedral for more than 20 years and I'm sure he deserves some recognition for his contributions.

By the way, the Belgian was an engineer called Hugo Loos. Below is an article on the cathedral organs, which I have pieced together from various sources. The Cathedral of the Good Shepherd houses two pipe organs - one in the second floor gallery and a smaller one on the ground floor in the north transept. To date, it has 28 working stops, the result of additions and alterations made to the original organ by Singapore's sole organ builder, Robert Navaratnam. Ranks such as the trumpet are used on more than one stop.

The organ also incorporates pipework from various other organs, notably the Bombarde 16' from the former St. Clair organ at the Victoria Concert Hall. The gallery organ is easily recognized from its unusual asymmetric facade - only the central organ case is original, the left and right were added by Navaratnam. The action, once electropneumatic, is now fully direct-electric. This causes occasional problems with nonsounding notes and ciphers, resulting from the ingress of dirt into an open building and the general humidity.

It is the oldest playable organ in Singapore. The north transept nine-rank choir organ was built in by Navaratnam, utilising old pipework from various other organs. This is also a two manual and pedal instrument, the pipework housed in an enclosed chamber supported by steel square beams over the choir stands. There is no pipework for the pedal division and no expression shoe for the pipework.

At the end of , the old Conn console shell with keyboards and pedalboard which controlled the pipework was replaced with an equally old Allen electronic console. This replacement includes the Allen electronic stops, which adds colour to the nine ranks of pipework and also supplies the pedal division. There is very little literature available on the cathedral organs.

Bits of information on the older organ are available mainly through personal accounts. An elderly parishioner recounted helping out on Sundays as a young boy operating the manual air pump of the organ. By the s, the gallery organ became so dilapidated that it remained silent for nearly two decades. Hugo Loos, a Belgian engineer then based in Singapore, volunteered his services as both organist and repairman. Driven by his passion and love for pipe organs, he was able to render minor repairs but much work was still required.

Towards the end of , the then-cathedral rector, Father Robert Balhatchet, was introduced to Navaratnam who had been trained as a pipe organ builder in Germany. The organ has since been in the care of Navaratnam, who also plays for services at the cathedral. On Dec 16, , a concert was organized to rededicate the gallery organ. No one else should interfere in a married couple's relationship, not even the husband's mother, says Father Henry Siew. Instead, he should be the peacemaker because he is in the best position to help both parties accept and respect each other.

If the relationship cannot be improved, even with the best effort, he must know where his priority lies. The Bible has very clear guidelines on this matter: A husband should not be judgemental or hostile to his wife if she can't get along with his mother. He should avoid saying things like: Such comments assume that the wife is wrong or that she should always give in to the mother-in-law.

This will cause her to be hurt and resentful. If she retorts, arguments and quarrels will follow. The man cannot expect one party to "bow down" to appease the other. If his mother provokes the animosity by nitpicking and is often critical and harsh to his wife, the husband should protect his wife. He does not have to reprimand his mother, but he must tell her that he will not side with her indiscriminately and that as he is "no longer two but one" with his wife and any attack on her from his mother is not acceptable.

Although he is still his mother's son, he must now love and care for his wife more than he cares for his mother. If it is his wife who is intolerant, disrespectful and rude to his mother, he may have to adopt the strategy of avoidance. He should advise his mother to stay away for the time being since his wife is unable to accept her. The mother-in-law should not try to instruct or correct her since the latter is not disposed to being corrected by her. Neither should the husband try to reason with his wife to behave amiably with his mother.

The wife will feel threatened and is likely to turn aggressive to protect herself. The mother-in-law must learn to be patient and tolerant and, hopefully, eventually win over her daughter-in-law's heart. When a man is married to a woman, their relationship is sacred. They have their rights and duties towards each other. No one else should interfere in their couple relationship. His mother should not intrude into her son's marital affairs. She can continue to show concern over her adult son, but never attempt to control him. Being filial does not mean that you must live with your parents.

The stress of living together with little space for privacy increases the likelihood of conflicts. Whenever possible, if your spouse feels uncomfortable staying with your parents, you should try to get your own house. Filial piety also does not mean blind loyalty or unquestioning obedience to your parents. It is shameful for an adult child to feel obliged to obey his or her parents in daily decision making. An adult person should have the maturity to think and act independently. He or she may want to consult the parents, but ultimately he or she makes the decision and takes responsibility for it.

Filial piety is essentially an attitude of love and care for the parents. Concretely, it is shown by regular contacts and visits; and relating to them with respect and concern. However, their interactive pattern should be more like those of good friends with equal rights and mutual respect. Their goals are to provide emotional support and practical help to one another. Family life involves all kinds of human relationships. The most important relationship is the one between husband and wife. Any belief I had that I controlled the events of my life shattered. Like a blind child, I clung on desperately to the hand of God.

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The story began on the first day I set eyes on Jega. I was 31 and he was a year-old going to be baptized "John" two months later. Our first meeting took place at a food centre at the East Coast Park. It was arranged by two mutual friends who felt sure that we were made for each other. What utter nonsense, I thought. But it was love at first sight for both of us and we got married a year later. I gave birth to our first child, Seth, a year into our marriage. It was an easy pregnancy until the 28th week when Seth stopped growing and I started experiencing a series of early contractions.

This was attributed to the presence of anti-nuclear antibodies ANA in my blood which could cause premature births. I was given steroid injections to boost Seth's growth and he was delivered via caesarean section at 38 weeks. Eight months after delivering Seth, my auto immune illness flared with a vengeance. It attacked all my major joints and connective tissues. I moved around with a pair of crutches, pureed my food and sucked it through a thin straw because it was impossible to move my inflamed jaw.

I was finally diagnosed with lupus after four months of a desperate search for a cure. Seth's behaviour - persistent screams at night, allergies, obsessive play patterns and silence - was given the official label of autism spectrum disorder when he was two-and-a-half years old. It was a shattering moment for us and our families. Seth had brought us on our first roller coaster ride and we were afraid. Months later, we chanced upon a rosary CD, which Seth fell in love with the moment he heard it.

The rosary became his nightly lullaby as we massaged his tiny body into blissful sleep. Seth made sure that we had ample opportunity to meditate on the life of Christ as it often took us all the mysteries before he could find that elusive sleep, way past midnight. In particular, the Joyful Mysteries with its message on the role of the family in bringing the love and light of God to the world became a powerful call to us. It was another difficult pregnancy.

I bled for six months. On Dec 22, , I delivered my second son, Jude, via caesarean section at 38 weeks as his growth rate had dropped significantly after the 35th week. I gave up my job as a manager in June to focus on Seth's growing needs. Another roller coaster ride I had all my plans beautifully laid out but exactly two months after resigning, I discovered that I was pregnant yet again. I shook my head in shock and denial.

We were already surviving on a single income and struggling with Seth's expensive intervention programmes. How were we going to cope? But Seth had taught us well. We took a deep breath, knelt at the altar, and once again said "Yes" to God's will. We were ready to take another roller coaster ride. And what a ride it turned out to be.

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My gynaecologist, Dr Peter Chew, had earlier requested that I go for a thorough scan at 13 weeks. Midway through the scan, the chatty radiographer went silent and avoided my eyes. My heart skipped a few beats and started racing madly. Then a doctor gave me the painful news. I told myself to be brave, called Jega on my mobile and gave in to my sorrows with loud sobs in a toilet nearby.

Jega hopped out of the taxi an hour later and embraced me in a bear hug. I clung to him as I broke down again. At that instant, I felt again that magic moment when I first set eyes on him and loved the essence of his simple soul. I couldn't share Jega's positive declaration of the baby's health; but I knew that God would give me the grace and strength I would need for this new challenge in life; just as he did when I first learnt of Seth's autism.

Dr Peter Chew was the first face of God we encountered, amongst many others, in the months to come, to help in our journey with the baby. He held each of our hands in his, looked into our eyes with the love of a father for his children, and said, "This is not going to be easy, but I'm going to ask the two of you a very important question: Are you ready to do God's will?

I nodded, the sudden pain in my heart preventing words, but Jega gave a strong, affirmative "Yes! Dr Chew explained that our little baby had cystic hygroma, a fatal congenital condition where there is a collection of brain and spinal fluid around the neck of the foetus. Our baby also displayed thick folds around the neck region, which was consistent with Down's or Turner's syndrome.

We were told that her condition was so severe that death inside my womb or within a few days after delivery was a certainty. We were advised to prepare for the worst. In the following week, I mourned for the loss of a normal pregnancy and prepared for the death of my child. However, a chance call to my rheumatologist confirmed that the diagnosis had also indicated that there was a tiny chance of survival for the baby but it would be born with severe physical and mental disabilities.

For a frighteningly long moment, the future seemed so bleak and dark that each time I ventured there, my heart shrank. How seductive then was the thought of ending all this pain and uncertainty. A second disabled child - please God, no! I, who had, all of my life, protested vehemently against abortion, understood then why the act of terminating the life of a foetus often seemed to be the perfect answer; it was so practical, and it "solved" everything.

I could focus on Seth's needs and help Jude to grow up well - just the way Jega and I had planned it all when I gave up my job. But deep in my heart there was never a doubt that the baby had a right to live. Jega and I decided that we wanted this baby, that we were meant to have three unique children. We told the baby we wanted her - in whatever package she was coming in. The use of continental ancestry markers ensured that each participant in our study was truly of European ancestry. In addition, the detailed assessment of population substructure in European derived cases has not been previously applied to genetic studies of SLE manifestations.

This study does have limitations. The first limitation is the skewed distribution of the primary predictor, percent northern European ancestry. This skewing may reflect an overall predominately northern European ancestry of many North Americans of European descent. Ideally, the associations identified in this study should be further investigated in a sample of SLE subjects with more southern European ancestry. Secondly, while the north-south cline in Europe is the largest source of population substructure in European Americans 10 , more subtle stratification due to ethnic or regional differences may influence specific phenotypes.

In addition, since these SLE cases are not part of a longitudinal cohort, misclassification of the outcomes may occur. SLE patients may develop additional manifestations as their disease progresses. However, this misclassification error results in biasing our finding towards the null, and thus should not cause false positive results. Lastly, we had limited statistical power to detect association with certain SLE phenotypes e. To fully identify genetic predictors for the rare outcomes, one would need to enrich the case group for these manifestations to achieve a sample size adequate to study these outcomes.

In summary, this study emphasizes the concept that SLE cases descended from the same major continental ethnic group e. As an example, we have shown in this study that increased northern European ancestry is associated with photosensitivity and discoid rash, and protective for autoantibody production. These findings also indicate that geographic ancestry, likely reflecting genetic differences between those of northern and southern European ancestry, may contribute to the clinical heterogeneity seen in SLE patients of European descent.

Further detailed investigation of the genetic differences among SLE patients with more northern vs. Given the association between SLE-related autoantibodies with potentially severe disease manifestations e. Finally, the overall findings of this study also have substantial implications for case-control genetics studies of SLE.

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Future genetic studies of SLE subphenotypes, even if investigating only a single continental ethnic group, should include assessment for population substructure to avoid confounding by differences in genetic ancestry. We would like to thank all of the SLE participants and referring physicians for their contributions to our research. Hom, Graham, and Behrens, and Mr.

Ortmann are employees of Genentech, Inc. Harley is supported by the Alliance for Lupus Research and the U. Department of Veterans Affairs. Gaffney and Moser are supported by the Lupus Foundation of Minnesota. Moser is supported by the Arthritis Foundation. Criswell is supported by a Kirkland Scholar Award. National Center for Biotechnology Information , U.

Acute Kidney Injury Recognition in Low- and Middle-Income Countries

Author manuscript; available in PMC Aug 1. Lee , PhD, Ward A. Tsao , PhD, John B.

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Gaffney , MD, Kathy L. Gregersen , MD, Carl D. Langefeld , PhD, Timothy W. Behrens , MD, Michael F. Author information Copyright and License information Disclaimer. Address for reprint requests and corresponding author: The publisher's final edited version of this article is available free at Arthritis Rheum. See other articles in PMC that cite the published article.

Abstract Objective To determine whether genetic substructure in European-derived populations is associated with specific manifestations of systemic lupus erythematosus SLE , including mucocutaneous phenotypes, autoantibody production, and renal disease. Conclusions This study demonstrates that specific SLE manifestations vary according to northern vs.

Introduction Systemic lupus erythematosus SLE is the prototypic systemic autoimmune disease and can affect virtually any organ system. Genotyping and estimation of European ancestry The primary genotyping data for this study were obtained from two genome-wide association scans of SLE 25 , Statistical analysis Associations between the SLE phenotypes of interest and the primary predictor of percent northern European ancestry were assessed first using Spearman rank correlations since the primary predictor was not normally distributed see Figure 1.

Open in a separate window. Results Clinical characteristics for the analyzed SLE subjects in this study are provided in Table 1 , including the overall prevalence of the 11 ACR criteria and autoantibody frequencies the SLE phenotypes under study. Table 1 Demographic and clinical disease characteristics of the study population. See Materials and Methods for further details. Table 3 Tests of trend for discoid rash, photosensitivity, arthritis, and renal disorder using Cochran-Mantel-Haenszel combined odds ratios OR from multivariate analyses for each quartile.

Table 4 Tests of trend for autoantibody-related phenotypes using Cochran-Mantel-Haenszel combined odds ratios OR from multivariate analyses for each quartile. Discussion This study shows that genetic substructure within European-derived populations is associated with specific manifestations of SLE. Supplementary Material Supp Data Click here to view. Acknowledgements We would like to thank all of the SLE participants and referring physicians for their contributions to our research.

Epidemiology Pathology and Pathogenesis. Primer on the Rheumatic Diseases. The prevalence and incidence of systemic lupus erythematosus in Birmingham, England. Relationship to ethnicity and country of birth. Demographic differences in the development of lupus nephritis: Can morbidity and mortality of SLE be improved? Best Pract Res Clin Rheumatol. Rus V, Hochberg M. The epidemiology of sytemic lupus erythematosus. Systemic lupus erythematosus in three ethnic groups: LUpus in MInority populations: Ward MM, Studenski S.

Clinical manifestations of systemic lupus erythematosus. Identification of racial and socioeconomic influences.