Sicklecell disease 455

if the family clearly forbids physical aggression and name-calling and instead spends time together in enjoyable activities.

Research also shows that exposure to violent TV and movie images increases the risk of aggressive behavior among children, and that children's shows that portray significant sibling conflict and disrespect can increase sibling rivalry at home. This is why it is important for parents to teach critical viewing skills and to help their children understand the consequences of violence and disrespect.

Most experts agree that parents should get involved in their children's disputes if there is a risk of physical harm; otherwise, children should be encouraged to resolve the problems themselves. If parents must intervene, they should separate the children and ask them to come up with at least one idea about how their conflict could have been avoided or resolved. It is far more effective to allow children to solve their own problems than to punish them for not getting along. At the same time, parents should try not to figure out which child is to blame but simply assume that since it takes two to fight, everyone involved is partly responsible.

Severe sibling rivalry may best be handled during weekly family meetings in which parents remind their children of family rules about fighting and name-calling and review ways to settle conflicts.

In a few families, the conflict between siblings is so severe that the help of a mental health professional may be required. Signs that a family may need outside help in solving the problem include conflict that is causing marital problems, creates a real danger of physical harm, or that is hurting a child's self-esteem or psychological well-being.

sickle-cell disease An inherited blood disorder that affects red blood cells. Children with sickle-cell disease have red blood cells that contain mostly "hemoglobin S," an abnormal type of hemoglobin (the main substance in red blood cells that helps carry oxygen from the air in the lungs to the rest of the body). In sickle-cell disease, these red blood cells become abnormally shaped into a sickle, or crescent, which makes it difficult for them to pass through small blood vessels.

When sickle-shaped cells block small blood vessels, this interferes with the flow of blood to that part of the body, eventually damaging the tissue. This is what causes the complications of sickle-cell disease.

Cause

Normal red blood cells contain hemoglobin A; hemoglobin S and hemoglobin C are abnormal types of hemoglobin. Normal red blood cells are soft and round and can squeeze through tiny blood vessels and typically live for about 120 days before new ones replace them.

Children with sickle-cell conditions produce a different form of hemoglobin A, called hemoglobin S ("S" stands for sickle). Red blood cells containing hemoglobin S live only about 16 days, becoming stiff and distorted until they cannot pass through the body's small blood vessels. When sickle-shaped cells block small blood vessels, less blood can reach that part of the body. Tissue that does not receive a normal blood flow eventually becomes damaged. This is what causes the complications of sickle-cell disease.

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