151
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Gong M, Zhang S, Li W, Wang W, Wu R, Guo L, Lu C. Association between Childhood Maltreatment and Suicidal Ideation and Suicide Attempts among Chinese Adolescents: The Moderating Role of Depressive Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176025. [PMID: 32824995 PMCID: PMC7503513 DOI: 10.3390/ijerph17176025] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/16/2020] [Accepted: 08/17/2020] [Indexed: 12/25/2022]
Abstract
Suicidal behavior is a major public health concern worldwide and has become the second-leading cause of death among adolescents. The purposes of this study were to investigate the associations between childhood maltreatment and suicidal behavior and to test whether depressive symptoms have moderating effects on these associations. A multistage stratified cluster randomized sampling method was adopted to collect data from 21,019 high school students in Guangdong Province, China. The prevalence of suicidal ideation and suicide attempts among Chinese adolescents were 18.2% and 3.6%, respectively. Physical abuse (adjusted odds ratios (AOR) = 1.35, 95% confidence intervals (CI) = 1.32–1.38), emotional abuse (AOR = 1.26, 95% CI = 1.25–1.28), sexual abuse (AOR = 1.25, 95% CI = 1.21–1.30), physical neglect (AOR = 1.09, 95% CI = 1.08–1.11), and emotional neglect (AOR = 1.08, 95% CI = 1.08–1.09) were all associated with an increased risk of suicidal ideation, and these associations were also found for suicide attempts. According to stratification analyses, physical abuse/emotional abuse/sexual abuse had a stronger effect on suicidal ideation and suicide attempts among students without depressive symptoms than among students with depressive symptoms. Childhood maltreatment was associated with an increased risk of suicidal ideation and suicide attempts in Chinese adolescents. Depressive symptoms play a moderating role in the association between childhood maltreatment and suicidal behaviors.
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Affiliation(s)
| | | | | | | | | | - Lan Guo
- Correspondence: (L.G.); (C.L.); Tel.: +86-20-87332477 (C.L.)
| | - Ciyong Lu
- Correspondence: (L.G.); (C.L.); Tel.: +86-20-87332477 (C.L.)
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152
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Elnimeiri MKM, Satti SSM, Ibrahim MKM. Barriers of access and utilization of reproductive health services by adolescents-Khartoum state-Sudan-2020: study protocol. Reprod Health 2020; 17:121. [PMID: 32795353 PMCID: PMC7427964 DOI: 10.1186/s12978-020-00967-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 07/29/2020] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Adolescence is widely defined as the time in life when the developing individual attains the skills and attributes necessary to become a productive and reproductive adult. Most adolescents are healthy, but there is still substantial premature death, illness, and injury among adolescents. Illnesses can hinder their ability to grow and develop to their full potential. Alcohol or tobacco use, lack of physical activity, unprotected sex and/or exposure to violence can jeopardize not only their current health, but also their health as adults or even health of their future children. METHOD Community and institutional-based cross sectional study will be conducted in Khartoum State the seven localities will be included. This state is the national capital of Sudan, which has an area of 22,122 km2. The sample size of participant is estimated using the population formula (n = N/1+ (n*d2)). The sample will be drawn using multistage cluster sampling. Also the concerned bodies involved in the delivery of reproductive health services for adolescents included in this study. Data will be collected using interviews with key informants and administered pre-coded, pretested closed ended questionnaire with community participants. Data will be managed and analyzed using Statistical Package for Social Sciences version 21. Analysis is mostly univariate descriptive and bi-variate with Chi Square & Fischer Exact test analysis to find associations between variables of interest. DISCUSSION The census of adolescents mounted to 25% of the population and thus it is important to care for such significant portion of the population to document their reproductive health problems and their access to health care services. The study is expected to generate base-line indicators about barriers of access to reproductive health services by adolescents that can be used for better planning, monitoring and evaluation of the delivered services. The research about barriers of access to reproductive health services by adolescents in Sudan is still limited and the information is scanty and scattered. Thus, it is necessary to conduct such study to enrich the current database.
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153
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Children, seen and heard: a descriptive study of all children (aged 12 years and under) referred for acute psychiatric assessment in Tallaght University Hospital over a 10-year period. Ir J Psychol Med 2020:1-9. [PMID: 32741383 DOI: 10.1017/ipm.2020.85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES A review of the literature demonstrates that relatively little is known about acute psychiatric presentations in children (0-12 years), compared with adolescents or young adults (12 years+). This study aims to review psychiatric presentations of children to a CAMHS Liaison Service at Children's Hospital Ireland (CHI) at Tallaght University Hospital over a 10-year period. METHODS A retrospective study was undertaken of case notes of all children aged 12 years and under who were referred to the CAMHS Liaison Service between January 2009 and December 2018 (n = 318). Data were anonymised and inputted into SPSSv25 for analysis. The relationships between presentations and methods of self-harm over time were measured using Pearson's correlation. Associations between categorical variables were analysed using chi-squared tests. RESULTS There was a significant increase in presentations of under-12s over the 10-year period (r(8)=0.66, p = 0.02). There was also a significant increase in children presenting with a disturbance of conduct and/or emotions over time (r(8) = 0.79, p < 0.001). There was a significant association between female gender and ingestion (X2 = 12.73, df = 1, p < 0.05) and between male gender and ligature as a method of self-harm (X2 = 5.54, df = 1, p < 0.05). Over half (53%) of children presented with suicidal thoughts and 22% presented with suicidal behaviours. The reported use of ligature as a method of self-harm emerged only from 2012 among cases studied. CONCLUSIONS Children aged 12 years and under are presenting in increasing numbers with acute mental health difficulties, including suicidal thoughts and behaviours. There is a worrying trend in methods of self-harm, particularly in high lethality behaviours such as attempted strangulation.
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154
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Using Social Indicators to Describe Neighborhood-Level Disparities in Adolescent Health in Baltimore City Circa 2017. J Adolesc Health 2020; 67:270-277. [PMID: 32169527 DOI: 10.1016/j.jadohealth.2020.01.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 12/22/2019] [Accepted: 01/15/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of this study was to use social indicators to compare adolescent health disparities across neighborhoods in Baltimore, Maryland, circa 2017. Neighborhoods heavily influence adolescent health outcomes. Baltimore remains a hypersegregated city along racial boundaries with a recently growing population of Latino immigrant youth. This segregation may promulgate adolescent health disparities, yet the magnitude of needs and how they may differ among Baltimore's minoritized adolescents remain unknown. METHODS The most predominantly white, black, and Latino neighborhoods in Baltimore were analyzed across six indicators relevant to adolescent health: teen birth rate, high school achievement, poverty, health insurance, youth mortality rate, and lead paint violation rate. The indicators were used to create a composite adolescent deprivation index. Measures of absolute and relative disparity were then calculated between white, black, and Latino neighborhood clusters. RESULTS Both black and Latino neighborhoods had similar adolescent deprivation relative to white neighborhoods. Latino neighborhoods had the highest teen birth rate and children without health insurance. Black neighborhoods had the lowest educational achievement and the highest poverty, youth mortality, and lead paint violation rate. CONCLUSIONS The overall magnitude of social deprivation is similar across communities of color in Baltimore. However, black adolescents tend to live in neighborhoods with greater physical deprivation and youth mortality that limits within-group bonding capacity, whereas Latino adolescents tend to live in neighborhoods with limited health and social resources that prevent between-group bridging capacity. These indicators thus orient policies and programs to promote differential asset-based strategies for positive youth development.
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155
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Aggarwal S, Patton G, Bahl D, Shah N, Berk M, Patel V. Explanatory style in youth self-harm: an Indian qualitative study to inform intervention design. EVIDENCE-BASED MENTAL HEALTH 2020; 23:100-106. [PMID: 32651178 DOI: 10.1136/ebmental-2020-300159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/27/2020] [Accepted: 06/01/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND There are very few studies that have examined the effectiveness of psychological interventions (PIs) that have been developed and tested in high-income countries to reduce self-harm in low and middle-income countries. OBJECTIVE To evaluate the perspectives and explanatory styles of youth with self-harm and their caregivers to inform the design of an evidence based PI in a non-Western cultural setting. An additional objective was to suggest ways of integrating local practices and traditions to enhance its acceptability. METHODS We conducted 15 in-depth qualitative interviews with youth with self-harm and four interviews with the caregivers in the psychiatry department of a tertiary hospital located in Mumbai, India. Data were analysed using phenomenological thematic analysis. FINDINGS Five themes were uncovered: (i) contextual factors related to self-harm including interpersonal factors, intrapersonal factors and socio-cultural factors; (ii) formulation and current feelings about the attempt (iii) family members and friends as the perceived supports and deterrents for future self-harm attempts; (iv) treatment related experiences with counselling, in-patient and outpatient treatment and barriers to treatment; and (v) coping strategies. Recommendations for key areas of adaptation include therapist adaptation, content adaptation to accommodate for cultural considerations and broader social context. Gender based socio-cultural norms, beliefs and stigma attached to self-harm need to be specifically addressed in South Asian setting. Interpersonal conflicts are the most common triggers. CONCLUSION AND CLINICAL IMPLICATIONS To our knowledge this is the first study in the South Asian context evaluating explanatory styles of youth with self-harm and their caregivers to inform the design of an intervention to ensure its cultural congruence. Cultural adaptation of an evidence based PI results in competent delivery and ensures best results in diverse ethno-cultural populations.
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Affiliation(s)
- Shilpa Aggarwal
- Department of Mental Health and Non-Communicable Diseases, Public Health Foundation of India, New Delhi, Delhi, India
| | - George Patton
- Department of Adolescent Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Deepika Bahl
- Department of Mental Health and Non-Communicable Diseases, Public Health Foundation of India, New Delhi, Delhi, India
| | - Nilesh Shah
- Department of Psychiatry, Sion Hospital, Mumbai, Maharashtra, India
| | - Michael Berk
- Department of Psychiatry, Deakin University School of Medicine, Geelong, Victoria, Australia
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
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156
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Omerov P, Kneck Å, Karlsson L, Cronqvist A, Bullington J. To Identify and Support Youths Who Struggle with Living-Nurses' Suicide Prevention in Psychiatric Outpatient Care. Issues Ment Health Nurs 2020; 41:574-583. [PMID: 32286108 DOI: 10.1080/01612840.2019.1705946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Nurses working in psychiatric care daily encounter youths who are struggling with living. Despite this, nurses' suicide-prevention work is seldom addressed in research or in recommendations for care. The overall aim of this paper is to discuss how nurses, with their caring science perspective, may contribute to suicide prevention. The paper presents how nurses in psychiatric outpatient care may identify and support suicidal youths, according to experts in suicide prevention. The interviews with six experts in suicide prevention resulted in three themes: Engagement necessary but demanding, Acknowledgement of warnings signs and Supportive relationship. The respondents elaborated on how suicide-risk can be assessed. A good rapport with the youths was stressed and the recommended act of care included: to listen openheartedly without interrupting as well as to listen after risk- and protective factors to emphasize or to penetrate. To ask about suicidality as well as to let the person elaborate on what's important for him or her. To endure in the patients' suffering as well as steering the conversations toward hope. The paper also presents warning signs that need to be noticed according to the experts and the literature consensus. Our findings suggest that communication in suicide-prevention is an "art and act" that cannot be reduced to a method or simple guidelines. We argue that the recommended acts of care demand sensitivity and skills and that nurses as well as the domain of caring science may contribute to this competence.
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Affiliation(s)
- P Omerov
- The Department of Health Care Sciences, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | - Å Kneck
- The Department of Health Care Sciences, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | - L Karlsson
- The Department of Health Care Sciences, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | - A Cronqvist
- The Department of Health Care Sciences, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | - J Bullington
- The Department of Health Care Sciences, Ersta Sköndal Bräcke University College, Stockholm, Sweden
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157
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Ajayi AI, Ushie BA, Mwoka M, Igonya EK, Ouedraogo R, Juma K, Aboderin I. Mapping adolescent sexual and reproductive health research in sub-Saharan Africa: protocol for a scoping review. BMJ Open 2020; 10:e035335. [PMID: 32611738 PMCID: PMC7332189 DOI: 10.1136/bmjopen-2019-035335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Previous studies have attempted to review the vast body of evidence on adolescent sexual and reproductive health (ASRH), but none has focused on a complete mapping and synthesis of the body of inquiry and evidence on ASRH in sub-Saharan Africa (SSA). Such a comprehensive scoping is needed, however, to offer direction to policy, programming and future research. We aim to undertake a scoping review of studies on ASRH in SSA to capture the landscape of extant research and findings and identify gaps for future research. METHODS AND ANALYSIS This protocol is designed using the framework for scoping reviews developed by the Joanna Briggs Institute. We will include English and French language peer-reviewed publications and grey literature on ASRH (aged 10-19) in SSA published between January 2010 and June 2019. A three-step search strategy involving an initial search of three databases to refine the keywords, a full search of all databases and screening of references of previous review studies for relevant articles missing from our full search will be employed. We will search AJOL, JSTOR, HINARI, Scopus, Science Direct, Google Scholar and the websites for the WHO, UNICEF, UNFPA, UNESCO and Guttmacher Institute. Two reviewers will screen the titles, abstracts and full texts of publications for eligibility and inclusion-using Covidence (an online software). We will then extract relevant information from studies that meet the inclusion criteria using a tailored extraction frame and template. Extracted data will be analysed using descriptive statistics and thematic analysis. Results will be presented using tables and charts and summaries of key themes arising from available research findings. ETHICS AND DISSEMINATION Ethical approval is not required for a scoping review as it synthesises publicly available publications. Dissemination will be through publication in a peer-review journal and presentation at relevant conferences and convening of policymakers and civil society organisations working on ASRH in SSA.
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Affiliation(s)
- Anthony Idowu Ajayi
- Population Dynamics and Sexual and Reproductive Health and Rights, African Population and Health Research Center, Nairobi, Kenya
| | - Boniface Ayanbekongshie Ushie
- Population Dynamics and Sexual and Reproductive Health and Rights, African Population and Health Research Center, Nairobi, Kenya
| | - Meggie Mwoka
- Population Dynamics and Sexual and Reproductive Health and Rights, African Population and Health Research Center, Nairobi, Kenya
| | - Emmy Kageha Igonya
- Population Dynamics and Sexual and Reproductive Health and Rights, African Population and Health Research Center, Nairobi, Kenya
| | - Ramatou Ouedraogo
- Population Dynamics and Sexual and Reproductive Health and Rights, African Population and Health Research Center, Nairobi, Kenya
| | - Kenneth Juma
- Population Dynamics and Sexual and Reproductive Health and Rights, African Population and Health Research Center, Nairobi, Kenya
| | - Isabella Aboderin
- Population Dynamics and Sexual and Reproductive Health and Rights, African Population and Health Research Center, Nairobi, Kenya
- Perivoli Chair in Africa Research and Partnerships, Perivoli Africa Research Centre, University of Bristol, Bristol, UK
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158
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Shah PA, Christie SA, Motwani G, Dissak-Delon FN, Mefire AC, Mekolo D, Ngono GM, Dicker R, Etoundi GAM, Juillard C. Financial Risk Protection and Hospital Admission for Trauma in Cameroon: An Analysis of the Cameroon National Trauma Registry. World J Surg 2020; 44:3268-3276. [PMID: 32524159 DOI: 10.1007/s00268-020-05632-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Half of the global population is at risk for catastrophic health expenditure (CHE) in the event that they require surgery. Universal health coverage fundamentally requires protection from CHE, particularly in low- and middle-income countries (LMICs). Financial risk protection reports in LMICs covering surgical care are limited. We explored the relationship between financial risk protection and hospital admission among injured patients in Cameroon to understand the role of health insurance in addressing unmet need for surgery in LMICs. METHODS The Cameroon National Trauma Registry, a database of all injured patients presenting to the emergency departments (ED) of three Cameroonian hospitals, was retrospectively reviewed between 2015 and 2017. Multivariate regression analysis identified predictors of hospital admission after injury and of patient report of cost inhibiting their care. RESULTS Of the 7603 injured patients, 95.7% paid out-of-pocket to finance ED care. Less than two percent (1.42%) utilized private insurance, and more than half (54.7%) reported that cost inhibited their care. In multivariate analysis, private insurance coverage was a predictor of hospital admission (OR 2.17, 95% CI: 1.26, 3.74) and decreased likelihood of cost inhibiting care (OR 0.34, 95% CI: 0.20, 0.60) when compared to individuals paying out-of-pocket. CONCLUSION The prevalence of out-of-pocket spending among injured patients in Cameroon highlights the need for financial risk protection that encompasses surgical care. Patients with private insurance were more likely to be admitted to the hospital, and less likely to report that cost inhibited care, supporting private health insurance as a potential financing strategy.
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Affiliation(s)
- Pooja A Shah
- Center for Global Surgical Studies, Department of Surgery, University of California San Francisco, San Francisco, CA, USA
| | - S Ariane Christie
- Center for Global Surgical Studies, Department of Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Girish Motwani
- Center for Global Surgical Studies, Department of Surgery, University of California San Francisco, San Francisco, CA, USA
| | | | - Alain Chichom Mefire
- Department of Surgery, Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - David Mekolo
- Emergency Unit, Laquintinie Hospital of Douala, Douala, Cameroon
| | | | - Rochelle Dicker
- Department of Surgery, University of California, 10833 Le Conte Avenue, 72215 CHS, Los Angeles, CA, 90095, USA
| | | | - Catherine Juillard
- Department of Surgery, University of California, 10833 Le Conte Avenue, 72215 CHS, Los Angeles, CA, 90095, USA.
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159
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Zhang T, Wang H, Wang X, Yang Y, Zhang Y, Tang Z, Wang L. The adverse maternal and perinatal outcomes of adolescent pregnancy: a cross sectional study in Hebei, China. BMC Pregnancy Childbirth 2020; 20:339. [PMID: 32487101 PMCID: PMC7268722 DOI: 10.1186/s12884-020-03022-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 05/20/2020] [Indexed: 11/10/2022] Open
Abstract
Background The adverse pregnancy outcomes caused by teenage pregnancy are major public health problems with significant social impact. While China is the most populous country in the world, and 8.5% of the women aged 10–50 years are adolescent women, we aimed to analyze the adverse maternal and perinatal outcomes of the adolescent pregnancy in Hebei Province, China. Methods There were 238,598 singleton pregnant women aged 10–34 years from January 1, 2013 to December 31, 2017 in the database of Hebei Province Maternal Near Miss Surveillance System (HBMNMSS). The 238,598 pregnant women were divided into two groups: adolescent group (aged 10–19 years) and adult group (aged 20–34 years). The adolescent group was divided into two subgroups (aged 10–17 years, aged 18–19 years), the adult group was divided into two subgroups (aged 20–24 years, aged 25–34 years). We compared the risk of adverse pregnancy outcomes using univariate and multivariate logistic regression. We also made a stratified analysis of nulliparous and multiparous adolescent pregnancy. Results Compared with women aged 20–34 years, women aged 10–19 years had lower risk of cesarean delivery [adjusted risk ratio (aRR): 0.75, 95% confidence interval (CI): 0.70–0.80], gestational diabetes mellitus (GDM) (aRR: 0.55, 95%CI: 0.41–0.73). Women aged 10–19 years had higher risk of preterm delivery (aRR: 1.76, 95%CI: 1.54–2.01), small for gestational age (SGA) (aRR: 1.19, 95%CI: 1.08–1.30), stillbirth (aRR: 2.58, 95%CI: 1.83–3.62), neonatal death (aRR: 2.63, 95%CI: 1.60–4.32). The adolescent women aged 10–17 years had significantly higher risk of stillbirth (aRR: 5.69, 95%CI: 3.36–9.65) and neonatal death (aRR: 7.57, 95%CI: 3.74–15.33) compared with the women aged 25–34 years. Younger adults (20–24 years) also had higher risks of preterm delivery (aRR: 1.26, 95%CI: 1.20–1.32), stillbirth (aRR: 1.45, 95%CI: 1.23–1.72), and neonatal death (aRR: 1.51, 95%CI: 1.21–1.90) compared with women aged 25–34 years. The structural equation model showed that preterm delivery and cesarean delivery had an indirect effect on neonatal death in adolescent pregnancy. Conclusions The adolescent pregnancy was related to adverse perinatal (fetal and neonatal) outcomes, such as preterm delivery, stillbirth and neonatal death, especially in younger adolescent pregnancies.
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Affiliation(s)
- Ting Zhang
- Department of Obstetrics and Gynecology, Hebei General Hospital, Hebei Medical University, Shijiazhuang, Hebei, China.,Graduate School, Hebei North University, Zhangjiakou, Hebei, China
| | - Huien Wang
- Department of Thoracic Surgery, Hebei General Hospital, Shijiazhuang, Hebei, China
| | - Xinling Wang
- Department of Obstetrics and Gynecology, Hebei General Hospital, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yue Yang
- Department of Obstetrics and Gynecology, Hebei General Hospital, Hebei Medical University, Shijiazhuang, Hebei, China.,Graduate School, Hebei North University, Zhangjiakou, Hebei, China
| | - Yingkui Zhang
- Hebei Women and Children's Health Center, Shijiazhuang, China
| | - Zengjun Tang
- Department of Obstetrics and Gynecology, Hebei General Hospital, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Li Wang
- Department of Obstetrics and Gynecology, Hebei General Hospital, Hebei Medical University, Shijiazhuang, Hebei, China.
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160
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Roche E, O'Sullivan R, Gunawardena S, Cannon M, Lyne JP. Higher rates of disengagement among young adults attending a general adult community mental health team: Time to consider a youth-specific service? Early Interv Psychiatry 2020; 14:330-335. [PMID: 31368245 DOI: 10.1111/eip.12860] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 01/01/2019] [Accepted: 07/14/2019] [Indexed: 11/30/2022]
Abstract
AIM The initial onset of mental illness occurs most frequently in adolescence or early adulthood. In order to inform the development of mental health services tailored for youth, we sought to compare the characteristics of young (18-25 years old) and older (over 25 years old) adults following referral to a general adult community mental health team. METHODS All individuals referred to a Dublin-based community mental health team and offered an appointment between January 1 and December 31, 2016 were included in the study. Information in relation to engagement patterns, demographic characteristics and clinical characteristics was collected. RESULTS A total of 298 appointments were offered during the study period among which 94 (31.6%) were for young adults. Significant differences in demographic and clinical characteristics between the two age groups were evident. Young adults were significantly less likely to have been prescribed psychotropic medication at the point of referral (63% vs. 82% respectively, χ2 = 12.30, p < .001). Older adults were four times more likely to demonstrate a good level of early engagement in treatment than young adults (AOR 4.00, 95% CI 1.11-14.37, p = .03). CONCLUSIONS Young adults had distinct clinical needs and a lower level of engagement in the early stage of treatment compared with their older counterparts in this community team. Further research and stakeholder consultation is needed to more clearly identify the issues in relation to patient engagement. These insights will help to inform the development of youth-specific community mental health services.
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Affiliation(s)
- Eric Roche
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland.,Swords Community Adult Mental Health Service, Dublin, Ireland
| | | | | | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - John Paul Lyne
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland.,Swords Community Adult Mental Health Service, Dublin, Ireland
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161
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Gonsalves L, Wyss K, Gichangi P, Hilber AM. Pharmacists as youth-friendly service providers: documenting condom and emergency contraception dispensing in Kenya. Int J Public Health 2020; 65:487-496. [PMID: 32472373 PMCID: PMC7275003 DOI: 10.1007/s00038-020-01348-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 12/17/2019] [Accepted: 03/11/2020] [Indexed: 12/05/2022] Open
Abstract
Objectives This Kenya-based study ascertained whether pharmacies were an untapped source of ‘youth-friendly’ health services by determining (1) whether young people (aged 18–24) could successfully obtain condoms and emergency contraception (ECP); (2) whether contraceptives were dispensed according to national guidelines; and (3) how young people felt about obtaining ECP and condoms from pharmacy personnel. Methods This study used several methods to capture and cross-check purchasing experiences as reported by young people with those of dispensing pharmacy personnel. These included: focus group discussions; in-depth interviews; key informant interviews; and mystery shoppers. Results When in stock, young people were successfully able to obtain ECP and condoms from pharmacies. Counselling was sporadic: when it happened, it was not always accurate. Despite a lack of counselling, young people reported being satisfied with the quick, transactional interaction with pharmacy personnel. Conclusions The brief, transactional interactions between pharmacy personnel and young clients appear to be ‘youth-friendly enough’. While there is room to strengthen the services provided (improving both accuracy and scope), this should be done in a manner that does not fundamentally alter the current interaction.
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Affiliation(s)
- Lianne Gonsalves
- Department of Sexual and Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland. .,Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland. .,University of Basel, Basel, Switzerland.
| | - Kaspar Wyss
- Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Peter Gichangi
- International Centre for Reproductive Health Kenya, Mombasa, Kenya.,Department of Human Anatomy, University of Nairobi, Nairobi, Kenya.,Ghent University, Ghent, Belgium
| | - Adriane Martin Hilber
- Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland.,University of Basel, Basel, Switzerland
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162
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Davis LE, Abio A, Wilson ML, Shaikh MA. Extent, patterns and demographic correlates for physical fighting among school-attending adolescents in Namibia: examination of the 2013 Global School-based Health Survey. PeerJ 2020; 8:e9075. [PMID: 32435537 PMCID: PMC7227638 DOI: 10.7717/peerj.9075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 04/07/2020] [Indexed: 11/20/2022] Open
Abstract
Background Physical fighting is particularly detrimental for young people, often affecting other areas of their developing lives, such as relationships with friends and family and participating in risky behaviors. We aim to quantify the amount of problematic physical fighting in Namibian adolescents and identify modifiable risk factors for intervention. Methods We used the Namibia 2013 Global School-based Student Health Survey (GSHS). This survey collects health-related information on school-attending adolescents in grades 7 to 12. We defined physical fighting as having participated in at least two physical fights in the 12 months prior to responding to the survey. Factors that may be associated with physical fighting were identified a prior based on the literature and included age, sex, anxiety, suicide planning, truancy, physical activity, bullying victimization, presence of supportive parental figures, presence of helpful peers, extent of social network, and food insecurity. Multivariable logistic regression models were created to identify factors associated with physical fighting. Results A total of 4,510 adolescents were included in the study. A total of 52.7% female. 16.9% of adolescents reported engaging in at least two physical fights in the previous year. Factors associated with an increased odds of physical fighting included having a suicide plan, anxiety, truancy, food deprivation and being bullied. Increased age and loneliness were associated with a decreased odds of physical fighting. Conclusion This study identifies problematic physical fighting among adolescents in Namibia. We recommend public health and school-based programming that simultaneously targets risk behaviours and conflict resolution to reduce rates of physical fighting.
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Affiliation(s)
- Laura E Davis
- Center for Injury Prevention and Community Safety, Peercorps Trust Fund, Dar es Salaam, Tanzania.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Anne Abio
- Injury Epidemiology and Prevention Research Group, Turku Brain Injury Center, Division of Clinical Neurosciences, University of Turku, Turku, Finland
| | - Michael Lowery Wilson
- Injury Epidemiology and Prevention Research Group, Turku Brain Injury Center, Division of Clinical Neurosciences, University of Turku, Turku, Finland.,Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Masood Ali Shaikh
- Injury Epidemiology and Prevention Research Group, Turku Brain Injury Center, Division of Clinical Neurosciences, University of Turku, Turku, Finland
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Grande AJ, Elia C, Peixoto C, Jardim PDTC, Dazzan P, Veras AB, Cruickshank JK, Harding S. Mental health interventions for suicide prevention among indigenous adolescents: a systematic review protocol. BMJ Open 2020; 10:e034055. [PMID: 32423928 PMCID: PMC7239512 DOI: 10.1136/bmjopen-2019-034055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 03/10/2020] [Accepted: 04/16/2020] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION There are more than 370 million indigenous people from 5000 cultures living in 90 countries worldwide. Although they make up 5% of the global population, they account for 15% of the extreme poor. Youth suicide is the second leading cause of mortality among 15-29 years old and disproportionately affects indigenous youth. This research protocol pertains to a systematic review of studies that use a comparator/control group to evaluate the effectiveness of suicide interventions targeting indigenous adolescents (aged 10-19 years). METHODS AND ANALYSIS We will conduct a systematic search on MEDLINE, EMBASE, CINAHL, LILACS and PsycINFO from inception to September 2019 to identify articles that compare mental health interventions for suicide prevention among indigenous adolescents. Two reviewers will independently determine the eligibility of each study. Studies will be assessed for methodological quality using the risk of bias tool to assess non-randomised studies of interventions. We will conduct a meta-analysis if possible and use established statistical methods to identify and control for heterogeneity where appropriate. ETHICS AND DISSEMINATION This systematic review will use published data and does not require ethics approval. However, this review is in preparation of a feasibility study that will examine how best to support the physical and mental health of indigenous adolescents in Brazil. Ethics approval for the feasibility study was obtained from National Research Ethics Commission. Findings will be disseminated through a peer-reviewed publication and will be made available to key decision-makers with authority for indigenous health and other relevant stakeholders. PROSPERO REGISTRATION NUMBER CRD42019141754.
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Affiliation(s)
- Antonio José Grande
- State University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Christelle Elia
- King's College London Faculty of Life Sciences and Medicine, London, UK
| | - Clayton Peixoto
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Paola Dazzan
- King's College London Faculty of Life Sciences and Medicine, London, UK
| | - Andre Barciela Veras
- State University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
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Polek E, Neufeld SAS, Wilkinson P, Goodyer I, St Clair M, Prabhu G, Dolan R, Bullmore ET, Fonagy P, Stochl J, Jones PB. How do the prevalence and relative risk of non-suicidal self-injury and suicidal thoughts vary across the population distribution of common mental distress (the p factor)? Observational analyses replicated in two independent UK cohorts of young people. BMJ Open 2020; 10:e032494. [PMID: 32398331 PMCID: PMC7223145 DOI: 10.1136/bmjopen-2019-032494] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES To inform suicide prevention policies and responses to youths at risk by investigating whether suicide risk is predicted by a summary measure of common mental distress (CMD (the p factor)) as well as by conventional psychopathological domains; to define the distribution of suicide risks over the population range of CMD; to test whether such distress mediates the medium-term persistence of suicide risks. DESIGN Two independent population-based cohorts. SETTING Population based in two UK centres. PARTICIPANTS Volunteers aged 14-24 years recruited from primary healthcare registers, schools and colleges, with advertisements to complete quotas in age-sex-strata. Cohort 1 is the Neuroscience in Psychiatry Network (n=2403); cohort 2 is the ROOTS sample (n=1074). PRIMARY OUTCOME MEASURES Suicidal thoughts (ST) and non-suicidal self-injury (NSSI). RESULTS We calculated a CMD score using confirmatory bifactor analysis and then used logistic regressions to determine adjusted associations between risks and CMD; curve fitting was used to examine the relative prevalence of STs and NSSI over the population distribution of CMD. We found a dose-response relationship between levels of CMD and risk of suicide. The majority of all subjects experiencing ST and NSSI (78% and 76% in cohort 1, and 66% and 71% in cohort 2) had CMD scores no more than 2 SDs above the population mean; higher scores indicated the highest risk but were, by definition, infrequent. Pathway mediation models showed that CMD mediated the longitudinal course of both ST and NSSI. CONCLUSIONS NSSI and ST in youths reflect CMD that also mediates their persistence. Universal prevention strategies reducing levels of CMD in the whole population without recourse to screening or measurement may prevent more suicides than approaches targeting youths with the most severe distress or with psychiatric disorders.
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Affiliation(s)
- Ela Polek
- Psychiatry, University of Cambridge, Cambridge, Cambridgeshire, UK
- Psychology, University College Dublin, Dublin, Ireland
| | | | - Paul Wilkinson
- Psychiatry, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Ian Goodyer
- Psychiatry, University of Cambridge, Cambridge, Cambridgeshire, UK
| | | | - Gita Prabhu
- Wellcome Centre for Human Neuroimaging, University College London, London, UK
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, University College, London, UK
| | - Ray Dolan
- Wellcome Centre for Human Neuroimaging, University College London, London, UK
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, University College, London, UK
| | | | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Jan Stochl
- Psychiatry, University of Cambridge, Cambridge, Cambridgeshire, UK
- NIHR Applied Research Collaboration East of England, Cambridge, Cambridgeshire, UK
| | - Peter B Jones
- Psychiatry, University of Cambridge, Cambridge, Cambridgeshire, UK
- NIHR Applied Research Collaboration East of England, Cambridge, Cambridgeshire, UK
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Burggraf M, Polan C, Husen M, Mester B, Wegner A, Spodeck D, Dudda M, Kauther MD. Trauma induced clotting factor depletion in severely injured children: a single center observational study. World J Emerg Surg 2020; 15:31. [PMID: 32375899 PMCID: PMC7201748 DOI: 10.1186/s13017-020-00311-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 04/22/2020] [Indexed: 01/09/2023] Open
Abstract
Background Coagulopathy following severe trauma contributes significantly to mortality. Impaired clotting factors have been observed in adult trauma patients, but in pediatric trauma victims their activity has not yet been investigated. Methods Sixteen pediatric trauma patients were evaluated according to the ISS and assigned to two cohorts. An additional control group (CO; n = 10) was formed. Routine coagulation parameters and the soluble clotting factors (F) were tested. Nonparametric data was analyzed using the Mann-Whitney U test. Results are reported as median and interquartile range. Results The ISS of severely (SI, n = 8) and mildly (MI, n = 8) injured children differed significantly (25 [19–28] vs. 5 [4–6]; p < 0.001). INR was elevated in the SI cohort only when compared to the CO (1.21 [1.04-1.58] vs. 0.96 [0.93-1.00]; p = 0.001). Differences between SI and MI were found for FII (67 [53-90] vs. 82 [76-114] %; p = 0.028), FV (76 [47-88] vs. 92 [82-99] %; p = 0.028), and FXIII (67 [62-87] vs. 90 [77-102] %; p = 0.021). Comparison of the SI with the CO (FII 122 [112-144] %; p < 0.001; FV 123 [100-142] %; p = 0.002; and FXIII 102 [79-115] %; p = 0.006) also revealed a reduction in the activity of these factors. Furthermore, fibrinogen (198 [80-242] vs. 296 [204-324] mg/dl; p = 0.034), FVII (71 [63-97] vs. 114 [100-152] %; p = 0.009), FIX (84 [67-103] vs. 110 [90-114] %; p = 0.043), and FX (70 [61-85] vs. 122 [96-140] %; p = 0.001) were reduced in the SI in comparison with the CO. Finally, FVIII was considerably, yet not significantly, increased in both patient cohorts (235 [91-320] % and 197 [164-238] %, respectively). Conclusions This study proves that children suffer a depletion of clotting factors following severe injury which basically reflects the findings for adult trauma patients. Attempts to correct the impaired clotting factor activity could be based on a specific hemostatic therapy involving administration of coagulation factors. Nevertheless, therapeutic implications need to be investigated in future studies.
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Affiliation(s)
- Manuel Burggraf
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany.
| | - Christina Polan
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Martin Husen
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Bastian Mester
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Alexander Wegner
- Department of Orthopedics and Trauma Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Daniel Spodeck
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Marcel Dudda
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
| | - Max Daniel Kauther
- Department of Trauma, Hand and Reconstructive Surgery, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Germany
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Govindasamy D, Seeley J, Olaru ID, Wiyeh A, Mathews C, Ferrari G. Informing the measurement of wellbeing among young people living with HIV in sub-Saharan Africa for policy evaluations: a mixed-methods systematic review. Health Qual Life Outcomes 2020; 18:120. [PMID: 32370772 PMCID: PMC7201613 DOI: 10.1186/s12955-020-01352-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 04/03/2020] [Indexed: 12/11/2022] Open
Abstract
Young people living with HIV (YPLHIV) in sub-Saharan Africa (SSA) are at high risk of having a poor quality of life. Addressing wellbeing explicitly within HIV/AIDS policies could assist mitigation efforts. However, guidance on wellbeing measures to evaluate policies for YPLHIV is scarce. The aims of this mixed-methods review were to identify: i) key dimensions of wellbeing and ii) wellbeing measures that align to these dimensions among YPLHIV (15-24 years) in SSA. We searched six social science and medical databases, including grey literature. We included studies that examined correlates and lived experiences of wellbeing, among YPLHIV in SSA, from January 2000 to May 2019. Two reviewers independently screened abstracts and full texts and assessed methodological quality of included articles. We analysed quantitative and qualitative data using descriptive and meta-ethnographic approaches, respectively. Thereafter, we integrated findings using a framework approach. We identified 6527 citations. Of these, 10 quantitative and 30 qualitative studies were included. Being male, higher educational status, less stigma and more social support were likely correlates of wellbeing. Themes that shaped experiences suggestive of wellbeing were: 1) acceptance and belonging- stigma, social support; 2) coping; 3) standard of living. Our final synthesis found that the following dimensions potentially characterise wellbeing: self-acceptance, belonging, autonomy; positive relations, environmental mastery, purpose in life. Wellbeing for YPLHIV is multi-dimensional and relational. Relevant measures include the Personal Wellbeing Index, Ryff's Psychological Wellbeing Scale and Mental Health Continuum Short Form. However, psychometric evaluations of these scales among YPLHIV in SSA are needed.
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Affiliation(s)
- Darshini Govindasamy
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
- Health Systems Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, PO Box 19070, Tygerberg, 7501, South Africa.
- Adolescent Health Research Unit, Department of Child and Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa.
| | - Janet Seeley
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Ioana D Olaru
- Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Biomedical Research and Training Institute, Harare, Zimbabwe
| | - Alison Wiyeh
- Cochrane South Africa, South African Medical Research Council, Tygerberg, South Africa
- Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA
| | - Catherine Mathews
- Health Systems Research Unit, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, PO Box 19070, Tygerberg, 7501, South Africa
- Adolescent Health Research Unit, Department of Child and Adolescent Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Giulia Ferrari
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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O'Reilly LM, Pettersson E, Quinn PD, Klonsky ED, Lundström S, Larsson H, Lichtenstein P, D'Onofrio BM. The association between general childhood psychopathology and adolescent suicide attempt and self-harm: A prospective, population-based twin study. JOURNAL OF ABNORMAL PSYCHOLOGY 2020; 129:364-375. [PMID: 32271026 PMCID: PMC7179089 DOI: 10.1037/abn0000512] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Few quantitative behavior genetic studies have examined why psychopathology is associated with suicide attempt (SA) and self-harm (SH) in adolescence. The present study analyzed data from the Child and Adolescent Twin Study in Sweden to examine the extent to which genetic and environmental factors explain SA/SH and its association with psychopathology in childhood, an often-cited risk factor of subsequent SA/SH. When children were 9 or 12 years old (n = 30,444), parents completed the Autism-Tics, AD/HD and other Comorbidities Inventory (Larson et al., 2010) regarding their children's psychiatric problems as part of an ongoing, longitudinal study. At age 18 years (n = 10,269), adolescents completed self-report questionnaires, including SA/SH assessments. In a bifactor model of childhood psychopathology, a general factor of psychopathology was a statistically significant predictor of adolescent SA/SH at a higher magnitude (β, 0.25, 95% confidence interval [CI; 0.15, 0.34] for suicide attempt), as compared with specific factors of inattention, impulsivity, oppositional behavior, and anxiety/emotion symptoms. Quantitative genetic modeling indicated that the additive genetic influences on the general factor accounted for the association with each outcome (β, 0.24, 95% CI [0.13, 0.34] for suicide attempt). The results remained virtually identical when we fit a higher order factors model. Two additional outcomes demonstrated comparable results. The results extend current literature by revealing the shared genetic overlap between general psychopathology during childhood and adolescent SA/SH. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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168
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de Munter L, Polinder S, Haagsma JA, Kruithof N, van de Ree CL, Steyerberg EW, de Jongh M. Prevalence and Prognostic Factors for Psychological Distress After Trauma. Arch Phys Med Rehabil 2020; 101:877-884. [DOI: 10.1016/j.apmr.2019.10.196] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 10/31/2019] [Indexed: 11/26/2022]
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Mohammed Z, Aledhaim A, AbdelSalam EM, El-Setouhy M, El-Shinawi M, Hirshon JM. Factors associated with injuries among preschool children in Egypt: demographic and health survey results, 2014. BMC Public Health 2020; 20:595. [PMID: 32357864 PMCID: PMC7193349 DOI: 10.1186/s12889-020-08658-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Accepted: 04/06/2020] [Indexed: 11/22/2022] Open
Abstract
Background Childhood injuries are a significant and growing global public health problem, often with high morbidity and, at times, mortality. A large proportion of injuries in preschool children occur in or around the home. We aimed to identify socioeconomic and demographic factors associated with preschool children injuries in Egypt. Methods Secondary data analysis were done for the Egyptian Demographic and Health Surveys (EDHS), 2014. Potential associated factors were measured from data on child welfare and questions on the prevalence of accidents and injuries of preschool children. These data were linked to the children demographic data, maternal age at marriage, working status of the mother, and questions on childcare arrangements. Results Out of the 634 injured children, 520 (83.4%) children required medical care for their injuries. The most common reported injury was an open wound 288 (45.5%), followed by fractures 237 (35.7%), burns 124 (19.7%), electrical shock 12 (1.9%) and other unknown types of injury 15 (2.4%). There was a positive correlation between injury and child’s age, household wealth, mother’s age at marriage, and unsupervised children or children left in the care of a minor. Conclusion Leaving children unsupervised or in the presence of other young children is significantly associated with the occurrence of child injuries.
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Affiliation(s)
- Zeinab Mohammed
- Public Health and Community Medicine Department, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt. .,Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Ali Aledhaim
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Maged El-Setouhy
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia.,Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed El-Shinawi
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.,Department of General Surgery, Ain Shams University, Cairo, Egypt
| | - Jon Mark Hirshon
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.,Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
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Ando S, Nishida A, Yamasaki S, Koike S, Morimoto Y, Hoshino A, Kanata S, Fujikawa S, Endo K, Usami S, Furukawa TA, Hiraiwa-Hasegawa M, Kasai K. Cohort Profile: The Tokyo Teen Cohort study (TTC). Int J Epidemiol 2020; 48:1414-1414g. [PMID: 30879075 PMCID: PMC6857749 DOI: 10.1093/ije/dyz033] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2019] [Indexed: 12/31/2022] Open
Affiliation(s)
- Shuntaro Ando
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.,Department of Psychiatry and Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Atsushi Nishida
- Department of Psychiatry and Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Syudo Yamasaki
- Department of Psychiatry and Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Shinsuke Koike
- University of Tokyo Institute for Diversity and Adaptation of Human Mind (UTIDAHM), University of Tokyo, Tokyo, Japan.,The International Research Center for Neurointelligence (WPI-IRCN), University of Tokyo Institutes for Advanced Study (UTIAS), Tokyo, Japan
| | - Yuko Morimoto
- Department of Psychiatry and Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Aya Hoshino
- Department of Psychiatry and Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Sho Kanata
- Department of Psychiatry, Teikyo University School of Medicine, Tokyo, Japan
| | - Shinya Fujikawa
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Kaori Endo
- Department of Psychiatry and Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Satoshi Usami
- Center for Research and Development on Transition from Secondary to Higher Education, University of Tokyo, Tokyo, Japan
| | - Toshiaki A Furukawa
- Department of Health Promotion and Human Behavior.,Department of Clinical Epidemiology, Kyoto University, Kyoto, Japan
| | - Mariko Hiraiwa-Hasegawa
- School of Advanced Science, SOKENDAI (Graduate University for Advanced Studies), Kanagawa, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.,The International Research Center for Neurointelligence (WPI-IRCN), University of Tokyo Institutes for Advanced Study (UTIAS), Tokyo, Japan
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A functional SNP in MIR124-1, a brain expressed miRNA gene, is associated with aggressiveness in a Colombian sample. Eur Psychiatry 2020; 30:499-503. [DOI: 10.1016/j.eurpsy.2015.03.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 03/02/2015] [Accepted: 03/04/2015] [Indexed: 12/12/2022] Open
Abstract
AbstractBackground:Interpersonal violence and suicide are among the main causes of mortality and morbidity around the world. In several developing countries, such as Colombia, they are among the first five entities of public health concern. Aggressiveness is an important endophenotype for aggression and suicidal behavior, having a heritability of around 50%. Exploration of classical candidate genes, involved in serotoninergic and dopaminergic neurotransmission, has identified few consistent risk factors for aggressiveness. miRNAs are a novel class of molecules with a growing role in normal neural function and neuropsychiatric disorders; of special interest, miR-124 is a brain-specific miRNA that is key for neuronal plasticity. We evaluated the hypothesis that a functional polymorphism in MIR124-1 gene might be associated with aggressiveness in a Colombian sample.Methods:The Spanish adaptation of the refined version of the Aggression Questionnaire and the abbreviated Barratt Impulsiveness Scale were applied to 170 young subjects. The functional SNP in MIR124-1 (rs531564) was genotyped by a TaqMan assay.Results:We found a significant association between the MIR124-1 and aggressiveness in our sample, with G/G carriers having lower scores (P = 0.01). This association seemed to be specific for aggressiveness, as it was not significant for impulsiveness.Conclusions:We showed for the first time the association of a functional polymorphism in MIR124-1 and aggressiveness. Known targets of miR-124 (such as BDNF and DRD4 genes) could explain the effect of this miRNA on behavior. A future analysis of additional novel functional polymorphisms in other brain expressed miRNAs could be useful for a deeper understanding of aggression in humans.
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Nguyen HTL, Nakamura K, Seino K, Vo VT. Relationships among cyberbullying, parental attitudes, self-harm and suicidal behavior among adolescents: results from a school-based survey in Vietnam. BMC Public Health 2020; 20:476. [PMID: 32276608 PMCID: PMC7146902 DOI: 10.1186/s12889-020-08500-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 03/10/2020] [Indexed: 02/07/2023] Open
Abstract
Background The rapid and widespread development of social networking sites has created a venue for an increase in cyberbullying among adolescents. Protective mechanisms and actions must be considered, such as how proximal family factors can prevent self-harm and suicidal behaviors among adolescents exposed to cyberbullying. The present study examined the associations among cyberbullying, parental attitudes, self-harm, and suicidal behaviors after adjusting for confounding factors. Methods Data were obtained from a school-based survey of randomly selected grade 6 students (11 years old) performed in Hue City, Vietnam, in 2018. A total of 648 students were interviewed face-to-face using a structured questionnaire based on the Global School-based Student Health Survey (GSHS). Univariate, multivariable logistic regression analyses were performed at 95% confidence level. Results After adjusting for gender, perceived academic pressure, unhealthy behaviors, use of Internet devices, school bullying, and family living situation, a significantly higher risk of self-harm was detected among those who had experienced cyberbullying (adjusted odd ratio [AOR] = 2.97; 95% CI, 1.32–6.71). Parental acceptance retained a significant association with self-harm and suicidal behavior (P < 0.05) while parental concentration did not exhibit a significant association in a multivariable logistic regression model. In addition, suicidal ideation and suicidal planning were associated with an interaction effect between cyberbullying and parental concentration (AOR = 0.37; 95% CI, 0.15–0.94 and AOR = 0.23; 95% CI, 0.06–0.87, respectively). Conclusion Cyberbullying has become an important phenomenon associated with self-harm among young adolescents in developing countries, and parental acceptance in proxy of parental attitude was positively related with severe mental health issues among adolescents. Thus, sufficient attention in efforts to promote adolescent health should be focused on family factors in the digital era of developing countries.
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Affiliation(s)
- Hoang Thuy Linh Nguyen
- Department of Global Health Entrepreneurship, Division of Public Health, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.,Faculty of Public Health, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam.,Institute for Community Health Research, Hue University of Medicine and Pharmacy, Hue, Vietnam
| | - Keiko Nakamura
- Department of Global Health Entrepreneurship, Division of Public Health, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
| | - Kaoruko Seino
- Department of Global Health Entrepreneurship, Division of Public Health, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Van Thang Vo
- Faculty of Public Health, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam.,Institute for Community Health Research, Hue University of Medicine and Pharmacy, Hue, Vietnam
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Rahman A, Austin A, Anwar I, Taneepanichskul S. Comparing trends of perinatal mortality in two rural areas of Matlab, Bangladesh. JOURNAL OF HEALTH RESEARCH 2020. [DOI: 10.1108/jhr-06-2019-0123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PurposeSixteen million adolescents give birth each year, constituting 11% of all births worldwide. Adverse adolescent pregnancy outcomes are well-documented. Available data on adolescent pregnancies have mainly relied on self-reported age and retrospective survey data, which might not capture adolescent births accurately. This paper reports on trends in adolescent pregnancy and associated adverse birth outcomes in Matlab, Bangladesh, using data from the Matlab Heath and Demographic System (HDSS) which precisely documents maternal age.Design/methodology/approachThe study was conducted in the rural subdistrict of Matlab in Bangladesh. HDSS data were used to examine trends in adolescent motherhood (10–19 years) in the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b) service areas (ISA) and government service areas (GSA) between 2007 and 2015. A total of 4,996 adolescent mothers were included in the analysis. Chi-square testing and binary logistic regression were used to document adolescent pregnancy trends and the differences in and causes of perinatal death.FindingsThe fertility rate was 27 per 1000 adolescent mothers in ISA and 20 per 1000 adolescent mothers in GSA, during the 9 years of the study period. The adjusted odd of an adolescent mother having a perinatal death in ISA, relative to GSA was 0.69. Significant determinants of perinatal death among adolescent mothers included maternal education, paternal education, mother’s age at first birth, asset score and distance from the nearest health facility.Originality/valueThis paper documents the real trend of adolescent pregnancy by capturing the accurate age at pregnancy for the first time in Bangladesh.
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174
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Welsh JW, Mataczynski M, Sarvey DB, Zoltani JE. Management of Complex Co-occurring Psychiatric Disorders and High-Risk Behaviors in Adolescence. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2020; 18:139-149. [PMID: 33162851 PMCID: PMC7587883 DOI: 10.1176/appi.focus.20190038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Adolescents often present to treatment with multiple psychiatric diagnoses. The presence of certain co-occurring mental health conditions can significantly affect an individual's treatment course. Adolescence is also a time of developmentally appropriate risk taking and experimenting with novel behaviors. Difficulties in accurate diagnosis and lack of effective treatment options create obstacles to helping this vulnerable patient population. Appropriate management of adolescents' complex symptoms and high-risk behaviors during a developmentally sensitive period can be challenging, even for the most skilled of clinicians. This article focuses on the assessment and management of complex, co-occurring psychiatric disorders during adolescence, with specific guidance on how to manage high-risk behaviors, such as self-harm and suicidality. Controversial topics, including antidepressants and youth suicide risk, as well as "off-label" use of mood stabilizers and antipsychotics, are also reviewed.
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Affiliation(s)
- Justine W Welsh
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Welsh and Mataczynski); Adolescent Acute Residential Treatment, McLean Hospital, Harvard Medical School, Belmont, Massachusetts (Sarvey); Yale New Haven Psychiatric Hospital, Yale School of Medicine, New Haven, Connecticut (Zoltani)
| | - Maggie Mataczynski
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Welsh and Mataczynski); Adolescent Acute Residential Treatment, McLean Hospital, Harvard Medical School, Belmont, Massachusetts (Sarvey); Yale New Haven Psychiatric Hospital, Yale School of Medicine, New Haven, Connecticut (Zoltani)
| | - Dana B Sarvey
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Welsh and Mataczynski); Adolescent Acute Residential Treatment, McLean Hospital, Harvard Medical School, Belmont, Massachusetts (Sarvey); Yale New Haven Psychiatric Hospital, Yale School of Medicine, New Haven, Connecticut (Zoltani)
| | - Jessica E Zoltani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Welsh and Mataczynski); Adolescent Acute Residential Treatment, McLean Hospital, Harvard Medical School, Belmont, Massachusetts (Sarvey); Yale New Haven Psychiatric Hospital, Yale School of Medicine, New Haven, Connecticut (Zoltani)
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175
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Steeg S, Carr MJ, Mok PLH, Pedersen CB, Antonsen S, Ashcroft DM, Kapur N, Erlangsen A, Nordentoft M, Webb RT. Temporal trends in incidence of hospital-treated self-harm among adolescents in Denmark: national register-based study. Soc Psychiatry Psychiatr Epidemiol 2020; 55:415-421. [PMID: 31654088 DOI: 10.1007/s00127-019-01794-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 10/09/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Studies conducted in the UK and in Ireland have reported increased rates of self-harm in adolescent females from around the time of the 2008 economic recession and through periods of subsequent national austerity programme implementation. It is not known if incidence rates have increased similarly in other Western European countries during this period. METHODS Data from interlinked national administrative registers were extracted for individuals born in Denmark during 1981-2006. We estimated gender- and age-specific incidence rates (IRs) per 10,000 person-years at risk for hospital-treated non-fatal self-harm during 2000-2016 at ages 10-19 years. RESULTS Incidence of self-harm peaked in 2007 (IR 25.1) and then decreased consistently year on year to 13.8 in 2016. This pattern was found in all age groups, in both males and females and in each parental income tertile. During the last 6 years of the observation period, 2011-2016, girls aged 13-16 had the highest incidence rates whereas, among boys, incidence was highest among 17-19 year olds throughout. CONCLUSIONS The temporal increases in incidence rates of self-harm among adolescents observed in some Western European countries experiencing major economic recession were not observed in Denmark. Restrictions to sales of analgesics, access to dedicated suicide prevention clinics, higher levels of social spending and a stronger welfare system may have protected potentially vulnerable adolescents from the increases seen in other countries. A better understanding of the specific mechanisms behind the temporal patterns in self-harm incidence in Denmark is needed to help inform suicide prevention in other nations.
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Affiliation(s)
- Sarah Steeg
- Division of Psychology and Mental Health, Centre for Mental Health and Safety, Manchester Academic Health Science Centre, The University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, England, UK. .,Manchester Academic Health Science Centre (MAHSC), Manchester, UK.
| | - Matthew J Carr
- Division of Psychology and Mental Health, Centre for Mental Health and Safety, Manchester Academic Health Science Centre, The University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, England, UK.,Manchester Academic Health Science Centre (MAHSC), Manchester, UK
| | - Pearl L H Mok
- Division of Psychology and Mental Health, Centre for Mental Health and Safety, Manchester Academic Health Science Centre, The University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, England, UK.,Manchester Academic Health Science Centre (MAHSC), Manchester, UK
| | - Carsten B Pedersen
- Centre for Integrated Register-based Research at Aarhus University, Aarhus, Denmark.,National Centre for Register-based Research, Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Sussie Antonsen
- Centre for Integrated Register-based Research at Aarhus University, Aarhus, Denmark.,National Centre for Register-based Research, Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Darren M Ashcroft
- Division of Pharmacy and Optometry, Centre for Pharmacoepidemiology and Drug Safety, The University of Manchester, Manchester, UK.,NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK.,Manchester Academic Health Science Centre (MAHSC), Manchester, UK
| | - Nav Kapur
- Division of Psychology and Mental Health, Centre for Mental Health and Safety, Manchester Academic Health Science Centre, The University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, England, UK.,NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK.,Manchester Academic Health Science Centre (MAHSC), Manchester, UK.,Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Annette Erlangsen
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen University Hospital, Hellerup, Denmark
| | - Merete Nordentoft
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen University Hospital, Hellerup, Denmark
| | - Roger T Webb
- Division of Psychology and Mental Health, Centre for Mental Health and Safety, Manchester Academic Health Science Centre, The University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, England, UK.,NIHR Greater Manchester Patient Safety Translational Research Centre, The University of Manchester, Manchester, UK.,Manchester Academic Health Science Centre (MAHSC), Manchester, UK
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176
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Adjorlolo S, Anum A, Amin JM. Validation of the Suicidal Behaviors Questionnaire-Revised in adolescents in Ghana. J Ment Health 2020; 31:302-308. [DOI: 10.1080/09638237.2020.1739239] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Samuel Adjorlolo
- Department of Mental Health, School of Nursing and Midwifery, College of Health Sciences, University of Ghana, Accra, Ghana
- Research and Grant Institute of Ghana, Accra, Ghana
| | - Adote Anum
- Department of Psychology, School of Social Sciences, College of Humanities, University of Ghana, Accra, Ghana
| | - Jibril Muhammad Amin
- Department of Mental Health, School of Nursing and Midwifery, College of Health Sciences, University of Ghana, Accra, Ghana
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177
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Shi Z, Malki A, Abdel-Salam ASG, Liu J, Zayed H. Association between Soft Drink Consumption and Aggressive Behaviour among a Quarter Million Adolescents from 64 Countries Based on the Global School-Based Student Health Survey (GSHS). Nutrients 2020; 12:nu12030694. [PMID: 32150827 PMCID: PMC7146469 DOI: 10.3390/nu12030694] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/02/2020] [Accepted: 03/03/2020] [Indexed: 11/30/2022] Open
Abstract
Soft drink consumption has become a significant public health concern that is associated with various adverse health outcomes. We aim to examine the association between soft drink consumption and aggressive behavior among adolescents. We used open access data from 79 studies in 64 countries, including 263,890 adolescents aged 12–18 years who completed the global school-based student health survey (GSHS). Self-reported data on past 30-day carbonated soft drink consumption (number of times per day) and past 12-month physical fighting were utilized for analysis. Of the 263,890 participants (48% boys) aged 12–18 years, the weighted mean frequency of soft drink consumption varied from 0.5 in Kiribati to 2.5 times/day in Surname, while the weighted prevalence of frequent aggressive behavior varied from to 2.7% in Laos to 49.2% in Tuvalu. We found that each increment of soft drink consumption (time/day) was associated with an 11% (95%CI 10–13%) increase of the likelihood of frequent physical fighting. This result remained significant after adjusting for various covariates. In this large pooled sample of multinational data, there is a significant positive association between soft drink consumption and aggressive behavior among adolescents. Reducing soft drink consumption may help reduce aggressive behavior, a major risk factor for violence.
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Affiliation(s)
- Zumin Shi
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, 2713 Doha, Qatar
- Correspondence: ; Tel.: +974-4403-6037
| | - Ahmed Malki
- Department of Biomedical Sciences, College of Health Sciences, QU Health, Qatar University, 2713 Doha, Qatar; (A.M.); (H.Z.)
| | - Abdel-Salam G Abdel-Salam
- Department of Mathematics, Statistics and Physics, College of Health Sciences, QU Health, Qatar University, 2713 Doha, Qatar;
| | - Jianghong Liu
- University of Pennsylvania School of Nursing, Philadelphia, PA 19104, USA;
| | - Hatem Zayed
- Department of Biomedical Sciences, College of Health Sciences, QU Health, Qatar University, 2713 Doha, Qatar; (A.M.); (H.Z.)
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178
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Abstract
Child marriage, defined by the United Nations as marriage before the age of 18, is considered a violation of human rights with negative consequences for girls' health. We systematically reviewed existing academic literature and news media to learn what is known about the frequency of child marriage in Canada and its effects on health. Approximately 1% of 15-19-year-olds in Canada were married or in common law unions in 2016. News reports document cases of child marriage among religious minority communities but no nationwide estimates of the frequency of marriage before the age of 18 were identified. Sources consistently show girls are more likely to marry as teens than boys. Information on married teens between 15 and 19 years of age suggests similarities in marriage patterns among this age group in Canada and child marriage practices globally. Further research is needed to measure Canada's progress toward eliminating child marriage.
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Affiliation(s)
- Michele Zaman
- Master of Science in Public Health student, McGill University, Department of Epidemiology, Biostatistics and Occupational Health, Montreal, Quebec, Canada
| | - Alissa Koski
- Assistant Professor, McGill University Department of Epidemiology, Biostatistics and Occupational Health and the Institute for Health and Social Policy, Montreal, Quebec, Canada
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179
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Syria civil war pediatric casualties treated at a single medical center. J Pediatr Surg 2020; 55:523-529. [PMID: 30902455 DOI: 10.1016/j.jpedsurg.2019.02.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 02/07/2019] [Accepted: 02/18/2019] [Indexed: 11/23/2022]
Abstract
PURPOSE We describe the medical and surgical treatment outcomes of Syrian civil war pediatric casualties admitted to our tertiary medical center in northern Israel and compare them to reports of pediatric war victims in Iraq and Afghanistan. METHODS 117 pediatric casualties up to age 18 (median age: 12 years, 91 males) were admitted from 2013 to 2016. We measured demographics, injury mechanism, wound type, injury severity, surgical interventions, morbidity, and mortality. RESULTS Injury mechanisms were penetrating injuries (n = 87, 74%), blunt (n = 34, 29%) and blast (n = 13, 11%) injuries, caused by fragments (56, 48%), blasts (51, 44%), and gunshot wounds (24, 21%). Most common injuries were head trauma (n = 66, 56%) and lower extremities injury (n = 45, 38%). 51 children (44%) had Injury Severity Score > 25. Surgical procedures, most commonly orthopedic (n = 35) and neurosurgical (n = 27), were performed on 81 children (69%). Average number of procedures per patient was 2 ± 2.5; average hospitalization time was 25.8 days. Mortality rate was 3.4% (four children). Injury characteristics were different from those reported for pediatric war casualties in Iraq and Afghanistan. CONCLUSIONS Head trauma was associated with serious injury and mortality; most injuries were penetrating and complex. Collaboration of various hospital departments was often necessary for efficient and successful treatment. LEVEL OF EVIDENCE III Retrospective comparison study.
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180
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Glenn CR, Kleiman EM, Kellerman J, Pollak O, Cha CB, Esposito EC, Porter AC, Wyman PA, Boatman AE. Annual Research Review: A meta-analytic review of worldwide suicide rates in adolescents. J Child Psychol Psychiatry 2020; 61:294-308. [PMID: 31373003 DOI: 10.1111/jcpp.13106] [Citation(s) in RCA: 124] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/02/2019] [Indexed: 12/01/2022]
Abstract
Suicide is a leading cause of death among youth worldwide. The purpose of the current review was to examine recent cross-national trends in suicide mortality rates among 10- to 19-year-olds. This study extracted suicide mortality data from the World Health Organization's (WHO) Mortality Database for the most recent year (since 2010) from any country with available high-quality data (as defined by the WHO's guidelines). Data on access to lethal means (firearms, railways) and measures of economic quality (World Bank Income Group) and inequality (Gini coefficients) were obtained from publicly available data sources. Cross-national suicide mortality rates in youth were heterogeneous. The pooled estimate across all ages, sexes, and countries was 3.77/100,000 people. The highest suicide rates were found in Estonia, New Zealand, and Uzbekistan. Suicide rates were higher among older compared with younger adolescents and higher among males than females. The most common suicide methods were hanging/suffocation and jumping/lying in front of a moving object or jumping from a height. Firearm and railway access were related to suicide deaths by firearms and jumping/lying, respectively. Economic quality and inequality were not related to overall suicide mortality rates. However, economic inequality was correlated with a higher ratio of male:female suicides. This study provides a recent update of cross-national suicide trends in adolescents. Findings replicate prior patterns related to age, sex, geographic region, and common suicide methods. New to this review are findings relating suicide method accessibility to suicide mortality rates and the significant association between income inequality and the ratio of male:female suicide. Future research directions include expanding the worldwide coverage to more low- and middle-income countries, examining demographic groupings beyond binary sex and to race/ethnicity within countries, and clarifying factors that account for cross-national differences in suicide trends.
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Affiliation(s)
- Catherine R Glenn
- Department of Psychology, University of Rochester, Rochester, NY, USA.,Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Evan M Kleiman
- Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - John Kellerman
- Department of Psychology, University of Rochester, Rochester, NY, USA
| | - Olivia Pollak
- Department of Psychology, Teachers College, Columbia University, New York, NY, USA
| | - Christine B Cha
- Department of Psychology, Teachers College, Columbia University, New York, NY, USA
| | - Erika C Esposito
- Department of Psychology, University of Rochester, Rochester, NY, USA
| | - Andrew C Porter
- Department of Psychology, University of Rochester, Rochester, NY, USA
| | - Peter A Wyman
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Anne E Boatman
- Department of Psychology, University of Rochester, Rochester, NY, USA
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181
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Smith-Greenaway E, Trinitapoli J. Maternal cumulative prevalence measures of child mortality show heavy burden in sub-Saharan Africa. Proc Natl Acad Sci U S A 2020; 117:4027-4033. [PMID: 32041875 PMCID: PMC7049139 DOI: 10.1073/pnas.1907343117] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
We advance a set of population-level indicators that quantify the prevalence of mothers who have ever experienced an infant, under 5-y-old child, or any-age child die. The maternal cumulative prevalence of infant mortality (mIM), the maternal cumulative prevalence of under 5 mortality (mU5M), and the maternal cumulative prevalence of offspring mortality (mOM) bring theoretical and practical value to a variety of disciplines. Here we introduce maternal cumulative prevalence measures of mortality for multiple age groups of mothers in 20 sub-Saharan African countries with Demographic and Health Surveys data spanning more than two decades. The exercise demonstrates the persistently high prevalence of African mothers who have ever experienced a child die. In some African countries, more than one-half of 45- to 49-y-old mothers have experienced the death of a child under age 5, and nearly two-thirds have experienced the death of any child, irrespective of age. Fewer young mothers have experienced a child die, yet in many countries, up to one-third have. Our results show that the mIM and mU5M can follow distinct trajectories from the infant mortality rate (IMR) and under 5 mortality rate (U5MR), offering an experiential view of mortality decline that annualized measures conceal. These measures can be adapted to quantify the prevalence of recurrent offspring mortality (mROM) and calculated for subgroups to identify within-country inequality in the mortality burden. These indicators can be used to improve current understandings of mortality change, bereavement as a public health threat, and population dynamics.
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182
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Gupta AK, Santhya KG. Promoting Gender Egalitarian Norms and Practices Among Boys in Rural India: The Relative Effect of Intervening in Early and Late Adolescence. J Adolesc Health 2020; 66:157-165. [PMID: 31227386 DOI: 10.1016/j.jadohealth.2019.03.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 03/11/2019] [Accepted: 03/11/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE Although the importance of exposing adolescent boys to gender transformative programs has been recognized, such programs are limited in India. Studies that assessed the relative effect of intervening in early compared with late adolescence are even more limited. This article examines the differential effect of exposing boys to a gender transformative program in early and late adolescence on their gender role attitudes and practices. METHODS We used data from a cluster randomized trial of a gender transformative life-skills education cum sports-coaching program for younger boys (aged 13-14 years) and older boys (aged 15-19 years) (N = 962) and used generalized estimating equation model to examine the differential effect. RESULTS The intervention had a greater effect in helping younger than older boys to espouse gender-egalitarian attitudes (β = .669; p < .001 vs. β = .344; p < .001) and attitudes rejecting men's controlling behaviors (β = .973; p < .003 vs. β = .453; p < .088), men's perpetration of wife beating (β = .423; p < .002 vs. β = .282; p < .035), and violence on unmarried girls (β = .332; p < .038 vs. β = .306; p < .045). Younger boys had higher odds of reporting that their peers would respect them for acting in gender-equitable ways (odds ratio [OR] = 2.15; p < .003) compared with older boys (OR = 1.78; p < .014). However, younger boys had lower odds of intervening to stop incidents of violence that they had witnessed, compared with older boys (OR = 2.17; p < .03 vs. OR = 2.56; p < .002). These differences remained significant even when difference in regular exposure to the intervention was adjusted. CONCLUSIONS Gender transformative programs are likely to be more effective in changing traditional attitudes and practices among boys if they target them during early adolescence compared with late adolescence.
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Affiliation(s)
| | - K G Santhya
- Population Council, India Habitat Centre, New Delhi, India
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183
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Aramouny C, Kerbage H, Richa N, Rouhana P, Richa S. Knowledge, Attitudes, and Beliefs of Catholic Clerics' Regarding Mental Health in Lebanon. JOURNAL OF RELIGION AND HEALTH 2020; 59:257-276. [PMID: 30661138 DOI: 10.1007/s10943-019-00758-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Arabic speakers rarely seek the help of professional mental health providers while they heavily rely on religious leaders. However, little is known about the knowledge, beliefs, and attitudes of clerics regarding mental illness. A standardized questionnaire was administered to 115 Christian religious men. Clerics appeared to have an informed, scientifically based understanding of the causes of mental disorders and of the importance of medications in effective treatment. However, several stigmatizing attitudes were identified. Contact with the patients significantly reduced the discrimination. Fear of the unpredictable highlights the need to develop and implement targeted approaches that outreach clergy.
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Affiliation(s)
- Christina Aramouny
- Department of Psychiatry, Hôtel Dieu de France, Beirut, Lebanon.
- Department of Psychiatry, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.
| | - Hala Kerbage
- Department of Psychiatry, Hôtel Dieu de France, Beirut, Lebanon
- Department of Psychiatry, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Nathalie Richa
- Department of Psychology, Holy Spirit University of Kaslik, Kaslik, Lebanon
| | - Paul Rouhana
- Pontifical Faculty of Theology, Holy Spirit University of Kaslik, Kaslik, Lebanon
| | - Sami Richa
- Department of Psychiatry, Hôtel Dieu de France, Beirut, Lebanon
- Department of Psychiatry, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
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184
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Maddock A, Corfield AR, Donald MJ, Lyon RM, Sinclair N, Fitzpatrick D, Carr D, Hearns S. Prehospital critical care is associated with increased survival in adult trauma patients in Scotland. Emerg Med J 2020; 37:141-145. [PMID: 31959616 PMCID: PMC7057794 DOI: 10.1136/emermed-2019-208458] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 12/20/2019] [Accepted: 12/21/2019] [Indexed: 11/25/2022]
Abstract
Background Scotland has three prehospital critical care teams (PHCCTs) providing enhanced care support to a usually paramedic-delivered ambulance service. The effect of the PHCCTs on patient survival following trauma in Scotland is not currently known nationally. Methods National registry-based retrospective cohort study using 2011–2016 data from the Scottish Trauma Audit Group. 30-day mortality was compared between groups after multivariate analysis to account for confounding variables. Results Our data set comprised 17 157 patients, with a mean age of 54.7 years and 8206 (57.5%) of male gender. 2877 patients in the registry were excluded due to incomplete data on their level of prehospital care, leaving an eligible group of 14 280. 13 504 injured adults who received care from ambulance clinicians (paramedics or technicians) were compared with 776 whose care included input from a PHCCT. The median Injury Severity Score (ISS) across all eligible patients was 9; 3076 patients (21.5%) met the ISS>15 criterion for major trauma. Patients in the PHCCT cohort were statistically significantly (all p<0.01) more likely to be male; be transported to a prospective Major Trauma Centre; have suffered major trauma; have suffered a severe head injury; be transported by air and be intubated prior to arrival in hospital. Following multivariate analysis, the OR for 30-day mortality for patients seen by a PHCCT was 0.56 (95% CI 0.36 to 0.86, p=0.01). Conclusion Prehospital care provided by a physician-led critical care team was associated with an increased chance of survival at 30 days when compared with care provided by ambulance clinicians.
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Affiliation(s)
- Alistair Maddock
- Anaesthetics, Queen Elizabeth University Hospital, Glasgow, UK .,Emergency Medical Retrieval Service, ScotSTAR, Paisley, UK
| | - Alasdair R Corfield
- Emergency Medical Retrieval Service, ScotSTAR, Paisley, UK.,Emergency Medicine, Royal Alexandra Hospital, Paisley, UK
| | - Michael J Donald
- Emergency Medical Retrieval Service, ScotSTAR, Paisley, UK.,Emergency Medicine, Ninewells Hospital, Dundee, UK
| | - Richard M Lyon
- Emergency Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK.,Pre-hospital Emergency Medical Care, University of Surrey, Guildford, Surrey, UK
| | - Neil Sinclair
- Emergency Medical Retrieval Service, ScotSTAR, Paisley, UK.,Scottish Ambulance Service, Edinburgh, UK
| | - David Fitzpatrick
- Faculty of Health Science and Sport, University of Stirling, Stirling, UK
| | - David Carr
- Information Services Division, NHS National Services Scotland, Glasgow, UK
| | - Stephen Hearns
- Emergency Medical Retrieval Service, ScotSTAR, Paisley, UK.,Emergency Medicine, Royal Alexandra Hospital, Paisley, UK
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185
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Borschmann R, Janca E, Carter A, Willoughby M, Hughes N, Snow K, Stockings E, Hill NTM, Hocking J, Love A, Patton GC, Sawyer SM, Fazel S, Puljević C, Robinson J, Kinner SA. The health of adolescents in detention: a global scoping review. LANCET PUBLIC HEALTH 2020; 5:e114-e126. [PMID: 31954434 PMCID: PMC7025881 DOI: 10.1016/s2468-2667(19)30217-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/18/2019] [Accepted: 10/18/2019] [Indexed: 12/12/2022]
Abstract
Adolescents detained within the criminal justice system are affected by complex health problems, health-risk behaviours, and high rates of premature death. We did a global synthesis of the evidence regarding the health of this population. We searched Embase, PsycINFO, Education Resources Information Center, PubMed, Web of Science, CINCH, Global Health, the Cochrane Database of Systematic Reviews, the Campbell Library, the National Criminal Justice Reference System Abstract Database, and Google Scholar for peer-reviewed journal articles, including reviews, that reported the prevalence of at least one health outcome (physical, mental, sexual, infectious, and neurocognitive) in adolescents (aged <20 years) in detention, and were published between Jan 1, 1980, and June 30, 2018. The reference lists of published review articles were scrutinised for additional relevant publications. Two reviewers independently screened titles and abstracts, and three reviewed full texts of relevant articles. The protocol for this Review was registered with PROSPERO (CRD42016041392). 245 articles (204 primary research articles and 41 reviews) were included, with most primary research (183 [90%]) done in high-income countries. A high lifetime prevalence of health problems, risks, and conditions was reported in detained adolescents, including mental disorders (0–95%), substance use disorders (22–96%), self-harm (12–65%), neurodevelopmental disabilities (2–47%), infectious diseases (0–34%), and sexual and reproductive conditions (pregnant by age 19 years 20–37%; abnormal cervical screening test result 16%). Various physical and mental health problems and health-risk behaviours are more common among adolescents in detention than among their peers who have not been detained. As the social and structural drivers of poor health overlap somewhat with factors associated with exposure to the criminal justice system, strategies to address these factors could help to reduce both rates of adolescent detention and adolescent health inequalities. Improving the detection of mental and physical disorders, providing appropriate interventions during detention, and optimising transitional health care after release from detention could improve the health outcomes of these vulnerable young people.
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Affiliation(s)
- Rohan Borschmann
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
| | - Emilia Janca
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Annie Carter
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Melissa Willoughby
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health; Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Nathan Hughes
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Department of Sociological Studies, University of Sheffield, Sheffield, UK
| | - Kathryn Snow
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Centre for International Child Health, Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, Australia
| | | | - Jane Hocking
- Sexual Health Unit, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Alexander Love
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health; Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - George C Patton
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Royal Children's Hospital, Melbourne, VIC, Australia
| | - Susan M Sawyer
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Royal Children's Hospital, Melbourne, VIC, Australia
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Cheneal Puljević
- Centre for Health Services Research, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Jo Robinson
- Orygen Youth Health, Melbourne, VIC, Australia
| | - Stuart A Kinner
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Centre for Adolescent Health; Murdoch Children's Research Institute, Melbourne, VIC, Australia; Mater Research Institute-UQ, University of Queensland, Brisbane, QLD, Australia; Griffith Criminology Institute, Griffith University, Brisbane, QLD, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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186
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Müssener U, Löf M, Bendtsen P, Bendtsen M. Using Mobile Devices to Deliver Lifestyle Interventions Targeting At-Risk High School Students: Protocol for a Participatory Design Study. JMIR Res Protoc 2020; 9:e14588. [PMID: 31904576 PMCID: PMC6971512 DOI: 10.2196/14588] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 10/09/2019] [Accepted: 10/22/2019] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Unhealthy lifestyle behaviors such as insufficient physical activity, unhealthy diet, smoking, and harmful use of alcohol tend to cluster (ie, individuals may be at risk from more than one lifestyle behavior that can be established in early childhood and adolescence and track into adulthood). Previous research has underlined the potential of lifestyle interventions delivered via mobile phones. However, there is a need for deepened knowledge on how to design mobile health (mHealth) interventions taking end user views into consideration in order to optimize the overall usability of such interventions. Adolescents are early adopters of technology and frequent users of mobile phones, yet research on interventions that use mobile devices to deliver multiple lifestyle behavior changes targeting at-risk high school students is lacking. OBJECTIVE This protocol describes a participatory design study with the aim of developing an mHealth lifestyle behavior intervention to promote healthy lifestyles among high school students. METHODS Through an iterative process using participatory design, user requirements are investigated in terms of technical features and content. The procedures around the design and development of the intervention, including heuristic evaluations, focus group interviews, and usability tests, are described. RESULTS Recruitment started in May 2019. Data collection, analysis, and scientific reporting from heuristic evaluations and usability tests are expected to be completed in November 2019. Focus group interviews were being undertaken with high school students from October through December, and full results are expected to be published in Spring 2020. A planned clinical trial will commence in Summer 2020. The study was funded by a grant from the Swedish Research Council for Health, Working Life, and Welfare. CONCLUSIONS The study is expected to add knowledge on how to design an mHealth intervention taking end users' views into consideration in order to develop a novel, evidence-based, low-cost, and scalable intervention that high school students want to use in order to achieve a healthier lifestyle. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/14588.
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Affiliation(s)
- Ulrika Müssener
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Marie Löf
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Preben Bendtsen
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Marcus Bendtsen
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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187
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Suicide on Facebook-the tales of unnoticed departure in Bangladesh. Glob Ment Health (Camb) 2020; 7:e12. [PMID: 32742670 PMCID: PMC7379323 DOI: 10.1017/gmh.2020.5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 03/06/2020] [Accepted: 03/29/2020] [Indexed: 02/06/2023] Open
Abstract
Facebook has transformed social communication and offers the opportunity to share personal thoughts to people including suicide ideas, plans and attempts. Suicide after Facebook posts has been reported in different parts of the world and it has become a potential area of research for suicide prevention. The analysis of Facebook posts prior to suicide or Facebook live streaming may help in understanding the etiological factors, patterns of communication and possible prevention approaches for a particular community. However, there is a dearth of evidence about suicide incidents after Facebook posts and Facebook live streaming in low and middle-income countries. This study aims to explore the trends and phenomena of suicide after Facebook posts and live streaming in Bangladesh. We conducted an online search using the Google, Facebook and five daily online newspaper archives from 15th August to 15th September 2019. Two research assistants independently conducted the initial searching to find out people who committed suicide after Facebook posts or live streamed suicide in Bangladesh and documented 21 cases. After further evaluation of each of the 21 cases we confirmed 19 cases that met the selection criteria. All of them were under 35-years of age. We observed sucide after Facebook posts were more common in male(78%) e and students. Hanging was the most frequently used method of suicide followed by poisoning. Their Facebook posts and livestream videos indicated relationship problems, academic stress and mental disorders were the common stressors for their suicide. This study lays the foundation for the future researchers to work on suicidal posts on Facebook in Bangladesh and develop culture-specific, real-time suicide preventive systems using a social media platform.
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188
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Hernández-Vásquez A, Vargas-Fernández R, Díaz-Seijas D, Tapia-López E, Bendezu-Quispe G. Prevalence of suicidal behaviors and associated factors among Peruvian adolescent students: an analysis of a 2010 survey. Medwave 2019; 19:e7755. [PMID: 31999680 DOI: 10.5867/medwave.2019.11.7753] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 11/20/2019] [Indexed: 11/27/2022] Open
Abstract
Introduction Adolescence is one of the stages in life most affected by suicide. In Peru, 22% of suicides occur in people 10 to 19 years old. However, mental health overall and factors associated with suicidal behaviors have not been well studied. Objective To determine the prevalence of suicidal behaviors (ideation and ideation plus suicidal planning) and associated factors in Peruvian adolescent students. Methods A cross-sectional study analyzing data from the Global School-based Student Health Survey for Peru in 2010 was conducted to measure the prevalence of suicidal behaviors (ideation and ideation plus suicidal planning) and associated factors in Peruvian adolescent students. Results Of the 2521 students evaluated, 19.9% (95% CI: 17.8 to 22.2) presented suicidal ideation and 12.7% (95% CI: 11.1 to 14.5) presented suicidal planning in the last 12 months. Females had a higher prevalence of both ideation (27.5%, 95% CI: 24.9 to 30.4) and ideation plus suicidal planning (18.5%, 95% CI: 16.4 to 20.7). Multivariate analysis found that being female, having little parental support, having felt loneliness, having suffered from physical aggression, having been bullied, and alcohol consumption, were associated with ideation and ideation plus suicidal planning in adolescent students. Conclusion Ideation and ideation plus suicidal planning is a problem in the Peruvian adolescent population and is associated with several factors. Strategies are needed to identify and register suicide in adolescents in Peru and to develop prevention programs.
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Affiliation(s)
- Akram Hernández-Vásquez
- Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Lima, Peru. ORCID: 0000-0003-1431-2526
| | | | - Deysi Díaz-Seijas
- Universidad Nacional Mayor de San Marcos. Lima, Peru; Instituto Nacional Cardiovascular Carlos Alberto Peschiera Carrillo - INCOR, EsSalud, Lima, Peru. ORCID: 0000-0002-7247-3662
| | - Elena Tapia-López
- Universidad Peruana Cayetano Heredia, Lima, Peru. ORCID: 0000-0003-3892-6776
| | - Guido Bendezu-Quispe
- Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru. Address: 550 La Fontana Av, La Molina, 00012, Lima, Peru. . ORCID: 0000-0002-5140-0843
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189
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Shayo FK, Lawala PS. Does bullying predict suicidal behaviors among in-school adolescents? A cross-sectional finding from Tanzania as an example of a low-income country. BMC Psychiatry 2019; 19:400. [PMID: 31842830 PMCID: PMC6916072 DOI: 10.1186/s12888-019-2402-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 12/11/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Bullying and suicidal behaviors are a silent public health problem among adolescents. Little is known about the link between bullying and suicidal behaviors in low-income countries such as Tanzania. In the current study, we estimated the prevalence of being bullied and determined its association with suicidal behaviors among in-school adolescents. METHODS We performed a secondary analysis of the Tanzania Global School-based Student Health Survey (GSHS) conducted in 2014. This was the first nationally representative survey conducted to a sample of 3793 in-school adolescents. The primary independent variable was being bullied, while the outcome variables of interest were suicide ideation and suicide attempt. We used a chi-square χ2 test for group variables comparisons and multivariate logistic regression for statistical associations between independent and outcome variables. In our analysis, a p < 0.05 was considered statistically significant at 95% confidence intervals. RESULTS The prevalence of being bullied among 3793 surveyed in-school adolescents was 27.0%. In an adjusted multivariate regression model, being bullied was independently associated with suicidal ideation and suicide attempt: [AOR; 1.9, 95% C.I; 1.5-2.4], and [AOR; 3.6, 95% C.I; 2.9-4.5] respectively, p < 0.001. CONCLUSIONS Bullying is prevalent and possibly a potential predictor of suicidal behaviors among in-school adolescents in Tanzania. There is a need for all educational stakeholders: teachers, parents, students, mental health professionals, and policymakers to design a program for mitigating the problem of bullying in schools.
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Affiliation(s)
- Festo K Shayo
- Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, P. O Box, 65001, Dar es Salaam, Tanzania.
- Department of Global Health Entrepreneurship, Division of Public Health, Graduate School of Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
- , Dar es Salaam, Tanzania.
| | - Paul S Lawala
- Department of Psychiatry and Mental Health, Mbeya Zonal Referral Hospital, P.O. Box 419, Mbeya, Tanzania
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190
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Ahinkorah BO, Hagan JE, Seidu AA, Budu E, Hormenu T, Mintah JK, Sambah F, Schack T. Access to Adolescent Pregnancy Prevention Information and Services in Ghana: A Community-Based Case-Control Study. Front Public Health 2019; 7:382. [PMID: 31921747 PMCID: PMC6927296 DOI: 10.3389/fpubh.2019.00382] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 11/28/2019] [Indexed: 12/02/2022] Open
Abstract
Background: Pregnancy among girls 10-19 years remains a challenge that requires critical resolution all over the world. Despite this worrying sexual phenomenon, research pertaining to prevention information and related services in Sub-Saharan nations like Ghana is sparse. This study sought to determine the influence of access to pregnancy prevention information and services on adolescent pregnancy in the Komenda-Edina-Eguafo-Abrem Municipality in the Central Region of Ghana. Methods and Results: Adopting a matched case-control research design with a 1:1 mapping, female adolescents aged between 15 and 19 years in the KEEA Municipality were selected using a facility based sampling technique. Results from both bivariate and multivariate analyses revealed that non-pregnant adolescents were about two times more likely to have access to pregnancy prevention information from health workers compared to pregnant adolescents [OR = 0.57, 95% CI = (0.33-0.96), p = 0.036]. Likewise, pregnant adolescents were five times more likely to have access to pregnancy prevention information from media compared to non-pregnant adolescents [OR = 5.44, 95% CI = (2.64-11.23), p = 0.000]. Additionally, non-pregnant adolescents were two times more likely to receive information on pregnancy prevention from school compared to pregnant adolescents [OR = 0.48, 95% CI = (0.28-0.81), p = 0.006]. Conclusion: Sexuality and reproductive health (SRH) programme organizers should target specific intervention programmes that focus on training health workers and/or other analogous staff to enhance their awareness, attitudes, and skills to more effectively meet with the specific needs of adolescents. Specific health workers training and redesign of health facilities to foster more adolescent user friendly working environment (e.g., extension in operational times, reduction in fees of SRH services, transforming physical design to promote privacy or confidentiality) ought to be encouraged. Different media outreach programmes should also combine other community level events [e.g., informative methods through schools (e.g., focus group discussions, participatory learning), assisting connections to health services, community information network (e.g., use of sirens)] to provide well-tailored advocacy that would help modify SRH and sociocultural norms that hinder positive sexual behaviors among young people.
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Affiliation(s)
- Bright Opoku Ahinkorah
- Faculty of Health, The Australian Centre for Public and Population Health Research (ACPPHR), University of Technology Sydney, Sydney, NSW, Australia
| | - John Elvis Hagan
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Bielefeld, Germany
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Eugene Budu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Thomas Hormenu
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Joseph Kwame Mintah
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Francis Sambah
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Thomas Schack
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Bielefeld, Germany
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191
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Rickard J, Beilman G, Forrester J, Sawyer R, Stephen A, Weiser TG, Valenzuela J. Surgical Infections in Low- and Middle-Income Countries: A Global Assessment of the Burden and Management Needs. Surg Infect (Larchmt) 2019; 21:478-494. [PMID: 31816263 DOI: 10.1089/sur.2019.142] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background: The burden of surgical infections in low- and middle-income countries (LMICs) remains poorly defined compared with high-income countries. Although there are common infections necessitating surgery prevalent across the world, such as appendicitis and peptic ulcer disease, other conditions are more localized geographically. To date, comprehensive assessment of the burden of surgically treatable infections or sequelae of surgical infections in LMICs is lacking. Methods: We reviewed the literature to define the burden of surgical infections in LMICs and characterize the needs and challenges of addressing this issue. Results: Surgical infections comprise a broad range of diseases including intra-abdominal, skin and soft tissue, and healthcare-associated infections and other infectious processes. Treatment of surgical infections requires a functional surgical ecosystem, microbiology services, and appropriate and effective antimicrobial therapy. Systems must be developed and maintained to evaluate screening, prevention, and treatment strategies. Solutions and interventions are proposed focusing on reducing the burden of disease, improving surveillance, strengthening antibiotic stewardship, and enhancing the management of surgical infections. Conclusions: Surgical infections constitute a large burden of disease globally. Challenges to management in LMICs include a shortage of trained personnel and material resources. The increasing rate of antimicrobial drug resistance, likely related to antibiotic misuse, adds to the challenges. Development of surveillance, infection prevention, and antimicrobial stewardship programs are initial steps forward. Education is critical and should begin early in training, be an active process, and be sustained through regular programs.
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Affiliation(s)
- Jennifer Rickard
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Gregory Beilman
- Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Joseph Forrester
- Department of Surgery, Stanford University, Stanford, California, USA
| | - Robert Sawyer
- Department of Surgery, Homer Stryker MD School of Medicine, Western Michigan University, Kalamazoo, Michigan, USA
| | - Andrew Stephen
- Department of Surgery, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Thomas G Weiser
- Department of Surgery, Stanford University, Stanford, California, USA
| | - Julie Valenzuela
- Department of Surgery, Northwell Health, New Hyde Park, New York, USA
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192
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Haverkamp FJC, van Gennip L, Muhrbeck M, Veen H, Wladis A, Tan ECTH. Global surgery for paediatric casualties in armed conflict. World J Emerg Surg 2019; 14:55. [PMID: 31827594 PMCID: PMC6902420 DOI: 10.1186/s13017-019-0275-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 10/31/2019] [Indexed: 11/10/2022] Open
Abstract
Background Understanding injury patterns specific for paediatric casualties of armed conflict is essential to facilitate preparations by organizations that provide medical care in conflict areas. The aim of this retrospective cohort study is to identify injury patterns and treatment requirements that are specific for paediatric patients in conflict zones. Methods Characteristics of children (age < 15 years) treated in medical facilities supported by the International Committee of the Red Cross (ICRC) between 1988 and 2014 in Kabul, Kao-i-Dang, Lokichogio, Kandahar, Peshawar, Quetta and Goma were analysed; patient characteristics were compared between treatment facilities and with those of adult patients (age ≥ 15 years). Results Of the patients listed in the database, 15% (5843/38,088) were aged < 15 years. The median age was 10 years (IQR 6–12); 75% (4406/5843) were male. Eighty-six percent (5012/5,843) of the admitted children underwent surgery, with a median of 2 surgeries per patient (IQR 1–3). When compared with adult patients, children were more frequently seen with fragment injuries, burns and mine injuries; they had injuries to multiple body regions more often and had higher in-hospital mortality rates. Conclusions Children more often sustained injuries to multiple body regions and had higher in-hospital mortality than adults. These findings could have implications for how the ICRC and other organizations prepare personnel and structure logistics to meet the treatment needs of paediatric victims of armed conflicts.
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Affiliation(s)
- Frederike J C Haverkamp
- 1Department of Surgery, Radboudumc, Geert Grooteplein Zuid, 9101, 618 Nijmegen, the Netherlands
| | - Lisanne van Gennip
- 1Department of Surgery, Radboudumc, Geert Grooteplein Zuid, 9101, 618 Nijmegen, the Netherlands
| | - Måns Muhrbeck
- 2Department of Surgery, Linköping University, Norrköping, Sweden.,3Department of Clinical and Experimental Medicine, Linköping University, Norrköping, Sweden.,4Center for Disaster Medicine and Traumatology, Linköping University, Linköping, Sweden
| | - Harald Veen
- 1Department of Surgery, Radboudumc, Geert Grooteplein Zuid, 9101, 618 Nijmegen, the Netherlands.,2Department of Surgery, Linköping University, Norrköping, Sweden.,3Department of Clinical and Experimental Medicine, Linköping University, Norrköping, Sweden.,4Center for Disaster Medicine and Traumatology, Linköping University, Linköping, Sweden
| | - Andreas Wladis
- 3Department of Clinical and Experimental Medicine, Linköping University, Norrköping, Sweden.,4Center for Disaster Medicine and Traumatology, Linköping University, Linköping, Sweden
| | - Edward C T H Tan
- 1Department of Surgery, Radboudumc, Geert Grooteplein Zuid, 9101, 618 Nijmegen, the Netherlands
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193
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Golub SA, Maza Reyes JC, Stamoulis C, Leal Pensabene A, Tijerino Cordón PA, Calgua E, Hassan A. Guatemala City youth: an analysis of health indicators through the lens of a clinical registry. Int Health 2019; 11:265-271. [PMID: 30428054 DOI: 10.1093/inthealth/ihy081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 08/29/2018] [Accepted: 09/13/2018] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Despite the inclusion of adolescent health in recent global frameworks, limited data exist on health indicators in low-income countries. Our objective was to identify socioeconomic measures, risk behaviors and health indicators of young people in Guatemala. METHODS We conducted a secondary data analysis of the Pan American Health Organization's Sistema Informático del Adolescente of 2831 participants ages 10-24 y from 2008 to 2014. We examined frequencies for a core set of items, and generalized regression models assessed correlations between age, sex and ethnicity with health outcomes of interest. RESULTS Fewer than 17% of participants reported a history of chronic illness (16.6%) and severe psychological problems (16.8%). While 66.1% of participants' mothers and 36.6% of fathers reported job instability, far fewer families had housing instability (1.9% with no electricity, 6.3% with no running water). Fewer than one-third (29.1%) were sexually active and the majority (76.0%) routinely used condoms. About one-quarter (22.6%) reported abnormal mood. Indigenous participants were significantly more likely to have experienced psychological problems (odds ratio [OR] 1.75 [confidence interval {CI} 1.65-1.86]) and violence (OR 1.34 [CI 1.27-1.42]) compared with whites. CONCLUSIONS The prevalence of risk behaviors and mental health concerns is low compared with other sources of national and regional data. Further work is needed to examine the benefits and limitations of this system in order to improve health surveillance.
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Affiliation(s)
- Sarah A Golub
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Juan Carlos Maza Reyes
- Departamento Pediatria Adolescentes, Hospital San Juan De Dios, Guatemala City, Guatemala.,School of Medicine, Universidad de San Carlos de Guatemala, Guatemala City, Guatemala
| | - Catherine Stamoulis
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | | | | | - Erwin Calgua
- School of Medicine, Universidad de San Carlos de Guatemala, Guatemala City, Guatemala
| | - Areej Hassan
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, MA, USA.,Department of Pediatrics, Harvard Medical School, Boston, MA, USA
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Nyundo A, Manu A, Regan M, Ismail A, Chukwu A, Dessie Y, Njau T, Kaaya SF, Smith Fawzi MC. Factors associated with depressive symptoms and suicidal ideation and behaviours amongst sub-Saharan African adolescents aged 10-19 years: cross-sectional study. Trop Med Int Health 2019; 25:54-69. [PMID: 31698526 DOI: 10.1111/tmi.13336] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This study aimed to determine the burden of depression, suicidal ideation and suicidal behaviour amongst adolescents at sites in six sub-Saharan African countries and examine associated risk and protective factors. METHODS Household-based cross-sectional study involving male and female adolescents ages 10-19 years. A total of 7,662 adolescents from eight sites in six countries participated in the survey. Three sites were urban: Dar es Salaam (Tanzania), Harar (Ethiopia) and Ibadan (Nigeria); five were rural: Dodoma (Tanzania), Iganga/Mayuge (Uganda), Kersa (Ethiopia), Ningo Prampram (Ghana) and Nouna (Burkina Faso). Log-binomials models were used to estimate relative risks and confidence intervals for factors associated with depression and suicidal behaviour. This was supplemented using log-Poisson models as needed. RESULTS The prevalence of suicidal behaviour over the last 12 months ranged between 1.2% and 12.4% in the eight sites. Depressive symptoms and suicidal ideation/behaviours were associated with older age, female sex, food insecurity, poor access to health care and substance use. Depression was strongly associated with increased risk of suicidal behaviour at two sites where the multivariate model converged: Harar, Ethiopia (RR = 3.5, 95% CI 1.8, 7.0, P < 0.05) and Ibadan, Nigeria (RR = 3.7, 95% CI 2.2, 6.3, P < 0.0001). CONCLUSIONS Depressive symptoms and suicidal behaviour are common amongst sub-Saharan African adolescents at these 8 sites. Most factors associated with depressive symptoms are modifiable and preventable. Routine screening for depressive symptoms in services frequented by adolescents in these and similar communities would be crucial in early detection and prompt intervention.
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Affiliation(s)
- Azan Nyundo
- Department of Psychiatry and Mental Health, School of Medicine, University of Dodoma, Dodoma, Tanzania
| | - Adom Manu
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Mathilda Regan
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Abbas Ismail
- Department of Statistics, University of Dodoma, Dodoma, Tanzania
| | - Angela Chukwu
- Department of Statistics, University of Ibadan, Ibadan, Nigeria
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia
| | - Tasiana Njau
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Sylvia F Kaaya
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Mary C Smith Fawzi
- Department of Global Health and Social Medicine, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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195
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Hinze V, Crane C, Ford T, Buivydaite R, Qiu L, Gjelsvik B. The relationship between pain and suicidal vulnerability in adolescence: a systematic review. THE LANCET. CHILD & ADOLESCENT HEALTH 2019; 3:899-916. [PMID: 31606322 PMCID: PMC6842327 DOI: 10.1016/s2352-4642(19)30267-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 07/16/2019] [Accepted: 07/19/2019] [Indexed: 02/02/2023]
Abstract
Leading suicide theories and research in adults suggest that pain can exacerbate the suicidal risk of an individual. Although pain and suicidality (including suicidal ideation, behaviour, and death by suicide) both increase in prevalence during adolescence, the relationship between these factors remains unclear. We aimed to systematically review the empirical evidence for such an association in adolescence. We included 25 observational studies published between January 1961 and December 2018, exploring the potential association between pain and suicidality in adolescents aged 10-19 years. Across various samples and manifestations of pain and suicidality, we found that pain approximately doubles the suicidal risk in adolescents, with a few studies suggesting that pain can predict suicidality longitudinally. Although depression was an important factor, it did not fully explain the association between pain and suicidality. Evidence for associations between pain characteristics and suicidality is sparse and inconclusive, and potentially hides developmental differences between adolescents and adults. Identification of psychological mediators and moderators is required to develop interventions tailored to the needs of adolescents experiencing pain. This study is registered with the PROSPERO database, number CRD42018097226.
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Affiliation(s)
- Verena Hinze
- Department of Psychiatry, University of Oxford, Oxford, UK.
| | | | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | | | - Lin Qiu
- Department of Psychiatry, University of Oxford, Oxford, UK; Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Bergljot Gjelsvik
- Department of Psychiatry, University of Oxford, Oxford, UK; Department of Psychology, University of Oslo, Oslo, Norway
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196
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Leung J, Chiu V, Connor JP, Peacock A, Kelly AB, Hall W, Chan GCK. Alcohol consumption and consequences in adolescents in 68 low and middle-income countries - a multi-country comparison of risks by sex. Drug Alcohol Depend 2019; 205:107520. [PMID: 31707267 DOI: 10.1016/j.drugalcdep.2019.06.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 06/10/2019] [Accepted: 06/11/2019] [Indexed: 01/26/2023]
Abstract
AIMS Alcohol use is a leading risk factor for disease burden among youth. This study estimated sex differences in the prevalence of alcohol use and consequences among adolescents living in low and middle-income countries (LMIC). DESIGN Multi-staged cross-sectional international standardized self-report questionnaires administered in the classroom. SETTING The Global school-based student health survey (GSHS) comprised adolescents from 68 LMIC between 2003-2014. PARTICIPANTS 271,156 students aged 13-17 years old. MEASUREMENTS Alcohol measures included: past month alcohol consumption, history of intoxication and alcohol-related problems. Regions were based on the World Health Organization definitions: Africa, America, Eastern Mediterranean, Europe, South-east Asia, and Western Pacific. FINDINGS Overall, males had higher odds of alcohol use (OR = 2.38 [1.91-2.96]), a history of intoxication (OR = 2.64 [2.11-3.31]), and alcohol-related problems (OR = 1.72 [1.41-2.10]) than females. All regions recorded overall greater odds of alcohol use by males versus females; five regions (excluding Europe) recorded greater odds of intoxication in males; and three regions (America, South-east Asia, and Western Pacific) recorded greater odds of alcohol-related problems amongst males. However, there were country-level differences - in some countries, adolescent drinking rates and consequences were comparable by sex. Countries with the highest odds of alcohol use among males compared to females were Indonesia, Myanmar, Cambodia, Tuvalu, Morocco, Senegal, Kiribati, and Thailand. CONCLUSIONS Among adolescents living in LMIC, males had on average two-fold higher odds of drinking alcohol and experiencing adverse consequences. Growing affluence and improvements in sex equality in societies may increase the future prevalence of hazardous drinking in females in LMICs.
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Affiliation(s)
- Janni Leung
- School of Psychology, Brisbane, The University of Queensland, QLD 4067, Australia; National Drug and Alcohol Research Centre, Sydney, University of New South Wales, NSW 2031, Australia; Centre for Youth Substance Abuse Research, Brisbane, The University of Queensland, QLD 4067, Australia; Institute for Health Metrics and Evaluation, University of Washington, WA 98121, United States.
| | - Vivian Chiu
- School of Psychology, Brisbane, The University of Queensland, QLD 4067, Australia; National Drug and Alcohol Research Centre, Sydney, University of New South Wales, NSW 2031, Australia; Centre for Youth Substance Abuse Research, Brisbane, The University of Queensland, QLD 4067, Australia.
| | - Jason P Connor
- Centre for Youth Substance Abuse Research, Brisbane, The University of Queensland, QLD 4067, Australia.
| | - Amy Peacock
- National Drug and Alcohol Research Centre, Sydney, University of New South Wales, NSW 2031, Australia.
| | - Adrian B Kelly
- Institute of Health and Biomedical Innovation, Queensland University of Technology, QLD 4059, Australia.
| | - Wayne Hall
- Centre for Youth Substance Abuse Research, Brisbane, The University of Queensland, QLD 4067, Australia; King's College London, London, WC2R 2LS, United Kingdom.
| | - Gary C K Chan
- Centre for Youth Substance Abuse Research, Brisbane, The University of Queensland, QLD 4067, Australia.
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197
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Prinsloo C, Prinsloo A. A Qualitative Exploration of South Korean Emerging Adults' Perspectives on Death and Suicide Through Short Stories. OMEGA-JOURNAL OF DEATH AND DYING 2019; 84:245-266. [PMID: 31726937 DOI: 10.1177/0030222819887248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Despite the alarming suicide rate among South Korean emerging adults, relatively little is known about their unfettered perspectives on death and suicide. Therefore, an innovative data collection technique was developed to apprehend the meanings that emerging adults attribute to death and suicide in their explorations of the phenomena through a selection of short stories. A convenience sample (N = 114) responded to a survey in which participants transferred their feelings toward death and suicide to characters or events in the short stories. A qualitative content analysis revealed relatively permissive perspectives toward death and suicide. Negative perspectives on death are associated with societal victimization and positive perspectives with naturalistic fatalism. Positive perspectives on suicide are overwhelmingly rooted in existential, individual choices while negative perspectives focus on societal pressures. These perspectives contribute to illuminating tensions between traditionalist collectivism and contemporary individualism in Korean society that could inform suicide prevention initiatives for emerging adults.
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Affiliation(s)
| | - Adri Prinsloo
- Department of Psychology, Faculty of Humanities, University of Pretoria, South Africa
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198
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Abstract
PURPOSE OF REVIEW Suicide is the second leading cause of death in youth aged 10-24 years old globally, but detecting those at risk is challenging. Novel preventive strategies with wide influence across populations are required. Interest in the potential for both detrimental and supportive influences of social media/internet use on suicidal behaviour has been growing; however, the relationship remains unclear. RECENT FINDINGS A systematic search of articles from database inception up to 25 January 2019 across five databases: Medline, PsycINFO, EMBASE, HMIC and CINAHL revealed nine independent studies investigating social media/internet use and suicide attempts in young people less than 19 years old (n = 346 416). An independent direct association was found between heavy social media/internet use and increased suicide attempts in seven studies (adjusted ORs ranged from 1.03 to 5.10), although adjusting for cyberbullying victimization and sleep disturbance reduced the strength of this association. Two studies found that some social media/internet use, versus no use, may be associated with fewer suicide attempts. There were no studies investigating the relationship between social media/internet use and completed suicide. SUMMARY There is an independent association between problematic use of social media/internet and suicide attempts in young people. However, the direction of causality, if any, remains unclear. Further evaluation through longitudinal studies is needed.
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Affiliation(s)
- Rosemary Sedgwick
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London
- South London and Maudsley NHS Foundation Trust
| | - Sophie Epstein
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London
- South London and Maudsley NHS Foundation Trust
| | - Rina Dutta
- South London and Maudsley NHS Foundation Trust
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Dennis Ougrin
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London
- South London and Maudsley NHS Foundation Trust
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199
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Oginni OA, Robinson EJ, Jones A, Rahman Q, Rimes KA. Mediators of increased self-harm and suicidal ideation in sexual minority youth: a longitudinal study. Psychol Med 2019; 49:2524-2532. [PMID: 30468143 DOI: 10.1017/s003329171800346x] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Sexual minority youth have elevated suicidal ideation and self-harm compared with heterosexual young people; however, evidence for mediating mechanisms is predominantly cross-sectional. Using a longitudinal design, we investigated self-esteem and depressive symptoms as mediators of increased rates of suicidal ideation or self-harm (SISH) among sexual minority youth, and the roles of childhood gender nonconformity (CGN) and sex as moderators of these relationships. METHOD In total, 4274 youth from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort reported sexual orientation at age 15 years, and past-year SISH at age 20 years. Self-esteem and depressive symptoms were assessed at ages 17 and 18 years, respectively. CGN was measured at 30-57 months. Covariates included sociodemographic variables and earlier measures of mediator and outcome variables. Mediation pathways were assessed using structural equation modelling. RESULTS Sexual minority youth (almost 12% of the sample) were three times more likely than heterosexual youth to report past-year SISH (95% confidence interval 2.43-3.64) at 20 years. Two mediation pathways were identified: a single mediator pathway involving self-esteem and a multiple-mediated pathway involving self-esteem and depressive symptoms. Although CGN was associated with past-year SISH, it did not moderate any mediation pathways and there was no evidence for moderation by sex. CONCLUSIONS Lower self-esteem and increased depressive symptoms partly explain the increased risk for later suicidal ideation and self-harm in sexual minority youth. Preventive strategies could include self-esteem-enhancing or protecting interventions, especially in female sexual minority youth, and treatment of depression.
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Affiliation(s)
- O A Oginni
- Social Genetic and Developmental Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - E J Robinson
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - A Jones
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Q Rahman
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - K A Rimes
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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200
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Abstract
Carefully planned, long-term partnerships can build surgical capacity in developing countries, which can save lives and alleviate suffering. Good partnerships are built around the goal of educating local staff. They involve consistent engagement with the same local hosts over time. Teaching is directed more broadly than just to surgeons; anesthesia, nursing, sterile processing, and biomedical engineering are also important partners.
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