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Flodin N, Lejtzen S, Gunnarsdóttir H. The Perceived Power and Powerlessness in School Health Nurses' Mental Health Promotion Practices: A Synthesis of Qualitative Studies. J Sch Nurs 2024:10598405241241212. [PMID: 38602147 DOI: 10.1177/10598405241241212] [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: 04/12/2024] Open
Abstract
Schools are important arenas for mental health promotion initiatives. School nurses have the opportunity and ability to support and promote students' mental health, but their role and practices have been perceived as somewhat unclear. Therefore, the aim of this study was to explore school nurses' mental health promotion practices. A total of 12 scientific studies were synthesized through a meta-ethnographic approach. The overarching results of the synthesis show that school nurses' mental health promotion practices are largely about balancing and combining the students' needs with different professional perspectives, competencies, and conditions. The school nurses perceived that they had the power to influence their practices through a variety of ways, highlighting the importance of letting the students' needs guide the practices. Yet, at the same time they described feelings of powerlessness because of the different organizational structures that were hindering their mental health promotion practices.
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Affiliation(s)
- Nina Flodin
- Department of Health Sciences, University West, Trollhättan, Sweden
- Lindholmens Tekniska Gymnasium, The Educational Administration, City of Gothenburg, Sweden
| | - Stina Lejtzen
- Department of Health Sciences, University West, Trollhättan, Sweden
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Tunesi S, Tambuzzi S, Decarli A, Cattaneo C, Russo AG. Trends in mortality from non-natural causes in children and adolescents (0-19 years) in Europe from 2000 to 2018. BMC Public Health 2023; 23:2223. [PMID: 37950237 PMCID: PMC10638782 DOI: 10.1186/s12889-023-17040-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/21/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Non-natural mortality in children and adolescents is a global public health problem that varies widely from country to country. Data on child and adolescent maltreatment are not readily available, and mortality due to violent causes is also underestimated. METHODS Injury-related mortality rates (overall and by specific causes) from 2000 to 2018 in selected European countries were analysed to observe mortality patterns in children and adolescents using data from the Eurostat database. Age-standardized mortality rates per 100,000 person-years were calculated for each country. Joinpoint regression analysis with a significance level of 0.05 and 95% confidence intervals was performed for mortality trends. RESULTS Children and adolescent mortality from non-natural causes decreased significantly in Europe from 10.48 around 2005 to 5.91 around 2015. The Eastern countries (Romania, Bulgaria, Poland, Slovakia, Czech Republic) had higher rates; while Spain, Denmark, Italy, and the United Kingdom had the lowest. Rates for European Country declined by 5.10% per year over the entire period. Larger downward trends were observed in Ireland, Spain and Portugal; smaller downward trends were observed for Eastern countries (Bulgaria, Czech Republic, Poland, Slovakia) and Finland. Among specific causes of death, the largest decreases were observed for accidental causes (-5.9%) and traffic accidents (-6.8%). CONCLUSIONS Mortality among children and adolescents due to non-natural causes has decreased significantly over the past two decades. Accidental events and transport accidents recorded the greatest decline in mortality rates, although there are still some European countries where the number of deaths among children and adolescents from non-natural causes is high. Social, cultural, and health-related reasons may explain the observed differences between countries.
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Affiliation(s)
- Sara Tunesi
- Epidemiology Unit, Agency for Health Protection of Milan, Via Conca del Naviglio, 45, 20123, Milano, (MI), Italy
| | - Stefano Tambuzzi
- Bureau of Legal Medicine and Insurance, Department of Biomedical Science for Health, University of Milan, Milan, Italy
| | - Adriano Decarli
- Epidemiology Unit, Agency for Health Protection of Milan, Via Conca del Naviglio, 45, 20123, Milano, (MI), Italy
| | - Cristina Cattaneo
- Bureau of Legal Medicine and Insurance, Department of Biomedical Science for Health, University of Milan, Milan, Italy
| | - Antonio Giampiero Russo
- Epidemiology Unit, Agency for Health Protection of Milan, Via Conca del Naviglio, 45, 20123, Milano, (MI), Italy.
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Ilia S, Sakapeti E, Briassoulis P, Gerostergios G, Vgontzas A, Briassoulis G. Suicidality Prevalence in a Pediatric Psychiatric Clinic: Relation to Social and Environmental Risk Factors. CHILDREN 2023; 10:children10030558. [PMID: 36980115 PMCID: PMC10047874 DOI: 10.3390/children10030558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/11/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023]
Abstract
Suicidality is a growing public health problem in children and adolescents. The aim of this retrospective data analysis study was to estimate the prevalence of suicidality in pediatric patients admitted to an academic Pediatric Psychiatric Clinic (PPC) and to analyze social and environmental risk factors associated with suicide. Suicidal ideation was assessed by the Self-Injurious Thoughts and Behaviors Interview. Using established psychometric scales, social and stressful events were analyzed. During the four-year study, 249 episodes of care were experienced by 152 individuals (mean age 15.2 ± 2 years, girls/boys 107/45). Twenty-eight patients (11.2%) were admitted from the Pediatric Intensive Care Unit and the Department of Pediatrics, 162 (65.1%) from the Pediatric Emergency Department, and 59 (23.7%) from other Hospitals (p = 0.003). A significant longitudinal increase in admissions to PPC, with increasing trends of suicidal ideation, suicide attempts, and suicidality, was recorded. Suicidal behavior, bullying, internet addiction, friends quarreling, and family problems were risk factors for suicide attempts and suicidality. Our results have implications for prevention programs, highlighting an increasing need for care for suicide attempts and suicidal ideation, related to specific stressful events and contextual socio-environmental status.
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Affiliation(s)
- Stavroula Ilia
- Postgraduate Program “Emergency and Intensive Care in Children Adolescents and Young Adults”, School of Medicine, University of Crete, 71003 Heraklion, Greece
- Pediatric Intensive Care Unit, University Hospital, School of Medicine, University of Crete, 71110 Heraklion, Greece
| | - Evangelia Sakapeti
- Postgraduate Program “Emergency and Intensive Care in Children Adolescents and Young Adults”, School of Medicine, University of Crete, 71003 Heraklion, Greece
- Department of Psychiatry, University Hospital, School of Medicine, University of Crete, 71110 Heraklion, Greece
| | - Panagiotis Briassoulis
- Pediatric Intensive Care Unit, University Hospital, School of Medicine, University of Crete, 71110 Heraklion, Greece
- Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - George Gerostergios
- Department of Psychiatry, University Hospital, School of Medicine, University of Crete, 71110 Heraklion, Greece
| | - Alexandros Vgontzas
- Department of Psychiatry, University Hospital, School of Medicine, University of Crete, 71110 Heraklion, Greece
| | - George Briassoulis
- Postgraduate Program “Emergency and Intensive Care in Children Adolescents and Young Adults”, School of Medicine, University of Crete, 71003 Heraklion, Greece
- Pediatric Intensive Care Unit, University Hospital, School of Medicine, University of Crete, 71110 Heraklion, Greece
- Correspondence: ; Tel.: +30-2810-394675
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Regional clozapine, ECT and lithium usage inversely associated with excess suicide rates in male adolescents. Nat Commun 2023; 14:1281. [PMID: 36918566 PMCID: PMC10015020 DOI: 10.1038/s41467-023-36973-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 02/20/2023] [Indexed: 03/16/2023] Open
Abstract
Advanced psychiatric treatments remain uncertain in preventing suicide among adolescents. Across the 21 Swedish regions, using nationwide registers between 2016-2020, we found negative correlation between adolescent excess suicide mortality (AESM) and regional frequencies of clozapine, ECT, and lithium (CEL) usage among adolescents (β = -0.613, p = 0.0003, 95% CI: -0.338, -0.889) and males (β = -0.404, p = 0.009, 95% CI: -0.130, -0.678). No correlation was found among females (p = 0.197). Highest CEL usage among male adolescents was seen in regions with lowest quartile (Q1) AESM (W = 74, p = 0.012). Regional CEL treatment frequency in 15-19-year-olds was related to lower AESM in males, reflecting potential treatment efficacy, treatment compliance or better-quality mental health care. Suicide prevention may benefit from early recognition and CEL treatment for severe mental illness in male adolescents. The results indicate association but further research, using independent samples and both prospective and observational methodologies, is needed to confirm causality.
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Pigolkin YI, Gornostaev DV, Shigeev SV, Yagmurov OD, Sheptulin DA. [Forensic medical characteristic of hanging incidents among juvenile]. Sud Med Ekspert 2023; 66:9-13. [PMID: 37496475 DOI: 10.17116/sudmed2023660419] [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: 07/28/2023]
Abstract
THE AIM OF THE STUDY Was to conduct the epidemiological analysis of juveniles' deaths by hanging, registered in the Bureau of Forensic Medical Expertise, Moscow for 2017-2021 years. The number of incidents equal 61 was revealed (2.65% of whole hanging incidents for the researched period). The amount of hanging deaths among juveniles and their percent in the total quantity of deaths from this type of strangulated asphyxia increased in 2017, 2018 and 2019 years to 8 (1.6%), 15 (3.1%) and 18 (3.6%) incidents respectively; decreased in 2020 year to 7 (1.7%) incidents and increased again in 2021 year to 13 (3.0%) incidents. Juveniles died by hanging were mostly male (73.8%) aged from 15 to 18 years (63.9%). The median age for girls was 16 years (IQR 15.0-16.75) and for boys 15 years (IQR 13.0-16.5). Most of juveniles' corps were found in their place of residence: in apartments or residential houses (the whole number was 49 or 80.4%). Generally, juvenile hanging occurred between November and January (36.1% of all incidents) and in April (11.5%); less frequently were in February (1.6%), June and July (9.8%). Alcohol was found in blood of 18.2% juveniles aged from 15 to 18.
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Affiliation(s)
- Yu I Pigolkin
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - D V Gornostaev
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Bureau of Forensic Medical Expertise, Moscow, Russia
| | - S V Shigeev
- Bureau of Forensic Medical Expertise, Moscow, Russia
| | - O D Yagmurov
- Bureau of Forensic Medicine, St. Petersburg, Russia
| | - D A Sheptulin
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Grabska K, Pilarska I. Acute poisoning among children and adolescents: a narrative review. MEDICAL SCIENCE PULSE 2022. [DOI: 10.5604/01.3001.0015.9656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Acute poisoning is a frequent emergency and a significant health concern in the pediatric population. The pattern of acute intoxication differs between countries and within each country. Poisoning depends on many factors. It can be divided into two categories (accidental and intentional), and each one has its own characteristics.
Aim of the study: This study aimed to analyze and discuss the overall patterns of accidental and intentional poisoning among children and adolescents.
Material and methods: A systematic literature search was conducted using Google Scholar, Elsevier, and the PubMed database. The following keywords were used: “acute poisoning”, “pediatric poisoning”, “intentional poisonings”, “unintentional poisonings”, and “suicide attempts”.
Results: A total of 38 articles were included in the review. Half had been published in the last five years. The analysis focused on the characteristics of the materials and methods, results, and conclusions sections of each study.
Conclusions: Unintentional poisonings dominate among younger children, with a slight male predominance. They usually occur at home and occasionally lead to severe harm or even death. The most common causes of intoxication in this population are medications and household products. The majority of poisonings among adolescents are intentional suicide attempts. Among older children, over-the-counter analgesics are the most common cause of acute poisoning. Accidental poisoning can be avoided by providing preventive educational programs to guardians and replacing potentially toxic household products with safer ones. The prevention of intentional poisoning should be based on a community support system and behavioral programs. Healthcare professionals should be familiar with poisoning and be aware of the different patterns of intoxication according to age and gender.
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Affiliation(s)
- Kinga Grabska
- St. Anna’s Hospital of Trauma Surgery in Warsaw, Poland; Student Research Association of Pediatric Emergency Medicine, Medical University of Warsaw, Poland
| | - Izabela Pilarska
- Central Clinical Hospital of the Ministry of the Interior, Warsaw, Poland; Student Research Association of Pediatric Emergency Medicine, Medical University of Warsaw, Poland
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