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Incidence of suicide among teenagers and young adults in Transkei, South Africa  [cached]
Banwari L. Meel
African Journal of Primary Health Care & Family Medicine , 2009, DOI: 10.4102/phcfm.v1i1.45
Abstract: Background: Transkei is the least developed of the former black homelands in South Africa and has a population of about 4 million. People in this area are poor and depend mainly on the income from migratory workers to the gold mines. Suicide is a complex problem, with no definitive causative agent that has been identified as yet. Suicide among teenagers and young adults is now emerging as an important mental health issue. Suicidal behaviour in the population is under- researched, and therefore under-reported. Method: This is a retrospective record review from 1993 to 2003, carried out in the Umtata General Hospital mortuary. About 1 000 medico-legal autopsies are conducted annually, and the mortuary caters for a population of about 400 000. Results: Of the 10 340 medico-legal autopsies, 398 (3.84%) suicide cases were due to hanging. The number has increased from 5.2 per 100 000 of the population in 1993 to 16.2 in 2003. More than a half (55%) of the hangings were of people less than 30 years of age, and less than one-quarter (23%) of these victims were younger than 20 years. The rate in males has increased from 4.5 (1993) to 14 per 100 000, and in females from 0.7 to 2.2 per 100 000. The male/female ratio is recorded highest (9 : 1) in the 20- and 29-year age group. Conclusion: There is an increasing incidence of suicides among young adults. Suicidal tendency among teenagers and young adults is emerging as an important health issue that needs to be addressed. How to cite this article: Meel BL. Incidence of suicide among teenagers and young adults in Transkei, South Africa. Afr J Prm Health Care Fam Med. 2009;1(1), Art. #45, 5 pages. DOI: 10.4102/phcfm.v1i1.45
Colorectal Carcinoma in Children and Young Adults in Ilorin, Nigeria
OK Ibrahim, AE Afolayan, KA Adeniji, OM Buhari, KB Badmos
West African Journal of Medicine , 2011,
Abstract: Background: Colorectal carcinoma is thought to be rare among children and young adults among whom presentation is usually at a late stage with poor prognosis. Objective: To review the demography, clinical presentation, morphology, and pathological stage of cases of colorectal carcinomas diagnosed in the children and adults. Methods: This was a retrospective review of cases of histologically diagnosed colorectal carcinoma of patients aged 40 years and below, between 1979 and 2008, using the request cards and hematoxylin and eosin stained slides. Results: Seventy-six (31.5%) of all cases of colorectal carcinoma were seen in patients aged 40 years and below. The mean age at presentation was 31years and the youngest aged 16 years. The male : female ratio was 1.6 : 1. The dominant clinical presentations were bloody diarrhea and rectal bleeding. Fifty-one (67.1%) cases were localized to the rectum, nine (16.1%) cases in the sigmoid colon, and eight (10.5%) cases in the caecum. Adenocarcinoma was the most common histological variant. Mucin-producing tumours were seen in 25 (32.9%) cases. Almost all the patients presented at advanced pathological stage. Conclusion: Colorectal carcinoma is not rare among young Nigerians and it should be suspected when young patients present with chronic bloody diarrhoea. Digital rectal examination should be encouraged as part of clinical examination in this age group too since a large percentage of colorectal carcinomas is within the reach of the examining finger.
Qualitative Approach to Attempted Suicide by Adolescents and Young Adults: The (Neglected) Role of Revenge  [PDF]
Massimiliano Orri, Matteo Paduanello, Jonathan Lachal, Bruno Falissard, Jordan Sibeoni, Anne Revah-Levy
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0096716
Abstract: Background Suicide by adolescents and young adults is a major public health concern, and repetition of self-harm is an important risk factor for future suicide attempts. Objective Our purpose is to explore the perspective of adolescents directly involved in suicidal acts. Methods Qualitative study involving 16 purposively selected adolescents (sex ratio1:1) from 3 different centers. Half had been involved in repeated suicidal acts, and the other half only one. Data were gathered through semistructured interviews and analyzed according to Interpretative Phenomenological Analysis. Results We found five main themes, organized in two superordinate themes. The first theme (individual dimensions of the suicide attempt) describes the issues and explanations that the adolescents saw as related to themselves; it includes the subthemes: (1) negative emotions toward the self and individual impasse, and (2) the need for some control over their lives. The second main theme (relational dimensions of attempted suicide) describes issues that adolescents mentioned that were related to others and includes three subthemes: (3) perceived impasse in interpersonal relationships, (4) communication, and (5) revenge. Conclusions Adolescents involved in suicidal behavior are stuck in both an individual and a relational impasse from which there is no exit and no apparent way to reach the other. Revenge can bridge this gap and thus transforms personal distress into a relational matter. This powerful emotion has been neglected by both clinicians and researchers.
Hypercholesterolaemia in children and young adults – current management
J.F Raal
Journal of Endocrinology, Metabolism and Diabetes of South Africa , 2009,
Abstract: Atherosclerosis begins in childhood. Not uncommonly, the first presentation of atherosclerosis is sudden cardiac death. It therefore makes sense that risk-factor modification to prevent the development or delay the onset of atherosclerosis needs to begin early in life. Dietary intervention is the key component for the primary prevention of hyperlipidaemia. However, if diet and lifestyle fail to correct hyperlipidaemia, drug therapy may have to be considered. All children and adolescents with high-risk lipid disorders such as familial hypercholesterolaemia (FH), those with diabetes mellitus or other cardiovascular disease risk factors or with a family history of premature coronary artery disease should be considered for lipid-lowering therapy if diet and lifestyle intervention are ineffective. There are now numerous studies that have documented the safety and efficacy of statin therapy in both children and young adults. Based on these studies, it is now recommended that statin therapy be initiated in all male FH children from the age of ten years and at the onset of menses in females with FH. The initiation of statin therapy could be considered even earlier in FH children at high risk.
Immigration, Transition into Adult Life and Social Adversity in Relation to Psychological Distress and Suicide Attempts among Young Adults  [PDF]
Kyriaki Kosidou, Clara Hellner-Gumpert, Peeter Fredlund, Christina Dalman, Johan Hallqvist, G?ran Isacsson, Cecilia Magnusson
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0046284
Abstract: Background The increasing incidence of mental health problems among young people is a major concern in many Western countries. The causal mechanisms underlying these trends are not well established, but factors influenced by current societal changes ought to be implicated. Such factors include immigration and social adversity as well as the timing of taking on adult social roles (e.g. gainful employment, parenthood and own housing tenure). We therefore examined relationships between these factors and the risks of psychological distress as well as suicide attempts in young adults, with a focus on gender differences. Methods We conducted a population-based study including 10,081 individuals aged 18–29, recruited in 2002 and 2006 in Stockholm, Sweden. Data were collected by record linkage and questionnaires. Results Non-European immigrants had an increased risk of distress, and female non-European immigrants had a markedly higher risk of suicide attempts. Both early parenthood (≤24 years) and not being a parent, being a student and the lack of own housing tenure were associated with distress, but only in women. In both sexes, financial strain was associated with the increased risk of distress and suicide attempts, while unemployment was only associated with distress. Conclusions Immigration from outside Europe and social adversity are associated with mental health problems in young adults, especially females. Postponed transition into adulthood is associated with poor mental health in young women. These factors are influenced by current societal changes, and may have contributed to the increasing incidence of mental health problems among young people in Western countries.
In Need of Creative Mobile Service Ideas? Forget Adults and Ask Young Children  [PDF]
Ilona Kuzmickaja,Xiaofeng Wang,Daniel Graziotin,Gabriella Dodero,Pekka Abrahamsson
Computer Science , 2015,
Abstract: It is well acknowledged that innovation is a key success factor in mobile service domain. Having creative ideas is the first critical step in the innovation process. Many studies suggest that customers are a valuable source of creative ideas. However, the literature also shows that adults may be constrained by existing technology frames, which are known to hinder creativity. Instead young children (aged 7-12) are considered digital natives yet are free from existing technology frames. This led us to study them as a potential source for creative mobile service ideas. A set of 41,000 mobile ideas obtained from a research project in 2006 granted us a unique opportunity to study the mobile service ideas from young children. We randomly selected two samples of ideas (N=400 each), one contained the ideas from young children, the other from adults (aged 17-50). These ideas were evaluated by several evaluators using an existing creativity framework. The results show that the mobile service ideas from the young children are significantly more original, transformational, implementable, and relevant than those from the adults. Therefore, this study shows that young children are better sources of novel and quality ideas than adults in the mobile services domain. This study bears significant contributions to the creativity and innovation research. It also indicates a new and valuable source for the companies that seek for creative ideas for innovative products and services.
The Co-Morbidity Burden of Children and Young Adults with Autism Spectrum Disorders  [PDF]
Isaac S. Kohane, Andrew McMurry, Griffin Weber, Douglas MacFadden, Leonard Rappaport, Louis Kunkel, Jonathan Bickel, Nich Wattanasin, Sarah Spence, Shawn Murphy, Susanne Churchill
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0033224
Abstract: Objectives Use electronic health records Autism Spectrum Disorder (ASD) to assess the comorbidity burden of ASD in children and young adults. Study Design A retrospective prevalence study was performed using a distributed query system across three general hospitals and one pediatric hospital. Over 14,000 individuals under age 35 with ASD were characterized by their co-morbidities and conversely, the prevalence of ASD within these comorbidities was measured. The comorbidity prevalence of the younger (Age<18 years) and older (Age 18–34 years) individuals with ASD was compared. Results 19.44% of ASD patients had epilepsy as compared to 2.19% in the overall hospital population (95% confidence interval for difference in percentages 13.58–14.69%), 2.43% of ASD with schizophrenia vs. 0.24% in the hospital population (95% CI 1.89–2.39%), inflammatory bowel disease (IBD) 0.83% vs. 0.54% (95% CI 0.13–0.43%), bowel disorders (without IBD) 11.74% vs. 4.5% (95% CI 5.72–6.68%), CNS/cranial anomalies 12.45% vs. 1.19% (95% CI 9.41–10.38%), diabetes mellitus type I (DM1) 0.79% vs. 0.34% (95% CI 0.3–0.6%), muscular dystrophy 0.47% vs 0.05% (95% CI 0.26–0.49%), sleep disorders 1.12% vs. 0.14% (95% CI 0.79–1.14%). Autoimmune disorders (excluding DM1 and IBD) were not significantly different at 0.67% vs. 0.68% (95% CI ?0.14-0.13%). Three of the studied comorbidities increased significantly when comparing ages 0–17 vs 18–34 with p<0.001: Schizophrenia (1.43% vs. 8.76%), diabetes mellitus type I (0.67% vs. 2.08%), IBD (0.68% vs. 1.99%) whereas sleeping disorders, bowel disorders (without IBD) and epilepsy did not change significantly. Conclusions The comorbidities of ASD encompass disease states that are significantly overrepresented in ASD with respect to even the patient populations of tertiary health centers. This burden of comorbidities goes well beyond those routinely managed in developmental medicine centers and requires broad multidisciplinary management that payors and providers will have to plan for.
M. H. Harirchian,M. Ghaffarpour,D. Doratotaj M. B. Akhavirad
Acta Medica Iranica , 2006,
Abstract: Numerous etiologies are responsible for cases of stroke in young adults. This study reviews the causes of two types of stroke (ischemic and intracerebral hemorrhage) in young adults aged 15 to 40years, admitted to our center (a tertiary care center) from 1997 to 2002. The purpose of this study is to determine the relative frequency of causes of stroke in young adults and compare this with published data in the literature. Using the codes 46.0 to 46.8 of the International Classification of Diseases- 10th Edition (ICD-10), cases were identified from the records of the stroke patients admitted in Imam Khomeini Hospital and the data were collected from their files using a comprehensive questionnaire. Forty-two cases of ischemic stroke (62%) and 26 cases of intracerebral hemorrhage (38%) were identified. The leading cause of ischemic stroke was cardioembolism (38.1%), followed by atherosclerosis in 5 cases (11.9%). Among cardiac causes infarction was attributable to consequences of rheumatic heart disease in 8 cases. In 3 cases a cessation or decrease in dose of warfarin was followed directly by an ischemic stroke. The most leading cause of intracerebral hemorrhage was hypertension (30.8%). Other causes were anticoagulant therapy, intratumoral hemorrhage, aplastic anemia, leukemia, arteriovenous malformations, and chronic active hepatitis. In conclusion, cardioembolism and hypertension were the most leading causes of ischemic and hemorrhagic stroke in young adults admitted in our hospital.
Quantification of left ventricular myocardial collagen system in children, young adults, and the elderly
Mendes,Andrea Bogoslavsky Levy; Ferro,Marcelo; Rodrigues,Bruno; Souza,Monica Rodrigues de; Araujo,Rubens Correa; Souza,Romeu Rodrigues de;
Medicina (Buenos Aires) , 2012,
Abstract: studies on the collagen system of the human myocardium are still limited compared to those on small laboratory animals. the aim of this work was to observe the collagen tissue of the myocardium of the human heart as a function of age. the types of collagen, as well as the density of collagen tissue and the diameter of collagen fibrils, were examined. fragments of the left ventricular wall from 15 hearts, 5 from children, 5 from young adults, and 5 from elderly individuals, were analyzed by using the picrosirius-polarization method and by transmission electron microscopy (tem). the results showed the presence of collagen type iii and collagen type i, both in the endomysium and perimysium of the 3 groups studied. measurements of collagen content in myocardial tissue displayed that both endomysial and perimysial collagen increase in number and thickness in the adult and elderly. these histochemical results coincided with the observations obtained with the electron microscope in showing an increase in the number of collagen fibrils with a large diameter in the adult and elderly hearts. the present results on cardiac collagen may be important for assessing the pathogenesis of several cardiopathies in the hearts of children, young adults, and the elderly.
The Heterogeneity of Asthma Phenotypes in Children and Young Adults  [PDF]
Bill Hesselmar,Anna-Carin Enelund,Bo Eriksson,Leonid Padyukov,Lars ?. Hanson,Nils ?berg
Journal of Allergy , 2012, DOI: 10.1155/2012/163089
Abstract: Objective. Genetic heterogeneity and risk factor distribution was analyzed in two previously proposed asthma phenotypes. Method. A sample of 412 subjects was investigated at 7-8, 12-13, and 21-22 years of age with questionnaires, skin prick tests, and genetic analysis of IL-4 receptor (IL4R) single-nucleotide polymorphisms. The sample was subdivided in one group with no asthma, and two groups with asthma separated by age of onset of symptoms, namely, early onset asthma (EOA) and late onset asthma (LOA). Risk factors and IL4R markers were analyzed in respect to asthma phenotypes. Results. EOA and LOA groups were both associated with atopy and a maternal history of asthma. Female gender was more common in LOA, whereas childhood eczema, frequent colds in infancy, and a paternal history of asthma were more common in EOA. The AA genotype of rs2057768 and the GG genotype of rs1805010 were more common in LOA, whereas the GG genotype of rs2107356 was less common in EOA. Conclusion. Our data suggest that early and late onset asthma may be of different endotypes and genotypes. 1. Introduction Asthma is a common disease, but it has been questioned if it is one single disease, or a group of asthmatic diseases. Such different “phenotypes” of asthma may vary in response to treatment [1], in prognosis [2], in inflammatory patterns [3], and in susceptibility to environmental exposure [4]. Identifying possible subphenotypes has therefore rendered increasing interest in recent years [5, 6]. But a reliable subgroup classification of asthma (or any other disease) can seldom include only clinical parameters, very often additional biomarkers have to be included [7] in order to find genetic or endotypic differences. In the 1990s, the Tucson group presented data on lung function of infants from a population-based birth-cohort study and they also retrospectively classified preschool wheeze into three subgroups or phenotypes, namely, transient wheeze, early persistent wheeze, and late onset asthma [8]. Interestingly, not only transient wheeze had a characteristic phenotype pattern, there were also differences between the two asthma subgroups, with eczema being more common among children with early persistent wheeze than among children with asthma onset after the age of 3 years. If the noticed difference in the prevalence of eczema in children with early versus late onset of respiratory symptoms is of any phenotypic significance is, however, not known. Our own data reveal that 12-13-year-old children with asthma and eczema differ regarding the interleukin-4 receptor genotype from
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