There are presently few international studies that examine adolescents' own experience of both triggering and the underlying reasons behind their suicide attempts.
To present the rates, triggering factors, and underlying reasons for such behavior.
The 23-year (1984-2006) surveillance study reported includes all general hospital-treated suicide attempters aged between 13 and 19 years (n = 254) living in the municipality of Bærum, a suburb on the outskirts of Oslo, Norway.
Suicide attempt rates for both sexes decreased during the period of study. The female suicide attempt rate was on average 3.5 times higher than the male rate. An average of 8.2% of the suicide attempters made a repeat attempt within the following year. Overall, the most commonly reported trigger was a relational conflict (50.2%), and the most commonly reported underlying reason was a dysfunctional family situation (43.6%), followed by mental health problems (22.8%). The main gender difference for both triggers and underlying reasons was that relational conflicts were reported significantly more often by girls than by boys as triggers (55.0% versus 32.7%), and dysfunctional family issues were reported significantly more often by girls than by boys (47.1% versus 30.8%) as underlying reasons for the attempt. Mental health problems were reported less frequently as an underlying reason by girls than boys (21.2% versus 28.8%).
A family-oriented intervention embracing the extended family system seems warranted in a majority of the cases in our study.
Surgical problems in children result in significant morbidity and mortality. A retrospective analysis of all surgical patients admitted to the Ethio-Swedish Children's Hospital (ESCH) over a five year period from 1984 to 1988 was made. There were a total of 2,281 surgical patients admitted, accounting for 22% of all hospital admissions (total = 10,364). The gastrointestinal and musculoskeletal systems were the most common systems involved. Acute appendicitis accounted for 13.9% (N = 318), cleft-lip and palate 8% (N = 183), and burns 6.9% (N = 157) of all surgical admissions. Accidents and trauma accounted for 25% of the surgical admissions (N = 564). Of these, the most common conditions were burns, car accidents, accidental falls, and foreign body aspirations. The over all mortality rate was 4% (N = 98). Acute appendicitis, intussusception, acute laryngotracheobronchitis (ALTB), and burns were associated with a high mortality. Of the neonatal admissions, one third died shortly after surgery, probably due to anaesthetic, fluid and electrolyte imbalance. Examination of the general pattern of surgical admissions revealed that many of the conditions were preventable, or amenable to medical therapy if detected early. Health education of the public is therefore necessary in order to reduce the morbidity and mortality of these conditions.
The epidemiologic triad of causation states that all illness results from a disequilibrium between host, agent and environmental factors. The "illness" investigated in this report--increased LOS--resulted from a combination of: patient factors--the increased prevalence of chronic diseases in childhood, a revolution in neonatal survival and an increase in survivorship in general for severe diseases, such as congenital anomalies and genetic diseases; agent factors--the transition from agents of infectious disease to agents of chronic disease as well as iatrogenesis; and health care environmental factors--equity issues involving the ethics of treatment, changes in medical technology and patterns of medical practice. The use of preadmission testing, increased participation by parents in the care of their children, an investigation of the appropriate venue for care of chronically ill children and the back transfer of recovering children to their home hospitals were recommended and considered by the hospital's administration and board of governors.
Based on a three years controlled intervention study among elderly subjects, aged 75 years or more and living in their own homes, the methodological and practical experiences achieved through interdisciplinary cooperation is described. The combination of social, medical and psychological interventions within the framework of a clinical controlled trial has documented remarkably favourable consequences for the intervention group. The planning, intervention, work up and publication periods of the study are described in the wish that future necessary intervention studies may be guided to an easier procedure.
This qualitative study examined the delivery of Assertive Community Treatment from the perspective of service providers of 4 ACT teams in southeastern Ontario. Overall, providers were positive about their involvement with ACT. Eight tensions experienced in the context of delivering services emerged: negotiating governance structures; providing 24-hour coverage; balancing the clinical-administrative responsibilities of team leaders; accessing hospital beds; meeting local population needs; integrating treatment and rehabilitation; changing services to meet changes in the population being served; and implementing ambiguous ACT standards. Framing these challenges in the context of ACT structures and the broader community mental health system, the study suggests possibilities for the ongoing development of the model to facilitate the realization of the ACT vision.
This article examines changes in hospital separations of children aged 1 to 14 between 1986/87 and 1996/97. It focuses on four common causes of childhood hospitalization: asthma, chronic disease of tonsils and adenoids, fractures, and acute appendicitis.
Hospital separation data are from the Hospital Morbidity File, from Statistics Canada for fiscal year 1986/87, and from the Canadian Institute for Health Information for fiscal year 1996/97.
Diagnoses were coded to the International Classification of Diseases, Ninth Revision and surgical procedures were coded to the Canadian Classification of Diagnostic, Therapeutic, and Surgical Procedures. Population estimates for 1986 and 1996 were used to calculate hospital separation rates and surgical rates.
In 1986/87, there were 355,000 hospital separations of children aged 1 to 14; by 1996/97, the number of separations had fallen to just over 206,000. The hospital separation rate was 37.0 per 1,000 children in 1996/97, down from 69.7 ten years earlier. The average length of stay fell from 4.5 days to 3.8. The total annual number of days Canadian children stayed in hospital dropped from over 1.6 million to 788,700.
Congestive heart failure (CHF) is a common disease requiring admission to hospital among elderly people and is associated with a high mortality rate. The objective of this study was to examine trends in CHF mortality and admissions to hospital in Montreal between 1990 and 1997 for individuals aged 65 years or more.
We obtained information about deaths from the Quebec Death Certificate Registry database and information about admissions to hospital from the Quebec Med-Echo database. Patients with a primary diagnosis that was classified as ICD-9 code 428 were considered cases of CHF.
Although age-adjusted rates of mortality from CHF did not change significantly between 1990 and 1997, the annual rate of admission to hospital for CHF increased from 92 per 10,000 population in 1990/91 to 124 per 10,000 population in 1997/98 (p
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Sixty-nine Asian patients were admitted to the psychiatric hospitals of Leicestershire in 1978. A case-note comparison was made with sixty-nine matched indigenous control patients. Four aspects were studied in particular, which showed: There was no significant difference in the number of compulsory admissions between Asian and indigenous patients. The two groups did not differ in their length of stay in hospital. The diagnoses given to the Asian patients were significantly different from those of the control group. Major treatment received by the two groups differed according to the diagnostic labels but there was slightly increased use of Electro-convulsive Therapy in the Asian patients with a diagnosis of Schizophrenia.