Vulnerability within families headed by teen and young adult mothers investigated by child welfare services in Canada

Introduction Young mothers’ families are at increased risk of child maltreatment and other poor health and social outcomes. Methods Young mothers’ families are at increased risk of child maltreatment and other poor health and social outcomes. Results Twenty-six percent of young mothers were 18 years or younger. Most (68% of teen-mother families and 57% of families with a young adult mother) received social assistance as their main source of income compared with 36% of families with a mother aged 22 years or older. Teen and young adult mothers were more likely than those aged 22 or older to have childhood histories of out-of-home care (31% and 23% vs. 10%) and were more likely to have risk factors such as alcohol abuse (25% and 23% vs. 18%) and few social supports (46% and 41% vs. 37%). Secondary caregivers in families with young mothers also had more risk factors. Teen and young adult mother families were more likely to have their child placed out-of-home during the investigation (29% and 27% vs. 17%). All were equally likely to be victims of domestic violence and to have mental health issues. Conclusion Within this sample of high-risk families, young mothers’ families were more at risk than comparison families. Mothers’ youth may be a useful criterion to identify families for targeted interventions.

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Characteristics and outcomes of acute COVID-19 infection in paediatric and young adult patients with underlying cardiac disease

Cardiology in the Young ◽

10.1017/s1047951121004029 ◽

2021 ◽

pp. 1-7

Author(s):

Joshua M. Fisher ◽

Sarah Badran ◽

John T. Li ◽

Jodie K. Votava-Smith ◽

Patrick M. Sullivan

Keyword(s):

Risk Factors ◽

Young Adult ◽

Pulmonary Disease ◽

Cardiac Disease ◽

Single Ventricle ◽

Cardiac Risk ◽

Adult Patients ◽

Chronic Pulmonary Disease ◽

Cardiac Risk Factors ◽

Increased Risk

Abstract Objective To describe outcomes of acute coronavirus disease 2019 in paediatric and young adult patients with underlying cardiac disease and evaluate the association between cardiac risk factors and hospitalisation. Study design We conducted a retrospective single-institution review of patients with known cardiac disease and positive severe acute respiratory syndrome coronavirus 2 RT-PCR from 1 March, 2020 to 30 November, 2020. Extracardiac comorbidities and cardiac risk factors were compared between those admitted for coronavirus disease 2019 illness and the rest of the cohort using univariate analysis. Results Forty-two patients with a mean age of 7.7 ± 6.7 years were identified. Six were 18 years of age or more with the oldest being 22 years of age. Seventy-six percent were Hispanic. The most common cardiac diagnoses were repaired cyanotic (n = 7, 16.6%) and palliated single ventricle (n = 7, 16.6%) congenital heart disease. Fourteen patients (33.3%) had underlying syndromes or chromosomal anomalies, nine (21%) had chronic pulmonary disease and eight (19%) were immunosuppressed. Nineteen patients (47.6%) reported no symptoms. Sixteen (38.1%) reported only mild symptoms. Six patients (14.3%) were admitted to the hospital for acute coronavirus disease 2019 illness. Noncardiac comorbidities were associated with an increased risk of hospitalisation (p = 0.02), particularly chronic pulmonary disease (p = 0.01) and baseline supplemental oxygen requirement (p = 0.007). None of the single ventricle patients who tested positive required admission. Conclusions Hospitalisations for coronavirus disease 2019 were rare among children and young adults with underlying cardiac disease. Extracardiac comorbidities like pulmonary disease were associated with increased risk of hospitalisation while cardiac risk factors were not.

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Abstract P152: Cardiometabolic Risk Factors in Adolescent Blood Donors

Circulation ◽

10.1161/circ.135.suppl_1.p152 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

James Keeton ◽

Stephen J Eason ◽

Merlyn Sayers ◽

Colby Ayers ◽

Maria O Gore

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Total Cholesterol ◽

Blood Donors ◽

Cardiometabolic Risk ◽

Blood Donation ◽

Cardiometabolic Risk Factors ◽

Cardiometabolic Risk Factor ◽

Targeted Interventions ◽

Increased Risk

Objective: Cardiometabolic risk factors have been extensively studied in adults, but to a lesser extent in adolescents. We assessed potential cardiometabolic risk factors in a large cohort of adolescent blood donors. Methods: Glycated hemoglobin (HbA 1c ), blood pressure (BP), and total cholesterol were measured in 10,756 blood donors aged 16-19 years at school blood drives conducted by Carter BloodCare, a large North Texas blood center. Borderline values were defined as HbA 1c 5.7-6.4%, BP (systolic/diastolic) 120-139/80-89 mm Hg, and total cholesterol 170-199 mg/dL. Elevated values were defined as HbA 1c ≥6.5%, BP ≥140/90, and total cholesterol ≥200 mg/dL. Subjects were classified into one of three subcohorts: (A) no borderline or elevated values (“healthy” subcohort); (B) one borderline value; (C) either two borderline values or one elevated value. The subcohorts were further stratified as shown in the Table. Results: Of the 10,756 blood donors, 35.2% had one borderline cardiometabolic risk factor, and 17.9% had either two borderline or one elevated risk factor. There were more girls than boys in the “healthy” subcohort (p<0.0001). Girls had a higher prevalence of borderline or elevated total cholesterol (p<0.0001), whereas boys had higher prevalence of borderline or elevated BP (p<0.0001). Other differences between subcohorts are summarized in the Table. Conclusion: More than half of adolescents in this study had at least one cardiometabolic risk factor that was either borderline or elevated. Blood donation programs can serve as highly efficient and cost-effective gateways for cardiometabolic risk screening in adolescents, with potential for the development of targeted interventions aimed at promoting healthy behaviors early in life, specifically among those at increased risk.

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Child Maltreatment Among Singletons and Multiple Births in Japan: A Population-Based Study

Twin Research and Human Genetics ◽

10.1017/thg.2015.67 ◽

2015 ◽

Vol 18 (6) ◽

pp. 806-811 ◽

Cited By ~ 4

Author(s):

Yoshie Yokoyama ◽

Terumi Oda ◽

Noriyo Nagai ◽

Masako Sugimoto ◽

Kenji Mizukami

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Child Maltreatment ◽

Personal Information ◽

Population Based ◽

Multiple Births ◽

Population Based Study ◽

Factors Associated ◽

Increased Risk ◽

The Relationship

Background: The occurrence of multiple births has been recognized as a risk factor for child maltreatment. However, few population-based studies have examined the relationship between multiple births and child maltreatment. This study aimed to evaluate the degree of risk of child maltreatment among singletons and multiple births in Japan and to identify factors associated with increased risk. Methods: Using population-based data, we analyzed the database of records on child maltreatment and medical checkups for infants aged 1.5 years filed at Nishinomiya City Public Health Center between April 2007 and March 2011. To protect personal information, the data were transferred to anonymized electronic files for analysis. Results: After adjusting by logistic regression for each associated factor and gestation number, multiples themselves were not associated with the risk of child maltreatment. However, compared with singletons, multiples had a significantly higher rate of risk factors for child maltreatment, including low birth weight and neural abnormality. Moreover, compared with mothers of singleton, mothers of twins had a significantly higher rate of poor health, which is a risk factor of child maltreatment. Conclusion: Multiples were not associated with the risk of child maltreatment. However, compared with singletons, multiples and their mothers had a significantly higher rate of risk factors of child maltreatment.

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Improvement of Abandonment of Therapy in Pediatric Patients with Cancer in Guatemala

Journal of Global Oncology ◽

10.1200/jgo.2016.004648 ◽

2016 ◽

Vol 2 (3_suppl) ◽

pp. 76s-76s ◽

Cited By ~ 2

Author(s):

Elysia Alvarez ◽

Midori Seppa ◽

Kevin Messacar ◽

John Kurap ◽

E. Alejandro Sweet-Cordero ◽

...

Keyword(s):

Risk Factors ◽

Psychosocial Intervention ◽

Intervention Program ◽

Proportional Hazards ◽

Conflicts Of Interest ◽

Population Based ◽

Cox Proportional Hazards ◽

Middle Income ◽

Targeted Interventions ◽

Increased Risk

Abstract 59 Background: Abandonment of therapy is a major cause of therapeutic failure in the treatment of childhood cancer in Low and Middle Income Countries (LMIC). This study examines factors associated with increased risk of therapy abandonment in Guatemalan children with cancer and the rates of therapy abandonment before and after implementation of a multidisciplinary psychosocial intervention program. Methods: A retrospective population-based study was performed to identify risk factors for abandonment of therapy in Guatemalan children, ages 0-18, with cancer who were seen at UNOP from 2001-2008. Patient data was collected from the Pediatric Oncology Networked Database (POND4Kids). Abandonment was defined as a lapse of 4 weeks in planned treatment or failure to begin treatment for a potentially curable cancer. Cox proportional hazards analysis identified the effect of age, sex, year of diagnosis, distance travelled to UNOP, ethnicity, and principal diagnosis on abandonment of therapy. Kaplan Meier analysis was used to evaluate survival. Results: A retrospective analysis of 1,789 charts was performed and 367 patients abandoned therapy. The rate of abandonment decreased from 27% in 2001 to 7% in 2008 following a multidisciplinary psychosocial intervention program. Greater distance to UNOP (p = 0.00), younger age (p = 0.02) and earlier year of diagnosis (p = 0.00) were associated with increased risk of abandonment. Abandonment of therapy correlated with decreased survival. The cumulative survival at 8.3 years was 0.57 ± 0.02 (survival±SE) for those who completed therapy vs 0.06 ± 0.02 for those who abandoned and refused therapy (p=0.000) in an abandonment sensitive analysis. Conclusion: This study identified distance, age, and year of diagnosis as risk factors for abandonment of therapy for pediatric cancer in Guatemala. This study highlights risk factors for abandonment of therapy and the role of targeted interventions in altering rates of abandonment that could be replicated in other LMIC countries. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: No COIs from the authors.

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Risk factors of sudden death in young adult patients with myelomeningocele

Journal of Neurosurgery Pediatrics ◽

10.3171/2011.11.peds11269 ◽

2012 ◽

Vol 9 (2) ◽

pp. 149-155 ◽

Cited By ~ 12

Author(s):

Sarah C. Jernigan ◽

Jay G. Berry ◽

Dionne A. Graham ◽

Stuart B. Bauer ◽

Lawrence I. Karlin ◽

...

Keyword(s):

Risk Factors ◽

Sleep Apnea ◽

Young Adult ◽

Sudden Death ◽

Adult Patients ◽

Csf Shunt ◽

Study Cohort ◽

Fisher Exact Test ◽

Adult Women ◽

Increased Risk

Object Although survival for patients with myelomeningocele has dramatically improved in recent decades, the occasional occurrence of sudden, unexplained death in young adult patients with myelomeningocele has been noted by the authors. This study was undertaken to determine risk factors for sudden death in this population. Methods The authors performed a retrospective chart review of patients born between 1978 and 1990 who received care at Children's Hospital Boston. The relationship between sudden death and patient demographics, presence of CSF shunt and history of shunt revisions, midbrain length as a marker for severity of hindbrain malformation, seizures, pulmonary and ventilatory dysfunction, body mass index, scoliosis, renal dysfunction, and cardiac disease was evaluated using the t-test, Fisher exact test, and logistic regression analysis. Results The age range for 106 patients in the study cohort was 19–30 years, with 58 (54.7%) women and 48 (45.3%) men. Six patients, all of whom were young women, experienced sudden death. In multivariate analysis, female sex, sleep apnea, and midbrain elongation ≥ 15 mm on MR imaging remained significantly associated with a higher risk of sudden death. These risk factors were cumulative, and female patients with sleep apnea and midbrain length ≥ 15 mm had the greatest risk (adjusted risk ratio 24.0, 95% CI 7.3–79.0; p < 0.05). No other comorbidities were found to significantly increase the risk of sudden death. Conclusions Young adult women with myelomeningocele are at significantly increased risk of sudden death in the setting of midbrain elongation and sleep apnea. Further investigation is needed to determine the benefit of routine screening to identify at-risk patients for closer cardiopulmonary monitoring and treatment.

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DATA LINKAGE FOR EVALUATING MATERNAL INFLUENCES ON INFANT MORTALITY AND MALTREATMENT IN CANADA

Paediatrics & Child Health ◽

10.1093/pch/pxy054.010 ◽

2018 ◽

Vol 23 (suppl_1) ◽

pp. e4-e4

Author(s):

Jennifer Smith ◽

Astrid Guttmann ◽

Alexander Kopp ◽

Michelle Shouldice ◽

Katie Harron

Keyword(s):

Public Health ◽

Risk Factors ◽

Child Maltreatment ◽

Infant Mortality ◽

Maternal Age ◽

Maternal Risk Factors ◽

Maternal Risk ◽

Increased Risk ◽

All Cause Mortality ◽

Young Maternal Age

Abstract BACKGROUND A number of social risk factors are reported to increase infant mortality rates and child maltreatment. Public health programs attempt to mitigate risk factors and improve outcomes for infants. This study aimed to explore the association of exposure factors in mothers with infant mortality and maltreatment in Ontario. OBJECTIVES Objectives for this study included: 1. Describe prevalence of infant mortality and maltreatment in Ontario. 2. Explore how maternal risk factors influence infant mortality and maltreatment. DESIGN/METHODS This was a population-based study of 845, 567 infants born between April 1, 2005 and March 31, 2015 using administrative and healthcare databases available at the Institute of Clinical Evaluative Sciences (ICES). Maternal risk factors were selected based on public health home visiting referral criteria. These exposures included, maternal adversity (substance abuse, intimate partner violence, homelessness), newcomer status (new to Canada in past 3 years) and young maternal age (less than 22 years of age). The primary outcome measure was all-cause mortality of infants less than 12 months age. The secondary outcome measures were combined fatal and non-fatal child maltreatment outcomes and were defined using International Classification of Diseases for maltreatment diagnoses. Baseline characteristics and outcomes were described. The association between maternal risk factors and infant mortality and maltreatment was analysed using multivariable logistic modelling, including analysis by type of maternal risk factors and number of risk factors. RESULTS All-cause deaths were present in 0.14% and combined fatal and non-fatal maltreatment outcomes were present in 0.05% of the study population. Young maternal age increased the risk of all-cause mortality 2.4 times (n 171, OR 2.4, 95% CI 2.0–3.0) and maltreatment 6.3 times (n 292, OR 6.3, 95% CI 5.0–7.8). Mental health diagnosis increased the odds of maltreatment by 90% (n 209, OR 1.9, 95% CI 1.5–2.4). Adversity increased the odds of maltreatment by 63% (n 40, OR 1.63, 95% CI 1.0–2.6). The risk of maltreatment also increased as the number of risk factors increased with an OR of 3.5 (95% CI 2.9–4.4) with one risk factor, an OR of 8.2 (95% CI 5.9–11.4) with two risk factors, and an OR of 10.9 (95% CI 5.7 20.7) with three or more risk factors. Newcomer status was not associated with increased risk of maltreatment and mortality. Gestational age showed increasing ORs as prematurity increased. Material deprivation was included as a covariate and was associated with increased risk of maltreatment with increased level of deprivation. CONCLUSION Young maternal age carried the greatest risk of death and maltreatment in infants. There was also an increasing risk of infant mortality and maltreatment with increasing number of risk factors. These findings are important for ensuring public health interventions are targeting the most vulnerable populations with the aim of preventing maltreatment.

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Abuse and neglect in children with disabilities: risk varies by type of disability

International Journal for Population Data Science ◽

10.23889/ijpds.v1i1.197 ◽

2017 ◽

Vol 1 (1) ◽

Cited By ~ 1

Author(s):

Miriam Maclean ◽

Scott Sims ◽

Melanie Hansen ◽

Helen Leonard ◽

Jenny Bourke ◽

...

Keyword(s):

Intellectual Disability ◽

Child Maltreatment ◽

Child Protection ◽

Linkage Study ◽

Health Issues ◽

Parental Mental Health ◽

Out Of Home Care ◽

Abuse And Neglect ◽

Different Types ◽

Western Australian

ABSTRACT ObjectivesTo examine the risk of abuse and neglect for children with different types of disabilities taking into account other existing adversities, including socioeconomic disadvantage, parental mental health issues, etc. ApproachPopulation based record linkage study of all children born between 1990-2010 utilising the Western Australian Register of Developmental Anomalies, the Intellectual Disabilities Exploring Answers database, Health data and Child Protection data. ResultsAfter taking into account existing adversities intellectual disability was associated with the highest risk of a child maltreatment allegation and entering out-of-home care. Further results include risk by level of intellectual disability and causes of disability. ConclusionDifferent disabilities are associated with differing risk of child maltreatment and child protection involvement. Groups that are considered at higher risk require services to identify and address the support needs of this group and determine how prevention and early intervention can lower the risk for child abuse and neglect in this vulnerable group.

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Risk Factors of Breast Cancer Among Western Algerian Women Under 40 years’ old

Medical & Clinical Research ◽

10.33140/mcr.06.03.03 ◽

2021 ◽

Vol 6 (3) ◽

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Young Adult ◽

Multivariable Analysis ◽

Oral Contraception ◽

Adult Women ◽

Young Adult Women ◽

Nulliparous Women ◽

Increased Risk ◽

Western Algeria

Background: The frequency of patients developing Breast Cancer (BC) among all other types of cancers exceeds 35% in Western Algeria. The main objective here was to determine which risk factors were associated with this high frequency of BC occurrence in young adult women (<40 years old) in Western Algeria. Methods: A BC case-control study matching with the woman age was conducted. The total number of participants was 484 women from Western Algeria. Inclusion criteria were BC and age <40 and women older than 40 or without documented BC were excluded. Results: Univariable analysis showed that i) there was an increased risk of BC; OR = 1.77 [1.06 to 2.93] in married women using oral contraception drugs; ii) in contrast there was a lesser risk; OR = 0.43 [0.28 to 0.65] of BC in multiparous compared to nulliparous women; iii) similarly there was a lesser risk; OR = 0.45 [0.26 to 0.76] of BC in married, divorced and widowed women compared to single women. Multivariable analysis showed a higher risk; OR = 2.34 [1.05 to 5.22] of BC in non-breastfeeding than lactating women. Conclusion: The use of oral contraception drugs, nulliparity, lack of breastfeeding and the single unmarried status are risk factors associated with increased BC in young adult women (<40) from Western Algeria.

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Cerebrovascular Disease in the Young Adult: Examining Melatonin’s Possible Multiple Roles

Journal of Experimental Neuroscience ◽

10.1177/1179069519827300 ◽

2019 ◽

Vol 13 ◽

pp. 117906951982730 ◽

Cited By ~ 4

Author(s):

Adejoke Yetunde Onaolapo ◽

Olakunle James Onaolapo ◽

Thomas I Nathaniel

Keyword(s):

Risk Factors ◽

Young Adults ◽

Young Adult ◽

Animal Studies ◽

Neuronal Damage ◽

Well Being ◽

Stroke In Young Adults ◽

Stroke Population ◽

Increased Risk ◽

Stroke In Young

In the last decade or more, there have been reports suggesting a rise in the incidence of stroke in young adults. Presently, it appears that the risk factors associated with the cause of stroke in young adults remain relatively constant across different geographic regions of the world. Moreover, the endogenous rhythm of a neurohormone such as melatonin is known to play certain roles in the modulation of some of the risk factors that are associated with an increased risk of stroke in young people. Whereas animal studies have shown that melatonin plays diverse roles in stroke, only a limited number of human studies examined the roles of exogenous melatonin administration in the prevention of stroke, attenuation of neuronal damage, and improving outcome or well-being in stroke patients. In this review, first we summarize existing studies of stroke in the young adult and then provide insights on melatonin and stroke. Thereafter, we discuss the role of melatonin in models of stroke and how melatonin can be regulated to prevent stroke in young adults. Finally, we highlight the possible roles of melatonin in the management and outcome of stroke, especially in the young adult stroke population.

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Opportunities for Prevention: A Data-Linkage Study to Inform A Public Health Response to Youth Offending in The Northern Territory, Australia

10.21203/rs.3.rs-81412/v1 ◽

2020 ◽

Cited By ~ 1

Author(s):

Vincent Yaofeng He ◽

Bernard Leckning ◽

Catia Malvaso ◽

Tamika Williams ◽

Leanne Liddle ◽

...

Keyword(s):

Public Health ◽

Child Maltreatment ◽

Home Care ◽

Cumulative Incidence ◽

Northern Territory ◽

Public Health Response ◽

Out Of Home Care ◽

Health Response ◽

Increased Risk ◽

The Impact

Abstract Background Numerous studies have demonstrated a strong link between child maltreatment and subsequent youth offending, leading to calls for early intervention initiatives. However, there have been few whole-population studies into the dimensions of statutory child maltreatment responses that can inform these programs. The aim of this study was to investigate the sex-specific association between level and timing of child protection system (CPS) contact and youth offending.Methods This retrospective cohort study used linked individual-level records from multiple agencies, for 10,438 Aboriginal children born in the Northern Territory between 1999 and 2006. The outcome measure was the first alleged offence. Key explanatory variables were level (no contact through to out-of-home care) and timing (0-4 years, 5-9 years, or both) of CPS contact. The Kaplan–Meier method was used to estimate cumulative incidence and a flexible parametric survival model to estimate hazard ratios (HR).Results Children with no record of CPS contact before age 10 had the lowest cumulative incidence of first offence by age 18 (boys: 23.4% [95%CI:21.0-26.1]; girls: 6.6% [95%CI:5.3-8.2]) and those with a record of out-of-home care the highest CI (boys: 45.5% [95%CI:37.0-54.9]; girls: 18.6% [95%CI:13.0-26.2]). The impact of CPS contact on risk of first alleged offence was greatest for children aged 10-13 years and decreased with age. Timing of CPS contact was also associated with increasing cumulative incidence. The relative risk for first offence was generally higher for children with CPS contact, of any type, during both developmental phases including notifications during both phases (boys, HR at age 11: 8.9 [95%CI:4.2-17.2]; girls, HR at age 11: 13.7 [95%CI:3.8-48.9]) and substantiations during both phases (boys, HR at age 11: 17.0 [95%CI:9.6-30.0]; girls, HR at age 11: 54.1 [95%CI:18.1-162]). Conclusion The increased risk of offending associated with level and timing of early CPS contact highlights opportunities for a differentiated public health response to improve life trajectories for children and to reduce youth crime. Although children with unsubstantiated notifications of maltreatment do not meet the criteria for a statutory CPS response, the higher risk of offending among these children supports their inclusion in targeted preventive interventions.

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