Depressive Symptoms among Self-Harming Adolescents

Self-harm is a common form of high-risk behaviour in adolescents. It is often linked to depression; however, the correlation between these two variables has scarcely been studied. The presented study on a sample of 1,117 adolescents aged from 11 to 19 (mean age 15.56) compares the occurrence of depressive symptoms (measured by the CDI questionnaire) in individuals who self-harm versus those who do not self-harm, it investigates whether there is a correlation between the intensity of self-harm (measured by a modified SHI questionnaire) and depressive symptoms on a sample of self-harming adolescents, as well as explores the specificities of the correlation in terms of the age and sex of the subjects. The results showed that the occurrence of depressive symptoms: 1/ is statistically significantly higher (p = 0.000) among self-harming individuals compared to non-self-harmers, particularly in female subjects, 2/ significantly correlates with the intensity of self-harming behaviour in the group of self-harmers (p = 0.000), and 3/ it decreases with age among self-harming female subjects. The conclusions point to a need for the clarification of the relationship between depressive symptoms and self-harming behaviour (presence and direction of causality) and to the consequences in clinical practice.

Risk Taking Behaviour Associated with Alcohol use among College Student

Objective: This study is designed to examine the risk taking behaviours that are harmful to students at a selected university. In this case, high-risk behaviours have been studied, such as harmful behaviours, coercion, smoke, alcohol contain substance abuse, and drug addiction. Materials and methods: Current study which is a type of descriptive survey research. The sample of this study included 200 students from a selected university in Bhubaneswar, who were selected through a convenient sampling technique. The Self -structured questionnaire tool has been used for a to collect socio demographic variables. A Structured checklist developed to measure risk taking behaviour. For this section rating scale was adopted with score was low risk, medium risk and high risk. In this study, score range 14-28 divided in to 3 scales- Low risk (14-18), Medium (19-24), High (25-28). A behavioural rating scale was used to analyse the behaviour. Results: The results showed that the increase in risky behaviour among students was 87% and higher for boys than girls and 40% for campus students had a higher risk of alcohol use. About 69.5% of the age group 19-27 were involved in alcohol consumption due to level of high living standard, high sources of income and happiness. Conclusion: The results of the study on identification of risky behaviours to precedence among students, by accessing a high-risk behaviour profile will help policymakers accurately identify student behaviours to make plan for promoting health improvements activity, with to linking the group's real needs and challenges.

Excess mortality among patients with severe mental disorders and effects of community-based mental healthcare: a community-based prospective study in Sichuan, China

Background High-quality primary care reduces premature mortality in the general population, but evidence for psychiatric patients in China is scarce. Aims To confirm excess mortality in patients with severe mental illness (SMI), and to examine the impact of community-based mental healthcare and other risk factors on their mortality. Method We included 93 655 patients in 2012 and 100 706 in 2013 from the national mental health surveillance system in Sichuan, China to calculate the standardised mortality ratio (SMR). A total of 112 576 patients were followed up from 2009 to 2014 for model analyses. We used growth models to quantify the patterns of change for community management measures, high-risk behaviour, disease stability and medication adherence of patients over time, and then used multilevel proportional hazard models to examine the association between change patterns of management measures and mortality. Results The SMR was 6.44 (95% CI 4.94–8.26) in 2012 and 7.57 (95% CI 5.98–9.44) in 2013 among patients with SMI aged 15–34 years, and diminished with age. Unfavourable baseline socioeconomic status increased the hazard of death by 38–50%. Positive changes in high-risk behaviour, disease stability and medication adherence had a 54% (95% CI 47–60%), 69% (95% CI 63–73%) and 20% (4–33%) reduction in hazard of death, respectively, versus in those where these were unchanged. Conclusions High excess mortality was confirmed among younger patients with SMI in Sichuan, China. Our findings on the relationships between community management and socioeconomic factors and mortality can inform community-based mental healthcare policies to reduce excess mortality among patients with SMI.

Patterns of Sexual Behaviour Associated with Repeated Chlamydia Testing and Infection in Men and Women: A Latent Class Analysis

Background: Adolescents and young adults are at higher risk of acquiring Chlamydia trachomatis infection (chlamydia), so testing is promoted in these populations. Studies have shown that re-testing for chlamydia is common amongst them. We investigated how sexual risk behaviour profiles are associated with repeated testing for chlamydia.Methods: We used baseline data from a cohort of 2,814 individuals recruited at an urban STI -clinic. We applied latent class (LC) analysis using 9 manifest variables on sexual behaviour and substance use self-reported by the study participants. We fitted ordered logistic regression to investigate the association of LC membership with the outcomes repeated testing during the past 12 months and lifetime repeated testing for chlamydia. Models were fit separately for men and women.Results: We identified four LCs for men and three LCs for women with increasing gradient of risky sexual behaviour. The two classes with the highest -risk among men were associated with lifetime repeated testing for chlamydia: adjOR = 2.26 (95%CI: 1.50 - 3.40) and adjOR = 3.03 (95%CI: 1.93 -4.74) as compared with the class with lowest risk. In women, the class with the highest risk was associated with increased odds of repeated lifetime testing (adjOR =1.85 (95%CI: 1.24-2.76)) and repeated testing during past 12 months (adjOR = 1.72 (95%CI: 1.16-2.54)). An association with chlamydia positive test at the time of the study and during the participant´s lifetime was only found in the male high-risk classes.Conclusion: Prevention messages with regard to testing for chlamydia after unprotected sexual contact with new/casual partners seem to reach individuals in high-risk behaviour classes who are more likely to test repeatedly. Prevention efforts should involve enhanced targeting and promotion of safe sex.

SOP: treatment of delirium

Introduction Delirium is a frequent complication in hospitalised patients, often leading to difficulties in patient management and is associated with increased morbidity and mortality. Most patients in intensive care units develop delirium, however, it is also frequently observed in non-intensive care unit settings. Risk factors are, among others, older age, brain pathology, severe trauma, orthopaedic or heart surgery, metabolic or electrolyte dysregulations, infections and polypharmacy. The most important measures to prevent and treat delirium are recognition and removal of risk factors and causes. Although delirium is a very common and serious complication, evidence for pharmacological treatment is poor, and guidelines remain controversial. Accordingly, non-pharmacological treatments have gained increasing attention and should be applied. Based on current literature, guidelines and personal recommendations, we developed a standard operating procedure (SOP) encompassing non-pharmacological and pharmacological treatment of delirium. Comments In order to prevent delirium, risk factors should be identified and taken into account when planning the hospital stay and treatment. Prevention should include multimodal non-pharmacological interventions. The treatment of delirium should encompass the elimination of potential causes and non-pharmacological interventions. Pharmacological treatment should be used in a time-limited manner and in the lowest possible dose for the management of highly stressful symptoms or high-risk behaviour. Conclusion The SOP provides a pragmatic algorithm for the non-pharmacological and pharmacological treatment of delirium.

High Risk Behaviour Tertular HIV/AIDS pada Anak Buah Kapal

The purpose of this study was to analyze the factors that influence the high risk behavior of contracting HIV / AIDS on ship crews in Makassar City. This type of research is a quantitative study with a cross sectional study design. The results showed that there was no influence of knowledge and support from health workers with the high risk behavior of contracting HIV / AIDS on ship crew at Soekarno-Hatta Port because crew members already know a lot about transmission from HIV / AIDS and are also supported by the education level of ABK (p. value> 0.05). In conclusion, knowledge and the role of health workers had no effect on the high risk behavior of contracting HIV / AIDS among ship crew. Keywords: Crew, Behavior, High Risk

THE NEUROSCIENCE ASPECTS OF ADOLESCENT BEHAVIOUR AND ITS IMPLICATIONS

Education is considered to be a tool for providing knowledge, building character and promising a comfortable lifeto its learners. To ensure desired learning outcomes, a lot is being done in the areas of developing better curriculum, making state of the art institutions, improving teacher quality, providing digital platforms, enhancing parental involvement etc. However, when it comes to designing Pedagogical Tools based on the learning patterns of the brain, there is seen a wide gap between what is researched in laboratories and what is witnessed in our classrooms. Pedagogical practices not based on an understanding of how a learner’s brain works and what are its needs can lead to undesired behavioural consequences in them. This becomes more pronounced as learners enter into adolescence, a period in development marked with rapid changes at mental, physical, emotional and psychological levels. This paper looks into various researches that have been done in Cognitive Neuroscience and their educational implications on adolescent learners. It explores why educational practices must take into consideration the cognitive aspects of an adolescent’s brain like role of reward system, enhancing Working Memory, providing multisensory stimulus, using memory strategies, understanding learner behavior and needs etc. This paper concludes by providing insights on how learnings from these Neuroscience researches can address the issue of high risk behaviour tendencies and mental disorders amongst adolescent learners.

Does being on HIV antiretroviral therapy increase the risk of syphilis? An analysis of a large national cohort of MSM living with HIV in England 2009–2016

ObjectiveA resurgence in bacterial STIs, notably syphilis, among gay, bisexual and other men who have sex with men (MSM) has been detected in England. A Canadian modelling study postulated that antiretroviral therapy (ART) may increase susceptibility to syphilis. We assess the association between ART and syphilis incidence in a comprehensive national cohort of MSM living with HIV in England.MethodsNational surveillance data were used to create a cohort of MSM attending for both HIV and STI care in England between 2009 and 2016. Survival analysis was used to calculate the incidence of infectious syphilis during periods on and off ART. Multivariable Poisson regression was used to assess the association between ART use and syphilis, after adjustment for potential confounders, including, as a proxy measure for high-risk behaviour, being diagnosed with >1 other STI prior to a syphilis diagnosis.Results19 428 HIV diagnosed MSM contributed 112 960 person-years of follow-up from 2009 to 2016. The overall rate of syphilis was 78.0 cases per 1000 person-years follow-up. Syphilis rates were higher among men receiving ART (36.8) compared with those who did not (28.4) (absolute rate difference 4.7 cases per 1000 person-years). Multivariable analysis showed no statistical association between receiving ART and syphilis. Increased risk of syphilis was found in MSM aged 25–34 (HR 1.89, 95% CI 1.43 to 2.51) and in those diagnosed with two other STIs (HR 5.83, 95% CI 5.37 to 6.32).ConclusionWhile we observed a small increase in the rate of syphilis among those on ART, when adjusting for potential confounding factors, including a proxy measure for high-risk behaviour, there was no evidence of an increased risk of syphilis in MSM receiving ART. High-risk sexual behaviour markers were the main risk factors for syphilis, and our results highlight the need for STI prevention interventions in MSM living with HIV to target these particularly high-risk sexual networks.

Factors Associated with Urban Risk-Taking Behaviour during 2018 Typhoon Mangkhut: A Cross Sectional Study

Although much of the health emergency and disaster risk management (Health-EDRM) literature evaluates methods to protect health assets and mitigate health risks from disasters, there is a lack of research into those who have taken high-risk behaviour during extreme events. The study’s main objective is to examine the association between engaging in high-risk behaviour and factors including sociodemographic characteristics, disaster risk perception and household preparedness during a super typhoon. A computerized randomized digit dialling cross-sectional household survey was conducted in Hong Kong, an urban metropolis, two weeks after the landing of Typhoon Mangkhut. Telephone interviews were conducted in Cantonese with adult residents. The response rate was 23.8% and the sample was representative of the Hong Kong population. Multivariable logistic regressions of 521 respondents adjusted with age and gender found education, income, risk perception and disaster preparedness were insignificantly associated with risk-taking behaviour during typhoons. This suggests that other factors may be involved in driving this behaviour, such as a general tendency to underestimate risk or sensation seeking. Further Health-EDRM research into risk-taking and sensation seeking behaviour during extreme events is needed to identify policy measures.