Adolescent Expectations of Early Death Predict Adult Risk Behaviors

Only a handful of public health studies have investigated expectations of early death among adolescents. Associations have been found between these expectations and risk behaviors in adolescence. However, these beliefs may not only predict worse adolescent outcomes, but worse trajectories in health with ties to negative outcomes that endure into young adulthood. The objectives of this study were to investigate perceived chances of living to age 35 (Perceived Survival Expectations, PSE) as a predictor of suicidal ideation, suicide attempt and substance use in young adulthood. We examined the predictive capacity of PSE on future suicidal ideation/attempt after accounting for sociodemographics, depressive symptoms, and history of suicide among family and friends to more fully assess its unique contribution to suicide risk. We investigated the influence of PSE on legal and illegal substance use and varying levels of substance use. We utilized the National Longitudinal Study of Adolescent Health (Add Health) initiated in 1994–95 among 20,745 adolescents in grades 7–12 with follow-up interviews in 1996 (Wave II), 2001–02 (Wave III) and 2008 (Wave IV; ages 24–32). Compared to those who were almost certain of living to age 35, perceiving a 50–50 or less chance of living to age 35 at Waves I or III predicted suicide attempt and ideation as well as regular substance use (i.e., exceeding daily limits for moderate drinking; smoking ≥ a pack/day; and using illicit substances other than marijuana at least weekly) at Wave IV. Associations between PSE and detrimental adult outcomes were particularly strong for those reporting persistently low PSE at both Waves I and III. Low PSE at Wave I or Wave III was also related to a doubling and tripling, respectively, of death rates in young adulthood. Long-term and wide-ranging ties between PSE and detrimental outcomes suggest these expectations may contribute to identifying at-risk youth

Adolescent expectations of early death predict young adult socioeconomic status

Among adolescents, expectations of early death have been linked to future risk behaviors. These expectations may also reduce personal investment in education and training, thereby lowering adult socioeconomic status attainment. The importance of socioeconomic status is highlighted by pervasive health inequities and dramatic differences in life expectancy among education and income groups. The objectives of this study were to investigate patterns of change in perceived chances of living to age 35 (Perceived Survival Expectations; PSE), predictors of PSE, and associations between PSE and future socioeconomic status attainment. We utilized the U.S. National Longitudinal Study of Adolescent Health (Add Health) initiated in 1994-95 among 20,745 adolescents in grades 7-12 with follow-up interviews in 1996 (Wave II), 2001-02 (Wave III) and 2008 (Wave IV; ages 24-32). At Wave I, 14% reported ≤ 50% chance of living to age 35 and older adolescents reported lower PSE than younger adolescents. At Wave III, PSE were similar across age. Changes in PSE from Wave I to III were moderate, with 89% of respondents reporting no change (56%), one level higher (22%) or one level lower (10%) in a 5-level PSE variable. Higher block group poverty rate, perceptions that the neighborhood is unsafe, and less time in the U.S. (among the foreign-born) were related to low PSE at Waves I and III. Low PSE at Waves I and III predicted lower education attainment and personal earnings at Wave IV in multinomial logistic regression models controlling for confounding factors such as previous family socioeconomic status, individual demographic characteristics, and depressive symptoms. Anticipation of an early death is prevalent among adolescents and predictive of lower future socioeconomic status. Low PSE reported early in life may be a marker for worse health trajectories

Hospital-based injury data in Malawi: strategies for data collection and feasibility of trauma scoring tools

Injury is a major cause of morbidity and mortality in developing countries. Utilizing a partnership between Kamuzu Central Hospital (KCH) and the University of North Carolina Departments of Surgery, we describe an approach to injury surveillance, examine the utility of trauma scoring systems, and outline steps necessary before such scoring systems can be reliably instituted in a resource-constrained setting

Epidemiology of Injuries at a Tertiary Care Center in Malawi

Injury surveillance is an ongoing process required for primary, secondary, and tertiary injury prevention. In Malawi, hospital-based injury data are not available

Nurse staffing level and nosocomial infections: empirical evaluation of the case-crossover and case-time-control designs

The authors compared a case-crossover design, a case-time-control design, and a cohort design to evaluate the effect of nurse staffing level on the risk of nosocomial infections. They evaluated two strategies, conditional logistic regression and generalized estimating equation, to analyze the case-crossover study. The study was performed among critically ill patients in the medical intensive care unit of the University of Geneva Hospitals, Geneva, Switzerland. Of 366 patients who stayed more than 7 days in the intensive care unit between 1999 and 2002, 144 developed an infection. The main reasons for admission were infectious (35.3%), cardiovascular (32.5%), and pulmonary (19.7%) conditions. A comparison of the three study designs showed that lower nurse staffing was associated with an approximately 50% increased risk of nosocomial infections. All analyses yielded similar estimates, except that the point estimate obtained by the conditional logistic regression used in the case-crossover design was biased away from unity; the generalized estimating equation yielded unbiased results and is the most appropriate technique for case-crossover designs. The case-crossover methodology in hospital epidemiology is a promising alternative to traditional approaches, but selection of the referent periods is challenging

Cartoons and economics: general analysis based on colombian economic cartoons

May cartoons be considered as a viable and credible source for the study of economics? There is hardly any research on the subject, even though there is a quite significant amount of cartoons with economic content. This suggests that economics (and economists) have not paid enough attention and do not incorporate in their analysis a relevant primary source. The present paper aims to explore the value of using cartoons as a complementary primary source in economic analysis. We present a way of analyzing economic history through cartoons; first, reviewing cartoons which describe particular historical circumstances and second, examining cartoons that represent generic economic situations and are not necessarily linked to a historical period. We choose 17 cartoons, from different cartoonist, especially Colombian cartoonists that may give us an idea of economic matters and economic history