Differences between younger and older adults in the structure of suicidal intent and its correlates

OBJECTIVE: To analyze differences in the variables associated with severity of suicidal intent and in the main factors associated with intent when comparing younger and older adults. DESIGN: Observational, descriptive cross-sectional study. SETTING: Four general hospitals in Madrid, Spain. PARTICIPANTS: Eight hundred seventy suicide attempts by 793 subjects split into two groups: 18-54 year olds and subjects older than 55 years. MEASUREMENTS: The authors tested the factorial latent structure of suicidal intent through multigroup confirmatory factor analysis for categorical outcomes and performed statistical tests of invariance across age groups using the DIFFTEST procedure. Then, they tested a multiple indicators-multiple causes (MIMIC) model including different covariates regressed on the latent factor "intent" and performed two separate MIMIC models for younger and older adults to test for differential patterns. RESULTS: Older adults had higher suicidal intent than younger adults (z = 2.63, p = 0.009). The final model for the whole sample showed a relationship of intent with previous attempts, support, mood disorder, personality disorder, substance-related disorder, and schizophrenia and other psychotic disorders. The model showed an adequate fit (chi²[12] = 22.23, p = 0.035; comparative fit index = 0.986; Tucker-Lewis index = 0.980; root mean square error of approximation = 0.031; weighted root mean square residual = 0.727). All covariates had significant weights in the younger group, but in the older group, only previous attempts and mood disorders were significantly related to intent severity. CONCLUSIONS: The pattern of variables associated with suicidal intent varies with age. Recognition, and treatment of geriatric depression may be the most effective measure to prevent suicidal behavior in older adults.

Reviewing the evidence base for the Children and Young People Safety Thermometer (CYPST):a mixed studies review

The objective was to identify evidence to support use of specific harms for the development of a children and young people's safety thermometer (CYPST). We searched PubMed, Web of Knowledge, and Cochrane Library post-1999 for studies in pediatric settings about pain, skin integrity, extravasation injury, and use of pediatric early warning scores (PEWS). Following screening, nine relevant articles were included. Convergent synthesis methods were used drawing on thematic analysis to combine findings from studies using a range of methods (qualitative, quantitative, and mixed methods). A review of PEWS was identified so other studies on this issue were excluded. No relevant studies about extravasation injury were identified. The synthesized results therefore focused on pain and skin integrity. Measurement and perception of pain were complex and not always carried out according to best practice. Skin abrasions were common and mostly associated with device related injuries. The findings demonstrate a need for further work on perceptions of pain and effective communication of concerns about pain between parents and nursing staff. Strategies for reducing device-related injuries warrant further research focusing on prevention. Together with the review of PEWS, these synthesized findings support the inclusion of pain, skin integrity, and PEWS in the CYPST.

'Their tummys don't really suit that food':children and young teenagers understanding of food allergy

Background: Food allergy (FA) is aunique chronic condition as sufferers aregenerally well unless they accidentally ingest an allergen, whereupon symptoms can be life threatening. A good under-standing of the condition is essential forsuccessful self-management, however little is known about children and young teenagers' understanding. This study aimed toexplore understanding of FA in childrenwith and without FA and whether under-standing changes as children get older.Method: Participants aged 6–14 years (53with FA; 89 without), recruited from loc evidence of a prospective associationbetween maternal, perinatal or infant VDIand subsequent IgE-mediated FA schools and allergy clinics took part insemi-structured interviews; data were analysed using thematic analysis.Results: Three themes were identified fromthe data across the different age groups andallergy statuses: food allergy as a sickness, food allergy as an illness and food allergy asintolerance to food. Children aged 6–8 years described FA as a sickness; you were not allowed the food because it makes youpoorly. Children aged 9–11 years also talked about FA as something that makesyou poorly, but many also described it as anillness and understood that symptoms were caused by food. Children aged 12–14 yearsdescribed it as an intolerance or that FA was your body's response to a particularfood. These age-related differences wereseen in children with and without FA. Conclusion: Although sophistication ofknowledge of FA increases with age, it is still a little understood condition by chil-dren and young teenagers. Clear, age-re-lated information about food allergy andhow it should be managed is needed forthose with and without allergy, to avoidmisunderstanding, and aid awareness andbetter self-management of the condition

A Review of Merger and Acquisition Wave Literature: Proposing Future Research in the Restaurant Industry

The purpose of this study is to identify research trends in Merger and Acquisition waves in the restaurant industry and propose future research directions by thoroughly reviewing existing Merger and Acquisition related literature. Merger and Acquisition has been extensively used as a strategic management tool for fast growth in the restaurant industry. However, there has been a very limited amount of literature that focuses on Merger & Acquisition in the restaurant industry. Particular, no known study has been identified that examined M&A wave and its determinants. A good understanding of determinants of M&A wave will help practitioners identify important factors that should be considered before making M&A decisions and predict the optimal timing for successful M&A transactions. This study examined literature on six U.S M&A waves and their determinants and summarized main explanatory factors examined, statistical methods, and theoretical frameworks. Inclusion of unique macroeconomic factors of the restaurant industry and the use of factor analysis are suggested for future research.

The Relation Between Civic Education and Political Attitudes and Behavior

It is generally assumed that civic education efforts will have a positive effect on the political attitudes and behaviors of adolescents and young adults. There is less agreement, however, on the most effective forms of civic education. In the present study, we distinguish between formal civic education, an open classroom climate and active learning strategies, and we explore their effect on political interest, efficacy, trust and participation. To analyze these effects, we rely on the results of a two-year panel study among late adolescents in Belgium. The results indicate that formal civic education (classroom instruction) and active learning strategies (school council membership and, to a lesser extent, group projects) are effective in shaping political attitudes and behavior. An open classroom climate, on the other hand, has an effect on political trust. We conclude that there is no reason to privilege specific forms of civic education, as each form contributes to different relevant political attitudes and behaviors.

Natural history of retinopathy in children and young people with type 1 diabetes

Purpose: To describe the prevalence and natural history of retinopathy in a cohort of children and young people with type 1 diabetes attending a tertiary hospital diabetes clinic. Methods: We analysed retinopathy screening data from 2008 to 2010 on all eligible children using the 'Twinkle' diabetes database and the regional retinal screening database. Results: A total of 88% (149/169) of eligible children were screened in 2008, median age 14 years, 52% male. The prevalence of retinopathy was 19.5% (30/149). All children had background retinopathy grade R1. There was significant difference in median (range) duration of diabetes, 7.7 years (0.6–13.7) vs 5 years (0.2–12.5) (P<0.001) and median (range) HbA1C, 9.1% (7.2–14) vs 8.6% (5.6–13.1) (P=0.02), between the groups with and without retinopathy. At 2- years follow-up, 12/30 (40%) had unchanged retinopathy grade R1, 10/30 (33.3%) showed resolution of changes (R0), 1/30 progressed to maculopathy, and 7/30 had no follow-up data. Median (range) HbA1C in 2008 and 2010 for the groups with stable vs resolved changes was similar, 9.1% (7.2–14.0) and 9.2% (7–14.0) vs 9.5% (7.8–14.0) and 9.2% (8.7–14.0). Of the 119 without retinopathy in 2008, 27 (22.5%) had developed retinopathy within 2 years, including 1 with pre-proliferative retinopathy and 1 with maculopathy. There was no significant difference in HbA1c between those who progressed to retinopathy (8.7% (7.1–13.1)) (8.7% (7.1–13.1)), and those who did not (8.6% (6.3–12.2)). Conclusions: Prevalence of background retinopathy in our cohort was comparable to the previously published reports, with higher HbA1c and longer duration of diabetes being significant risk factors. On short-term follow-up, Grade 1 retinopathy is likely to resolve in a third of patients and remain unchanged in just over a third.

Measurements of stress-optic coefficient and Young's modulus in PMMA fibers drawn under different conditions

We have systematically measured the differential stress-optic coefficient, ΔC, and Young's modulus, E, in a number of PMMA fibers drawn with different stress, ranging from 2 up to 27 MPa. Effect of temperature annealing on those parameters was also investigated. ΔC was determined in transverse illumination by measuring the dependence of birefringence on additional axial stress applied to the fiber. Our results show that ΔC in PMMA fibers has a negative sign and ranges from -4.5 to -1.5×10-12 Pa -1 depending on the drawing stress. Increase of the drawing stress results in greater initial fiber birefringence and lower ΔC. The dependence of ΔC and initial birefringence upon drawing stress is nonlinear and gradually saturates for higher drawing stress. Moreover, we find that ΔC is linearly proportional to initial fiber birefringence and that annealing the fiber has no impact on the slope of this dependence. On the other hand, no clear dependence was observed between the fiber drawing stress and the Young's modulus of the fibers as measured using microscopic digital image correlation with the fibers tensioned using an Instron tension tester. © 2010 SPIE.

Infused: Millennials and the Future of the Black Church

Deep societal trends impact the religious fervency and participation of millennials in the Black Church. Many young adults, though remaining Christian, have fallen away from their faith communities, finding them irrelevant for their daily lives. Even the most religiously committed have shown signs of waning faith, as evidenced by limited participation, and theological and ideological dissonance with the Black Church. Historically strong across all indicators, the Black Church is ideally positioned to stave off the attrition of youth and young adults, having a missional mindset toward this cohort—prioritizing them in their ministry development and programming. African American congregational leaders must develop disciples who have cohesive identities, live integrated lives, and experience an infusion of their personal vocation and the mission of the Church. Thus the future of the Black Church depends on the development of millennials who have an integrated faith life, which is distinguishable by its practices, disciplines, and virtues that are nurtured by an understanding of the Church’s mission and their role in it. Key will be establishing mentoring relationships that allow for questioning, exploration and discovery. To enact the changes necessary the church must understand the cultural worlds of young adults and engage them in holistic ministry that is reflective of the mission of God through Christ (missio dei)—activity that culminates with reaching the world with God’s redemptive plan for humanity.

Family Troubles? Exploring Changes and Challenges in the Family Lives of Children and Young People

As the everyday lives of children and young people are increasingly understood as matters of public policy and concern, the question of how we can understand the difference between normal” family troubles and troubled or troubling families has become more important. In this timely and thought-provoking book, a wide range of contributors address topics such as infant care, sibling conflict, divorce, disability, illness, substance abuse, violence, kinship care, and forced marriage, in an effort to explore how the concept of trouble features in normal families and how the concept of normal features in troubled families.

Challenges and barriers in primary school education: The experiences of Traveller children and young people in Northern Ireland

Exclusion, discrimination and widespread disadvantage are issues common to the Traveller community. Children from the Traveller community are often seen as the most at risk within the education system in respect of attendance, attainment and bullying. In this article, we consider the views of Traveller children and parents with respect to primary level education in Northern Ireland and assess the level of support that exists to help Traveller children within the education system. The findings from the research are discussed with reference to institutional discrimination and the varying experiences of children and their families, including an identification of positive attitudes to education contrary to typical stereotypes.

Angiomatoid fibrous histiocytoma: comparison of fluorescence in situ hybridization and reverse transcription polymerase chain reaction as adjunct diagnostic modalities

Angiomatoid fibrous histiocytoma (AFH) is a rare soft tissue neoplasm of intermediate biologic potential and uncertain differentiation, most often arising in the extremities of children and young adults. Although it has characteristic histologic features of a lymphoid cuff surrounding nodules of ovoid cells with blood-filled cystic cavities, diagnosis is often difficult due to its morphologic heterogeneity and lack of specific immunoprofile. Angiomatoid fibrous histiocytoma is associated with recurrent chromosomal translocations, leading to characteristic EWSR1-CREB1, EWSR1-ATF1, and, rarely, FUS-ATF1 gene fusions; fluorescence in situ hybridization (FISH), detecting EWSR1 or FUS rearrangements, and reverse transcription-polymerase chain reaction (RT-PCR) for EWSR1-CREB1 and EWSR1-ATF1 fusion transcripts have become routine ancillary tools. We present a large comparative series of FISH and RT-PCR for AFH. Seventeen neoplasms (from 16 patients) histologically diagnosed as AFH were assessed for EWSR1 rearrangements or EWSR1-CREB1 and EWSR1-ATF1 fusion transcripts. All 17 were positive for either FISH or RT-PCR or both. Of 16, 14 (87.5%) had detectable EWSR1-CREB1 or EWSR1-ATF1 fusion transcripts by RT-PCR, whereas 13 (76.5%) of 17 had positive EWSR1 rearrangement with FISH. All 13 of 13 non-AFH control neoplasms failed to show EWSR1-CREB1 or EWSR1-ATF1 fusion transcripts, whereas EWSR1 rearrangement was present in 2 of these 13 cases (which were histopathologically myoepithelial neoplasms). This study shows that EWSR1-CREB1 or EWSR1-ATF1 fusions predominate in AFH (supporting previous reports that FUS rearrangement is rare in AFH) and that RT-PCR has a comparable detection rate to FISH for AFH. Importantly, cases of AFH can be missed if RT-PCR is not performed in conjunction with FISH, and RT-PCR has the added advantage of specificity, which is crucial, as EWSR1 rearrangements are present in a variety of neoplasms in the histologic differential diagnosis of AFH, that differ in behavior and treatment.

The impact of childhood residential mobility on mental health outcomes in adolescence and early adulthood: a record linkage study.

Background Understanding the causes of poor mental health in early childhood and adolescence is important as this can be a significant determinant of mental well-being in later years. One potential and relatively unexplored factor is residential mobility in formative years. Previous studies have been relatively small and potentially limited due to methodological issues. The main aim of this study was to investigate the relationship between early residential instability and poor mental health among adolescents and young adults in Northern Ireland.

Methods A Census-based record linkage study of 28% of children aged 0–8 years in 2001 in Northern Ireland (n=49 762) was conducted, with six monthly address change assessments from health registration data and self-reported mental health status from the 2011 Census. Logistic regression models were built adjusting for socioeconomic status (SES), household composition and marital dissolution.

Results There was a graded relationship between the number of address changes and mental ill-health (adjusted OR 3.67, 95% CIs 2.11 to 6.39 for 5 or more moves). This relationship was not modified by SES or household composition. Marital dissolution was associated with poor mental health but did not modify the relationship between address change and mental health (p=0.206). There was some indication that movement after the age of five was associated with an increased likelihood of poor mental health.

Conclusions This large study clearly confirms the close relationship between address change in early years and later poor mental health. Residential mobility may be a useful marker for children at risk of poorer mental health in adolescence and early adulthood

Consultation on 'Co-operating to safeguard children and young people in Northern Ireland'

This draft policy has been updated to reflect changes in structures and legislation. The draft policy outlines how communities, organisations and individuals must work to ensure children and young people in Northern Ireland are safeguarded as effectively as possible. Consultation Documents Draft Co-operating to Safeguard Children and Young People (PDF 356KB) Draft Co-operating to Safeguard Children and Young People (MS WORD 463KB) Co-operating to Safeguard Children and Young People - (easy read) (PDF 15MB) Preliminary Equality Screening, Disability Duties and Human Rights Assessment (PDF 99KB) Regulatory Impact Assessment, and Rural proofing Assessments (PDF 37KB)   Consultation Response Questionnaire Consultation Response Questionnaire (MS Word 38KB)   How to respond to the consultation Please use the questionnaire to tell us your views on the draft policy. An Equality Impact Assessment, a Regulatory Impact Assessment and Rural Proofing templates are attached in respect of the draft policy. The deadline for responses is 5.00 pm on 21 August 2015. Please email the questionnaire response to: Child.Safeguarding@dhsspsni.gov.uk Or post it to: DHSSPSNIChild Safeguarding Policy TeamRoom A3.5Castle BuildingsStormont EstateBelfastBT4 3SQ The Department will consider requests to produce this document in other languages or in alternative formats – Braille, audio, large print or as a PDF document. If you require the document in these or other formats please contact us using the details provided above or telephone 02890522543.