Our future: a Lancet commission on adolescent health and wellbeing

Objectives. We estimated prevalence and assessed correlates of emotional, physical, sexual, and financial mistreatment and potential neglect (defined as an identified need for assistance that no one was actively addressing) of adults aged 60 years or older in a randomly selected national sample.Methods. We compiled a representative sample by random digit dialing across geographic strata. We used computer-assisted telephone interviewing to standardize collection of demographic, risk factor, and mistreatment data. We subjected prevalence estimates and mistreatment correlates to logistic regression.Results. We analyzed data from 5777 respondents. One-year prevalence was 4.6% for emotional abuse, 1.6% for physical abuse, 0.6% for sexual abuse, 5.1% for potential neglect, and 5.2% for current financial abuse by a family member. One in 10 respondents reported emotional, physical, or sexual mistreatment or potential neglect in the past year. The most consistent correlates of mistreatment across abuse types were ...

/pdf/prevalence-and-correlates-of-emotional-physical-sexual-and-cqkkqto5nl.pdf

Prevalence and correlates of emotional, physical, sexual, and financial abuse and potential neglect in the United States: the National Elder Mistreatment Study.

Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries.

Deliberate self-poisoning has become an increasingly common response to emotional distress in young adults,1 and it is now one of the most frequent reasons for emergency hospital admission.2 In industrialised countries, the drugs people commonly take in overdose - analgesics, tranquillisers, antidepressants3- are relatively non-toxic. The estimated case fatality for overdose in England, for example, is around 0.5%.4 Most individuals who self-harm do not intend to die. Studies carried out in industrialised countries have found that only 2% go on to commit suicide in the subsequent 12 months.5

In developing countries the situation is quite different.6 The substances most commonly used for self-poisoning are agricultural pesticides.6,7,8,9,10,11 Overall case fatality ranges from 10% - 20%.12 For this reason, deaths from pesticide poisoning make a major contribution to patterns of suicide in developing nations, particularly in rural areas.6 In rural China, for example, pesticides account for over 60% of suicides.8 Similarly high proportions of suicides are due to pesticides in rural areas of Sri Lanka (71%),13 Trinidad (68%),14 and Malaysia (>90%).10 There is, however, no evidence that levels of suicidal intent associated with pesticide ingestion in these countries are any higher than those associated with drug overdose in industrialised countries, where the drugs taken in overdose are less toxic.

Suicide by intentional ingestion of pesticides: a continuing tragedy in developing countries

Children and adolescents in low and middle income countries (LAMIC) constitute 35-50% of the population. Although the population in many such countries is predominantly rural, rapid urbanisation and social change is under way, with an increase in urban poverty and unemployment, which are risk factors for poor child and adolescent mental health (CAMH). There is a vast gap between CAMH needs (as measured through burden of disease estimates) and the availability of CAMH resources. The role of CAMH promotion and prevention can thus not be overestimated. However, the evidence base for affordable and effective interventions for promotion and prevention in LAMIC is limited. In this review, we briefly review the public health importance of CAM disorders in LAMIC and the specific issues related to risk and protective factors for these disorders. We describe a number of potential strategies for CAMH promotion which focus on building capacity in children and adolescents, in parents and families, in the school and health systems, and in the wider community, including structural interventions. Building capacity in CAMH must also focus on the detection and treatment of disorders for which the evidence base is somewhat stronger, and on wider public health strategies for prevention and promotion. In particular, capacity needs to be built across the health system, with particular foci on low-cost, universally available and accessible resources, and on empowerment of families and children. We also consider the role of formal teaching and training programmes, and the role for specialists in CAMH promotion.

Promoting child and adolescent mental health in low and middle income countries.

Este reporte hace una importante contribucion a nuestra comprension de la violencia y su impacto sobre las sociedades. Exhibe los diferentes rostros de la violencia, desde el sufrimiento "invisible" de los individuos mas vulnerables de la sociedad, a la notria tragedia de las sociedades en conflicto. El mismo mejora nuestro analisis de los factores que conducen a la violencia y las posibles respuestas de diferentes sectores de la sociedad. Al hacer esto, este documento nos recuerda que la proteccion y la seguridad no ocurren en forma espontanea, sino que son el resultado de un consenso colectivo y de politicas publicas dirigidas a tal fin.

Organización Mundial de la Salud

Papers

The World Report on violence and health