To assess the frequency of low self-esteem among adolescents of secondary school level in private schools of Karachi

It was a cross-sectional descriptive study done in ten private schools of Karachi for a period of 6 months. The proposal of the study was accepted by ethical committee of Jinnah Postgraduate Medical Centre, Karachi (called Institutional Review Board or IRB).The subjects fulfilling inclusion criteria were enrolled after obtaining informed consent by their parents. A semi-structured Performa was used to assess students’ particulars and included Rosenberg Self-esteem Questionnaire as a part of Performa. The data were analysed using SPSS version 17.0. Frequencies & percentages were generated for the level of self-esteem.Stratified analysis was done with a p value <0.05 taken as significant.

Out of the 246 students, 39.8% were of 14yrs of age, 36.2% were 15 years of age, while only 24% of adolescents were 16 years of age. Majority (64.2%) of the students were males while females were 35.8%. 70.3% of the students had normal level of self-esteem, whereas 28.9% of students had low self-esteem and only 0.8% of students had high self-esteem. Relationship of all the variables was found to be non-significant except that of educational level (p-value 0.047).

Self-esteem was found to be normal in most of the adolescents of secondary school level but still more than 1/4th of the study participants had low self-esteem which if assessed and addressed early may save the individuals from mental health issues as well as problems at work and home life.Having a better understanding of self-esteem, can help us to identify the adolescents who have low self-esteem and are predisposed to develop mental health difficulties in future.It can lead to not only early intervention and reducing the burden of disease but also help in developing programs to help improve self-esteem in adolescents,hence increasing their overall motivation and productivity.

Suicide accounts for 2.2% of all years of life lost worldwide. We aimed to establish whether infectious epidemics are associated with any changes in the incidence of suicide or the period prevalence of self-harm, or thoughts of suicide or self-harm, with a secondary objective of establishing the frequency of these outcomes.

In this systematic review and meta-analysis, MEDLINE, Embase, PsycINFO and AMED were searched from inception to 9 September 2020. Studies of infectious epidemics reporting outcomes of (a) death by suicide, (b) self-harm or (c) thoughts of suicide or self-harm were identified. A random-effects model meta-analysis for the period prevalence of thoughts of suicide or self-harm was conducted.

In total, 1354 studies were screened with 57 meeting eligibility criteria, of which 7 described death by suicide, 9 by self-harm, and 45 thoughts of suicide or self-harm. The observation period ranged from 1910 to 2020 and included epidemics of Spanish Flu, severe acute respiratory syndrome, human monkeypox, Ebola virus disease and coronavirus disease 2019 (COVID-19). Regarding death by suicide, data with a clear longitudinal comparison group were available for only two epidemics: SARS in Hong Kong, finding an increase in suicides among the elderly, and COVID-19 in Japan, finding no change in suicides among children and adolescents. In terms of self-harm, five studies examined emergency department attendances in epidemic and non-epidemic periods, of which four found no difference and one showed a reduction during the epidemic. In studies of thoughts of suicide or self-harm, one large survey showed a substantial increase in period prevalence compared to non-epidemic periods, but smaller studies showed no difference. As a secondary objective, a meta-analysis of thoughts of suicide and self-harm found that the pooled prevalence was 8.0% overall (95% confidence interval (CI) 5.2–12.0%; 14 820 of 99 238 cases in 24 studies) over a time period of between seven days and six months. The quality assessment found 42 studies were of low quality, nine of moderate quality and six of high quality.

There is little robust evidence on the association of infectious epidemics with suicide, self-harm and thoughts of suicide or self-harm. There was an increase in suicides among the elderly in Hong Kong during SARS and no change in suicides among young people in Japan during COVID-19, but it is unclear how far these findings may be generalised. The development of up-to-date self-harm and suicide statistics to monitor the effect of the current pandemic is an urgent priority.

Suicide accounts for 2.2% of all years of life lost worldwide. We aimed to establish whether infectious epidemics are associated with any changes in the incidence of suicide or the period prevalence of self-harm, or thoughts of suicide or self-harm, with a secondary objective of establishing the frequency of these outcomes.

In this systematic review and meta-analysis, MEDLINE, Embase, PsycINFO and AMED were searched from inception to 9 September 2020. Studies of infectious epidemics reporting outcomes of (a) death by suicide, (b) self-harm or (c) thoughts of suicide or self-harm were identified. A random-effects model meta-analysis for the period prevalence of thoughts of suicide or self-harm was conducted.

In total, 1354 studies were screened with 57 meeting eligibility criteria, of which 7 described death by suicide, 9 by self-harm, and 45 thoughts of suicide or self-harm. The observation period ranged from 1910 to 2020 and included epidemics of Spanish Flu, severe acute respiratory syndrome, human monkeypox, Ebola virus disease and coronavirus disease 2019 (COVID-19). Regarding death by suicide, data with a clear longitudinal comparison group were available for only two epidemics: SARS in Hong Kong, finding an increase in suicides among the elderly, and COVID-19 in Japan, finding no change in suicides among children and adolescents. In terms of self-harm, five studies examined emergency department attendances in epidemic and non-epidemic periods, of which four found no difference and one showed a reduction during the epidemic. In studies of thoughts of suicide or self-harm, one large survey showed a substantial increase in period prevalence compared to non-epidemic periods, but smaller studies showed no difference. As a secondary objective, a meta-analysis of thoughts of suicide and self-harm found that the pooled prevalence was 8.0% overall (95% confidence interval (CI) 5.2–12.0%; 14 820 of 99 238 cases in 24 studies) over a time period of between seven days and six months. The quality assessment found 42 studies were of low quality, nine of moderate quality and six of high quality.

There is little robust evidence on the association of infectious epidemics with suicide, self-harm and thoughts of suicide or self-harm. There was an increase in suicides among the elderly in Hong Kong during SARS and no change in suicides among young people in Japan during COVID-19, but it is unclear how far these findings may be generalised. The development of up-to-date self-harm and suicide statistics to monitor the effect of the current pandemic is an urgent priority.

Compared to the general population, people with schizophrenia have a substantially higher risk of premature mortality which translates into a 10–15 year reduction in life expectancy. The aim of this investigation was to determine if symptoms (including aggression, hallucinations or delusions, and depression) or the environmental and functional status of people with schizophrenia contribute to the high mortality risk observed in this patient group.

We identified cases of schizophrenia, aged ≥15 years in a large secondary mental healthcare case register linked to national mortality tracing. We modelled the effect of specific symptoms, activities of daily living (ADLs), living conditions, occupational and recreational activities (Health of the Nation Outcome Scale [HoNOS] subscales) on all-cause mortality over a 4-year observation period (2007-10) using Cox regression.

We identified 4270 schizophrenia cases (170 deaths) in the observation period. After controlling for a broad range of covariates, mortality was not significantly associated with hallucinations and delusions or overactive-aggressive behaviour, but was associated with subclinical depression (adjusted HR 1.5; 95% CI 1.1-2.2) and ADL impairment (adjusted HR 1.8; 95% CI 1.2-2.9).

Severity of symptoms, such as delusions and hallucinations, was less important in predicting mortality than subclinical depression and difficulties carrying out activities of daily living. The overall picture appears to be one where the highest all-cause mortality risk is in service users who are least visible to clinical teams.

To assess interdependent effects of autonomous motivation to limit sugar-sweetened beverage (SSB) consumption in relation to SSB and healthy beverage (HB) intake in mother–adolescent and father–adolescent dyads.

Adopting a dyadic cross-sectional design, the actor–partner interdependence modelling (APIM) approach was used to construct and analyse two APIM for mother–adolescent and father–adolescent dyads. The first model assessed actor effects (individual’s autonomous motivation associated with his/her own beverage intake) and partner effects (individual’s autonomous motivation associated with another family member’s beverage consumption) of autonomous motivation on SSB consumption. The second model assessed actor and partner effects of autonomous motivation on HB intake.

Two Internet-based surveys were completed in participant households.

Data from a demographically representative US sample of parent–adolescent dyads (1225 mother–adolescent dyads, 424 father–adolescent dyads) were used.

In the first model (autonomous motivation on SSB consumption), actor effects were significant for adolescents, but not for parents. Partner effects were significant for mother–adolescent, but not father–adolescent dyads. In the second model (autonomous motivation on HB intake), actor effects were significant for adolescents and parents in all dyadic combinations. Regarding partner effects, adolescent autonomous motivation had a significant effect on HB intake for mothers and fathers. In addition, maternal autonomous motivation had a significant effect on adolescent HB intake. No partner effects for HB were identified for fathers.

We found significant interdependent effects of autonomous motivation in relation to SSB and HB intake in mother–adolescent and father–adolescent dyads for eleven out of sixteen pathways modelled.

This article describes a CDI outbreak in a long-term care (LTC) facility that used molecular typing techniques and whole-genome sequencing to identify widespread dissemination of the clonal strain in the environment which was successfully removed after terminal cleaning.

This study was conducted in a long-term care facility in Texas.

A recently hospitalized LTC patient was diagnosed with CDI followed shortly thereafter by 7 subsequent CDI cases. A stool specimen was obtained from each patient for culturing and typing. An environmental point-prevalence study of the facility was conducted before and after terminal cleaning of the facility to assess environmental contamination. Cultured isolates were typed using ribotyping, multilocus variant analysis, and whole-genome sequencing.

Stool samples were available for 5 of 8 patients; of these specimens, 4 grew toxigenic C. difficile ribotype 027. Of 50 environmental swab samples collected throughout the facility prior to the facility-wide terminal cleaning, 19 (38%) grew toxigenic C. difficile (most commonly ribotype 027, 79%). The terminal cleaning was effective at reducing C. difficile spores in the environment and at eradicating the ribotype 027 strain (P<.001). Using multilocus variance analysis and whole-genome sequencing, clinical and environmental strains were highly related and, in some cases, were identical.

Using molecular typing techniques, we demonstrated reduced environmental contamination with toxigenic C. difficile and the eradication of a ribotype 027 clone. These techniques may help direct infection control efforts and decrease the burden of CDI in the healthcare system.

The present study examined the prevalence of and risk factors for malnutrition in a population-based cohort of women of childbearing age in rural Bangladesh.

A cross-sectional study that collected pre-pregnancy weight, height, and data on selected risk factors for nutritional status of women.

The study was conducted in Sylhet District of Bangladesh.

Study subjects included 13 230 non-pregnant women of childbearing age. Women were classified into underweight (<18·5 kg/m2), normal (18·5–24·9 kg/m2) and overweight/obese (≥25·0 kg/m2) using BMI; and into moderate to severe stunting (<150 cm), mild stunting (150–<155 cm) and normal (≥155 cm) using height. Two multinomial logistic regression models were fitted for BMI: model 1 examined individual and household factors associated with BMI, and model 2 additionally examined the association of community variables. The same analysis was conducted for height.

Prevalence of underweight, overweight/obesity and moderate to severe stunting was 37·0, 7·2 and 48·6 %, respectively. Women’s education and household wealth were inversely related to both underweight status and stunting. Underweight rate was significantly lower in the post-harvest season. Women with any education and who belonged to households with higher wealth were more likely to be overweight/obese.

The study documented high underweight and stunting, and moderate overweight/obesity rates among rural Bangladeshi women; and recommends design and implementation of a multidimensional intervention programme based on individual-, household- and community-level risk factors that can address underweight, stunting and overweight/obesity to improve the nutritional status of women of childbearing age in Bangladesh.