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1
Quinn, Charles T., Zora R. Rogers, Timothy L. McCavit, and George R. Buchanan. "Improved survival of children and adolescents with sickle cell disease." Blood 115, no. 17 (April 29, 2010): 3447–52. http://dx.doi.org/10.1182/blood-2009-07-233700.
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Abstract The survival of young children with sickle cell disease (SCD) has improved, but less is known about older children and adolescents. We studied the Dallas Newborn Cohort (DNC) to estimate contemporary 18-year survival for newborns with SCD and document changes in the causes and ages of death over time. We also explored whether improvements in the quality of medical care were temporally associated with survival. The DNC now includes 940 subjects with 8857 patient-years of follow-up. Most children with sickle cell anemia (93.9%) and nearly all children with milder forms of SCD (98.4%) now live to become adults. The incidence of death and the pattern of mortality changed over the duration of the cohort. Sepsis is no longer the leading cause of death. All the recent deaths in the cohort occurred in patients 18 years or older, most shortly after the transition to adult care. Quality of care in the DNC has improved over time, with significantly more timely initial visits and preventive interventions for young children. In summary, most children with SCD now survive the childhood years, but young adults who transition to adult medical care are at high risk for early death.
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Donner, Elizabeth J., Charles R. Smith, and O. Carter Snead. "Sudden unexplained death in children with epilepsy." Neurology 57, no. 3 (August 14, 2001): 430–34. http://dx.doi.org/10.1212/wnl.57.3.430.
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Background: Sudden unexplained death is a significant cause of mortality in people with epilepsy. Risk factors that have been identified include male sex, poor compliance with medications, and antiepileptic drug (AED) polypharmacy. However, these may not apply to the pediatric population in which the causes of epilepsy differ from the adult population. Therefore, risk factors for sudden unexplained death in epilepsy (SUDEP) in children must be evaluated independently from those in the adult population.Methods: Cases of SUDEP in children less than 18 years of age occurring over a 10-year period in the province of Ontario, Canada, were identified. Records were reviewed for demographic and clinical features and neuropathology findings.Results: Twenty-seven cases of SUDEP in children were identified. Sixty-three percent were male. Age at death ranged from 8 months to 15 years. Fourteen children had symptomatic epilepsy (52%), five had cryptogenic epilepsy (18%), and eight had idiopathic epilepsy (30%). Twelve children were treated with one AED (46%), 10 were on two AED (38%), and three were on three AED (12%). At the time of death, seven children had one serum AED concentration below the therapeutic range (35%) and 12 children had AED levels within the therapeutic range (60%).Conclusions: This case series represents the largest series of sudden unexplained death in children with epilepsy. At least two previously described risk factors for SUDEP in adults, low serum AED levels at time of death and AED polytherapy, do not appear to be significant in children.
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Corr, Charles A. "Siblings and Child Friends in Death-Related Literature for Children." OMEGA - Journal of Death and Dying 59, no. 1 (August 2009): 51–68. http://dx.doi.org/10.2190/om.59.1.d.
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This article explores ways in which siblings and child friends are represented as being involved in death and loss experiences. These representations are taken from 51 selected examples of death-related literature designed to be read by or with children. The main goal is to ask how these youngsters respond when confronted by the death of a sibling or child friend. How do they act when they are on their own, with each other, or with adults? This is important because these representations of children coping with death-related situations can serve as partial role models for the youngsters who read these books, either on their own or with a companion adult. And when adults are involved in reading, discussing, or examining books of this type, they can gain some insights into the world of children as portrayed by these authors, insights that adult readers might not otherwise have had, insights about how children respond to death-related situations, what they need, and how they might be helped.
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Bower, Anne R. "The Adult Child's Acceptance of Parent Death." OMEGA - Journal of Death and Dying 35, no. 1 (August 1997): 67–96. http://dx.doi.org/10.2190/jry9-6bl8-kce1-hk5c.
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In the grief and bereavement literature, the discussion of acceptance often regards it as an end-point of the process and utilizes a definition that is linked to duration and intensity of grief. The study of parent death is no exception. Adult children are rarely asked whether or why they have or have not accepted the death of an elderly parent, or even what acceptance means to them. The extent to which such studies accurately report on the experience of parent death acceptance is questionable. Using ethnographic and linguistic techniques, this study approaches acceptance through a qualitative examination of adult children's verbatim responses to direct inquiries about their acceptance of an elderly parent's death. Findings indicate that while the majority of adult children readily assert acceptance of their parent's death, these assertions are contingent upon important beliefs and values relating to the death, the power of feelings, and the strength of memory. Further, and most important, acceptance appears to be a phenomenon adult children feel compelled to explain.
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Shanfield, Stephen B., Barbara J. Swain, and G. Andrew H. Benjamin. "Parents' Responses to the Death of Adult Children from Accidents and Cancer: A Comparison." OMEGA - Journal of Death and Dying 17, no. 4 (December 1987): 289–97. http://dx.doi.org/10.2190/lda0-und9-y8py-mc2d.
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Parents who lose adult children in traffic accidents are different from parents who lose adult children from cancer. Accident parents tend to be middle-aged and their children young adults at the time of death. They also tend to have more psychiatric distress and more health complaints than cancer parents. Cancer parents are usually older with children who are middle aged at the time of death, and these parents tend to experience the loss less painfully. Two factors explain a high percentage of differences between the groups. These are: 1) older age of children at the time of death; and 2) less intense expression of grief. The relationship between parent and child changes at different stages over the life cycle. Thus, accident parents tend to be more attached to their children than cancer parents, and this can account for differences between the groups. The circumstances of death also determine the different responses. Sudden loss of young adult children in traffic accidents appears to be more distressing. These findings have important implications for prevention.
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Pollack-Nelson, Carol, Alison G. Vredenburgh, Ilene B. Zackowitz, Michael J. Kalsher, and James M. Miller. "Adult Products That Kill and Injure Children." Proceedings of the Human Factors and Ergonomics Society Annual Meeting 61, no. 1 (September 2017): 886–89. http://dx.doi.org/10.1177/1541931213601513.
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Many of the most dangerous products killing and injuring children are not toys – they are adult products. Of the 150,000 products regulated by the CPSC, ATVs are responsible for more child deaths annually than any other. In many cases, the children injured or killed were riding adult ATVs. Products inside the home are also responsible for deaths and serious injuries. Dressers and televisions tip over and kill children at a rate of one every two weeks. Window covering cords have strangled at least one child every month for decades. And button batteries found in everything from remote control devices to bathroom scales are ingested by infants and young children, causing serious injuries and death. Finally, cell phone use by children has opened up a wide range of serious risks - not only driving and pedestrian accidents, but also risks associated with exposure to strangers and unsafe products. In this alternative format panel, experts address each of these products and explore how risk perception – by parents and children – affects their behavior and exposure to the hazard. Limitations of voluntary and mandatory regulations to mitigate product hazards are also discussed.
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Brubaker, Ellie. "Older Parents' Reactions to the Death of Adult Children:." Journal of Gerontological Social Work 9, no. 1 (September 20, 1985): 35–48. http://dx.doi.org/10.1300/j083v09n01_04.
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Rapa, Elizabeth, Jeffrey R. Hanna, Catriona R. Mayland, Stephen Mason, Bettina Moltrecht, and Louise J. Dalton. "Experiences of preparing children for a death of an important adult during the COVID-19 pandemic: a mixed methods study." BMJ Open 11, no. 8 (August 2021): e053099. http://dx.doi.org/10.1136/bmjopen-2021-053099.
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ObjectiveThe objectives of this study were to investigate how families prepared children for the death of a significant adult, and how health and social care professionals provided psychosocial support to families about a relative’s death during the COVID-19 pandemic.Design/settingA mixed methods design; an observational survey with health and social care professionals and relatives bereaved during the COVID-19 pandemic in the UK, and in-depth interviews with bereaved relatives and professionals were conducted. Data were analysed thematically.ParticipantsA total of 623 participants completed the survey and interviews were conducted with 19 bereaved relatives and 16 professionals.ResultsMany children were not prepared for a death of an important adult during the pandemic. Obstacles to preparing children included families’ lack of understanding about their relative’s declining health; parental belief that not telling children was protecting them from becoming upset; and parents’ uncertainty about how best to prepare their children for the death. Only 10.2% (n=11) of relatives reported professionals asked them about their deceased relative’s relationships with children. This contrasts with 68.5% (n=72) of professionals who reported that the healthcare team asked about patient’s relationships with children. Professionals did not provide families with psychosocial support to facilitate preparation, and resources were less available or inappropriate for families during the pandemic. Three themes were identified: (1) obstacles to telling children a significant adult is going to die, (2) professionals’ role in helping families to prepare children for the death of a significant adult during the pandemic, and (3) how families prepare children for the death of a significant adult.ConclusionsProfessionals need to: provide clear and honest communication about a poor prognosis; start a conversation with families about the dying patient’s significant relationships with children; and reassure families that telling children someone close to them is dying is beneficial for their longer term psychological adjustment.
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Feigelman, William, Beverly Feigelman, and Lillian M. Range. "Grief and Healing Trajectories of Drug-Death-Bereaved Parents." OMEGA - Journal of Death and Dying 80, no. 4 (January 22, 2018): 629–47. http://dx.doi.org/10.1177/0030222818754669.
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We explored parents’ views of the trajectories of their adult children’s eventual deaths from drugs with in-depth qualitative interviews from 11 bereaved parents. Parents reported great emotional distress and high financial burdens as their children went through death spirals of increasing drug involvements. These deaths often entailed anxiety-inducing interactions with police or medical personnel, subsequent difficulties with sharing death cause information with socially significant others, and longer term problems from routine interactions. Eventually, though, many of these longer term bereaved parents reported overcoming these obstacles and developing posttraumatic growth. Openly disclosing the nature of the death seemed to be an important building block for their healing.
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White, Diana L., Alexis J. Walker, and Leslie N. Richards. "Intergenerational Family Support following Infant Death." International Journal of Aging and Human Development 67, no. 3 (October 2008): 187–208. http://dx.doi.org/10.2190/ag.67.3.a.
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The death of a child is a traumatic, nonnormative family life event. Although parental bereavement has received substantial attention, little research has focused on extended family members affected by a child's death, and still less on how multiple family members perceive and respond to one another following the loss. Guided by a life course perspective, this article examines social support between grandparents and their adult children in the aftermath of infant death. Through structured, open-ended interviews, 21 grandparents and 19 parents from 10 families described how they provided support to and received support from their intergenerational partners. Data were analyzed using a grounded theory approach. Six categories of support were identified: being present, acknowledgment, performing immediate tasks, information, unskilled support, and no support. Most support was provided by grandparents to adult children rather than from adult children to grandparents. All families reported significant support from at least one grandparent and nearly all families described ambivalent relationships that complicated support. Gender, family lineage, and family history were major influences. Multiple family perspectives about a significant life event contribute to our understanding about the intersection between individual and family life.
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Okun, Barbara S., and Guy Stecklov. "The Impact of Grandparental Death on the Fertility of Adult Children." Demography 58, no. 3 (March 24, 2021): 847–70. http://dx.doi.org/10.1215/00703370-9015536.
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Abstract The increasingly central role of vertical family kinship in Western societies underscores the potential value of intergenerational linkages that tie grandparents to the fertility of their adult children. Recent research has examined the changing demography of grandparenthood and the roles fulfilled by living grandparents, but the complex implications of grandparental death—a key feature of intergenerational linkages over the life course—have drawn less attention. In this article, we explore whether and how childbearing of adult women is affected by the death of grandparents—their own parent(s) or their spouse's parent(s). We develop a novel conceptual framework that presents the pathways of influence and considers the overall impact of grandparental death on childbearing of adult children. We then estimate fixed-effects models to identify causal relationships between grandparental death and childbearing, using linked micro-level census and population register data from Israel for the period 1986–2014. We find that grandparental death leads to a reduction of approximately 5 percentage points in the five-year probability of childbirth. The effects of grandparental death are negative across all parities examined and are broadly similar across grandparent's gender and kinship relation. Additional effects are identified, including how the impact of grandparental death varies with time since the previous birth as well as residential proximity prior to death. We explain how our findings regarding the effect of grandparental death offer insight into the role of living grandparents. Our results suggest that policy-makers concerned with low fertility should explore mechanisms that reinforce potential sources of support from grandparents.
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Aduloju, Si mbo O., Sheila Palmer, and James R. Eckman. "Mortality in Sickle Cell Patient Transitioning from Pediatric to Adult Program: 10 Years Grady Comprehensive Sickle Cell Center Experience." Blood 112, no. 11 (November 16, 2008): 1426. http://dx.doi.org/10.1182/blood.v112.11.1426.1426.
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Abstract Over the last three decades there has been improvement in survival in children with sickle cell disease. Overall survival from birth to age 18 of 86% and 95% has been reported in children with sickle cell anemia (HbSS) and sickle hemoglobin C (Hb SC) disease respectively. These encouraging results are secondary to initiation of preventive measures like newborn screening, penicillin prophylaxis, immunization and stroke prevention and other supportive therapies. Ballas (Blood2004;104 supl:Abstr 3743) reported high death rate for young adults with the disease. To determine the death rates and cause of death in our population, we did a retrospective review of our patients who had recently transitioned into adult care. Mortality rate and circumstances of death in a 10 year period of transition from pediatric to adult program in Georgia Comprehensive Sickle Cell Center at Grady Memorial Hospital between 1996 and 2006 were determined. Total number of deaths was obtained from the clinical database. Death, autopsy and medical records were reviewed to determine the cause and circumstances of death. Between 1996 and 2006, 387 young adults with sickle cell disease (HbSS, HbSC, HbS beta thalassemia) transitioned to the adult program at age 18. Twenty two (5.8%) patients died during their first 10 years of transition. Mean age at death was 23.4 (range 21.6–26) and male to female ratio was 1.2 to 1. Ten patients (45%) died due to chronic organ failure all due to chronic iron overload (end stage liver disease in 8 and congestive heart failure in 2). Eight patients (36%) died due to complications of acute vaso-occlusive crisis (sudden death in 4, acute chest/multi-organ failure in 4) while 4 patients (18%) died of non-sickle related causes. Three of four who died of sudden death has documented pulmonary hypertension. Our mortality rate is lower than those reported by Ballas with the most common cause of death being complications of iron overload in chronically transfused patients. Specific interventions targeted at improving management of iron overload need to be developed for the increasing numbers of patients on chronic transfusion transitioning into adult care.
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Auman, Mary Jo. "Bereavement Support for Children." Journal of School Nursing 23, no. 1 (February 2007): 34–39. http://dx.doi.org/10.1177/10598405070230010601.
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The death of a parent is one of the most significant and stressful events children can encounter. Surviving children may experience psychiatric problems and social dysfunction during their childhood and possibly throughout their adult lives. Children surviving a sibling’s death may develop behavioral problems, because no one can fill the emptiness that remains in their lives, especially if their relationship was close. It is vital to recognize the trauma experienced by children who have suffered the loss of a loved one. Adults need to know when a grieving child needs help. Literature supports the need for education and counseling for grieving children. School nurses can be instrumental in meeting these needs for school-age children by performing early, comprehensive assessments, educating school administration regarding the benefits of bereavement support, initiating appropriate referrals, and providing bereavement support.
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Helmkamp, James C., Mary E. Aitken, and Bruce A. Lawrence. "ATV and Bicycle Deaths and Associated Costs in the United States, 2000–2005." Public Health Reports 124, no. 3 (May 2009): 409–18. http://dx.doi.org/10.1177/003335490912400310.
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Objective. We determined the rate and costs of recent U.S. all-terrain vehicle (ATV) and bicycle deaths. Methods. Fatalities were identified from the National Center for Health Statistics Multiple Cause-of-Death public-access file. ATV and bicycle deaths were defined by International Classification of Diseases, 10th Revision codes V86.0–V86.9 and V10–V19, respectively. Lifetime costs were estimated using standard methods such as those used by the National Highway Traffic Safety Administration. Results. From 2000 through 2005, 5,204 people died from ATV crashes and 4,924 from bicycle mishaps. A mean of 694 adults and 174 children died annually from ATV injuries, while 666 adults and 155 children died from bicycle injuries. Death rates increased among adult ATV and bike riders and child ATV riders. Males had higher fatality rates for both ATVs and bicycles. Among children, total costs increased 15% for ATV deaths and decreased 23% for bicycle deaths. In adults, ATV costs increased 45% and bike costs increased 39%. Conclusions. Bicycle- and ATV-related deaths and associated costs are high and, for the most part, increasing. Promotion of proven prevention strategies, including helmet use, is indicated. However, enforcement of helmet laws is problematic, which may contribute to observed trends.
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Lanzkron, Sophie, and Carlton Haywood. "Trends In Mortality Rates and Age of Death In Sickle Cell Disease (SCD): 1979–2005." Blood 116, no. 21 (November 19, 2010): 736. http://dx.doi.org/10.1182/blood.v116.21.736.736.
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Abstract Abstract 736 While improvements in care have resulted in significant decreases in mortality for children with SCD, it is unclear if similar decreases in mortality rates have occurred in adults with the disease. The purpose of this research is to describe mortality rates and trends in age of death for those with SCD over the last 3 decades. We used the National Center for Health Statistics Multiple Cause of Death (MCOD) files to examine age at death and calculate mortality rates from 1979–2005. ICD9 and ICD10 codes for SCD were used as appropriate to identify sickle cell related deaths. Mortality rates were calculated as deaths per 100,000 African American population. The number of African Americans each year was determined using available census data. Trends in mortality rates were examined using negative binomial regression and age of death was examined using t-tests and linear regression. After excluding certificates with codes for sickle trait and those with multiple sickle codes we identified 16,654 sickle-related deaths. The age range was 0 to 107 years. Mean age of death was significantly different for men (33.4, 95% CI [33.0, 33.7]) and women (36.9, 95% CI [36.5, 37.4]). SCD was the most common listed underlying cause of death (COD) at 62.8%. Infection was the second most common COD (5.9%). Controlling for sex and the presence of infection as COD, the mean age of death increased significantly by 0.08 years (p<0.001) each year over the time period studied, with men on average dying 4.3 years earlier than women (p<0.001). The mean age of death in 2005 was 43 yrs for women and 37 yrs for men. Those with COD of pulmonary hypertension, stroke and renal disease had a significantly older age of death than those without those diagnoses, while having infection as the underlying COD was associated with a younger age at death. The overall mortality rate increased by 0.7% (p<0.001) each year over the time period studied. Mortality rates for adults and children over time are shown in Figure 1. The adult (>19 yrs) mortality rate increased by 1% (p<0.001) each year over the time period studied. The pediatric mortality rate decreased by 3% (p<0.001) each year over the time period studied. When controlling for the pediatric mortality rate the adult mortality rate increased by 1.6% (p<0.001) each year. This data confirms prior studies showing a significant decrease in mortality for children with sickle cell disease over the last 30 yrs. The mortality rate for the adult population appears to be steadily increasing over the same time period. It seems unlikely that this is due merely to an influx of younger patients surviving to adulthood. Further investigation as to the cause of the increasing mortality rate in adults is needed. Disclosures: No relevant conflicts of interest to declare.
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Kimmel, Paul L., Chyng-Wen Fwu, Kevin C. Abbott, Marva M. Moxey-Mims, Susan Mendley, Jenna M. Norton, and Paul W. Eggers. "Psychiatric Illness and Mortality in Hospitalized ESKD Dialysis Patients." Clinical Journal of the American Society of Nephrology 14, no. 9 (August 22, 2019): 1363–71. http://dx.doi.org/10.2215/cjn.14191218.
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Background and objectivesLimited existing data on psychiatric illness in ESKD patients suggest these diseases are common and burdensome, but under-recognized in clinical practice.Design, setting, participants, & measurementsWe examined hospitalizations with psychiatric diagnoses using inpatient claims from the first year of ESKD in adult and pediatric Medicare recipients who initiated treatment from 1996 to 2013. We assessed associations between hospitalizations with psychiatric diagnoses and all-cause death after discharge in adult dialysis patients using multivariable-adjusted Cox proportional hazards regression models.ResultsIn the first ESKD year, 72% of elderly adults, 66% of adults and 64% of children had at least one hospitalization. Approximately 2% of adults and 1% of children were hospitalized with a primary psychiatric diagnosis. The most common primary psychiatric diagnoses were depression/affective disorder in adults and children, and organic disorders/dementias in elderly adults. Prevalence of hospitalizations with psychiatric diagnoses increased over time across groups, primarily from secondary diagnoses. 19% of elderly adults, 25% of adults and 15% of children were hospitalized with a secondary psychiatric diagnosis. Hazards ratios of all-cause death were higher in all dialysis adults hospitalized with either primary (1.29; 1.26 to 1.32) or secondary (1.11; 1.10 to 1.12) psychiatric diagnoses than in those hospitalized without psychiatric diagnoses.ConclusionsHospitalizations with psychiatric diagnoses are common in pediatric and adult ESKD patients, and are associated with subsequent higher mortality, compared with hospitalizations without psychiatric diagnoses. The prevalence of hospitalizations with psychiatric diagnoses likely underestimates the burden of mental illness in the population.
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Hoy, Wendy E., Susan Anne Mott, and Beverly June McLeod. "Transformation of mortality in a remote Australian Aboriginal community: a retrospective observational study." BMJ Open 7, no. 8 (August 2017): e016094. http://dx.doi.org/10.1136/bmjopen-2017-016094.
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ObjectivesTo describe trends in ages and causes of death in a remote-living Australian Aboriginal group over a recent 50-year period.DesignA retrospective observational study, from 1960 to 2010, of deaths and people starting dialysis, using data from local clinic, parish, dialysis and birthweight registers.SettingA remote island community in the Top End of Australia’s Northern Territory, where a Catholic mission was established in 1911. The estimated Aboriginal population was about 800 in 1960 and 2260 in 2011.ParticipantsAll Aboriginal residents of this community whose deaths had been recorded.Outcome measuresAnnual frequencies and rates of terminal events (deaths and dialysis starts) by age group and cause of death.ResultsAgainst a background of high rates of low birth weight, 223 deaths in infants and children and 934 deaths in adults (age>15 years) were recorded; 88% were of natural causes. Most deaths in the 1960s were in infants and children. However, over time these fell dramatically, across the birthweight spectrum, while adult deaths progressively increased. The leading causes of adult natural deaths were chronic lung disease, cardiovascular disease and, more recently, renal failure, and rates were increased twofold in those of low birth weight. However, rates of natural adult deaths have been falling briskly since 1986, most markedly among people of age ≥45 years. The population is increasing and its age structure is maturing.ConclusionsThe changes in death profiles, the expression of the Barker hypothesis and the ongoing increases in adult life expectancy reflect epidemiological and health transitions of astonishing rapidity. These probably flow from advances in public health policy and healthcare delivery, as well as improved inter-sectoral services, which are all to be celebrated. Other remote communities in Australia are experiencing the same phenomena, and similar events are well advanced in many developing countries.
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Pichiello, Matthew, Meghan McDarby, Elissa K. Kozlov, and Brian Carpenter. "LIVES WORSE THAN DEATH: ADULT CHILDREN ARE POOR AT ESTIMATING PARENTS’ QUALITY-OF-LIFE VALUATIONS." Innovation in Aging 3, Supplement_1 (November 2019): S636. http://dx.doi.org/10.1093/geroni/igz038.2368.
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Abstract Adult children often help older parents make medical decisions when their health is compromised. To do so in a way that respects parent values requires children to know how their parent views health states and consequent quality of life. The current study compared older parent and adult child valuations of quality of life in different health contexts. Families consisted of older parents (n = 37) and their adult children (n = 66). Parents rated perceived quality of life in 14 compromised health states on a scale from 1 (difficult but acceptable) to 5 (not worth living). Children estimated how their parent responded to each health state, yielding an index of their knowledge of parent perceptions. Overall, parents described all compromised health states as less acceptable than adult children thought they would, t(99) = 2.19, p < .05. Notably, parents believed situations that caused financial or emotional burden to their family were much less acceptable than their children estimated. Children were more knowledgeable about parent valuations for more extreme circumstances, such as living with a feeding tube. Within families, children demonstrated only slight knowledge about parent quality of life valuations (kappa = .081). Across the entire sample of families, there was a broad range of knowledge (kappas = -.181 – .351), but at best, knowledge was still only fair. Results from this study suggest that adult children may underestimate the impact of compromised health states on parent estimations of quality of life, which could affect collaborations on healthcare decisions.
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Villarruel, Antonia M., and Deborah Koniak-Griffin. "Lifestyle Behavior Interventions With Hispanic Children and Adults." Annual Review of Nursing Research 25, no. 1 (January 2007): 51–81. http://dx.doi.org/10.1891/0739-6686.25.1.51.
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Chronic diseases are the leading causes of death and disability in the United States and account for 7 of every 10 deaths. While the etiology of chronic diseases is multifactorial, individual modifiable behaviors play an important role in both risk and prevention. Hispanics are disproportionately affected by chronic diseases and are a growing and significant population. The purpose of this chapter is to analyze and critique behavioral lifestyle interventions conducted with adolescent and adult Hispanics. Specific recommendations for continued research and policy are provided.
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Bass, David M., Linda S. Noelker, Aloen L. Townsend, and Gary T. Deimling. "Losing An Aged Relative: Perceptual Differences between Spouses and Adult Children." OMEGA - Journal of Death and Dying 21, no. 1 (August 1990): 21–40. http://dx.doi.org/10.2190/pkjm-mxcv-yrqu-q577.
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Research on bereavement primarily focuses on conjugal loss; few studies examine differences between losing a spouse and losing an aged parent. The present investigation compares perceptions of nineteen bereaved spouses with forty-seven bereaved adult children in order to specify differences between conjugal and parental loss. Data from two larger surveys of family caregivers show spouses feel their physical and emotional health has been more negatively affected by the death, yet report increased participation in social activities. Adult children are more likely to discuss dying with an ill parent, although little difference occurs in other preparations. Differences between spouses and children also are found in the appraised difficulty of the death and in the number of peripheral sources of support, and in the likelihood of receiving assistance from friends and neighbors.
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Lutsenko, Anna M., and Alla S. Spivakovskaya. "REPRESENTATIONS OF “FAMILY PAIN” BY ADULT CHILDREN OF ALCOHOLICS." Moscow University Psychology Bulletin, no. 2 (2020): 83–102. http://dx.doi.org/10.11621/vsp.2020.02.05.
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Relevance. The term “family pain” is used in family psychotherapy to refer to the emotional state of dysfunctional family members. Research on this phenomenon in dysfunctional alcoholic families can expand the understanding of the family system and allow us to formulate the goals of psychotherapy with such families. Objective. To investigate the “family pain” experienced by adult children of alcoholics. Methods. The sample consisted of 52 people who were in a recovery program for adult children of alcoholics (ACA), and 50 controls. We implemented a phenomenological analysis of ACA groups, a content analysis of images of “family pain”, and factor analysis of the characteristics of “family pain”. Results. The study showed significant differences between the images of “family pain” experienced by adults who were raised and still live in alcoholic families, by those whose parents were alcoholics and had died by the time of the survey, and by those whose parents were not alcoholics. People who live with their alcoholic parents describe “family pain” as a familiar, long process with effects on the whole family. The experience of “family pain” includes anger, shame, and self-pity. People whose parents were alcoholics and have died describe “family pain” as a feeling of guilt towards their parents and a process of experiencing their parents’ death. The control group had difficulty describing “family pain”, or described it as a process of experiencing their parents’ death. Conclusions. Representations of “family pain” are associated with the subjective meaning of family dysfunction for the participant and the experience of negative emotions in the family.
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Pinto, Mariana Tomazini, Flavio Mavignier Cárcano, Ana Glenda Santarosa Vieira, Eduardo Ramos Martins Cabral, and Luiz Fernando Lopes. "Molecular Biology of Pediatric and Adult Male Germ Cell Tumors." Cancers 13, no. 10 (May 13, 2021): 2349. http://dx.doi.org/10.3390/cancers13102349.
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Cancer is a leading cause of death by disease in children and the second most prevalent of all causes in adults. Testicular germ cell tumors (TGCTs) make up 0.5% of pediatric malignancies, 14% of adolescent malignancies, and are the most common of malignancies in young adult men. Although the biology and clinical presentation of adult TGCTs share a significant overlap with those of the pediatric group, molecular evidence suggests that TGCTs in young children likely represent a distinct group compared to older adolescents and adults. The rarity of this cancer among pediatric ages is consistent with our current understanding, and few studies have analyzed and compared the molecular basis in childhood and adult cancers. Here, we review the major similarities and differences in cancer genetics, cytogenetics, epigenetics, and chemotherapy resistance between pediatric and adult TGCTs. Understanding the biological and molecular processes underlying TGCTs may help improve patient outcomes, and fuel further investigation and clinical research in childhood and adult TGCTs.
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Ivy, Dunbar. "The Pediatric Sildenafil Trial." Advances in Pulmonary Hypertension 10, no. 4 (December 1, 2012): 215–16. http://dx.doi.org/10.21693/1933-088x-10.4.215.
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While we have long understood pulmonary arterial hypertension (PAH) to be a chronic disorder of the pulmonary vasculature that can lead to right heart failure and death if untreated, there are currently no therapies approved for children. Recommendations for treatment for children have been derived from evidence-based adult guidelines. However, limited data suggest benefits for children utilizing drugs approved for adults. This landmark study is the first randomized, double-blind, placebo-controlled trial of a PAH therapy in children.
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Hoy, Wendy E., and Jennifer L. Nicol. "The Barker hypothesis confirmed: association of low birth weight with all-cause natural deaths in young adult life in a remote Australian Aboriginal community." Journal of Developmental Origins of Health and Disease 10, no. 1 (January 25, 2018): 55–62. http://dx.doi.org/10.1017/s2040174417000903.
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Barkeret al. proposed that low birth weight predisposes to higher death rates in adult life. We previously confirmed this fact in a cohort of young adults who were born in a remote Australian Aboriginal community between 1956 and 1985. We now present data in these same people with four more years of follow-up and a greater number of deaths. The fates of participants were documented from age 15 years until death, start of dialysis, or until the end of 2010 and causes of death were derived from clinic narratives and dialysis records. Rates of natural deaths were compared by birth cohorts and birth weight, and hazard ratios were calculated using Cox proportional hazards methods, by birth weight and adjusted for birth cohort and sex. Over follow-up of 19,661 person-years, 61 people died of natural causes between age 15 and the censor date. Low birth weights (<2.5 kg) were associated with higher rates of natural death, with HR (95% CI) 1.76 (1.1–2.9,P=0.03), after adjustment for year of birth and sex. The effect was particularly prominent for deaths at <41 years of age, and with deaths from respiratory conditions/sepsis and unusual causes. A predisposing effect of low birth weight on adult deaths was confirmed. This phenomenon, occurring in the context of dramatically improved survivals of lower birth weight infants and children since the early 1960s, helps explain the current epidemic of chronic disease in Aboriginal people. Birth weights continue to improve, so excess deaths from this source should progressively be minimized.
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Riely, Marsha. "Facilitating Children’s Grief." Journal of School Nursing 19, no. 4 (August 2003): 212–18. http://dx.doi.org/10.1177/10598405030190040601.
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A program of education and support is essential for children and their parent or adult caregivers when the children have experienced the death of a significant person. Children need guidance on how to deal with their profound feelings of grief. The purpose of this article is to give school nurses the ability to help children face the strange new world that follows the death experience. The review of literature defines commonly used terms, describes the mourning process experienced by children, and offers school nurses basic information about grief. The article presents the critical elements necessary for planning and implementing a 6-week grief education and support program that offers children and their parent or adult caregivers permission to grieve and the tools with which to process grief.
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Høgsnes, Linda, Karl-Gustaf Norbergh, Ella Danielson, and Christina Melin-Johansson. "The Shift in Existential Life Situations of Adult Children to Parents with Dementia Relocated to Nursing Homes." Open Nursing Journal 10, no. 1 (August 25, 2016): 122–30. http://dx.doi.org/10.2174/1874434601610010122.
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Background: Previous research describes spouses and adult children of people with dementia as a homogeneous group using one term: family caregivers. Recent research shows that the needs and experiences of spouses and adult children differ, therefore they cannot be studied as a homogeneous group. Aims: The aim of the study was to describe the shift in existential life situations of adult children of a parent with dementia relocated to nursing homes. Design: This is a qualitative study with an interpretive approach. Methods: Face-to-face interviews were held with 11 adult children aged 48-65 years. The interviews lasted 30–60 minutes and data were analysed using interpretive content analysis. Findings: The adult children described how they experienced their life situation before and after their parents’ relocation. Before relocation they described feelings of powerlessness, loneliness in their responsibilities, loss and guilt. After relocation they had feelings of freedom, ongoing responsibility, living with loss and having a new relationship with death. Conclusion: The most important finding in our study was that adult children developed a different relationship with death than before the parent became affected by dementia. It is essential that healthcare staff understand and address the adult children’s existential life situations and the suffering they are experiencing. Healthcare staff need to be conscious about adult children’s needs for support to address their existential life situations before and after their parents relocate to nursing homes.
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Lee, Hyo Jung, and Jacobbina Jin Wen Ng. "Conversations About Death and Dying, End-of-Life Care Plans and Preferences Between Aging Parents and Adult Children." Innovation in Aging 4, Supplement_1 (December 1, 2020): 417. http://dx.doi.org/10.1093/geroni/igaa057.1345.
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Abstract This study aims to investigate whether attitude and perception on late-life death and dying, end-of-life care plans and preferences could be better understood from current values shared between aging parents and their adult children in the multi-cultural city-bound country, Singapore. We are in the process of interviewing 20 aging parent-adult child dyads. Up to date, six semi-structured interviews were completed and transcribed. We performed Content analysis to analyze the transcripts. Preliminary findings showed that both aging parents and adult children rarely discussed this issue, although parents had their own plans or preferences. The major barriers against open conversations about death and dying of aging parents include: the perception of not-yet time to talk about this issue (without knowing when the right time is) and tendency to have conversations about death in tandem with finances, but not death itself. Although specific end-of-life care plans or arrangements were not thought out thoroughly, aging parents expressed a high level of trust and reliance on close family members’ decisions regarding their end-of-life care. They tended to agree on joint decision-making process within family, even though adult children had no or unmatched ideas about their aging parents’ end-of-life wishes. This did not necessarily align with previous findings in Western countries, underscoring individuals’ control over their own death and dying process. Open conversation within family, family-involved advance care planning, or joint decision-making processes may be warranted to promote quality of life and death in older Singaporeans and well-being of their family members of all ages.
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Barclay, Kieron J., Robyn Donrovich Thorén, Heidi A. Hanson, and Ken R. Smith. "The Effects of Marital Status, Fertility, and Bereavement on Adult Mortality in Polygamous and Monogamous Households: Evidence From the Utah Population Database." Demography 57, no. 6 (September 15, 2020): 2169–98. http://dx.doi.org/10.1007/s13524-020-00918-z.
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AbstractAlthough the associations among marital status, fertility, bereavement, and adult mortality have been widely studied, much less is known about these associations in polygamous households, which remain prevalent across much of the world. We use data from the Utah Population Database on 110,890 women and 106,979 men born up to 1900, with mortality follow-up into the twentieth century. We examine how the number of wife deaths affects male mortality in polygamous marriages, how sister wife deaths affect female mortality in polygamous marriages relative to the death of a husband, and how marriage order affects the mortality of women in polygamous marriages. We also examine how the number of children ever born and child deaths affect the mortality of men and women as well as variation across monogamous and polygamous unions. Our analyses of women show that the death of a husband and the death of a sister wife have similar effects on mortality. Marriage order does not play a role in the mortality of women in polygamous marriages. For men, the death of one wife in a polygamous marriage increases mortality to a lesser extent than it does for men in monogamous marriages. For polygamous men, losing additional wives has a dose-response effect. Both child deaths and lower fertility are associated with higher mortality. We consistently find that the presence of other kin in the household—whether a second wife, a sister wife, or children—mitigates the negative effects of bereavement.
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Stokes, Jeffrey E., Kyungmin Kim, and Deborah Carr. "BEREAVEMENT IN A FAMILY CONTEXT." Innovation in Aging 3, Supplement_1 (November 2019): S604. http://dx.doi.org/10.1093/geroni/igz038.2247.
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Abstract Bereavement is an impactful, often difficult experience for individuals throughout the life course. Moreover, bereavement experiences inherently involve wider family networks: The death of a spouse is often also the death of a parent, grandparent, or sibling, as well. The present symposium investigates a variety of different family loss experiences that individuals are exposed to in adulthood and older age, and situates such bereavement in a larger family context. Stahl explores how daily routines and sleep patterns can be altered by spousal bereavement, and assesses an intervention designed to improve widowed older adults’ behaviors and, in turn, reduce their depressive symptomology. Kim and colleagues analyze the death of a parent in adulthood, examining the extent to which pre-loss relationship quality and relationship importance may predict post-loss symptoms of grief. Stokes and colleagues extend this intergenerational perspective, examining the death of a grandparent in adulthood, and whether adult grandchildren’s relationships with their middle-generation parents – bereaved adult children themselves – impact their experiences of grief after loss. Focus is also paid to the influence of gender across all three generations. Lastly, Donnelly explores the cumulative consequences of experiencing multiple family deaths throughout the life course for adults’ health trajectories. Together, these papers expand the scope of bereavement research to incorporate spousal, multigenerational, and cumulative loss experiences and their repercussions for midlife and older adults. As discussant, Carr will assess the contributions of these papers to theory and the literature, and highlight potential directions for future research concerning aging, families, and bereavement.
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Husin, Mohammad, Gina Noor Djalilah, R. A. Kaniraras, and Afrita Amalia Laitupa. "The difference in severity and management between children and adult's cases of COVID-19." Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya 5, no. 1 (January 26, 2021): 1. http://dx.doi.org/10.30651/jqm.v5i1.6229.
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AbstractCOVID-19 (Coronavirus Disease 2019) has been started in Wuhan, China, and spread worldwide and resulting in many cases of death. COVID-19 attacks the respiratory tract acutely and infected both children and adults. The number of cases in children is less than in adults. By seeing from the clinical aspect, the COVID-19 case in children is milder. There are differences in immunology responses in children and adults where children have higher immunology response of COVID-19 than adults. Meanwhile, if the immunology response is slow in adults, it may cause them infected by COVID-19 with severe symptoms. There are some relations between immunization with immunology response to SARS-CoV-2 where children who already have BCG vaccination has lower infection rates of acute respiratory tract case. This study aims to know the difference between COVID-19 cases that infected adults and children seen in various aspects.Keywords : COVID-19,SARS-CoV-2, children, adult, severity, managementCorrespondence : mohammad_husin@yahoo.com
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Black, Helen K., and Robert L. Rubinstein. "Narratives of Three Elderly African-American Women Living in Poverty Who have Lost an Adult Child to Horrendous Death." OMEGA - Journal of Death and Dying 38, no. 2 (March 1999): 143–61. http://dx.doi.org/10.2190/1nkp-axbp-9rla-a5uh.
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Fifty Elderly African-American Women Living In Poverty Were Interviewed For A Research Project Entitled “Chronic Poverty And The Self In Later Life” Which Studies The Effects Of Long-Term Poverty On Women's Self-Concepts. The Fact That Ten Women Out Of The Forty-Five Women In Our Sample Who Bore Children Lost Them To Murder, drugs, or other forms of violence made the subject of horrendous death (Leviton, 1995) salient during data analysis. Interview transcripts from three women who lost children to horrendous death were examined for reactions to the children's deaths and subsequent thoughts and feelings about their own deaths. Key themes emerging from the women's narratives were: 1) women's experience with poverty and abandonment, their expectation that life includes suffering, and their religious faith assisted them in grief work; 2) currently, women focused on present joys and concerns rather than on past sorrows; 3) women did not articulate thoughts about their own deaths in light of their child(ren)‘s deaths; and 4) women doubted or negated the concept of an afterlife, which contradicts traditional African beliefs and may speak to the loss they endured.
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Renton, Kate, Anton-Paul Thomas Mayer, Lilias Alison, and Daniel Yeomanson. "Factors associated with place of death for children in South Yorkshire: a retrospective cohort study." BMJ Supportive & Palliative Care 10, no. 1 (November 15, 2018): e10-e10. http://dx.doi.org/10.1136/bmjspcare-2018-001584.
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ObjectivesPlace of death (POD) is considered a key quality indicator for adult end of-life care, but paediatric evidence is limited. Data from Child Death Overview Panel (CDOP) databases provides an opportunity to describe trends in POD as regional paediatric palliative medicine (PPM) options have increased. Aims were to identify and describe trends in POD for children in South Yorkshire.MethodsRetrospective cohort study. Anonymised data extracted from five CDOP databases 2008–2015. Data included age, gender, ethnicity, postcode (outward code only), POD, classification and category of death. Descriptive statistical analysis using χ2 test was used to assess intergroup differences.Results748 deaths were notified from 2008 to 2015. Neonatal deaths were excluded, 46% (n=345). Of non-neonatal deaths (n=403), 58% (n=232) were ‘expected’. Of expected deaths (n=232), 19% (n=45) died in home, 19% (n=45) died in hospice and 61% (n=141) died in hospital. This was significantly different from comparable national data which showed considerably more hospital deaths. There was no significant change in POD over time.ConclusionHospital remains the POD for most children, whether deaths are ‘expected’ or not, suggesting specialised PPM should be expanded into the hospital setting. More research is needed regarding preference for POD. This study may help inform future service planning for PPM and hospice development.
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Ramos, Eliza Miranda, Dr Gilberto Gonçalves Facco, and Dr Valter Aragão do Nascimento. "VITAMIN D, IN THE BEST CLINIC IN AUTOIMMUNE, INFLAMMATORY INFECTIOUS AND DEMELINIZING DISEASES." International Journal for Innovation Education and Research 8, no. 4 (April 1, 2020): 554–59. http://dx.doi.org/10.31686/ijier.vol8.iss4.2130.
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The term demyelination is used to characterize any inflammatory changes that occur in the medullary or cephalic region. Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system and in general, besides being inflammatory [08, 25], demyelinating and with significant neuronal degeneration, it is considered an important cause of permanent disability in young adults [02-05]. The inflammatory process occurs by an irregular immune response usually mediated by T cells and acts as autoantigens and leads to destruction of the myelin sheath with genetic predispositions [21]. Thus, these chronic and disabling characteristics place a high cost on public health coffers by temporarily or permanently restricting the economic and social activities of their holders and also impacting the lives of their families in a financial and emotional way [15-18]. Still regarding the high cost treatment to inflammatory-infectious processes, primary and autoimmune demyelinating agents, such as sepsis in the adult and child population is considered a critical disease as the main cause of death in children intensive care in Brazil. In recent years in Brazil [24], the high rate of death from sepsis in Brazilian intensive care units has surpassed deaths from stroke and infarction and approximately 230.000 adult patients undergoing intensive care unit treatment have sepsis and estimated 55.7% of hospitalized patients with sepsis died [24]. It is recognized that Vitamin D deficiency is common in both children and adults hospitalized in severe clinical conditions in intensive care [06-12].
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Lopes, Antonio Alberto, Everaldo Costa, Yara Aragão Costa, Edilson Sacramento, Antonio Ralph Ribeiro de Oliveira Junior, Marcelo Barreto Lopes, and Gildete Barreto Lopes. "Comparative study of the in-hospital case-fatality rate of leptospirosis between pediatric and adult patients of different age groups." Revista do Instituto de Medicina Tropical de São Paulo 46, no. 1 (February 2004): 19–24. http://dx.doi.org/10.1590/s0036-46652004000100004.
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The main objective was to compare the in-hospital case-fatality rate of leptospirosis between pediatric (< 19 years) and adult (>19 years) patients, taking into account gender, renal function, duration of symptoms and jaundice. Medical records of 1016 patients were reviewed. Comparative analysis was restricted to 840 patients (100 pediatric, 740 adults) with recorded information on the variables included in the analysis. Among these patients 81.7% were male and 91.5% were icteric. The case-fatality rate of leptospirosis was 14.4%. The odds of death adjusted for gender, jaundice, duration of symptoms, serum urea and serum creatinine were almost four times higher for the adult than for the pediatric group (odds ratio (OR) = 3.94; 95% confidence interval = 1.19-13.03, p = 0.029). Among adults, increased age was also significantly and independently associated with increased risk of death (p < 0.01). Older patients were also more often treated by dialysis. In conclusion, the data suggest that the in-hospital case fatality rate of leptospirosis is higher for adults than for children and adolescents, even after taking into account the effects of several potential risk factors of death. Among adults, older age was also strongly and independently associated with higher risk of death.
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Humboldt, Sofia von, and Isabel Leal. "INTERGENERATIONAL RELATIONSHIPS AMONG OLDER ADULTS AND ADULT CHILDREN: AMBIVALENT FEELINGS." Innovation in Aging 3, Supplement_1 (November 2019): S179. http://dx.doi.org/10.1093/geroni/igz038.638.
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Abstract Objectives: The relationship of older adults with their adult children involves great emotional complexity and the quality of these relationships is associated with older adults’ well-being. This qualitative study aims to examine how older adults conceptualize intergenerational relationships with adult children. Methods: The present study on qualitative data collected from in-depth interviews was conducted with English and Portuguese older adults living in the community, designed to address their perspectives on intergenerational relations with adult children. 316 older adults participated in our study. The mean age of this group was 71.2 years. 65.3% were women, and a majority (54.7%) had a partner. Results: Content analysis generated four themes: affection and integration; satisfaction in the relationship; privacy and boundaries; financial support. Conclusions: Intergenerational relationships are experienced by older adults with ambivalence and and stress the contradictory expectations of older adults with grandchildren.
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Otani, Hiroyuki, Miwa Ozawa, Tatsuya Morita, Ayako Kawami, Sahana Sharma, Keiko Shiraishi, and Akira Oshima. "The death of patients with terminal cancer: the distress experienced by their children and medical professionals who provide the children with support care." BMJ Supportive & Palliative Care 9, no. 2 (February 4, 2016): 183–88. http://dx.doi.org/10.1136/bmjspcare-2014-000811.
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BackgroundFew studies have been conducted on the experiences of children of terminally ill patients or hospital-based medical professionals supporting such children.AimThis study explored distress among individuals whose parents died of cancer in childhood and among hospital-based medical professionals supporting such children.DesignA qualitative study.Setting/participantsThe sample was 12 adults whose parents had died of cancer in childhood and 20 hospital-based medical professionals supporting children of patients’ with terminal cancer. In-depth interviews were conducted, focusing on the distress experienced by the participants. The data were analysed thematically.ResultsAmong adults whose parents died of cancer in childhood, we identified themes related to the period before death (eg, concealing the parent's illness), the time of death (eg, alienation due to isolation from the parent), soon after death (eg, fear and shock evoked by the bizarre circumstances, regrets regarding the relationship with the deceased parent before death), several years thereafter (ie, distinctive reflection during adolescence, prompted by the parent's absence) and the present time (ie, unresolved feelings regarding losing the parent). We identified seven themes among the medical professionals (eg, lack of knowledge/experience with children, the family's attempts to shield the child from the reality of death, estrangement from the family once they leave the hospital).ConclusionsAn important finding of the study is that the participants’ grief reaction to their parents’ deaths during childhood was prolonged. Moreover, hospital medical professionals may find it difficult to directly support affected children. Comprehensive support involving organisations (eg, local communities) may be necessary for children who have lost a parent.
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Zou, Liping, Ye Zhang, and Rong Zhu. "Thymic Hypertrophy and Sudden Unexpected Death In Adults âA Retrospective Study Of 56 Autopsy Cases." International Journal of Human Anatomy 1, no. 1 (July 22, 2017): 1–8. http://dx.doi.org/10.14302/issn.2577-2279.ijha-17-1538.
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Status thymico-lymphaticus had ever been explained as a cause of sudden death usually in children, but few cases were reported in adults. We sought to determine the relationship between thymic hypertrophy and sudden unexpected death in adult (SUDA), and associated macroscopic and microscopic findings. Adult post mortems from 1984 to 2014 were reviewed and 23 thymic hypertrophy patients without SUDA, 33 thymic hypertrophy patients with SUDA and 172 SUDAs without thymic hypertrophy entered. The data of thymus, lymph nodes, spleen, heart, aorta, and adrenal glands were collected for macroscopic and histological analysis. Ten antibodies were used and applied to 3 children and 46 adult thymus specimens. We found, as an independent factor, thymic hypertrophy increased significantly the risk of SUDA (6.9 folds) in both male and female. Whatâs more, SUDAs associated with thymic hypertrophy were quite younger (22.5 years) than those without it. A majority of patients with hypertrophic thymus had a variable number of accompanied anomalies described as the typical characteristics of status thymico-lymphaticus, but no macroscopic and microscopic findings related to SUDA in patients with thymic hypertrophy. Cytokeratins (CKs) showed distinctly different immunohistochemical expression patterns in individuals who had different death causes and disease background. Instead of a disease entity âstatus thymico-lymphaticusâ is a systematic abnormality with thymic hypertrophy as a feature involving mainly immune and/or cardiovascular system, probably caused by gene mutations.
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Ridenour, Mascella V. "Golf Clubs: Hidden Home Hazard for Children." Perceptual and Motor Skills 86, no. 3 (June 1998): 747–53. http://dx.doi.org/10.2466/pms.1998.86.3.747.
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Different accident patterns for golf equipment were noted for adults and children. Children are more likely than adults to be hit by a golf club as bystanders who entered the swing zone of a golf club. Previous publications investigating accidents involving golf clubs and over 2000 incidents involving emergency room treatment of children injured by golf clubs were reviewed. Most injuries occurred when unsupervised children played with golf clubs at home. When studies limit their focus to accident victims, who are currently being treated in the emergency room, hospital, or outpatient facility, no deaths are reported. A separate analysis of death certificates of children between the ages of 4 and 14 years also identified death as a possible consequence as 19 deaths have been reported to the National Injury Information Clearinghouse. Based on these three sources of data, golf clubs should not be used by children unsupervised given the potential for serious and permanent head injury and death. Recommendations for parents and manufacturers regarding the safety of golf clubs are provided.
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Denfield, Susan W., and Arthur Garson. "Sudden Death in Children and Young Adults." Pediatric Clinics of North America 37, no. 1 (February 1990): 215–31. http://dx.doi.org/10.1016/s0031-3955(16)36841-9.
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Cox, Meredith, Erin Garrett, and James A. Graham. "Death in Disney Films: Implications for Children's Understanding of Death." OMEGA - Journal of Death and Dying 50, no. 4 (June 2005): 267–80. http://dx.doi.org/10.2190/q5vl-klf7-060f-w69v.
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This study examined the potential influence of Disney films on children's concepts of death. A content analysis was performed on 23 death scenes from 10 selected full-length Disney Classic animated films. The portrayal of death focused on five categories: character status; depiction of death; death status; emotional reaction; and causality. The findings indicate that some animated Disney films present scenes that eclipse the permanence and irreversibility of death and often leave deaths (especially those of villains) emotionally unacknowledged. Previous work has shown that many children tend not to discuss death with their friends or parents for many reasons. More importantly, the films may serve as catalysts to introduce the concept of death into discussions between children, peers, and adults.
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BERTI, E., S. SOLLAI, E. ORLANDINI, L. GALLI, M. DE MARTINO, and E. CHIAPPINI. "Analysis of measles-related hospitalizations in Tuscany from 2000 to 2014." Epidemiology and Infection 144, no. 12 (May 31, 2016): 2605–12. http://dx.doi.org/10.1017/s0950268816001023.
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SUMMARYTo evaluate measles incidence and its relevant changes over a 14-year period (2000–2014), we analysed data from the regional hospital discharge database on children and adults hospitalized in Tuscany, Italy. A total of 181 paediatric and 413 adult cases were identified. Despite all the efforts towards regional measles elimination, we observed that the overall measles hospitalization rates for children and adults living in Tuscany globally increased from 0·45 to 0·85/100 000 during the study period (P = 0·001) showing fluctuations due to periodic measles outbreaks. Data stratified by age group showed that the hospitalization rate significantly increased in young adults over the study period, confirming an increase in susceptibility to measles in this subpopulation. Conversely, no statistically significant difference was observed in the hospitalization rate in the other age groups. However, children aged <1 year still exhibit the highest hospitalization rate. Pneumonia represented the most common complication in both the adult and children subsets. No death was reported. Measles still represents a public health problem, and national strategies should be implemented, focusing on emergent susceptible subsets, such as infants and young adults.
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Dong, Jie, Weifeng Xu, Zhigang Ji, and Boju Pan. "Xp11.2 Translocation Renal Cell Carcinoma: Clinical Characteristics and Potential Prognostic Predictors." Disease Markers 2021 (September 1, 2021): 1–7. http://dx.doi.org/10.1155/2021/5647933.
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Background. Xp11.2 translocation renal cell carcinoma, a rare malignancy, has a higher prevalence in children than in adults. It is relatively indolent in children but manifests with an aggressive course in adults. Clinical characteristics and prognostic studies for adult patients are scarce due to its rarity. Methods. This retrospective single-center study consecutively enrolled 24 newly diagnosed Xp11.2 translocation RCC adult patients. Clinical presentations were recorded, and baseline laboratory results and follow-up data were collected. Possible risk factors for progression-free survival and overall survival were first scanned with chi-square tests and t -tests to compare patients who suffered from progression or death with who did not. Multivariate Cox regression was further utilized to identify independent risk factors. Results. Twenty-four adult patients (median age 32, range 16-73), with a male-to-female ratio of 1 : 1, was included from April 2010 to March 2020. After follow-up for 35.7 months (+/- months), seven patients died. With univariate analysis, higher C-reactive protein-to-albumin (CRP/Alb) ratio ( p = 0.028 ), higher baseline fibrinogen ( p = 0.006 ), and presence of distant metastasis ( p = 0.007 ) were associated with progression of the disease; higher preoperative fibrinogen ( p = 0.014 ) and distant metastasis ( p = 0.020 ) were associated with death. With multivariate Cox regression, only baseline fibrinogen level ( p = 0.001 ) was identified as an independent risk factor for progression-free survival; meanwhile, fibrinogen level ( p = 0.048 ) and distant metastasis ( p = 0.043 ) were identified as independent risk factors for survival. Conclusions. Overall, relatively high CRP/Alb ratios, fibrinogen, and distant metastasis were associated with a poor prognosis of Xp11.2 tRCC adult patients; among them, only baseline fibrinogen levels independently predicted the progression of Xp11.2 tRCC; thus, it may help to identify patients with worse progression or death risk.
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Clarke, Ciaran S., and Margo Wrigley. "Suicide-related bereavement and psychiatric morbidity in the elderly." Irish Journal of Psychological Medicine 21, no. 1 (March 2004): 22–24. http://dx.doi.org/10.1017/s0790966700008119.
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AbstractObjectives: We sought to determine whether elderly bereaved patients attending an old-age psychiatry service were more likely to have been bereaved through suicide than through other causes.Methods: We studied the demographic and clinical profiles of all patients attending an old-age psychiatry service who had experienced the death of an adult child. We compared the causes of the deaths of their children with the most recent figures for the national population.Results: Deaths from suicide among the children of the bereaved elderly were commoner than for the age-matched national population.Conclusions: Suicide is more likely than other causes of death to lead to psychiatric morbidity in elderly parents. The needs of elderly survivors should be considered in formulating national strategies for suicide prevention. Further studies are needed on risk factors for complicated bereavement in the elderly.
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Ågesen, Frederik Nybye, Bjarke Risgaard, Sára Zachariasardóttir, Reza Jabbari, Thomas Hadberg Lynge, Ole Ingemann-Hansen, Gyda Lolk Ottesen, et al. "Sudden unexpected death caused by stroke: A nationwide study among children and young adults in Denmark." International Journal of Stroke 13, no. 3 (August 1, 2017): 285–91. http://dx.doi.org/10.1177/1747493017724625.
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Background Stroke is the fifth leading cause of death in young individuals globally. Data on the burden of sudden death by stroke are sparse in the young. Aims The aim of this study was to report mortality rates, cause of death, stroke subtype, and symptoms in children and young adults who suffered sudden death by stroke. Methods We conducted a retrospective, nationwide study including all deaths within Danish borders between 2000–2009 and 2007–2009 in persons aged 1–35 years and 36–49 years, respectively. Two physicians identified all sudden death cases through review of all death certificates. All available autopsy reports and records from hospitals and general practitioners were retrieved and a neurologist identified all sudden death by stroke cases. Results Of the 14,567 deaths in the 10-year period, there were 1,698 sudden death cases, of which 52 (3%) were sudden death by stroke. There was a male predominance (56%) and the median age was 33 years. The incidence of sudden death by stroke in individuals aged 1–49 years was 0.19 deaths per 100,000 person-years. Stroke was hemorrhagic in 94% of cases, whereof subarachnoid hemorrhage was the cause of death in 63% of cases. Seventeen (33%) cases contacted the healthcare system because of neurological symptoms, whereof one was suspected of having a stroke (6%). Conclusions Sudden death by stroke in children and young adults occurs primarily due to hemorrhagic stroke. We report a high frequency of neurological symptoms prior to sudden death by stroke. Increased awareness among healthcare professionals towards stroke symptoms in children and young adults may lead to earlier detection of stroke, and thereby potentially lowering the incidence of sudden death by stroke.
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Koli, Rahul, Srinivas Goli, and Riddhi Doshi. "Epidemiological Transition in Urban Population of Maharashtra." Advances in Epidemiology 2014 (November 18, 2014): 1–11. http://dx.doi.org/10.1155/2014/328102.
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Our objective is to assess epidemiological transition in urban Maharashtra in India in past two decades. We used the medically certified causes of death (MCCD) data from urban areas of Maharashtra, 1990–2006. Cause-specific death rate was estimated, standardized for age groups, and projected by using an exponential linear regression model. The results indicate that the burden of mortality due to noncommunicable conditions increased by 25% between 1990 and 2006 and will add 20% more by 2020. Among specific causes, the “diseases of the circulatory system” were consistently the leading CoD between 1990 and 2006. The “infectious and parasitic disease” and “diseases related to respiratory system” were the second and third leading causes of death, respectively. For children and young population, the leading cause of death was the “certain conditions originating in the prenatal period” and “injury and poisoning,” respectively, among both sexes. Among adults, the leading cause of death was “infectious and parasitic diseases.” In case of the adult female and elderly population, “diseases of circulatory system” caused the most deaths. Overall the findings foster that socioeconomically developed and demographically advanced urban Maharashtra bears the double burden of disease-specific mortality.
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Harden, Cynthia, Torbjörn Tomson, David Gloss, Jeffrey Buchhalter, J. Helen Cross, Elizabeth Donner, Jacqueline A. French, et al. "Practice guideline summary: Sudden unexpected death in epilepsy incidence rates and risk factors." Neurology 88, no. 17 (April 24, 2017): 1674–80. http://dx.doi.org/10.1212/wnl.0000000000003685.
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Objective:To determine the incidence rates of sudden unexpected death in epilepsy (SUDEP) in different epilepsy populations and address the question of whether risk factors for SUDEP have been identified.Methods:Systematic review of evidence; modified Grading Recommendations Assessment, Development, and Evaluation process for developing conclusions; recommendations developed by consensus.Results:Findings for incidence rates based on 12 Class I studies include the following: SUDEP risk in children with epilepsy (aged 0–17 years) is 0.22/1,000 patient-years (95% confidence interval [CI] 0.16–0.31) (moderate confidence in evidence). SUDEP risk increases in adults to 1.2/1,000 patient-years (95% CI 0.64–2.32) (low confidence in evidence). The major risk factor for SUDEP is the occurrence of generalized tonic-clonic seizures (GTCS); the SUDEP risk increases in association with increasing frequency of GTCS occurrence (high confidence in evidence).Recommendations:Level B: Clinicians caring for young children with epilepsy should inform parents/guardians that in 1 year, SUDEP typically affects 1 in 4,500 children; therefore, 4,499 of 4,500 children will not be affected. Clinicians should inform adult patients with epilepsy that SUDEP typically affects 1 in 1,000 adults with epilepsy per year; therefore, annually 999 of 1,000 adults will not be affected. For persons with epilepsy who continue to experience GTCS, clinicians should continue to actively manage epilepsy therapies to reduce seizures and SUDEP risk while incorporating patient preferences and weighing the risks and benefits of any new approach. Clinicians should inform persons with epilepsy that seizure freedom, particularly freedom from GTCS, is strongly associated with decreased SUDEP risk.
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McClure, G. M. G. "Suicide in children and adolescents in England and Wales 1970–1998." British Journal of Psychiatry 178, no. 5 (May 2001): 469–74. http://dx.doi.org/10.1192/bjp.178.5.469.
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BackgroundSuicide rates for England and Wales have been decreasing recently, but rates for young adult males remain high.AimsTo review changes in suicide rates for children and adolescents in England and Wales between 1970 and 1998.MethodRates for suicide, ‘accidental’ death by causes similar to suicide and ‘undetermined’ death for 10–14- and 15–19-year-olds are calculated between 1970 and 1998 using suicide data and estimated mid-year populations obtained from the Office for National Statistics.ResultsThere has been a substantial increase in suicide rate between the 1970s and the 1990s for males aged 15–19 years. This remains true even when ‘undetermined’ and ‘accidental’ death rates for causes similar to suicide are examined. The increase was associated with an increase in self-poisoning with vehicle exhaust gas in the 1980s and an increase in hanging which has continued into the 1990s. Although there was a slight decrease in the official suicide rate for females aged 15–19 years, ‘undetermined’ deaths increased. There is no indication of a major change in suicide rate in 10–14-year-olds.ConclusionsThe substantial increase in suicide rate in 15–19-year-old males may indicate increased psychosocial stress, particularly affecting this group.
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Raqib, Rubhana, Pricila Khan Moly, Protim Sarker, Firdausi Qadri, Nurul Haque Alam, Minnie Mathan, and Jan Andersson. "Persistence of Mucosal Mast Cells and Eosinophils in Shigella-Infected Children." Infection and Immunity 71, no. 5 (May 2003): 2684–92. http://dx.doi.org/10.1128/iai.71.5.2684-2692.2003.
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ABSTRACT Cells of the innate immune system and their mediators were studied at the single-cell level in the rectums of pediatric and adult patients with Shigella infection to better understand why children are at higher risk for severe infection. Adult patients had increased infiltration of mucosal mast cells (MMC) at the acute stage (3 to 5 days after the onset of diarrhea) and eosinophils in early convalescence (14 to 16 days after onset). Increased expression of stem cell factor and prostaglandin H synthase-1 (PGHS-1) was associated with increased tryptase-Ki 67-double-positive MMC in the acute stage and increased apoptosis of MMC, which led to a rapid decline in early convalescence. The eosinophils demonstrated increased expression of major basic protein (MBP), eotaxin, and CCR3, as well as increased necrotic death. The neutrophils showed enhanced α-defensin and lactoferrin expression in the acute phase. In contrast to adults, the pediatric patients demonstrated delayed accumulation of mast cells and eosinophils, while α-defensin expression persisted during convalescence. In contrast, neutrophil counts and lactoferrin expression were reduced in children compared to adults. The results suggest that children with shigellosis have a persistent activation of the innate immune response in the convalescent phase, indicating delayed elimination of Shigella antigens compared to adults.
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Umberson, Debra, and Meichu D. Chen. "Effects of a Parent's Death on Adult Children: Relationship Salience and Reaction to Loss." American Sociological Review 59, no. 1 (February 1994): 152. http://dx.doi.org/10.2307/2096138.
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Davis, Susan L., David P. Furman, and Andrew T. Costarino. "Adult respiratory distress syndrome in children: Associated disease, clinical course, and predictors of death." Journal of Pediatrics 123, no. 1 (July 1993): 35–45. http://dx.doi.org/10.1016/s0022-3476(05)81534-3.
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