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  • 文章类型: Journal Article
    目的:了解1990年至2019年中国和全球水果摄入不足导致的食管癌(EC)疾病负担,按年龄和性别进行分层。
    方法:合并全球疾病负担研究(GBD2019)以计算死亡人数,标准化死亡率,1990年至2019年,中国和全球按年龄和性别划分的水果摄入量低,导致残疾调整生命年(DALY)和EC的DALY率。应用种群归因分数(PAF)估算了低水果摄入量引起的EC比例。Joinpoint用于估算年均变化百分比(AAPC),以反映中国和全球因水果摄入量不足而导致的EC负担的时间变化趋势。
    结果:在2019年的中国人口中,男性EC的归因DALY为356,000人年,而女性为80,600人年。中国不同年龄组归因标准化死亡率和DALY率随年龄增长而增加,在70岁及以上的人群中达到顶峰。从1990年到2019年在中国,死亡人数,标准化死亡率,由于水果摄入不足而导致的EC的DALY和标准化DALY率呈下降趋势(AAPC:-1.62%,-4.54%,-2.10%和-4.88%,分别),具有统计学意义(P<0.001)。
    结论:中国水果摄入不足导致的欧共体总体负担呈下降趋势。然而,由于人口老龄化,中国的疾病负担仍然高于全球平均水平。因此,预防和健康教育工作应集中在水果摄入量低的人群上。
    OBJECTIVE: To understand the disease burden of esophageal cancer (EC) attributable to inadequate fruit intake in China and global from 1990 to 2019 stratified by age and sex.
    METHODS: Global Burden of Disease Study (GBD 2019) were pooled to calculate the number of deaths, standardized mortality rate, disability-adjusted life years (DALY) and DALY rate of EC attributed to low fruit intake in China and globally by age and sex from 1990 to 2019. The population attributable fractions (PAF) were applied to estimate the proportion of EC caused by low fruit intake. Joinpoint was used to estimate average annual percentage of change (AAPC) to reflect the time change trend of the EC burden attributable to inadequate fruit intake in China and globally.
    RESULTS: In the Chinese population in 2019, the attributable DALY of EC in males was 356,000 person-years, while it was 80,600 person-years in females. The attributable standardized mortality and DALY rates for different age groups in China increased with age, peaking in the group aged 70 years and above. From 1990 to 2019 in China, the number of deaths, standardized mortality rates, DALY and standardized DALY rates of EC attributable to inadequate fruit intake showed a decreasing trend (AAPCs: -1.62%, -4.54%, -2.10% and -4.88%, respectively), with statistical significance (P<0.001).
    CONCLUSIONS: The overall burden of EC attributed to inadequate fruit intake in China has demonstrated a downward trend. However, due to the aging population, the disease burden in China remains higher than the global average. Hence, prevention and health education efforts should focus on the population with low fruit intake.
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  • 文章类型: Journal Article
    准确预测Kirsten大鼠肉瘤(KRAS)突变状态对于晚期结直肠癌患者的个性化治疗至关重要。然而,尽管深度学习模型在某些方面表现优异,他们往往忽视了多项任务之间的协同促进以及全球和本地信息的考虑,这可能会大大降低预测精度。为了解决这些问题,本文提出了一种称为多任务全局-局部协作混合网络(CHNet)的创新方法,旨在更准确地预测患者的KRAS突变状态。CHNet由两个分支组成,可以从分割和分类任务中提取全局和局部特征,分别,并交换补充信息以协作执行这些任务。在两个分支中,我们设计了一个通道混合变压器(CHT)和空间混合变压器(SHT)。这些变压器集成了变压器和CNN的优点,采用级联混合注意力和卷积从两个任务中捕获全局和局部信息。此外,我们创建了一个自适应协同注意(ACA)模块,以促进通过指导分割和分类特征的协同融合。此外,我们引入了一种新颖的类激活图(CAM)损失,以鼓励CHNet学习两个任务之间的互补信息。我们在T2加权MRI数据集上评估CHNet,KRAS突变状态预测准确率达到88.93%,其性能优于代表性的KRAS突变状态预测方法。结果表明,我们的CHNet可以通过多任务协作促进和考虑全局-局部信息的方式更准确地预测患者的KRAS突变状态。这可以帮助医生为患者制定更个性化的治疗策略。
    Accurate prediction of Kirsten rat sarcoma (KRAS) mutation status is crucial for personalized treatment of advanced colorectal cancer patients. However, despite the excellent performance of deep learning models in certain aspects, they often overlook the synergistic promotion among multiple tasks and the consideration of both global and local information, which can significantly reduce prediction accuracy. To address these issues, this paper proposes an innovative method called the Multi-task Global-Local Collaborative Hybrid Network (CHNet) aimed at more accurately predicting patients\' KRAS mutation status. CHNet consists of two branches that can extract global and local features from segmentation and classification tasks, respectively, and exchange complementary information to collaborate in executing these tasks. Within the two branches, we have designed a Channel-wise Hybrid Transformer (CHT) and a Spatial-wise Hybrid Transformer (SHT). These transformers integrate the advantages of both Transformer and CNN, employing cascaded hybrid attention and convolution to capture global and local information from the two tasks. Additionally, we have created an Adaptive Collaborative Attention (ACA) module to facilitate the collaborative fusion of segmentation and classification features through guidance. Furthermore, we introduce a novel Class Activation Map (CAM) loss to encourage CHNet to learn complementary information between the two tasks. We evaluate CHNet on the T2-weighted MRI dataset, and achieve an accuracy of 88.93% in KRAS mutation status prediction, which outperforms the performance of representative KRAS mutation status prediction methods. The results suggest that our CHNet can more accurately predict KRAS mutation status in patients via a multi-task collaborative facilitation and considering global-local information way, which can assist doctors in formulating more personalized treatment strategies for patients.
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  • 文章类型: Journal Article
    背景:研究表明,糖尿病和抑郁症之间存在很强的双向关联,糖尿病会增加患抑郁症的风险,反之亦然。糖尿病患者的抑郁与血糖控制不良有关,并发症,和可怜的自我照顾。
    目的:探讨全球有关糖尿病和抑郁症的研究现状,以帮助了解当前的研究环境并确定潜在的未来研究领域。
    方法:采用文献计量学方法,利用Scopus数据库收集2004年至2023年发布的相关研究文章。分析包含发布模式,重要贡献者,研究重点,流行的主题,最有影响力的文章,旨在辨别新兴的研究课题。
    结果:共确定了3229篇符合检索标准的出版物。在过去的二十年中,与糖尿病和抑郁症有关的出版物数量显着增加。生产力最高的国家是美国(n=1015;31.43%),其次是中国(n=325;10.07%),英国(n=236;7.31%),和德国(n=218;6.75%)。分析描述了抑郁症和糖尿病研究的三个主要主题。首先,探索这种共病的患病率和病因;第二,对干预措施的关注,特别是随机对照试验,旨在加强抑郁症患者的糖尿病管理;最后,对这种双向关系所涉及的危险因素和生物学机制的调查。
    结论:最近对糖尿病和抑郁症之间的关系的兴趣激增。这可以帮助研究人员确定文献中缺乏的领域,并塑造未来的研究。
    BACKGROUND: Studies have shown a strong bidirectional association between diabetes and depression, with diabetes increasing the risk of developing depression and vice versa. Depression among patients with diabetes is associated with poor glycemic control, complications, and poor self-care.
    OBJECTIVE: To explore the present state of research globally concerning diabetes and depression, to aid understanding the current research landscape and identify potential future areas of research.
    METHODS: A bibliometric approach was used, utilizing the Scopus database to gather pertinent research articles released from 2004 to 2023. Analyses encompassed publication patterns, significant contributors, research focal points, prevalent themes, and the most influential articles, aimed at discerning emerging research subjects.
    RESULTS: A total of 3229 publications that met the search criteria were identified. A significant increase in the number of publications related to diabetes and depression has been observed in the past two decades. The most productive nation was the USA (n = 1015; 31.43%), followed by China (n = 325; 10.07%), the UK (n = 236; 7.31%), and Germany (n = 218; 6.75%). Three principal themes in research on depression and diabetes were delineated by the analysis. First, the exploration of the elevated prevalence and etiology of this comorbidity; second, the focus on interventions, particularly randomized controlled trials, aimed at enhancing diabetes management among individuals with depression; and finally, the investigation of the involved risk factors and biological mechanisms underlying this bidirectional relationship.
    CONCLUSIONS: There has been a recent surge of interest in the relationship between diabetes and depression. This could aid researchers to identify areas lacking in the literature and shape future research.
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  • 文章类型: Journal Article
    国际合作在护理信息学研究领域至关重要,以增强我们进行全球相关研究的能力,从而为政策和实践提供信息。在本案例研究中,我们描述了我们如何建立国际研究合作,以评估护士在大流行期间使用技术的经验。我们首先描述合作是如何创建的,以及与我们的工作相关的成功,在强调主持人进行国际合作之前。我们还讨论了我们在这个合作企业中遇到的挑战,使其他希望建立国际合作并从我们的经验中学习的研究人员。
    International collaboration is crucial in the field of nursing informatics research to enhance our ability to conduct globally relevant research that informs policy and practice. In this case study we describe how we have established an international research collaboration to evaluate nurses\' experiences of technology use during the pandemic. We firstly describe how the collaboration was created and the successes associated with our work, before highlighting the facilitators to make an international collaboration work. We also discuss the challenges we have encountered during this collaborative enterprise, to enable other researchers who wish to establish international collaborations and learn from our experiences.
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  • 文章类型: Journal Article
    后院的鸡通常有开放的住房和觅食,促进与环境中存在的感染形式的寄生虫接触,并增加寄生虫感染的风险。球虫病和a虫病是清除鸡中的两种内部寄生虫,会给农民造成生产损失。在低收入和中等收入国家(LMICs)中,这两种疾病的患病率数据很少,但对于评估后院鸡的疾病负担是必要的。本研究使用回归归因方法估算了所有LMICs国家和地区水平的球虫病和a虫病的临床患病率。使用这些寄生虫的已知患病率数据并主要使用气候因素作为预测因子来开发回归模型。为每种疾病开发了二项随机效应模型,以估算患病率。球虫病的总体估计患病率为0.39(95%CI:0.37-0.42),在热带国家的平均患病率较高。总体估计的蛔虫病患病率为0.23(95%CI:0.22-0.25),在热带国家平均患病率较高,温带和大陆性气候。这项研究的结果可以帮助确定不同国家和地区的球虫病和蛔虫病感染的负担,它可以为疾病控制计划提供信息,并鼓励国际联盟促进获得预防措施,改善动物健康,减少生产损失。
    Backyard chickens usually have open housing and scavenge for food, facilitating contact with infective forms of parasites present in the environment and increasing the risk of parasitic infections. Coccidiosis and ascaridiosis are two internal parasites in scavenging chickens that cause production losses to farmers. Prevalence data of these two diseases are scarce in low-income and middle-income countries (LMICs) but necessary to assess the burden of disease in backyard chickens. This study estimates the clinical prevalence of coccidiosis and ascaridiosis at the country and regional levels in all LMICs using regression imputation methods. Regression models were developed with data of known prevalence of these parasites and using primarily climatic factors as predictors. A binomial random effects model was developed for each disease to impute prevalence. The overall estimated prevalence of coccidiosis was 0.39 (95 % CI: 0.37-0.42), with a higher mean prevalence in tropical countries. The overall estimated prevalence of ascaridiosis was 0.23 (95 % CI: 0.22-0.25) with a higher mean prevalence in countries with tropical, temperate and continental climates. The findings of this study can aid to identify the burdens of coccidiosis and ascaridiosis infections across countries and regions, which can inform disease control plans and, and encourage international alliances to facilitate access to preventive measures, improving animal health and reducing production losses.
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  • 文章类型: Journal Article
    流感A/H9病毒在全球野生和国内禽类中传播,继续进化并构成人畜共患风险。近年来,人类感染A/H9N2亚型禽流感病毒(AIV)的人数大大增加,并且出现了携带A/H9N2来源内部基因的新型重组体。使用不同的名称来描述流通和新兴的A/H9谱系。为了解决这个问题,来自动物和公共卫生实验室的国际专家组,由WOAH/FAO动物流感专家网络认可,基于对来自全球采样的A/H9AIV的10,638个血凝素序列的分析,创建了一个实用的谱系分类和命名系统。该系统结合了系统发育关系和流行病学特征,旨在追踪新兴和循环的谱系和进化枝。为了帮助血统和分支分配,已经创建了一个在线工具。这种拟议的分类能够快速理解A/H9AIV的全球传播和演变。
    Influenza A/H9 viruses circulate worldwide in wild and domestic avian species, continuing to evolve and posing a zoonotic risk. A substantial increase in human infections with A/H9N2 subtype avian influenza viruses (AIVs) and the emergence of novel reassortants carrying A/H9N2-origin internal genes has occurred in recent years. Different names have been used to describe the circulating and emerging A/H9 lineages. To address this issue, an international group of experts from animal and public health laboratories, endorsed by the WOAH/FAO Network of Expertise on Animal Influenza, has created a practical lineage classification and nomenclature system based on the analysis of 10,638 hemagglutinin sequences from A/H9 AIVs sampled worldwide. This system incorporates phylogenetic relationships and epidemiologic characteristics designed to trace emerging and circulating lineages and clades. To aid in lineage and clade assignment, an online tool has been created. This proposed classification enables rapid comprehension of the global spread and evolution of A/H9 AIVs.
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  • 文章类型: Journal Article
    这篇评论文章提供了根据摄入而被塑料污染的沿海和海洋鸟类物种的说明,分类法,喂食集群,类型,形状,颜色和致命和亚致命的影响。在七大洲的39个国家/地区发现了受塑料污染的鸟类。全球分析表明,低,全球鸟类都有中等和高塑料摄入。Fulmars,shearwaters,海燕,信天翁,海鸥,和kittiwakes(所有海洋/海鸟)被发现在世界上几个地方的塑料污染。属于Procellariidae的鸟类,Laridae,Diomedeidae(按分类法),食鱼,软体动物,和can食(通过喂养习惯)被塑料污染最多。微塑料,中塑和大塑性(按尺寸),PP,PE,PS,PET,PAN和PVC(按类型),碎片,颗粒,纤维,泡沫,床单,线程,钓鱼线和薄膜(按形状)和白色,蓝色,绿色,黑色,clear,红色和黄色(按颜色)是鸟类最常见的塑料。受塑料污染的几种鸟类属于极度濒危物种,濒危和脆弱的类别。摄入塑料会对鸟类造成直接伤害,导致死亡。此外,塑料衍生的有毒化学添加剂和塑料吸附的有毒化学物质将是一个额外的压力源,导致致命和亚致命的影响,可能对鸟类的健康造成更大的伤害。建议采取一些措施来减少环境中的塑料污染,以保护鸟类和环境。
    This review article provides an account of coastal and marine bird species contaminated with plastics in light of ingestion, taxonomy, feeding clusters, types, shapes, colours and lethal and sublethal effects. Bird species were found contaminated with plastics in 39 locations/countries across the seven continents. Global analysis shows that low, medium and high plastic ingestion occurred in bird species across the globe. Fulmars, shearwaters, petrels, albatrosses, gulls, and kittiwakes (all marine/seabirds) were found contaminated with plastics in several locations in the world. Bird species belonging to the Procellariidae, Laridae, Diomedeidae (by taxonomy), piscivorous, molluscivorous, and cancrivorous (by feeding habits) were most contaminated with plastics. Microplastic, mesoplastic and macroplastic (by sizes), PP, PE, PS, PET, PAN and PVC (by types), fragments, pellets, fibres, foams, sheets, threads, fishing lines and films (by shapes) and white, blue, green, black, clear, red and yellow (by colours) were the most common plastics ingested by birds. Several bird species contaminated with plastics fall within the critically endangered, endangered and vulnerable categories. The ingestion of plastics can cause direct harm to birds resulting in death. In addition, plastic-derived toxic chemical additives and plastic-adsorbed toxic chemicals would be an additional stressor causing both lethal and sublethal effects that can cause greater harm to the health of birds. Several measures are suggested to reduce plastic pollution in the environment to safeguard birds and the environment.
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  • 文章类型: Journal Article
    目的:肝癌是全球和中国的主要健康问题。这项分析调查了中国和全球肝癌的病因和危险因素的死亡和残疾调整生命年(DALYs)。
    方法:收集了全球和中国特有的肝癌死亡数据,DALYs,和年龄标准化率(ASR)来自2019年全球疾病负担研究数据库。肝癌的病因分为五组,危险因素分为三个级别。在不同的地理区域计算每个比例的肝癌负担。使用连接点回归模型评估1990-2019年的趋势。
    结果:2019年全球肝癌死亡人数为484,577人,ASR为每100,000人中5.9人。2019年,中国肝癌死亡ASR升高,男性ASR是全球的1.7倍。DALYs的全球ASR在75-79岁达到峰值,但在中国达到峰值较早。乙型肝炎病毒是全球(39.5%)和中国(62.5%)的突出病因,其次是丙型肝炎病毒和饮酒。在社会人口指数高的国家,非酒精性脂肪性肝炎作为病因学因素的贡献越来越大.由于各种病因导致的肝癌负担在全球范围内都有所下降。然而,代谢危险因素,特别是肥胖,对肝癌负担的贡献越来越大,尤其是男性。
    结论:尽管中国和世界范围内肝癌负担总体呈下降趋势,代谢风险因素的贡献在上升,强调执行有针对性的预防和控制战略以解决区域和性别差距的重要性。
    OBJECTIVE: Liver cancer is a major health concern globally and in China. This analysis investigated deaths and disability-adjusted life years (DALYs) with respect to etiologies and risk factors for liver cancer in China and worldwide.
    METHODS: Global and China-specific data were collected on liver cancer deaths, DALYs, and age-standardized rates (ASRs) from the Global Burden of Disease Study 2019 database. Liver cancer etiologies were classified into five groups and risk factors were categorized into three levels. Each proportion of liver cancer burden was calculated in different geographic regions. The joinpoint regression model were used to assess the trends from 1990-2019.
    RESULTS: Liver cancer accounted for 484,577 deaths worldwide in 2019 with an ASR of 5.9 per 100,000 population. China had an elevated liver cancer death ASR in 2019 and males had an ASR 1.7 times the global rate. The global ASR for DALYs peaked at 75-79 years of age but peaked earlier in China. Hepatitis B virus was the prominent etiology globally (39.5%) and in China (62.5%), followed by hepatitis C virus and alcohol consumption. In high sociodemographic index countries, non-alcoholic steatohepatitis has gained an increasing contribution as an etiologic factor. The liver cancer burden due to various etiologies has decreased globally in both genders. However, metabolic risk factors, particularly obesity, have had a growing contribution to the liver cancer burden, especially among males.
    CONCLUSIONS: Despite an overall decreasing trend in the liver cancer burden in China and worldwide, there has been a rising contribution from metabolic risk factors, highlighting the importance of implementing targeted prevention and control strategies that address regional and gender disparities.
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  • 文章类型: Journal Article
    背景:由于过分拥挤的生活条件和有限的医疗保健资源,在监狱中,镰刀是一个普遍存在的问题。最近发表在《感染与公共卫生杂志》上的一项研究发现,在不同地区和设施的囚犯中,sc疮的患病率差异很大。本综述旨在通过进行系统评价和荟萃分析来确定囚犯中sc疮的全球患病率和预测因素。
    方法:我们遵循系统评价和荟萃分析检查表的首选报告项目来报告我们的系统评价和荟萃分析的结果。相关数据库,包括PubMed,科克伦图书馆,ScienceDirect,和其他灰色文献数据库被用来搜索和检索文章。该研究包括以英语编写的已发表和未发表的研究,用于报告囚犯中人sc疮的患病率。此评论已在PROSPERO上注册。使用I2统计量评估数据的异质性。使用STATA17软件进行荟萃分析,95%的置信区间。研究人员还进行了发表偏倚和敏感性分析。
    结果:该综述包括7项研究,涉及1,309,323名囚犯。所有纳入的研究都涉及横断面研究设计。囚犯中sc疮的患病率从意大利的0.72%到喀麦隆的41.01%不等。囚犯中人类sc疮的全球合并患病率为6.57%(95%CI;2.16-19.94)。根据亚组分析,非洲囚犯sc疮的总体患病率为19.55%(95%CI;9.44-40.45),而非洲以外囚犯的患病率为1.57%(95%CI;0.77-3.19)。在监狱里度过的时间,分享衣服或床,和卫生习惯被发现是与囚犯发展为人类sc疮的可能性显着相关的因素。
    结论:在全世界的囚犯中,人类sc疮的总体患病率很高。在监狱里呆更多时间的囚犯共用衣服或床位,卫生习惯差的人更有可能患上sc疮。因此,政策制定者和计划管理者应努力降低监狱中sc疮的患病率。本系统评价和荟萃分析的方案已在国际前瞻性系统评价注册簿中注册,注册号为CRD42024516064。
    BACKGROUND: Scabies is a widespread issue in prisons due to overcrowded living conditions and limited healthcare resources. A recent study published in the Journal of Infection and Public Health discovered that the prevalence of scabies varies greatly among prisoners in different regions and facilities. This review aimed to determine the global prevalence and predictors of scabies among prisoners by conducting a systematic review and meta-analysis.
    METHODS: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist to report the findings of our systematic review and meta-analysis. Relevant databases including PubMed, Cochrane Library, ScienceDirect, and other grey literature databases were used to search and retrieve articles. The study included both published and unpublished research written in English languages for studies reporting the prevalence of human scabies among prisoners. This review has been registered on PROSPERO. The heterogeneity of the data was evaluated using the I2 statistic. A meta-analysis was conducted using STATA 17 software, with a 95% confidence interval. The researchers also conducted publication bias and sensitivity analysis.
    RESULTS: The review included 7 studies involving 1, 309,323 prisoners. All included studies involved cross-sectional study design. The prevalence of scabies among prisoners ranges from 0.72% in Italy to 41.01% in Cameroon. The global pooled prevalence of human scabies among prisoners was found to be 6.57% (95% CI; 2.16-19.94). According to subgroup analysis, the overall prevalence of scabies among African prisoners was 19.55% (95% CI; 9.44-40.45), while the prevalence among prisoners outside of Africa was 1.57% (95% CI; 0.77-3.19). The length of time spent in prison, sharing of clothing or beds, and hygiene practices were found to be factors that were significantly associated with the likelihood of prisoners developing human scabies.
    CONCLUSIONS: The overall prevalence of human scabies is high among prisoners worldwide. Prisoners who spent more time in prison shared clothing or beds, and had poor hygiene practices were more likely to develop human scabies. Thus, efforts should be made by policymakers and program administrators to decrease the prevalence of scabies in prisons. The protocol for this systematic review and meta-analysis was registered in the International Prospective Register of Systematic Reviews with registration number CRD42024516064.
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  • 文章类型: Journal Article
    背景:自杀是全球年轻人死亡的第二大原因,每年约有52,000例5-19岁儿童和青少年死亡。家族性,社会,心理,行为因素在自杀风险中起重要作用。由于COVID-19大流行等创伤性事件可能导致年轻人的自杀行为,有必要了解青少年自杀的现状,包括它的流行病学,相关因素,大流行的影响,和管理举措。
    方法:我们使用来自全球疾病负担的数据调查了5-19岁儿童和青少年的全球和区域自杀死亡率。受伤,和风险因素研究(GBD)2019年。在世界卫生组织(WHO)六个地区的204个国家和地区检查了1990年至2019年的自杀死亡率。此外,我们利用电子数据库,包括PubMed/MEDLINE和Scopus,并采用了“自杀”等术语的各种组合,“青少年”,\"青春\",\"children\",“风险因素”,“COVID-19大流行”,“预防”,和“干预”,以提供大流行后时代儿科人群自杀的叙述性回顾。
    结果:尽管1990年至2019年全球自杀死亡率呈下降趋势,但仍处于高位。男性因枪支或任何其他指定手段自杀而造成的死亡率均较高。此外,在世卫组织六个地区中,东南亚的自杀率最高。COVID-19大流行似乎增加了年轻人的自杀风险;因此,在大流行期间,仍然非常需要重新审视对自杀儿童和青少年的适当管理。
    结论:当前的叙述性综述整合了有关自杀流行病学和COVID-19大流行影响的最新知识,危险因素,和干预策略。尽管许多研究都描述了大流行前时期年轻人自杀的趋势,需要进一步的研究来调查大流行期间的自杀以及大流行后时期预防自杀的新策略。有必要确定针对年轻人的有效预防策略,特别是那些高风险的人,以及对已经表现出自杀行为的个体的成功治疗。父母应改善对自杀儿童和青少年的护理,学校,社区,和临床参与。
    BACKGROUND: Suicide is the second leading cause of death in young people worldwide and is responsible for about 52,000 deaths annually in children and adolescents aged 5-19 years. Familial, social, psychological, and behavioral factors play important roles in suicide risk. As traumatic events such as the COVID-19 pandemic may contribute to suicidal behaviors in young people, there is a need to understand the current status of suicide in adolescents, including its epidemiology, associated factors, the influence of the pandemic, and management initiatives.
    METHODS: We investigated global and regional suicide mortality rates among children and adolescents aged 5-19 years using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. The suicide mortality rates from 1990 to 2019 were examined in 204 countries and territories across six World Health Organization (WHO) regions. Additionally, we utilized electronic databases, including PubMed/MEDLINE and Scopus, and employed various combinations of terms such as \"suicide\", \"adolescents\", \"youth\", \"children\", \"risk factors\", \"COVID-19 pandemic\", \"prevention\", and \"intervention\" to provide a narrative review on suicide within the pediatric population in the post-pandemic era.
    RESULTS: Despite the decreasing trend in the global suicide mortality rate from 1990 to 2019, it remains high. The mortality rates from suicide by firearms or any other specified means were both greater in males. Additionally, Southeast Asia had the highest suicide rate among the six WHO regions. The COVID-19 pandemic seems to contribute to suicide risk in young people; thus, there is still a strong need to revisit appropriate management for suicidal children and adolescents during the pandemic.
    CONCLUSIONS: The current narrative review integrates up-to-date knowledge on suicide epidemiology and the effects of the COVID-19 pandemic, risk factors, and intervention strategies. Although numerous studies have characterized trends in suicide among young people during the pre-pandemic era, further studies are required to investigate suicide during the pandemic and new strategies for suicide prevention in the post-pandemic era. It is necessary to identify effective prevention strategies targeting young people, particularly those at high risk, and successful treatment for individuals already manifesting suicidal behaviors. Care for suicidal children and adolescents should be improved with parental, school, community, and clinical involvement.
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