As of 2022, the third leading cause of death among teenagers aged 15 to 19 years in the United States was intentional self-harm or suicide, contributing around 17 percent of deaths among age group. The leading cause of death at that time was unintentional injuries, contributing to around 37.4 percent of deaths, while 21.8 percent of all deaths in this age group were due to assault or homicide. Cancer and heart disease, the overall leading causes of death in the United States, are also among the leading causes of death among U.S. teenagers. Adolescent suicide in the United States In 2021, around 22 percent of students in grades 9 to 12 reported that they had seriously considered attempting suicide in the past year. Female students were around twice as likely to report seriously considering suicide compared to male students. In 2022, Montana had the highest rate of suicides among U.S. teenagers with around 39 deaths per 100,000 teenagers, followed by South Dakota with a rate of 33 per 100,000. The states with the lowest death rates among adolescents are New York and New Jersey. Mental health treatment Suicidal thoughts are a clear symptom of mental health issues. Mental health issues are not rare among children and adolescents, and treatment for such issues has become increasingly accepted and accessible. In 2021, around 15 percent of boys and girls aged 5 to 17 years had received some form of mental health treatment in the past year. At that time, around 35 percent of youths aged 12 to 17 years in the United States who were receiving specialty mental health services were doing so because they had thought about killing themselves or had already tried to kill themselves.

This statistic presents the global death rates for the leading causes of death among males aged 15 to 19 years in 2015, per 100,000 population. Road injuries emerged as the leading cause of global deaths among adolescent males aged 15 to 19 years with a death rate of ** per 100,000 population, followed by interpersonal violence and self-harm.

This statistic presents the global death rates for the leading causes of deaths among females aged 15 to 19 years in 2015, per 100,000 population. Maternal conditions emerged as the leading cause of global deaths among adolescent females aged 15 to 19 years with a death rate of **** per 100,000 population, followed by self-harm and road injury.

In 2022, the leading cause of death among teenagers in the United States aged 15 to 19 was accidents or unintentional injuries. At that time, the death rate for accidents among teens aged 15 to 19 years was 22 per 100,000 population.

Rank, number of deaths, percentage of deaths, and age-specific mortality rates for the leading causes of death, by age group and sex, 2000 to most recent year.

In 2022, the leading causes of death among children and adolescents in the United States aged 10 to 14 were unintentional injuries, intentional self-harm (suicide), and cancer. That year, unintentional injuries accounted for around 25 percent of all deaths among this age group. Leading causes of death among older teens Like those aged 10 to 14 years, the leading cause of death among older teenagers in the U.S. aged 15 to 19 years is unintentional injuries. In 2022, unintentional injuries accounted for around 37 percent of all deaths among older teens. However, unlike those aged 10 to 14, the second leading cause of death among teens aged 15 to 19 is assault or homicide. Sadly, the third leading cause of death among this age group is suicide, making suicide among the leading three causes of death for both age groups. Teen suicide Suicide remains a major problem among teenagers in the United States, as reflected in the leading causes of death among this age group. It was estimated that in 2021, around 22 percent of high school students in the U.S. considered attempting suicide in the past year, with this rate twice as high for girls than for boys. The states with the highest death rates due to suicide among adolescents aged 15 to 19 years are Montana, South Dakota, and New Mexico. In 2022, the death rate from suicide among this age group in Montana was 39 per 100,000 population. In comparison, New York, the state with the lowest rate, had just five suicide deaths among those aged 15 to 19 years per 100,000 population.

ObjectivePromoting adolescent health is essential to achieving the goals of the Healthy China 2030 (HC 2030) initiative. As socioeconomic conditions improve and medical practices and disease patterns evolve, adolescent mortality rates and causes of death vary considerably. This study provides up-to-date data on adolescent mortality and causes of death in China, highlighting key areas of focus for investment in adolescent health.MethodsData regarding mortality and causes of death in Chinese adolescents aged 10–19 years were extracted from the Global Burden of Disease study from 1990 to 2019. The data variables were examined according to year, sex, and age. The autoregressive integrated moving average model was used to predict non-communicable disease (NCD) mortality rates and rank changes in the leading causes of death until 2030.ResultsThe all-cause mortality rate (per 100,000 population) of Chinese adolescents aged 10–19 years steadily declined from 1990 (72.6/100,000) to 2019 (28.8). Male adolescents had a higher mortality (37.5/100,000 vs. 18.6 in 2019) and a slower decline rate (percent: −58.7 vs. −65.0) than female adolescents. Regarding age, compared with those aged 10–14 years, the mortality rate of adolescents aged 15–19 years had a higher mortality (35.9/100,000 vs. 21.2 in 2019) and a slower decrease rate (percent: −57.6 vs. −63.2). From 1990 to 2019, the rates of communicable, maternal, and nutritional diseases declined the most (percent: −80.0), while injury and NCDs mortality rates were relatively slow (percent: −50.0 and −60.0). In 2019, the five leading causes of death were road injuries (6.1/100,000), drowning (4.5), self-harm (1.9), leukemia (1.9), and congenital birth defects (1.3). Furthermore, NCDs' mortality rate decreased by −46.6% and −45.4% between 2015–2030 and 2016–2030, respectively.ConclusionA notable decline was observed in all-cause mortality rates among Chinese adolescents aged 10–19 years. In addition, the mortality rates of NCDs are projected to meet the target from the Global Strategy for Women's, Children's, and Adolescents' Health (2016–2030) and HC2030 reduction indicators by 2030. However, it should be noted that injury is the leading cause of death, with sexual and age disparities remaining consistent.

In 2022, the leading causes of death for children aged one to four years in the United States were unintentional injuries and congenital malformations, deformations, and chromosomal abnormalities. At that time, around 31 percent of all deaths among these children were caused by unintentional injuries. Differences in causes of death among children by age Just as unintentional injuries are the leading cause of death among children aged one to four, it is also the leading cause of death for the age groups five to nine and 10 to 14. However, congenital malformations, deformations, and chromosomal abnormalities account for fewer deaths as children become older, while the share of deaths caused by cancer is higher among those aged five to nine and 10 to 14. In fact, cancer is the second leading cause of death among five to nine-year-olds, accounting for around 15 percent of all deaths. Sadly, the second leading cause of death among children aged 10 to 14 is intentional self-harm, with 13 percent of all deaths among those in this age group caused by suicide. Leading causes of death in the United States The leading causes of death in the United States are heart disease and malignant neoplasms. Together, these two diseases accounted for around 40 percent of all deaths in the United States in 2022. That year, COVID-19 was the fourth leading cause of death, with about six percent of all deaths caused by COVID-19. In 2022, the lifetime odds that the average person in the United States would die from heart disease was one in six, while the odds for cancer were one in seven and for COVID-19 one in 23.

BR: Adolescent Fertility Rate: Births per 1000 Women Aged 15-19 data was reported at 42.686 Ratio in 2023. This records a decrease from the previous number of 42.881 Ratio for 2022. BR: Adolescent Fertility Rate: Births per 1000 Women Aged 15-19 data is updated yearly, averaging 81.277 Ratio from Dec 1960 (Median) to 2023, with 64 observations. The data reached an all-time high of 91.302 Ratio in 1960 and a record low of 42.686 Ratio in 2023. BR: Adolescent Fertility Rate: Births per 1000 Women Aged 15-19 data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s Brazil – Table BR.World Bank.WDI: Social: Health Statistics. Adolescent fertility rate is the number of births per 1,000 women ages 15-19.;United Nations Population Division, World Population Prospects.;Weighted average;This is the Sustainable Development Goal indicator 3.7.2 [https://unstats.un.org/sdgs/metadata/].

Number of deaths and mortality rates, by age group, sex, and place of residence, 1991 to most recent year.

BackgroundDecades of steady improvements in life expectancy in Europe slowed down from around 2011, well before the COVID-19 pandemic, for reasons which remain disputed. We aimed to assess how changes in risk factors and cause-specific death rates in different European countries related to changes in life expectancy in those countries before and during the COVID-19 pandemic.MethodsWe used data and methods from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021 to compare changes in life expectancy at birth, causes of death, and population exposure to risk factors in 16 European Economic Area countries (Austria, Belgium, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Luxembourg, the Netherlands, Norway, Portugal, Spain, and Sweden) and the four UK nations (England, Northern Ireland, Scotland, and Wales) for three time periods: 1990–2011, 2011–19, and 2019–21. Changes in life expectancy and causes of death were estimated with an established life expectancy cause-specific decomposition method, and compared with summary exposure values of risk factors for the major causes of death influencing life expectancy.FindingsAll countries showed mean annual improvements in life expectancy in both 1990–2011 (overall mean 0·23 years [95% uncertainty interval [UI] 0·23 to 0·24]) and 2011–19 (overall mean 0·15 years [0·13 to 0·16]). The rate of improvement was lower in 2011–19 than in 1990–2011 in all countries except for Norway, where the mean annual increase in life expectancy rose from 0·21 years (95% UI 0·20 to 0·22) in 1990–2011 to 0·23 years (0·21 to 0·26) in 2011–19 (difference of 0·03 years). In other countries, the difference in mean annual improvement between these periods ranged from –0·01 years in Iceland (0·19 years [95% UI 0·16 to 0·21] vs 0·18 years [0·09 to 0·26]), to –0·18 years in England (0·25 years [0·24 to 0·25] vs 0·07 years [0·06 to 0·08]). In 2019–21, there was an overall decrease in mean annual life expectancy across all countries (overall mean –0·18 years [95% UI –0·22 to –0·13]), with all countries having an absolute fall in life expectancy except for Ireland, Iceland, Sweden, Norway, and Denmark, which showed marginal improvement in life expectancy, and Belgium, which showed no change in life expectancy. Across countries, the causes of death responsible for the largest improvements in life expectancy from 1990 to 2011 were cardiovascular diseases and neoplasms. Deaths from cardiovascular diseases were the primary driver of reductions in life expectancy improvements during 2011–19, and deaths from respiratory infections and other COVID-19 pandemic-related outcomes were responsible for the decreases in life expectancy during 2019–21. Deaths from cardiovascular diseases and neoplasms in 2019 were attributable to high systolic blood pressure, dietary risks, tobacco smoke, high LDL cholesterol, high BMI, occupational risks, high alcohol use, and other risks including low physical activity. Exposure to these major risk factors differed by country, with trends of increasing exposure to high BMI and decreasing exposure to tobacco smoke observed in all countries during 1990–2021.InterpretationThe countries that best maintained improvements in life expectancy after 2011 (Norway, Iceland, Belgium, Denmark, and Sweden) did so through better maintenance of reductions in mortality from cardiovascular diseases and neoplasms, underpinned by decreased exposures to major risks, possibly mitigated by government policies. The continued improvements in life expectancy in five countries during 2019–21 indicate that these countries were better prepared to withstand the COVID-19 pandemic. By contrast, countries with the greatest slowdown in life expectancy improvements after 2011 went on to have some of the largest decreases in life expectancy in 2019–21. These findings suggest that government policies that improve population health also build resilience to future shocks. Such policies include reducing population exposure to major upstream risks for cardiovascular diseases and neoplasms, such as harmful diets and low physical activity, tackling the commercial determinants of poor health, and ensuring access to affordable health services.

BackgroundThe success of the “war on cancer” initiated in 1971 continues to be debated, with trends in cancer mortality variably presented as evidence of progress or failure. We examined temporal trends in death rates from all-cancer and the 19 most common cancers in the United States from 1970–2006.Methodology/Principal FindingsWe analyzed trends in age-standardized death rates (per 100,000) for all cancers combined, the four most common cancers, and 15 other sites from 1970–2006 in the United States using joinpoint regression model. The age-standardized death rate for all-cancers combined in men increased from 249.3 in 1970 to 279.8 in 1990, and then decreased to 221.1 in 2006, yielding a net decline of 21% and 11% from the 1990 and 1970 rates, respectively. Similarly, the all-cancer death rate in women increased from 163.0 in 1970 to 175.3 in 1991 and then decreased to 153.7 in 2006, a net decline of 12% and 6% from the 1991 and 1970 rates, respectively. These decreases since 1990/91 translate to preventing of 561,400 cancer deaths in men and 205,700 deaths in women. The decrease in death rates from all-cancers involved all ages and racial/ethnic groups. Death rates decreased for 15 of the 19 cancer sites, including the four major cancers, with lung, colorectum and prostate cancers in men and breast and colorectum cancers in women.Conclusions/SignificanceProgress in reducing cancer death rates is evident whether measured against baseline rates in 1970 or in 1990. The downturn in cancer death rates since 1990 result mostly from reductions in tobacco use, increased screening allowing early detection of several cancers, and modest to large improvements in treatment for specific cancers. Continued and increased investment in cancer prevention and control, access to high quality health care, and research could accelerate this progress.

The indicator measures the standardised death rate of tuberculosis, HIV and hepatitis (International Classification of Diseases (ICD) codes A15-A19_B90, B15-B19_B942 and B20-B24). The rate is calculated by dividing the number of people dying due to selected communicable diseases by the total population. Data on causes of death (COD) refer to the underlying cause which - according to the World Health Organisation (WHO) - is "the disease or injury which initiated the train of morbid events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury". COD data are derived from death certificates. The medical certification of death is an obligation in all Member States. The data are presented as standardised death rates, meaning they are adjusted to a standard age distribution in order to measure death rates independently of different age structures of populations. This approach improves comparability over time and between countries. The standardised death rates used here are calculated on the basis of the standard European population referring to the residents of the countries. Copyright notice and free re-use of data on: https://ec.europa.eu/eurostat/about-us/policies/copyright

IntroductionThe study aimed to analyze the characteristics of patients admitted to the neurology department of a tertiary hospital who subsequently died, focusing on those with high disease severity.Materials and methodsWe conducted a retrospective cohort study of patients who died among those admitted to the neurology department of a regional tertiary hospital from 2013 to 2021. Clinical, radiological, and laboratory results of the included patients were collected, and their primary diagnoses, duration from time of admission to death, and direct causes of death were analyzed. Furthermore, the patients were categorized into subgroups based on sex (male and female), primary diagnosis (ischemic and non-ischemic stroke), and cancer diagnosis for comparative analysis.ResultsOf 187 deaths, the primary diagnoses were ischemic stroke (131 cases), seizures (19 cases), encephalitis and encephalopathy (18 cases), and other conditions (19 cases). The direct causes of death included ischemic stroke in 68 patients, sepsis in 33, cerebral hemorrhage in 19, pneumonia in 15, acute kidney injury in nine, status epilepticus in seven, and other causes in 36. Pneumonia, cerebral hemorrhage, acute kidney injury, and status epilepticus were the more prevalent direct causes of death in men, whereas ischemic stroke and sepsis were more prevalent in women. Additionally, sepsis, pneumonia, acute kidney injury, and status epilepticus, as direct causes of death, were significantly higher among patients with a primary diagnosis of non-ischemic stroke than among those with a primary diagnosis of ischemic stroke. Furthermore, there were differences in some pre-existing diseases and laboratory findings when comparing between the cancer group and the non-cancer group.DiscussionIschemic stroke was the primary diagnosis and direct cause of death in a high proportion of patients. Other noteworthy direct causes of death were cerebral hemorrhage and infections such as sepsis and pneumonia. Based on these findings, the characteristics and prognoses of patients admitted to neurology departments can be predicted and used for management.

ObjectiveTo determine the long-term survival of patients receiving home hemodialysis (HHD) through self-punctured arteriovenous access.MethodsWe conducted an observational study of all patients receiving HHD at our facility between 2001 and 2020. The primary outcome was treatment survival, and it was defined as the duration from HHD initiation to the first event of death or technique failure. The secondary outcomes were the cumulative incidence of technique failure and mortality. Cox proportional hazard models were used to identify the predictive factors for treatment survival.ResultsA total of 77 patients (mean age, 50.7 years; 84.4% male; 23.4% with diabetes) were included. The median dialysis duration was 18 hours per week, and all patients self-punctured their arteriovenous fistula. During a median follow-up of 116 months, 30 treatment failures (11 deaths and 19 technique failures) were observed. The treatment survival was 100% at 1 year, 83.5% at 5 years, 67.2% at 10 years, and 34.6% at 15 years. Age (adjusted hazard ratio [aHR], 1.07) and diabetes (aHR, 2.45) were significantly associated with treatment survival. Cardiovascular disease was the leading cause of death, and vascular access-related issues were the primary causes of technique failure, which occurred predominantly after 100 months from HHD initiation.ConclusionThis study showed a favorable long-term prognosis of patients receiving HHD. HHD can be a sustainable form of long-term kidney replacement therapy. However, access-related technique failures occur more frequently in patients receiving it over the long term. Therefore, careful management of vascular access is crucial to enhance technique survival.

Abstract

The 1999 Nigeria Demographic and Health Survey (NDHS) is a nationally representative survey of 8,199 women age 15-49 and 3,082 men age 15-64, designed to provide information on levels and trends of fetility, family planning practice, maternal and child health, infant and child mortality, and maternal mortality, as well as awareness of HIV/AIDS and other sexually transmitted diseases (STDs) and female circumcision. Fieldwork for the survey took place between March and May 1999.

OBJECTIVES

The main objective of the 1999 Nigeria Demographic and Health Survey (NDHS) is to provide up-to-date information on reality and childhood mortality levels; nuptiality; fertility preferences; awareness, approval, and use of family planning methods; breastfeeding practices; nutrition levels; and maternal and child health. This information is intended to assist policymakers and administrators in evaluating and designing programmes and strategies for improving health and family planning services in Nigeria.

MAIN RESULTS

Fertility

The total fertility rate during the five years before the survey is 5.2 births per woman. This shows a drop from the level of 6.0 births per woman as reported in the 1990 NDHS and 5.4 from the 1994 Sentinel Survey. The total fertility rate may, however be higher due to evidence that some births were probably omitted in the data. Fertility is substantially higher in the Northeast and Northwest regions and lower in the Southeast, Southwest, and Central regions. Fertility rates are also lower for more educated women.

Childbearing begins early in Nigeria, with about half of women 25 years and above becoming mothers before reaching the age of 20. The median age at first birth is 20.

The level of teenage childbearing has declined somewhat, with the proportion of girls age 15-19 who have either given birth or are pregnant with their first child declining from 28 percent in 1990 to 22 percent in 1999.

Teenage childbearing is higher in rural than urban areas and for those with no education than those with education.

The data from the survey indicate that there is a strong desire for children and a preference for large families with 66 percent of married women and 71 percent of married men indicating a desire to have more children. Even among those with six or more children, 30 percent of married women and 55 percent of married men want to have more children. This indicates a decline for women from the 35 percent reported in the 1990 NDHS. Overall, women report a mean ideal number of children of 6.2, compared with 7.8 children for men.

Despite the increasing level of contraceptive use, the 1999 NDHS data show that unplanned pregnancies are common, with almost one in five births reported to be unplanned. Most of these (16 percent of births) are mistimed (wanted later), while 3 percent were unwanted at all.

Family Planning

Knowledge about family planning methods is increasing in Nigeria, with about 65 percent of all women and 82 percent of all men having heard of at least one method of contraception.

Among women, the pill is the best known method (53 percent) while among men, the condom is the best known method (70 percent). Radio is a main source of information about family planning, with 35 percent of women and 61 percent of men reporting that they heard a family planning message on the radio in the few months before interview. The proportions of women and men who have seen a television message are 23 and 40 percent, respectively. Only 17 percent of women had seen a family planning message in the print media.

The contraceptive prevalence rate in Nigeria has also increased, with 15 percent of married women and 32 percent of married men now using some method of family planning. The use of modem methods is lower at 9 percent for married women and 14 percent for men. Although traditional contraceptive methods are not actively promoted, their use is relatively high with about 6 percent of married women and 17 percent of married men reporting that they are using periodic abstinence or withdrawal. In 1990, only 6 percent of married women were using any method, with only 4 percent using a modern method.

There are significant differentials in levels of family planning use. Urban women and men are much more likely to be using a method than rural respondents. Current use among married women is higher in the Southwest regions (26 percent), Southeast (24 percent), and Central (18 percent) regions than in the Northwest and Northeast (3 percent each). The largest differences occur by educational attainment. Only 6 percent of married women with no education are using a method of contraception, compared with 45 percent of those with more than secondary school.

Users of modern contraception are almost as likely to obtain their methods from government as private sources. Forty-three percent of users obtain their methods from the public sector--mostly government hospitals and health centres--while 43 percent use private medical sources such as pharmacies and private hospitals and clinics; 8 percent get their methods from other private sources like friends, relatives, shops and non-governmental organisations.

Maternal Health

The results of the survey show that antenatal care is not uncommon in Nigeria, with mothers receiving antenatal check-ups from either a doctor, nurse or midwife for two out of three births in the three years preceding the survey. However, the content of antenatal care visits appears to be lacking in at least one respect: survey data indicate deficiencies in tetanus toxoid coverage during pregnancy. Mothers reported receiving the recommended two doses of tetanus toxoid for only 44 percent of births and one dose for I 1 percent of births. Almost 40 percent of births occurred without the benefit of a tetanus vaccination.

In Nigeria, home deliveries are still very common, with almost three in five births delivered at home. Compared with 1990, the proportion of home deliveries has declined, with more births now taking place in health facilities. Increasing the proportion of births occurring in facilities is important since they can be attended by medically trained personnel which can result in fewer maternal deaths and delivery complications. Currently, 42 percent of births are attended by doctors, nurses or midwives.

The 1999 NDHS data show that about one in four Nigerian women age 15-49 reported being circumcised. The practice of female genital cutting is more prevalent in the south and central parts of the country and is almost non-existent in the north.

Child Health

The 1999 NDHS data indicate a decline in childhood vaccination coverage, with the proportion of children fully immunised dropping from 30 percent of children age 12-23 months in 1990 to only 17 percent in 1999. Only a little over half of young children receive the BCG vaccine and the first doses of DPT and polio vaccines. Almost 40 percent of children have not received any vaccination.

Diarrhoea and respiratory illness are common causes of childhood death. In the two weeks before the survey, 11 percent of children under three years of age were ill with acute respiratory infections (ARI) and 15 percent had diarrhoea. Half of children with ARI and 37,percent of those with diarrhoea were taken to a health facility for treatment. Of all the children with diarrhoea, 34 percent were given fluid prepared from packets of oral rehydralion salts (ORS) and 38 percent received a home-made sugar-salt solution.

The infant mortality rate for the five-year period before the survey (early 1994 to early 1999) is 75 per thousand live births. The under-five mortality is 140 deaths per 1,000 births, which means that one in seven children born in Nigeria dies before reaching his/her fifth birthday. However, both these figures are probably considerably higher in reality since an in-depth examination of the data from the birth histories reported by women in the NDHS shows evidence of omission of births and deaths. For this reason, the dramatic decline observed in childhood mortality between the 1990 and 1999 NDHS surveys needs to be viewed with considerably skepticism. Based on the reported birth history information, the infant mortality rate fell from 87 to 75 deaths per 1,000 births, while the under-five mortality rate dropped from 192 to 140.

Problems with the overall levels of reported mortality are unlikely to severely affect differentials in childhood mortality. As expected, mother's level of education has a major effect on infant and child mortality. Whereas the lowest infant mortality rate was reported among children of mothers with post- secondary education (41 per thousand live births), the corresponding figure among infants of mothers with no schooling is 77 per thousand live births.

Data were also collected in the NDHS on the availability of various health services. The data indicate that the vast majority of Nigerian households live within five kilometres of a health facility, with health centres being the closest, followed by clinics and hospitals.

Breasffeeding and Nutrition

Breastfeeding is widely practiced in Nigeria, with 96 percent of children being breastfed. The median duration of breastfeeding is 19 months. Although it is recommended that children be exclusively breastfed with no supplements for the first 4 to 6 months, only 20 percent of children 0-3 months are exclusively breasffed, as are 8 percent of children 4-6 months. Two-thirds of children 4-6 months are being given supplements in addition to breast milk.

In the NDHS, interviewers weighed and measured children under three born to women who were interviewed. Unfortunately, data were either missing or implausible for more than half of these children. Of the half with plausible data, 46 percent of children under 3 are classified as stunted (low height-for-age), 12 percent are wasted (low

BackgroundDepressive disorders, with a prevalence of 15–21%, are among the most common disorders in children and adolescents, and increases the risk of suicide, the second leading cause of death in children aged 10 to 19.AimTo determine the prevalence and correlates of depressive disorders among senior students attending secondary schools in Abeokuta.MethodThe study was conducted in five schools randomly selected from a representative sample and was carried out in 2 phases. In the first phase, students were selected via systematic random sampling and given consent forms and GHQ-12 to administer to the parents. In the second phase, students who returned a signed informed consent form and filled out GHQ-12 were interviewed using MINI-KID, Rosenberg’s Self-Esteem Scale, Family-APGAR, and sociodemographic questionnaire. Multivariate regression analyses were conducted with p-value

AimTo determine the institutional maternal mortality ratio (iMMR) and avoidable factors (AVFs) before and during the COVID-19 pandemic in a tertiary hospital in South Africa.MethodsThis was a retrospective cross-sectional study. We reviewed medical records to compare iMMR and associated AVFs two years before (March 2018 – February 2020) and two years during (March 2020 – February 2022) COVID-19 pandemic.ResultsFifty-eight maternal deaths were recorded but available data was 57 (35 before and 22 during COVID-19 pandemic). The highest iMMR per 100,000 live births over a 12-month period was 329.1 before and 201.8 during COVID-19 pandemic. The mean ages were 31.0 ± 6.9 and 31 ± 6.2 years, p = 0.822 before and during COVID-19 pandemic, respectively. During COVID-19 pandemic, 40.9% (9/22) were diagnosed with COVID-19. Before and during the pandemic, 71.4% (25/35) and 68.2% (15/22) p = 1.0 were admitted into an intensive care unit (ICU), respectively, with corresponding 74.3% (26/35) and 50% (11/22), p = 0.026 requiring mechanical ventilation. There was a significant difference in the primary causes of death (p = 0.009) for the two periods, with preeclampsia with severe features (22.9%, 8/35) being the leading cause before COVID-19 pandemic compared to COVID-19 (31.8%, 7/22) during the pandemic. AVFs related to healthcare professionals were the most common occurring in 22/35 and 12/22 of the deceased before and during COVID-19 pandemic, respectively. Before COVID-19 pandemic, the most frequent patient-, healthcare professional-, and administrative-related AVFs were failure to book for antenatal care, administration of wrong treatment, and lack of ICU/high care bed spaces, respectively. During COVID-19 pandemic, the most common patient-, healthcare professional- and administrative-related AVFs were delay in seeking medical treatment, lack of critical care skills, and unavailability of ICU/high-care bed spaces, respectively.ConclusioniMMR was lower during than before the COVID-19 pandemic. AVFs related to healthcare professionals were the most common.

In the United States, Black people have higher rates of gun homicide than White people across all age groups. As of 2022, gun homicide rates were highest among Black people aged between 15 and 24 years, at ***** gun homicides per 100,000 of the population. In comparison, there were only **** gun homicides per 100,000 of the White population within this age range. However, the risk for gun homicide was greatest among all adolescents and adults between the ages of 15 to 44 in that year. The impact of guns on young Americans In the last few years, firearms have become the leading cause of death for American children and teenagers aged one to 19 years old, accounting for more deaths than car crashes and diseases. School shootings also remain on the rise recently, with the U.S. recording ** times as many school shootings than other high-income nations from 2009 to 2018. Black students in particular experience a disproportionately high number of school shootings relative to their population, and K-12 teachers at schools made up mostly of students of color are more likely to report feeling afraid that they or their students would be a victim of attack or harm. The right to bear arms Despite increasingly high rates of gun-related violence, gun ownership remains a significant part of American culture, largely due to the fact that the right to bear arms is written into the U.S. Constitution. Although firearms are the most common murder weapon used in the U.S., accounting for approximately ****** homicides in 2022, almost **** of American households have at least one firearm in their possession. Consequently, it is evident that firearms remain easily accessible nationwide, even though gun laws may vary from state to state. However, the topic of gun control still causes political controversy, as the majority of Republicans agree that it is more important to protect the right of Americans to own guns, while Democrats are more inclined to believe that it is more important to limit gun ownership.

ObjectiveTo determine the long-term survival of patients receiving home hemodialysis (HHD) through self-punctured arteriovenous access.MethodsWe conducted an observational study of all patients receiving HHD at our facility between 2001 and 2020. The primary outcome was treatment survival, and it was defined as the duration from HHD initiation to the first event of death or technique failure. The secondary outcomes were the cumulative incidence of technique failure and mortality. Cox proportional hazard models were used to identify the predictive factors for treatment survival.ResultsA total of 77 patients (mean age, 50.7 years; 84.4% male; 23.4% with diabetes) were included. The median dialysis duration was 18 hours per week, and all patients self-punctured their arteriovenous fistula. During a median follow-up of 116 months, 30 treatment failures (11 deaths and 19 technique failures) were observed. The treatment survival was 100% at 1 year, 83.5% at 5 years, 67.2% at 10 years, and 34.6% at 15 years. Age (adjusted hazard ratio [aHR], 1.07) and diabetes (aHR, 2.45) were significantly associated with treatment survival. Cardiovascular disease was the leading cause of death, and vascular access-related issues were the primary causes of technique failure, which occurred predominantly after 100 months from HHD initiation.ConclusionThis study showed a favorable long-term prognosis of patients receiving HHD. HHD can be a sustainable form of long-term kidney replacement therapy. However, access-related technique failures occur more frequently in patients receiving it over the long term. Therefore, careful management of vascular access is crucial to enhance technique survival.