IntroductionAlthough the pathogenesis of depressive disorders is not fully elucidated, untreated adolescent depression can lead to serious sequelae such as impaired academic performance and social functioning, substance use disorders, poor self-esteem, and increased risk for suicidal ideation and attempts. Literature on adolescent mental health in Vietnam is limited, despite increased international awareness of this critical issue. This study aimed to investigate the prevalence and associations of depressive symptoms in Vietnamese adolescents.MethodsA cross-sectional, self-administered survey was conducted in five provinces of Vietnam among adolescents aged 14 to 24 years. In addition to collecting participants' demographics, a structured questionnaire was developed to examine depressive symptoms, suicidal ideation, loneliness, and cyberbullying victimization. Depressive symptoms and loneliness were assessed via the PHQ-9 and UCLA Loneliness Scale, respectively. Two-tailed Chi-squared, Mann-Whitney, and Kruskal-Wallis tests were performed to examine associations between variables. Multivariate Logistic regression models were conducted to examine the associations between prior-defined variables and positive depressive symptoms.ResultsAmong 1,600 respondents, 31.8% of participants reported having mild-moderate or severe depressive symptoms. Participants within the moderate-severe depressive symptom group had significantly lower community cohesion scores than those of participants in normal and mild depressive symptom groups (p < 0.05). Youths living alone were more likely to have moderate-severe depressive symptoms (OR 2.16; 95% CI: 1.09–4.25). Cyberbullying had significant associations with depressive severity (OR 1.93; 95% CI 1.38–2.70).ConclusionThe findings of this study characterize various risk and protective factors for depression in Vietnamese youths and adolescents. The results highlight the importance of raising awareness and increasing access to educational resources for depression and other mental health illnesses. With the rising prevalence of depression, parents, teachers, and community leaders play a vital role in addressing mental health problems in adolescents.
Purpose There is mounting evidence of racial and ethnic discrimination in the Canadian health care system. Patient level race and ethnicity data are required to identify potential disparities in clinical outcomes and access to health care. However, it is not known what patient race, ethnicity, and language data are collected by Canadian hospitals. This gap limits opportunities to identify and address inequalities in the health care system. The emergency department (ED) is a major point of contact for many patients accessing the health care system, and is therefore a reasonable place to conduct analysis of patient data collection. This study aims to quantify the proportion of Canadian EDs that collect patient race, ethnicity, and primary language data. Methods We identified all Canadian EDs and distributed a survey to 616 EDs across the country. Results We received responses representing 202 EDs (32.8%). One fifth (20.3%) of responding EDs reported that they collected race and ethnicity data and 38.1% collected primary language data. Reported uses for these data included quality improvement, research, and direct patient care. Conclusion The majority of Canadian EDs do not collect patient race, ethnicity, and language data. This gap limits our ability to identify inequalities in health outcomes or access to health care. Lack of race, ethnicity, and language data also hinders our ability to develop and evaluate programs and interventions that aim to correct these inequalities. Supplementary Information The online version contains supplementary material available at 10.1007/s43678-022-00388-9.
The volume of geriatric surgery is expected to increase dramatically by 2020, requiring a more widespread appreciation of the unique risks and challenges of anesthesia in the elderly. Changes in pharmacokinetics along with age-related changes in organ function have important implications for patient monitoring and dosing of anesthetic, analgesic, and sedative medications. Preoperative screening for risk of postoperative morbidity is improved with an assessment of activities of daily living, and regional anesthesia may be considered to reduce the risk of postoperative delirium, although this remains controversial. Specific homeostatic parameters should be closely monitored in the perioperative period. The approach to anesthesia in geriatric patients should not be merely extrapolated from younger patients, and further evidence specific to geriatric anesthesia will improve surgical outcomes.
Ultrasound technology has rapidly progressed over the past decades to emerge as a portable, versatile imaging modality to complement the physical exam. It has been shown to be superior to clinical exam and equivalent to computed-tomography in detecting many life-threatening conditions, and thus is used in a variety of resuscitative settings, including the front lines of the military. A variety of imaging protocols exist for ultrasound, but in resource-deplete settings such as a disaster scenario, the focused assessment with sonography for trauma (FAST) exam is a rapid and accurate method of determining acute intraperitoneal bleeding. With improving portability, as well as the ability to transmit images to a centralized command hub, it can become a key component of the first responder’s toolkit.
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