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Using data from a national survey (N = 6,979) of young people in their last year in Norwegian secondary schools in 2007 (aged 18 and 19), this paper examines the effect of experience of violence including sexual abuse during childhood (before the age of 13) on the later academic achievement of young people. This investigation includes three types of violence: non-physical, physical and sexual, and two types of victimisation: being abused and witness to abuse. First we investigate the relationship between the experience of various violent acts before the age of 13 and young people's later academic achievement. Second, applying the structural equation modelling technique, we take into account the effect of background factors such as parents' educational attainment and gender, and the effect of mediating factors such as social capital and educational motivation on the academic achievement of the young victims. The results show that exposure to violence during childhood not only directly influences young people's educational outcomes but also exerts indirect influences on their achievement through its impact on young victims' social relations and psychological health.

Using data from a national survey (N=6979) of young people in their last year in Norwegian secondary schools in 2007 (aged 18-19), this article explores the relationship between sexual abuse and experiences of violence amongst young people in Norway and their reporting of suicidal ideation and self-harm. This investigation includes three types of abuse experienced by young people: non-physical, physical and sexual. We investigate suicidal ideation and two types of self-harming behaviour: non-suicidal self-injury (NSSI) and suicidal self-injury (SSI). The analyses that are reported involve descriptive analysis, chi-square and t-tests, and logistic regression. The hypothesis that was confirmed by the analysis was that being subject to sexual abuse or other violence was associated with increased risk of self-harm. The hypothesis that was partially supported by the analysis was that violence experienced during childhood would have more effect on suicidal ideation and self-harm than violence experienced at a later age. Contrary to our expectations, it was found that peer bullying has a stronger effect on young people's suicidal ideation and self-harming behaviours than sexual abuse or physical violence. The implications of these findings for practitioners working with children and youth involve raising awareness about the long-term effects of verbal, physical, sexual, and witnessed abuse.

Background: The incubation period of SARS-CoV-2 remains uncertain, which has important implications for estimating transmission potential, forecasting epidemic trends, and decision-making in prevention and control. Purpose: To estimate the central tendency and dispersion for incubation period of COVID-19 and, in turn, assess the effect of a certain length of quarantine for close contacts in active monitoring. Data Sources: PubMed, Embase, medRxiv, bioRxiv, and arXiv, searched up to April 26, 2020 Study Selection: COVID-19 studies that described either individual-level incubation period data or summarized statistics for central tendency and dispersion measures of incubation period were recruited. Data Extraction: From each recruited study, either individual-level incubation period data or summarized statistics for central tendency and dispersion measures were extracted, as well as population characteristics including sample size, average age, and male proportion. Data Synthesis: Fifty-six studies encompassing 4 095 cases were included in this meta-analysis. The estimated median incubation period for general transmissions was 5.8 days [95% confidence interval (95%CI), 5.3 to 6.2 d]. Median and dispersion were higher for SARS-CoV-2 incubation compared to other viral respiratory infections. Furthermore, about 20 in 10 000 contacts in active monitoring would develop symptoms after 14 days, or below 1 in 10 000 for young-age infections or asymptomatic transmissions. Limitation: Small sample sizes for subgroups; some data were possibly used repeatedly in different studies; limited studies for outside mainland China; non-negligible intra-study heterogeneity. Conclusion: The long, dispersive incubation period of SARS-CoV-2 contributes to the global spread of COVID-19. Yet, a 14-day quarantine period is sufficient to trace and identify symptomatic infections, which while could be justified according to a better understanding of the crucial parameters.

Objective To describe the rates and patterns of initial emergency department (ED) encounters and follow-up care for concussions among Medicaid-insured children before and after the 2013 enactment of Ohio concussion law.Study design Using a time-series design, this study analyzed concussion claim data obtained from Partners for Kids, a pediatric accountable-care organization in Ohio. A total of 12 512 concussions and 48 238 associated claims for services between January 1, 2008, and June 30, 2017, with an initial ED encounter among Medicaid-insured children (ages 0-18 years) were analyzed. The effect of the law on the odds of follow-up care were assessed using generalized estimating equations models, adjusted for sex, age group, and residence location. ResultsOf the total 12 512 concussions, 63.9% occurred in male patients, 70.1% in patients ages 10-18 years, and 65.2% in patients from urban areas. The rate of initial ED encounters for concussions increased from 2008 to 2014 (2.8 to 4.9 per 10 000 members), followed by a decrease in 2016 (4.2 per 10 000 members). A significant increase in follow-up care after the initial ED encounter was observed from pre-law to post-law (OR 1.73, 95% CI 1.61, 1.86). A shift in follow-up care was observed from radiology and ambulance services in pre-law to primary care providers in post-law.Conclusions The Ohio concussion law may have influenced the patterns of initial ED visit and follow-up care for concussions among Medicaid-insured children. Future studies evaluating the impact of the law should analyze the utilization patterns among children with various insurance/payment types. (J Pediatr 2019;206:178-83).

BackgroundThis study focuses on poly-victimization, with the aim of providing a realistic estimation of the prevalence of lifetime victimization in a Norwegian adolescent population (ages 18–19 years).MethodsBased upon the concept from previous research, we applied measures of child poly-victimization on Norwegian data obtained from a national youth survey in 2015 (N = 4,531) to arrive at an estimation of its prevalence. We used variables that measure individual characteristics such as gender and educational aspiration and socio-economic factors such as parents’ education level and home economic situation to derive a social and psychological profile of victimization and poly-victimization among young people. Finally, we estimated the effects of poly-victimization on mental health such as symptoms of depression, anxiety and trauma.ResultsOur study identified a poly-victimization prevalence of 8.6% among young people, i.e. they were exposed to three of all four forms of violence investigated by our study: non-physical violence, witnessing violence against parents, physical violence and sexual abuse. Adolescents of poly-victimization are six times more likely to report depression and anxiety and trauma when compared with those without victimization.ConclusionsPoly-victimization is a phenomenon that heavily burdens many young people across many national contexts. Poly-victims clearly tend to develop depression, anxiety, and posttraumatic stress symptoms. The early detection of sexual abuse, physical violence, and bullying victimization is of critical importance and preventive measures could consider addressing family factors through parental educational programs.

Apatinib is reported to significantly improve the overall survival (OS) of patients with advanced gastric cancer who have previously failed second-line chemotherapy. However, it is not well understood whether apatinib acts by improving progression or by prolonging post-progression survival. Here, based on phase III clinical trial data, the mediating effect of apatinib on patient overall survival was systematically quantified, through progression-free survival (PFS), post-progression survival (PPS), and the disease control rate (DCR). PFS was the primary mediator of the association between apatinib treatment and OS, with an indirect-effect mean survival time ratio of 1.63 (95%CI 1.35-1.97), which mediated 93.5% of the treatment effect. The DCR was also a significant mediator among secondary efficacy endpoints, and had an indirect-effect mean survival time ratio of 1.47 (95%CI 1.20-1.79, 50.9% mediated). Both primary and other targets of the DCR had similar results. The results indicated that apatinib treatment prolongs progression-free survival rather than post-progression survival, and in turn, leads to improved overall survival. Additionally, our study highlights the value of mediation analysis in clinical trials in providing additional information to build upon traditional primary analysis.

Previous research shows that there is a significant and positive relationship between being a victim of violence and experiencing high levels of psychological problems among young people. Conversely, resilience is negatively associated with psychological problems among young people in general, and this negative association is particularly strong among victims of violence. Our study examines resilience among young people (aged ≥ 18 years) who reported being victims of multiple forms of violence during childhood and adolescence using data from two national youth surveys administered in Norway in 2007 (N = 7033) and 2015 (N = 4531), respectively. We first compared the score of resilience, as measured by the Resilience Scale for Adolescents (READ), and the prevalence of poly-victimization, as identified by the number of young people in our study who were exposed to three of the four forms of violence (i.e., non-physical violence, witnessing violence against parents, physical violence, and sexual abuse). Second, we tested our hypothesis using our data and found that resilience—individuals’ capacity to handle adversity, as well as their use of social and cultural resources when facing adversity—moderates the association between poly-victimization and the onset of psychological problems.