scholarly journals School Refusal with Anxiety: a Review of Sixty-Three Cases

1970 ◽  
Vol 15 (3) ◽  
pp. 257-264 ◽  
Author(s):  
Stuart L. Smith
Keyword(s):  
Older Patients ◽  
Separation Anxiety ◽  
School Refusal ◽  
Young Age ◽  
Return To School ◽  
Younger Patients ◽  
School Phobia ◽  
Peak Incidence ◽  
The Family

A review of 63 cases of school refusal with anxiety seen at the Maudsley Hospital, London, England, indicates that the disorder has the following features: 1) peak incidence at age 11 or 12, 2) higher proportion of youngest children in the family, 3) presence of three separate syndromes seems indicated (with some intermixtures), namely, a) separation anxiety in the younger patients and in those whose difficulties started at a young age, b) school phobia in the older patients without previous episodes, and c) depression or withdrawal in some adolescents, 4) excellent prognosis as far as return to school is concerned, although somewhat poorer for patients of age 13 or over.

Wilfulness in School-Phobic Adolescents

1974 ◽  
Vol 125 (588) ◽  
pp. 468-469 ◽  
Author(s):  
Ian Berg ◽  
Tony Collins
Keyword(s):  
Young People ◽  
General Population ◽  
Secondary School ◽  
Early Adolescence ◽  
School Refusal ◽  
School Phobia ◽  
Family Situation ◽  
The Family ◽  
Emotional Upset

School-phobic youngsters have sometimes been described as wilful and stubborn in the family situation (Hersov, 1960), and this tendency has been invoked to explain the particular occurrence of school phobia in early adolescence (Leventhal and Sills, 1964). The emotional upset shown by these young people when faced with the prospect of going to school (Berg, Nichols and Pritchard, 1969), may occasionally appear to be more in the nature of anger, defiance and temper than either fearfulness or misery (Smith, 1970). The fact that in the general population dislike of school is reflected in actual absence only during the secondary school years (Mitchell and Shepherd, 1967) supports the view that assertiveness, which presumably becomes more effective as the child reaches the teens, plays some part in school refusal.

Characteristics and management of school phobia/refusal

1988 ◽  
Vol 2 ◽  
pp. 49-56
Author(s):  
Ian Hay
Keyword(s):  
School Environment ◽  
Management Strategies ◽  
Emotional Problem ◽  
Heterogeneous Group ◽  
Return To School ◽  
Social Emotional ◽  
Psychosomatic Symptoms ◽  
School Phobia ◽  
The Family

School phobics/ref usals form a heterogeneous group of students whose different etiology necessitates an understanding of different management strategies. Although anxiety and psychosomatic symptoms are common traits of the condition, a multi-faceted approach of evaluating and working with the school environment, the family and the student is needed. Younger students have responded well to behaviourally based strategies, while older and adolescent school phobic students are more resistant to treatment, with the school phobia often one aspect of a more complex social-emotional problem. The need to have the student return to school, yet still provide support and understanding to the family and the student is critical. Persistence, consistence and cooperation on the part of the school and family are important factors in the management strategies.

ACUTE KIDNEY INJURY IN ELDERLY PATIENTS

2019 ◽  
Vol 72 (8) ◽  
pp. 1466-1472
Author(s):  
Grażyna Kobus ◽  
Jolanta Małyszko ◽  
Hanna Bachórzewska-Gajewska
Keyword(s):  
Acute Kidney Injury ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Elderly Patients ◽  
Older Patients ◽  
Age Groups ◽  
Kidney Injury ◽  
The Elderly ◽  
Younger Patients ◽  
Common Cause

Introduction: In the elderly, impairment of kidney function occurs. Renal diseases overlap with anatomic and functional changes related to age-related involutionary processes. Mortality among patients with acute renal injury is approximately 50%, despite advances in treatment and diagnosis of AKI. The aim: To assess the incidence of acute kidney injury in elderly patients and to analyze the causes of acute renal failure depending on age. Materials and methods: A retrospective analysis included medical documentation of patients hospitalized in the Nephrology Clinic during the 6-month period. During this period 452 patients were hospitalized in the clinic. A group of 77 patients with acute renal failure as a reason for hospitalization was included in the study. Results: The prerenal form was the most common cause of AKI in both age groups. In both age groups, the most common cause was dehydration; in the group of patients up to 65 years of age, dehydration was 29.17%; in the group of people over 65 years - 43.39%. Renal replacement therapy in patients with AKI was used in 14.29% of patients. In the group of patients up to 65 years of age hemodialysis was 16.67% and above 65 years of age. -13.21% of patients. The average creatinine level in the group of younger patients at admission was 5.16 ± 3.71 mg / dl, in the group of older patients 3.14 ± 1.63 mg / dl. The size of glomerular filtration GFR in the group of younger patients at admission was 21.14 ± 19.54 ml / min, in the group of older patients 23.34 ± 13.33 ml / min. Conclusions: The main cause of acute kidney injury regardless of the age group was dehydration. Due to the high percentage of AKI in the elderly, this group requires more preventive action, not only in the hospital but also at home.

scholarly journals Clinical Characteristics and Prognostic Factors of Early-Onset Pancreatic Neuroendocrine Tumors

2021 ◽  
Vol 28 ◽  
pp. 107327482098682
Author(s):  
Min Shi ◽  
Biao Zhou
Keyword(s):  
Prognostic Factors ◽  
Neuroendocrine Tumors ◽  
Early Onset ◽  
Older Patients ◽  
Clinical Characteristics ◽  
Clinicopathological Characteristics ◽  
Pancreatic Neuroendocrine Tumors ◽  
Chi Square ◽  
Younger Patients ◽  
Significant Difference

Background: The incidence of pancreatic neuroendocrine tumors (PNETs) has increased significantly. The purpose of this study was to analyze the clinical characteristics and prognosis of patients under 50 years old. Methods: Patients with PNETs recorded in the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2015 were analyzed. The clinical characteristics were analyzed by Chi-square test. The Kaplan-Meier method was used to estimate overall survival (OS). Multivariate Cox proportional risk regression analysis was used to determine independent prognostic factors. Results: 2,303 patients included, of which 547 (23.8%) patients were younger than 50 years old. The number of younger patients has increased steadily, while the proportion in total PNETs decreased recently. Compared with older group, the proportion of the Black, grade I/II, and surgery were higher in early-onset PNETs. Liver was the most frequent metastatic site. There was no significant difference in the incidence of different metastatic sites between younger and older PNETs patients, while younger patients had better OS (P < 0.05). Grade, N stage, M stage, and surgery were independent prognostic factors for OS in early-onset PNETs. Conclusions: Younger patients have unique clinicopathological characteristics compared with older patients in PNETs. Better OS was observed in younger patients which might due to the higher proportion of well-differentiated tumor and surgery than older patients.

scholarly journals Patients fifty years and older attending two sexually transmitted disease clinics in Baltimore, Maryland

2016 ◽  
Vol 28 (4) ◽  
pp. 330-344 ◽  
Author(s):  
Susan A Tuddenham ◽  
Kathleen R Page ◽  
Patrick Chaulk ◽  
Erika B Lobe ◽  
Khalil G Ghanem
Keyword(s):  
Sexually Transmitted Infections ◽  
Older Women ◽  
Risk Behaviors ◽  
Sexually Transmitted Disease ◽  
Older Patients ◽  
Transmitted Disease ◽  
Transmitted Infection ◽  
Younger Patients ◽  
Sexually Transmitted ◽  
Younger Men

Many individuals remain sexually active into their eighth decade. Surveillance data suggest that rates of sexually transmitted infections in older patients are increasing. We compared demographics, risk behaviors, and predictors of acute infections in patients 50 years and older versus younger patients attending sexually transmitted disease clinics in Baltimore, Maryland. This was a retrospective study from a large electronic database of visits to two urban sexually transmitted disease clinics between 2005 and 2010. Proportions were compared using the Chi square test. Logistic regression was used to assess predictors of acute sexually transmitted infections in older versus younger groups. It was found that patients over 50 were more likely than younger patients to report never using condoms (32.6% [CI 0.31–0.34] versus 24.1% [CI 0.23–0.25]). The overall prevalence of acute sexually transmitted infections was 18.1% (CI 0.17–0.19) in older and 25.8% (CI 0.25–0.27) in younger patients. Older women were more likely to be diagnosed with trichomoniasis (21.5% [CI 18.6–24.5] versus 13.1% [CI 11.5–14.8]). Black race was predictive of having an acute sexually transmitted infections in younger men (OR 2.2 [CI 1.47–3.35]) and women (OR 2.7 [CI 1.34–5.30]) but not in older men (OR 1.2 [CI 0.79–1.73]) or women (OR 1.2 [CI 0.43–3.15]). Older age was associated with a decreased risk of acute STI diagnosis in younger men and older women only, while having had sex for money or drugs in the past month was predictive only in younger women. Reporting symptoms and increasing numbers of sexual partners in the last six months was predictive of acute sexually transmitted infection diagnosis in all age groups. Older patients seeking care at sexually transmitted disease clinics engage in important risk behaviors. Race, a factor predictive of acute sexually transmitted infections in younger patients is not a significant predictor of sexually transmitted infections in older persons.

Mortality of Public Mental Health Patients: A Singapore Experience

1993 ◽  
Vol 27 (1) ◽  
pp. 36-41 ◽  
Author(s):  
Lionel Chee-Chong Lim ◽  
Li-Ping Sim ◽  
Peak-Chiang Chiam
Keyword(s):  
Mental Health ◽  
General Population ◽  
Older Patients ◽  
Public Mental Health ◽  
Younger Patients ◽  
Standardised Mortality Ratio ◽  
Common Diagnosis ◽  
Mental Health Patients ◽  
Mortality Ratio ◽  
Age And Sex

This study reports the Standardised Mortality Ratio (SMR) by age and sex among public mental health patients in Singapore. The authors also examine the differences between those who were classified as “inpatient deaths” and those who were classified as “outpatient deaths”. Mortality was 5.1 times that of the general population and the SMR was most accentuated in the younger, female patients. Of the 217 deaths documented over two years, schizophrenia was the most common diagnosis. Inpatient deaths (N = 120) occurred in older patients with prior physical illness who died of natural causes. In contrast, outpatient deaths (N = 97) involved younger patients with no previous illness and the majority jumped to their deaths. Mortality studies are necessary in monitoring the efficacy of mental health provisions.

Characteristics, outcomes, and risk factors of ICANS after axicabtagene ciloleucel: Does age matter?

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e19556-e19556
Author(s):  
Kitsada Wudhikarn ◽  
Radhika Bansal ◽  
Arushi Khurana ◽  
Matthew Hathcock ◽  
Michael Ruff ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Older Patients ◽  
Clinical Course ◽  
International Prognostic Index ◽  
Age Groups ◽  
Central Nervous System Involvement ◽  
Microvascular Disease ◽  
B Cell Lymphoma ◽  
Younger Patients

e19556 Background: CD19 chimeric antigen receptor T cell therapy possesses unique side effects including cytokine release syndrome (CRS) and immune effector cell associated neurotoxicity syndrome (ICANS). Age is a major risk factor for ICANS. However, whether ICANS in older patients is different compared to younger patients is unknown. Herein, we report clinical course, outcomes and risk factors for ICANS in older patients with large B cell lymphoma (LBCL) treated with axicabtagene ciloleucel (axi-cel). Methods: We comprehensively reviewed detailed clinical courses of ICANS in 78 adult patients with LBCL treated with axi-cel between June 2016 and October 2020. Incidence, manifestation, risk factors, treatment, and outcomes of ICANS were compared between patients age ≥60 (n=32) and <60 (n=46) years old. Results: Baseline characteristics were comparable between older and younger patients except higher proportion of high international prognostic index and underlying cerebral microvascular disease in older patients. ICANS was observed in 16 patients in the older and 24 patients in the younger age group, with a 30-day incidence of 52% and 50%, respectively. Median time to CRS and ICANS were similar between 2 age groups. The most common initial neurological findings included aphasia, dysgraphia and encephalopathy in both age groups. Table summarizes the characteristics, clinical course and interventions of ICANS in older and younger patients. In Cox regression model, the presence of CRS was the only factor associated with ICANS in both age groups. Age, history of central nervous system involvement and cerebral microvascular disease were not associated with ICANS. Importantly, all patients had complete resolution of ICANS. No elderly patients in our cohort experienced seizure as a manifestation of ICANS. Conclusions: In our study, older age was not a risk factor for ICANS. CRS was the only factor associated with ICANS in both younger and older patients. Incidence, clinical course and neurological outcomes of ICANS in older patients treated with axi-cel were comparable to younger patients. [Table: see text]

School Phobia and Separation Anxiety

1990 ◽  
pp. 179-214 ◽  
Author(s):  
Thomas H. Ollendick ◽  
Neville J. King
Keyword(s):  
Separation Anxiety ◽  
School Phobia

scholarly journals Early prediction of hospital admission for emergency department patients: a comparison between patients younger or older than 70 years

2017 ◽  
Vol 35 (1) ◽  
pp. 18-27 ◽  
Author(s):  
Jacinta A Lucke ◽  
Jelle de Gelder ◽  
Fleur Clarijs ◽  
Christian Heringhaus ◽  
Anton J M de Craen ◽  
...  
Keyword(s):  
Heart Rate ◽  
Hospital Admission ◽  
Older Patients ◽  
Prediction Models ◽  
Age Groups ◽  
Vital Signs ◽  
Area Under The Curve ◽  
University Hospital ◽  
Multivariable Logistic Regression Analysis ◽  
Younger Patients

ObjectiveThe aim of this study was to develop models that predict hospital admission to ED of patients younger and older than 70 and compare their performance.MethodsPrediction models were derived in a retrospective observational study of all patients≥18 years old visiting the ED of a university hospital during the first 6 months of 2012. Patients were stratified into two age groups (<70 years old and ≥70 years old). Multivariable logistic regression analysis was used to identify predictors of hospital admission among factors available immediately after patient arrival to the ED. Validation of the prediction models was performed on patients presenting to the ED during the second half of the year 2012.Results10 807 patients were included in the derivation and 10 480 in the validation cohorts. The strongest independent predictors of hospital admission among the 8728 patients <70 years old were age, sex, triage category, mode of arrival, performance of blood tests, chief complaint, ED revisit, type of specialist, phlebotomised blood sample and all vital signs. The area under the curve (AUC) of the validation cohort for those <70 years old was 0.86 (95% CI 0.85 to 0.87). Among the 2079 patients ≥70 years, the same factors were predictive, except for gender, type of specialist and heart rate; the AUC was 0.77 (95% CI 0.75 to 0.79). The prediction models could identify a group of 10% of patients with the highest risk in whom hospital admission was predicted at ED triage, with a positive predictive value (PPV) of 71% (95% CI 68% to 74%) in younger patients and PPV of 87% (95% CI 81% to 92%) in older patients.ConclusionDemographic and clinical factors readily available early in the ED visit can be useful in identifying patients who are likely to be admitted to the hospital. While the model for the younger patients had a higher AUC, the model for older patients had a higher PPV in identifying the patients at highest risk for admission. Of note, heart rate was not a useful predictor in the older patients.

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