Demographic and epidemiological transitions and burden of adolescent healthcare in sub-Saharan Africa: A review.

This review's main objective is to discuss how demographic and epidemiological transitions relate to the burden of adolescent healthcare in sub-Saharan Africa (SSA). The review explicitly discussed the burden of adolescent healthcare, the current African policies on adolescent healthcare, and gaps in the African policies compared with Europe and North America. We also examined how adolescent healthcare policies evolve and documented the recommended essential part of the policy for enhancing its sustainability. The burden of adolescent health is high in SSA with diseases and reproductive health-related problems prevailing among adolescents. However, variations exist in the burden of adolescent healthcare across countries in the region. While some SSA countries are currently undergoing demographic and epidemiological transition processes concerning adolescent health care, the majority are either at an early stage of the transition or yet to commence the process. Policy-makers should consider effective ways to improve adolescents' health in SSA through preventive mechanisms and a multi-dimensional approach.

Compounding inequalities: Adolescent psychosocial wellbeing and resilience among refugee and host communities in Jordan during the COVID-19 pandemic.

PURPOSE: The COVID-19 pandemic and associated risk-mitigation strategies have altered the social contexts in which adolescents in low- and middle-income countries live. Little is known, however, about the impacts of the pandemic on displaced populations, and how those impacts differ by gender and life stage. We investigate the extent to which the pandemic has compounded pre-existing social inequalities among adolescents in Jordan, and the role support structures play in promoting resilience. METHODS: Our analysis leverages longitudinal quantitative survey data and in-depth qualitative interviews, collected before and after the onset of COVID-19, with over 3,000 Syrian refugees, stateless Palestinians and vulnerable Jordanians, living in camps, host communities and informal tented settlements. We utilize mixed-methods analysis combining multivariate regression with deductive qualitative tools to evaluate pandemic impacts and associated policy responses on adolescent wellbeing and mental health, at three and nine months after the pandemic onset. We also explore the role of support systems at individual, household, community, and policy levels. FINDINGS: We find the pandemic has resulted in severe economic and service disruptions with far-reaching and heterogenous effects on adolescent wellbeing. Nine months into the pandemic, 19.3% of adolescents in the sample presented with symptoms of moderate-to severe depression, with small signs of improvement (3.2 percentage points [pp], p<0.001). Two thirds of adolescents reported household stress had increased during the pandemic, especially for Syrian adolescents in host communities (10.7pp higher than any other group, p<0.001). Social connectedness was particularly low for girls, who were 13.4 percentage points (p<0.001) more likely than boys to have had no interaction with friends in the past 7 days. Adolescent programming shows signs of being protective, particularly for girls, who were 8.8 percentage points (p<0.01) more likely to have a trusted friend than their peers who were not participating in programming. CONCLUSIONS: Pre-existing social inequalities among refugee adolescents affected by forced displacement have been compounded during the COVID-19 pandemic, with related disruptions to services and social networks. To achieve Sustainable Development Goal targets to support healthy and empowered development in adolescence and early adulthood requires interventions that target the urgent needs of the most vulnerable adolescents while addressing population-level root causes and determinants of psychosocial wellbeing and resilience for all adolescent girls and boys.

O significado do uso de telas entre adolescentes: causas e consequências / El significado del uso de pantallas entre adolescentes: causas y consecuencias / The signification of the use of screens among adolescents: causes and consequences

RESUMO Objetivo: compreender o significado do uso de telas atribuído pelos adolescentes. Métodos: o presente estudo foi descritivo exploratório, com abordagem qualitativa e referencial teórico-metodológico do interacionismo simbólico. Participaram adolescentes de uma escola pública mineira. Os dados foram coletados através de entrevistas e grupos focais realizados de forma online e analisados conforme a análise temática no período deagosto a dezembro de 2020. Resultados: participaram oito adolescentescom idades entre 14 e 17 anos, que cursavam o ensino médioe relataram que a tela mais usada foi o celular. Os significados atribuídos ao uso de telas estiveram relacionados à possibilidade de interação e praticidade por possibilitar a realização de várias atividades. Houve o reconhecimento que, diante do uso excessivo, é preciso ter momento distante da tela. Após a análise foram desveladas três categorias: 1. Tela é diversidade 2. Tela é interação, 3. É bom parar um pouco. Considerações finais: a pesquisa mostrou que distanciar-se das telas é difícil e que a presença de profissionais da saúde, particularmente relacionados à saúde do adolescente, pode ajudá-los a encontrar alternativas para usar as telas com redução das consequências negativas.

RESUMEN Objetivo: comprender el significado del uso de pantallas asignado por los adolescentes. Métodos: el presente estudio fue descriptivo exploratorio, con abordaje cualitativo y referencial teórico-metodológico del interaccionismo simbólico. Participaron adolescentes de una escuela pública de Minas Gerais-Brasil. Los datos fueron recolectados a través de entrevistas y grupos focales realizados en forma online y analizados conforme el análisis temático en el período de agosto a diciembre de 2020. Resultados: participaron ocho adolescentes con edades entre 14 y 17 años, que cursaban la enseñanza secundaria y relataron que la pantalla más usada fue el celular. Los significados atribuidos al uso de pantallas estuvieron relacionados a la posibilidad de interacción y practicidad por posibilitar la realización de varias actividades. Hubo el reconocimiento de que, ante el uso excesivo, es necesario tener momento alejado de la pantalla. Después del análisis surgieron tres categorías: 1. La pantalla es diversidad; 2. La pantalla es interacción; 3. Es bueno detenerse un poco. Consideraciones finales: la investigación ha demostrado que distanciarse de las pantallas es difícil y que la presencia de profesionales de la salud, particularmente involucrados con la salud del adolescente, puede ayudarles a encontrar alternativas para usar las pantallas con reducción de las consecuencias negativas.

ABSTRACT Objective: to understand the signification of the use of screens attributed by adolescents. Methods: the current study was descriptive and exploratory, with a qualitative approach and theoretical-methodological framework of symbolic interactionism. Adolescents from a public school in Minas Gerais participated in it. Data were collected through interviews and focus groups carried out online and analyzed according to thematic analysis in the period from August to December 2020. Results: it had the participation of eight adolescents aged between 14 and 17 years, who attended high school and reported that the most used screen was the cell phone. The significations attributed to the use of screens were related to the possibility of interaction and practicality for allowing the performance of various activities. There was recognition that, in the face of excessive use, it is necessary to have a moment away from the screen. After the analysis, three categories were revealed: 1. Screen is diversity 2. Screen is interaction, 3. It is good to stop for a while. Final considerations: research has shown that distance from screens is difficult and the presence of health professionals, particularly related to adolescent health, can help them to find alternatives to use screens with reduced negative consequences.

Adolescent Health Series: The health of adolescents in sub-Saharan Africa: Challenges and opportunities.

OBJECTIVE: This article provides a concise overview of the current challenges that adolescents face in sub-Saharan Africa, summarises possible solutions and ongoing efforts to implement these, and briefly introduces the subsequent papers of this series. METHODS: We draw on data from the WHO Maternal, Newborn, Child and Adolescent Health and Ageing Data Portal. RESULTS: The opportunity provided by the growing number of adolescents in sub-Saharan Africa will only be realised if they survive, are healthy, receive a quality education and remain in Africa rather than joining the increasing out-migration exodus. Fortunately, there is an increasing focus on adolescent health and well-being both globally and in sub-Saharan Africa, and growing knowledge of what to do to promote adolescent health and well-being and how to do it, and a powerful resource in the form of adolescents themselves. CONCLUSION: There is no time to lose. African adolescents demand it, but are also ready to be part of the solution.

Continuidad de cuidados en Salud Mental infanto-juvenil

El siguiente artículo indaga las condiciones de articulación de la red socio-sanitaria en las prácticas de salud mental infanto-juvenil en el subsector público de salud en la Ciudad de Buenos Aires, siguiendo el hilo de políticas específicas de continuidad de cuidados en la red de servicios de salud mental en los últimos veinte años y las derivas presentes en la recepción de la llamada niñez en riesgo en sus recorridos de vida, singulares y colectivos. (AU)

Impacto psicológico del aislamiento por COVID-19 en jóvenes de San Carlos de Bariloche, Argentina: la mirada de los padres / Psychological impact of COVID-19 lockdown in children and adolescents from San Carlos de Bariloche, Argentina: Parents' perspective

Introducción. Los jóvenes no fueron muy afectados desde el punto de vista infeccioso por la pandemia de COVID-19. Sin embargo, las medidas de aislamiento social modificaron de manera profunda su estilo de vida, y se cree que esto los afecta psicológicamente. El objetivo fue evaluar el impacto del aislamiento por COVID-19en la salud emocional de jóvenes en escolaridad primaria o secundaria.Población y métodos. Participaron del estudio padres de jóvenes de San Carlos de Bariloche. Se evaluó la percepción del adulto sobre el impacto emocional y de comportamiento del aislamiento sobre el joven, cambio de hábitos de sueño, uso de pantallas, actividades deportivas y alimentación y de asistencia a consulta médica.Resultados. Se incluyeron 267 padres. El 96,3 % observó cambios emocionales y de comportamiento. Los más frecuentes fueron que estaban más aburridos (el 76,8 %), irritables (el 59,2 %), desganados (el 56,9 %) y enojados (el 54,7 %). Se observó que se levantaban y acostaban más tarde y dormían 30 minutos más. Además, el uso de pantallas por esparcimiento aumentó 3 horas durante los días hábiles. El tiempo dedicado a la actividad física no varió, pero sí cambió el tipo de actividades: la natación y los deportes de equipo fueron reemplazados por ciclismo, caminatas y esquí.Conclusiones. El aislamiento por COVID-19impactó sobre la salud emocional y los hábitos de los jóvenes. El aburrimiento, la irritabilidad y el desgano estuvieron más presentes durante el aislamiento. La posibilidad de realizar actividades al aire libre permitió que continuaran practicando deportes.

Introduction. From an infectious perspective, children and adolescents were not highly affected by the COVID-19 pandemic. However, social isolation measures have deeply changed their lifestyle, which is believed to have a psychological impact on them. The objective was to assess the impact of COVID-19 lockdown on the emotional health of children and adolescents attending primary or secondary school.Population and methods. Parents of children and adolescents from San Carlos de Bariloche participated in the study. Adults' perception of the emotional and behavioral impact of lockdown on children and adolescents, changes in sleeping habits, screen use, sports-related activities, eating, and medical consultations, was assessed.Results. A total of 267 parents were included. Of them, 96.3 % noticed emotional and behavioral changes. The most common ones were that their children were more bored (76.8 %), more irritable (59.2 %), more reluctant (56.9 %), and angrier (54.7 %). It was observed that they woke up and went to bed later, and slept 30 minutes more. Moreover, leisure screen use increased by 3 hours on weekdays. Time dedicated to physical activities did not change, but the type of activities did: swimming and team sports were replaced by biking, walking, and skiing.Conclusions. COVID-19 lockdown affected the emotional health and habits of children and adolescents. Boredom, irritability, and reluctance were more present during lockdown. The possibility of doing outdoor physical activities allowed them to keep practicing sports

Psychological impact of COVID-19 lockdown in children and adolescents from San Carlos de Bariloche, Argentina: Parents' perspective. / Impacto psicológico del aislamiento por COVID-19 en jóvenes de San Carlos de Bariloche, Argentina: la mirada de los padres.

INTRODUCTION: From an infectious perspective, children and adolescents were not highly affected by the COVID-19 pandemic. However, social isolation measures have deeply changed their lifestyle, which is believed to have a psychological impact on them. The objective was to assess the impact of COVID-19 lockdown on the emotional health of children and adolescents attending primary or secondary school. POPULATION AND METHODS: Parents of children and adolescents from San Carlos de Bariloche participated in the study. Adults' perception of the emotional and behavioral impact of lockdown on children and adolescents, changes in sleeping habits, screen use, sports-related activities, eating, and medical consultations, was assessed. RESULTS: A total of 267 parents were included. Of them, 96.3 % noticed emotional and behavioral changes. The most common ones were that their children were more bored (76.8 %), more irritable (59.2 %), more reluctant (56.9 %), and angrier (54.7 %). It was observed that they woke up and went to bed later, and slept 30 minutes more. Moreover, leisure screen use increased by 3 hours on weekdays. Time dedicated to physical activities did not change, but the type of activities did: swimming and team sports were replaced by biking, walking, and skiing. CONCLUSIONS: COVID-19 lockdown affected the emotional health and habits of children and adolescents. Boredom, irritability, and reluctance were more present during lockdown. The possibility of doing outdoor physical activities allowed them to keep practicing sports.

Introducción. Los jóvenes no fueron muy afectados desde el punto de vista infeccioso por la pandemia de COVID-19. Sin embargo, las medidas de aislamiento social modificaron de manera profunda su estilo de vida, y se cree que esto los afecta psicológicamente. El objetivo fue evaluar el impacto del aislamiento por COVID-19 en la salud emocional de jóvenes en escolaridad primaria o secundaria. Población y métodos. Participaron del estudio padres de jóvenes de San Carlos de Bariloche. Se evaluó la percepción del adulto sobre el impacto emocional y de comportamiento del aislamiento sobre el joven, cambio de hábitos de sueño, uso de pantallas, actividades deportivas y alimentación y de asistencia a consulta médica. Resultados. Se incluyeron 267 padres. El 96,3 % observó cambios emocionales y de comportamiento. Los más frecuentes fueron que estaban más aburridos (el 76,8 %), irritables (el 59,2 %), desganados (el 56,9 %) y enojados (el 54,7 %). Se observó que se levantaban y acostaban más tarde y dormían 30 minutos más. Además, el uso de pantallas por esparcimiento aumentó 3 horas durante los días hábiles. El tiempo dedicado a la actividad física no varió, pero sí cambió el tipo de actividades: la natación y los deportes de equipo fueron reemplazados por ciclismo, caminatas y esquí. Conclusiones. El aislamiento por COVID-19 impactó sobre la salud emocional y los hábitos de los jóvenes. El aburrimiento, la irritabilidad y el desgano estuvieron más presentes durante el aislamiento. La posibilidad de realizar actividades al aire libre permitió que continuaran practicando deportes.

Adolescent well-being and learning in times of COVID-19-A multi-country study of basic psychological need satisfaction, learning behavior, and the mediating roles of positive emotion and intrinsic motivation.

The sudden switch to distance education to contain the outbreak of the COVID-19 pandemic has fundamentally altered adolescents' lives around the globe. The present research aims to identify psychological characteristics that relate to adolescents' well-being in terms of positive emotion and intrinsic learning motivation, and key characteristics of their learning behavior in a situation of unplanned, involuntary distance education. Following Self-Determination Theory, experienced competence, autonomy, and relatedness were assumed to relate to active learning behavior (i.e., engagement and persistence), and negatively relate to passive learning behavior (i.e., procrastination), mediated via positive emotion and intrinsic learning motivation. Data were collected via online questionnaires in altogether eight countries from Europe, Asia, and North America (N = 25,305) and comparable results across countries were expected. Experienced competence was consistently found to relate to positive emotion and intrinsic learning motivation, and, in turn, active learning behavior in terms of engagement and persistence. The study results further highlight the role of perceived relatedness for positive emotion. The high proportions of explained variance speak in favor of taking these central results into account when designing distance education in times of COVID-19.

Global, regional, and national mortality trends in youth aged 15-24 years between 1990 and 2019: a systematic analysis.

BACKGROUND: The global health community is devoting considerable attention to adolescents and young people, but risk of death in this population is poorly measured. We aimed to reconstruct global, regional, and national mortality trends for youths aged 15-24 years between 1990 and 2019. METHODS: In this systematic analysis, we used all publicly available data on mortality in the age group 15-24 years for 195 countries, as compiled by the UN Inter-agency Group for Child Mortality Estimation. We used nationally representative vital registration data, estimated the completeness of death registration, and extracted mortality rates from surveys with sibling histories, household deaths reported in censuses, and sample registration systems. We used a Bayesian B-spline bias-reduction model to generate trends in 10q15, the probability that an adolescent aged 15 years would die before reaching age 25 years. This model treats observations of the 10q15 probability as the product of the actual risk of death and an error multiplier that varies depending on the data source. The main outcome that we assessed was the levels of and trends in youth mortality and the global and regional mortality rates from 1990 to 2019. FINDINGS: Globally, the probability of an individual dying between age 15 years and 24 years was 11·2 deaths (90% uncertainty interval [UI] 10·7-12·5) per 1000 youths aged 15 in 2019, which is about 2·5 times less than infant mortality (28·2 deaths [27·2-30·0] by age 1 year per 1000 live births) but is higher than the risk of dying from age 1 to 5 (9·7 deaths [9·1-11·1] per 1000 children aged 1 year). The probability of dying between age 15 years and 24 years declined by 1·4% per year (90% UI 1·1-1·8) between 1990 and 2019, from 17·1 deaths (16·5-18·9) per 1000 in 1990; by contrast with this total decrease of 34% (27-41), under-5 mortality declined by 59% (56-61) in this period. The annual number of deaths declined from 1·7 million (90% UI 1·7-1·9) in 1990 to 1·4 million (1·3-1·5) in 2019. In sub-Saharan Africa, the number of deaths increased by 20·8% from 1990 to 2019. Although 18·3% of the population aged 15-24 years were living in sub-Saharan Africa in 2019, the region accounted for 37·9% (90% UI 34·8-41·9) of all worldwide deaths in youth. INTERPRETATION: It is urgent to accelerate progress in reducing youth mortality. Efforts are particularly needed in sub-Saharan Africa, where the burden of mortality is increasingly concentrated. In the future, a growing number of countries will see youth mortality exceeding under-5 mortality if current trends continue. FUNDING: UN Children's Fund, Bill & Melinda Gates Foundation, United States Agency for International Development.

Genetic Influences on the Covariance and Genetic Correlations in a Bivariate Twin Model: An Application to Well-Being.

The distinction between genetic influences on the covariance (or bivariate heritability) and genetic correlations in bivariate twin models is often not well-understood or only one is reported while the results show distinctive information about the relation between traits. We applied bivariate twin models in a large sample of adolescent twins, to disentangle the association between well-being (WB) and four complex traits (optimism, anxious-depressed symptoms (AD), aggressive behaviour (AGG), and educational achievement (EA)). Optimism and AD showed respectively a strong positive and negative phenotypic correlation with WB, the negative correlation of WB and AGG is lower and the correlation with EA is nearly zero. All four traits showed a large genetic contribution to the covariance with well-being. The genetic correlations of well-being with optimism and AD are strong and smaller for AGG and EA. We used the results of the models to explain what information is retrieved based on the bivariate heritability versus the genetic correlations and the (clinical) implications.

Does the Temporal Pattern of Moving to a Higher-Quality Neighborhood Across a 5-Year Period Predict Psychological Distress Among Adolescents? Results From a Federal Housing Experiment.

Using data from the Moving to Opportunity (MTO) experiment (1994-2002), this study examined how a multidimensional measure of neighborhood quality over time influenced adolescent psychological distress, using instrumental variable (IV) analysis. Neighborhood quality was operationalized with the independently validated 19-indicator Child Opportunity Index (COI), linked to MTO family addresses over 4-7 years. We examined whether being randomized to receive a housing subsidy (versus remaining in public housing) predicted neighborhood quality across time. Using IV analysis, we tested whether experimentally induced differences in COI across time predicted psychological distress on the Kessler Screening Scale for Psychological Distress (n = 2,829; mean ß = -0.04 points (standard deviation, 1.12)). The MTO voucher treatment improved neighborhood quality for children as compared with in-place controls. A 1-standard-deviation change in COI since baseline predicted a 0.32-point lower psychological distress score for girls (ß = -0.32, 95% confidence interval: -0.61, -0.03). Results were comparable but less precisely estimated when neighborhood quality was operationalized as simply average post-random-assignment COI (ß = -0.36, 95% confidence interval: -0.74, 0.02). Effect estimates based on a COI excluding poverty and on the most recent COI measure were slightly larger than other operationalizations of neighborhood quality. Improving a multidimensional measure of neighborhood quality led to reductions in low-income girls' psychological distress, and this was estimated with high internal validity using IV methods.

Violence against children and adolescents: notification and alert in times of pandemic / Violência contra crianças e adolescentes: notificações e alerta em tempos de pandemia

ABSTRACT Objective: Social isolation is currently identified as the best way to prevent the infection by the new coronavirus. However, for some social groups, such as children and adolescents, this measure carries a contradiction: the home, which should be the safest place for them, is also a frequent environment of a sad aggravation: domestic violence. This study aims to evaluate the notifications of interpersonal/self-inflicted violence available in the Information System for Notifiable Diseases in the State of Santa Catarina (southern Brazil), for the juvenile age group, before and during the new coronavirus pandemics. Methods: Cross-sectional, descriptive study of violence against children and adolescents (from 0 to 19 years) notified by health professionals by completing and entering the occurrence in the Information System for Notifiable Diseases of the State of Santa Catarina in 11 weeks in which the social isolation measure was instituted as mandatory, comparing with the same period before this measure. Results: During the study period, 136 municipalities in Santa Catarina made 1,851 notifications. There was a decrease of 55.3% of them in the isolation period, and the difficulties encountered in seeking protection and assistance institutions were listed. Conclusions: The society needs to be aware of possible cases of violence in the children and adolescent population. It is important to provide accessible, effective, and safe ways for complaints and notifications, as well as a quick response to the cases, aiming at protecting victims and minimizing damages to prevent the perpetuation of the violence.

RESUMO Objetivo: O isolamento social é identificado, no momento, como a melhor forma para evitar o contágio pelo novo coronavírus. Porém, para alguns grupos sociais, como crianças e adolescentes, essa medida carrega uma contradição: o lar, que deveria ser o local mais seguro para eles, é também um ambiente frequente de um triste agravo, a violência doméstica. Este estudo visou avaliar e comparar as notificações compulsórias de violências interpessoais/autoprovocadas disponíveis no Sistema de Informação de Agravos de Notificação do Estado de Santa Catarina, pré e pós-pandemia do novo coronavírus. Métodos: Estudo transversal, descritivo e analítico das violências contra crianças e adolescentes (de 0 a 19 anos de idade completos) notificadas pelos profissionais de saúde mediante o preenchimento e a inserção das ocorrências no Sistema de Informação de Agravos de Notificação do Estado de Santa Catarina, no período de 11 semanas em que foi instituída como obrigatória a medida de isolamento social, comparando tais eventos com os de igual período anterior a essa medida. Resultados: No período estudado, 136 municípios catarinenses realizaram 1.851 notificações. Houve diminuição de 55,3% destas no período de isolamento, listando-se possíveis dificuldades encontradas para a procura de instituições de proteção e assistência. Conclusões: Alerta-se para a necessidade de a sociedade estar atenta para a suspeita e evidência dos casos de violência na população infantojuvenil, e ressalta-se a importância de que sejam propiciadas formas acessíveis, eficazes e seguras, como incentivo para as denúncias, a notificação e o rápido atendimento dos casos, visando à proteção das vítimas, à minimização dos danos e, assim, ao impedimento da perpetuação da violência.

Trends in Cancer Incidence in US Adolescents and Young Adults, 1973-2015.

Importance: Previous studies have demonstrated that adolescents and young adults (AYAs) with cancer are a distinct cancer population; however, research on long-term epidemiological trends and characteristics of cancers in AYAs is lacking. Objective: To characterize the epidemiology of cancer in AYAs aged 15 to 39 years with respect to (1) patient demographic characteristics, (2) frequencies of cancer types, and (3) cancer incidence trends over time. Design, Setting, and Participants: This retrospective, serial cross-sectional, population-based study used registry data from the Surveillance, Epidemiology, and End Results (SEER) database from January 1, 1973, to December 31, 2015 (SEER 9 and SEER 18). The study population was from geographically distinct US regions, chosen to represent the racial and ethnic heterogeneity of the country. Initial analyses were performed from January 1 to August 31, 2019. Main Outcomes and Measures: Incidence rates and descriptive epidemiological statistics for patients aged 15 to 39 years with invasive cancer. Results: A total of 497 452 AYAs diagnosed from 1973 to 2015 were included in this study, with 293 848 (59.1%) female and 397 295 (79.9%) White participants. As AYAs aged, an increase in the relative incidence of carcinomas and decrease in the relative incidence of leukemias, lymphomas, germ cell and trophoblastic neoplasms, and neoplasms of the central nervous system occurred. Among the female AYAs, 72 564 (24.7%) were diagnosed with breast carcinoma; 48 865 (16.6%), thyroid carcinoma; and 33 828 (11.5%), cervix and uterus carcinoma. Among the male AYAs, 37 597 (18.5%) were diagnosed with testicular cancer; 20 850 (10.2%), melanoma; and 19 532 (9.6%), non-Hodgkin lymphoma. The rate of cancer in AYAs increased by 29.6% from 1973 to 2015, with a mean annual percentage change (APC) per 100 000 persons of 0.537 (95% CI, 0.426-0.648; P < .001). Kidney carcinoma increased at the greatest rate for both male (APC, 3.572; 95% CI, 3.049-4.097; P < .001) and female (APC, 3.632; 95% CI, 3.105-4.162; P < .001) AYAs. Conclusions and Relevance: In this cross-sectional, US population-based study, cancer in AYAs was shown to have a unique epidemiological pattern and is a growing health concern, with many cancer subtypes having increased in incidence from 1973 to 2015. Continued research on AYA cancers is important to understanding and addressing the distinct health concerns of this population.

Lo sonoro musical, un universo posible al margen de las palabras

Relato del tratamiento de un paciente, que asistió al servicio de salud mental durante siete años, especialmente a sesiones de musicoterapia, donde pudo escribir material de su autoría.

VIOLENCE AGAINST CHILDREN AND ADOLESCENTS: NOTIFICATION AND ALERT IN TIMES OF PANDEMIC.

OBJECTIVE: Social isolation is currently identified as the best way to prevent the infection by the new coronavirus. However, for some social groups, such as children and adolescents, this measure carries a contradiction: the home, which should be the safest place for them, is also a frequent environment of a sad aggravation: domestic violence. This study aims to evaluate the notifications of interpersonal/self-inflicted violence available in the Information System for Notifiable Diseases in the State of Santa Catarina (southern Brazil), for the juvenile age group, before and during the new coronavirus pandemics. METHODS: Cross-sectional, descriptive study of violence against children and adolescents (from 0 to 19 years) notified by health professionals by completing and entering the occurrence in the Information System for Notifiable Diseases of the State of Santa Catarina in 11 weeks in which the social isolation measure was instituted as mandatory, comparing with the same period before this measure. RESULTS: During the study period, 136 municipalities in Santa Catarina made 1,851 notifications. There was a decrease of 55.3% of them in the isolation period, and the difficulties encountered in seeking protection and assistance institutions were listed. CONCLUSIONS: The society needs to be aware of possible cases of violence in the children and adolescent population. It is important to provide accessible, effective, and safe ways for complaints and notifications, as well as a quick response to the cases, aiming at protecting victims and minimizing damages to prevent the perpetuation of the violence.