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Biomedical subjects

N Madge

Publications and source records attributed to N Madge.

6 recordsLinked to original sources
PubMed1999

Suicide among the young--the size of the problem.

It is widely recognized that official suicide rates conceal the real scale of non-accidental self-injurious fatal behaviour, including among children and young people. There are many reasons for this including the constraints of registration policy and practice, uncertainty about the circumstances surrounding a death, an unwillingness-often for the family's sake-to affix a suicide label on a child, and perhaps the belief that the term "suicide" is not quite accurate. The present study examined all records over a 17-year period from an inner London coroner's office in order to make some quantitative assessment of the extent to which non-accidental self-injurious deaths might be underestimated by suicide returns among those under 20 years. It is suggested on the basis of this examination that the real rate of what might be termed "suicide" among this group may be up to three times the official recorded level. This finding received general confirmation from a smaller-scale comparison in an out of London location.

Adolescent↗
PubMed1999

Youth suicide in an international context.

Mortality statistics are examined for 10- to 19-year-old males and females to examine whether the widely-claimed high rates and upward trends in suicide among young men in England and Wales during recent years are applicable to this group. Various definitions of suicide are considered. A consistent increase in rates between 1980 and 1994 was found in England and Wales for 15- to 19-year-old males (and for younger males although not for females) but this was less dramatic than has been reported for a slightly wider age band. Comparisons between these profiles of young deaths and those for Finland, Germany, Hungary, Ireland and Norway indicated that, regardless of definition, rates of suicide for those under 20 years are lower in England and Wales than any of the other countries studied. Trends, nonetheless, showed varying patterns. While the upward trend among 15- to 19-year-old males in England and Wales was of similar order to that found in Finland or Norway, it represented a far less marked rise than in Ireland and was in contrast to the declining rates found in Germany and Hungary. Methods used in deaths recorded as suicide differed by country but there were few consistent trends.

Adolescent↗
PubMed1993

Pertussis immunisation and serious acute neurological illnesses in children.

OBJECTIVE: To determine long term outcome in children who had a severe acute neurological illness in early childhood associated with pertussis immunisation. DESIGN: Follow up study of cases and matched controls. SETTING: Assessment of children at home and at school throughout Britain. SUBJECTS: Children recruited into the national childhood encephalopathy study in 1976-9 were followed up, with one of their two original matched controls, in 1986-9. MAIN OUTCOME MEASURES: Performance in educational attainment tests; behaviour problems reported by teachers and parents; continuing convulsions; evidence of other neurological or physical dysfunction. RESULTS: Over 80% of cases and controls were traced. Case children were significantly more likely than controls to have died or to have some form of educational, behavioural, neurological, or physical dysfunction a decade after their illness. The prevalence of one or more of these adverse outcomes in case children who had been immunised with diphtheria, tetanus, and pertussis vaccine within seven days before onset of their original illness was similar to that in case children who had not been immunised recently. The relative risk for recent diphtheria, tetanus, and pertussis immunisation in children who had died or had any dysfunction in comparison with controls was 5.5 (95% confidence interval 1.6 to 23.7). However, the number of cases associated with vaccine (12) was extremely small and statistically vulnerable, and other possible agents or predisposing factors could not be excluded. CONCLUSIONS: Diphtheria, tetanus, and pertussis vaccine may on rare occasions be associated with the development of severe acute neurological illnesses that can have serious sequelae. Some cases may occur by chance or have other causes. The role of pertussis vaccine as a prime or concomitant factor in the aetiology of these illnesses cannot be determined in any individual case. The balance of possible risk against known benefits from pertussis immunisation supports continued use of the vaccine.

Acute Disease↗