Adolescents Ages Research Articles

Mindful Awareness Practices (MAPs) in Adolescents With ADHD and Cognitive Disengagement Syndrome (CDS): A Pilot Open Trial.

Objective: Very few studies have investigated intervention approaches that may be efficacious for youth with ADHD and co-occurring cognitive disengagement syndrome (CDS) symptoms. This study examined the feasibility, acceptability, and preliminary efficacy of a mindfulness-based intervention for adolescents with ADHD and co-occurring CDS symptoms. Methods: Fourteen adolescents ages 13 to 17 years (35.71% female; 64.29% White, 7.14% Black, 28.57% Multiracial) with ADHD and elevated CDS symptoms completed the 8-week group-based Mindful Awareness Practices (MAPs) program developed for individuals with ADHD. We collected measures of CDS, ADHD, mind-wandering, mindfulness, and other difficulties and functioning at baseline, 1-month post-intervention, and 3-month post-intervention to examine preliminary efficacy. We measured participant session attendance, session engagement, at-home practice adherence, and satisfaction of adolescents and caregivers at 1-month post-intervention to examine feasibility and acceptability. We also collected qualitative feedback from adolescents and caregivers at 1-month post-intervention. Results: The intervention was overall feasible to administer, and caregivers and adolescents reported satisfaction with the intervention despite some difficulties with attendance and engagement. We observed improvements to both caregiver- and adolescent-reported CDS symptoms and ADHD-inattentive symptoms from pre-intervention to post-intervention time points, though findings across 1- and 3-month follow-up differed based on informant. We also observed improvements to some indices of adolescent-reported mind-wandering, mindfulness, brooding rumination, and academic functioning. For caregiver report, the only other noted improvement was for executive functioning. No improvements were reported by teachers. Conclusions: Findings support the initial feasibility, acceptability, and preliminary efficacy of MAPs for adolescents with ADHD and co-occurring CDS symptoms on a range of outcomes. Larger trials with a randomized design are warranted to further examine mindfulness-based interventions for adolescents with ADHD and co-occurring CDS symptoms.

Correlates of Intention to Utilize HIV Screening Services Among Adolescents In Selected Secondary Schools In Osogbo, Osun State Nigeria

Background The spread of HIV/AIDS among the productive age group particularly young adults is a major public health concern in Nigeria. HIV screening services are affordable interventions that offer chances to raise knowledge about HIV and preventive measures. They are crucial parts of HIV prevention initiatives. This study investigated the level of knowledge, and attitude as correlates of intention to Utilize HIV Screening Services Among Adolescents in Selected Secondary Schools in Osogbo, Osun State, Nigeria. Methods Data were collected from 120 respondents who were conveniently selected from two senior secondary school at the two Local government areas in Osogbo, Osun state with semi-structured questionnaire (83% reliability). Data were analyzed using appropriate statistical tools. Results Most of the students were in the middle adolescence (14 – 16 years) age group. The Knowledge responses were grouped on a scale and the results showed that most of the adolescents had a moderate level of knowledge regarding HIV/AIDS and HIV Screening Services. Further results showed a fairly high and positive attitude for the participants (76.66%). There were significant correlations (at p < 0.05) between knowledge level (R = 0.348), attitude (R = 0.432), and Intention to Utilize HIV Screening Services. These factors are still quite modest, though. Additionally, knowledge level indicated that most participants were unaware of any importance of the utilization of HIV Screening services. Conclusions The report suggested launching vigorous campaigns of public health education and awareness that highlight the importance of utilizing HIV Screening services.

A Cross-sectional Study to Assess the Self-esteem Among Adolescents in an Urban Poor Locality of Bengaluru City

Self-esteem refers to the individual’s perception or subjective appraisal of one’s own self-worth, self-confidence and self-respect. Self-esteem plays an important role in determining and preventing mental health disorders. There is a dearth in the knowledge of understanding self-esteem among Indian urban slum adolescents; therefore, this study was taken to assess self-esteem among adolescents of an urban poor locality using ‘The Rosenberg Self-esteem scale’. A cross-sectional survey among adolescents aged 15 to 19 years was conducted from April to June 2023 in the urban poor locality of Bangalore. Taking prevalence of low self-esteem among adolescents as 15.3%, the sample size was calculated as 200. Out of 200 subjects, 52.7% were females and 47.5% were male. We found that 28.0% were school dropouts. The study showed a majority of the subjects had normal or high self-esteem and 10.5% had low self-esteem. Increasing age of the adolescents was found to be significantly associated with self-esteem scores ( p < .05). This study identified that 10.5% had poor self-esteem and they need support from family, school and Sneha Clinic at Urban Primary Health Centre to improve their life skills and prevent mental health issues in adolescence and adulthood.

Comparative analysis of micrometric parameters in the ovaries of adolescent, elderly and senile women

Aging is a systemic process affecting all tissues of the body. In this study, the choice of scientific interest fell on the paired gland, the key structure of the female reproductive system – the ovary.Objective: to carry out a comparative analysis of the parameters of the thickness of the cerebral and cortical layers, as well as the protein membrane of the ovaries in women in adolescence, the elderly and senile age. Materials and methods. The analysis of the results of a study of 60 women with normal pelvic dimensions and without pathology of the reproductive system organs was carried out. Group I included 28 victims of adolescent age (16-20 years old), group II consisted of 29 elderly victims (56-74 years old), group III included 27 elderly victims (75-90 years old). The thickness of the cerebral and cortical layers, as well as the albumen of both ovaries, were determined in histological samples.Results. A decrease in the thickness of the cortical and medulla and an increase in the thickness parameters of the albuminous membrane of both ovaries in the period from adolescence to old age were revealed. The thickness of the medulla of the right ovary is thinned by 3.76%, the left by 4.46%; the cortical substance of the right ovary by 29.9%, the left by 29.64% (p < 0,01). The thickness of the albumen of the right ovary, on the contrary, increases by 48.23%, of the left – by 50.21% (p < 0,01). From old age to senile age, there is a tendency to decrease the thickness of the cerebral and cortical matter of the ovary. The medulla is thinned by 0.95% on the right and 0.24% on the left (p > 0,05), the cortical substance – by 1.5% on the right and 1.21% on the left (p > 0,05). At the same time, the protein shell on the right becomes thicker by 14.08%, on the left – by 13.57% (p < 0,01). Conclusion. The results obtained can become a conditional "morphological standard" for certain age norms in the diagnosis of various diseases, as well as expand the understanding of changes in the morphological picture of a woman's ovaries with age.

Longitudinal panel networks of risk and protective factors for early adolescent suicidality in the ABCD sample.

Rates of youth suicidal thoughts and behaviors (STBs) are rising, and younger age at onset increases vulnerability to negative outcomes. However, few studies have investigated STBs in early adolescence (ages 10-13), and accurate prediction of youth STBs remains poor. Network analyses that can examine pairwise associations between many theoretically relevant variables may identify complex pathways of risk for early adolescent STBs. The present study applied longitudinal network analysis to examine interrelations between STBs and several previously identified risk and protective factors. Data came from 9,854 youth in the Adolescent Brain Cognitive Development Study cohort (Mage = 9.90 ± .62 years, 63% white, 53% female at baseline). Youth and their caregivers completed an annual measurement battery between ages 9-10 through 11-12 years. Panel Graphical Vector Autoregressive models evaluated associations between STBs and several mental health symptoms, socioenvironmental factors, life stressors, and substance use. In the contemporaneous and between-subjects networks, direct associations were observed between STBs and internalizing symptoms, substance use, family conflict, lower parental monitoring, and lower school protective factors. Potential indirect pathways of risk for STBs were also observed. Age-specific interventions may benefit from prioritizing internalizing symptoms and early substance use, as well as promoting positive school and family support.

Adding a Cultural Lens to Active Transport Initiatives: Māori and Pacific Adolescents’ Perceptions of Transport to School

In Aotearoa/New Zealand, there is government directive and community support to focus on health equity in research and health promotion. Culturally responsive policies and services are expected. The purpose of this research is to describe Māori and Pacific adolescents’ perceptions of different modes of transport to school (walking, cycling, busing and being driven/driving) rather than to compare perceptions between different ethnic groups through a deficit lens which is commonplace. Reporting findings in this way is so that equitable approaches to policy, and initiatives for active transportation to school can be considered. This study analysed data from adolescents (age 13 to 18 years) (n = 3608) who completed an online survey at school as part of the BEATS Research Programme in the city of Dunedin, New Zealand. In addition, four focus groups were conducted with Māori and Pacific adolescents. Overwhelmingly, adolescents across all ethnic groups had similar perceptions of walking, cycling, being driven/driving and busing to school. This similarity means that a whole of population approach to policy would be sufficient when combined with good quality overarching cultural responsiveness imbedded to support equity for Māori and Pacific adolescents. Findings specific to Māori and to Pacific adolescents are reported which will enable policy makers to consider additional cultural nuances in the active transport space.

Clinical Measures Associated with Subsequent Injury after Adolescent Concussion: A Prospective Cohort Study

ABSTRACT Purpose To examine associations between clinical measures (self-reported and clinician-administered) and subsequent injury rates in the year after concussion return to play (RTP) among adolescent athletes. Methods We performed a prospective, longitudinal study of adolescents ages 13-18 years. Each participant was initially assessed within 21 days of concussion and again within 5 days of receiving RTP clearance from their physician. Participants completed self-report measures: the Pittsburgh Sleep Quality Index (PSQI) and Tampa Scale of Kinesiophobia (TSK), and clinician-administered measures: single and dual-task tandem gait (TG) and reaction time (RT; simple and clinical) assessments. They then completed monthly surveys for a year after RTP which assessed exposure to injury (sport participation) and subsequent injuries (musculoskeletal or concussions) sustained. We used Poisson regression models to calculate injury rate ratios with number of subsequent injuries sustained as the outcome, adjusted for RTP clearance time and competitive exposures for each measure. Results 41 participants were included (age = 15.5±1.3 years, 56% female, 9.6±4.6 days post-concussion; 38.0±31.5 days to RTP). A higher injury rate per athletic exposure was observed for simple RT≥505 ms vs <505 ms (injury rate ratio = 3.22; 95% confidence interval = 1.56, 7.12; p = 0.002). Injury rates did not significantly differ by PSQI or TSK scores, single/dual-task TG time, or clinical RT. Conclusions Simple reaction time may be one risk factor that is associated with higher rates of subsequent injury after adolescent concussion. A simple reaction time measure incorporated into a comprehensive concussion RTP assessment may identify some individuals at higher risk of subsequent injury in the year following concussion, though further research is needed to better understand this relationship.

Disordered Eating in Early Adolescence: Disparities Among Minoritised Youth.

Disordered eating in early adolescence impacts development, with long-term health implications. Minoritised adolescents might be at higher risk of disordered eating due to minority stress, but most research has focused on White, heterosexual, cisgender individuals; less is known about disordered eating among minoritised adolescents. We examined sexual, gender, racial, and ethnic identities in relation to disordered eating in early adolescence. Using 2-year follow-up data from adolescents ages 10-14 in the Adolescent Brain Cognitive Development Study (N = 9385), we examined associations between sexual, gender, racial, and ethnic identities and past-2 week disordered eating (preoccupation with weight, weight control behaviors, and binge eating). Compared to heterosexual peers, gay/bisexual adolescents had higher odds of all three outcomes (AOR 1.90-3.32); those "questioning" their sexual identity had higher odds of preoccupation with weight (AOR 1.82) and binge eating (AOR 2.53). Compared to cisgender adolescents, transgender adolescents had higher odds of binge eating (AOR 2.62); those "questioning" their gender identity had higher odds of preoccupation with weight (AOR 2.45). Adolescents whose racial identity was categorised as "Another" had higher odds of preoccupation with weight (AOR 1.46) and weight control behaviors (AOR 1.58) compared to White adolescents. Finally, Hispanic adolescents had higher odds of all disordered eating outcomes than non-Hispanic adolescents (AOR 1.25-1.59). This study is among the first to reveal disparities in disordered eating among minoritised early adolescents. Further examination of these disparities can inform future interventions. Healthcare providers are encouraged to screen for disordered eating, recognising that minoritised early adolescents may be at risk.

Exploring associations between psychotic experiences and structural brain age: a population-based study in late adolescence.

Neuroimaging studies show advanced structural "brain age" in schizophrenia and related psychotic disorders, potentially reflecting aberrant brain ageing or maturation. The extent to which altered brain age is associated with subthreshold psychotic experiences (PE) in youth remains unclear. We investigated the association between PE and brain-predicted age difference (brain-PAD) in late adolescence using a population-based sample of 117 participants with PE and 115 without PE (aged 19-21 years) from the Avon Longitudinal Study of Parents and Children. Brain-PAD was estimated using a publicly available machine learning model previously trained on a combination of region-wise T1-weighted grey-matter measures. We found little evidence for an association between PEs and brain-PAD after adjusting for age and sex (Cohen's d = -0.21 [95% CI -0.47, 0.05], p = 0.11). While there was some evidence for lower brain-PAD in those with PEs relative to those without PEs after additionally adjusting for parental social class (Cohen's d = -0.31 [95% CI -0.58, -0.03], p = 0.031) or birth weight (Cohen's d = -0.29 [95% CI -0.55, -0.03], p = 0.038), adjusting for maternal education or childhood IQ did not alter the primary results. These findings do not support the notion of advanced brain age in older adolescents with PEs. However, they weakly suggest there might be a younger-looking brain in those individuals, indicative of subtle delays in structural brain maturation. Future studies with larger samples covering a wider age range and multimodal measures could further investigate brain age as a marker of psychotic experiences in youth.

Research Review: Pharmacological and non-pharmacological treatments for adolescents with attention deficit/hyperactivity disorder - a systematic review of the literature.

Attention Deficit/Hyperactivity Disorder (ADHD) demonstrates unique developmental manifestations in adolescence with implications for optimized, age-appropriate treatment. This 10-year update is the third in a series of systematic reviews examining the efficacy and safety of adolescent ADHD treatments. We broadly examined efficacy on ADHD symptoms, impairments, and other reported outcomes. Acute and long-term efficacy, and treatment moderators, were considered. We performed PubMed, EMBASE, and PsycINFO searches for articles published or in press from 2013 to 2024, integrated with hand search and randomized controlled trials (RCTs) identified in this series' earlier reviews. RCTs examining the safety or efficacy of interventions delivered to adolescents (ages 10.0-19.9) with a diagnosis of ADHD were included. Study characteristics were extracted and reviewed, quality of evidence was assessed using GRADE, and effect sizes were calculated for individual studies and illustrated using forest plots. Sixty-three RCTs were identified. Quality of evidence ranged from high (medication; k = 29) to very low (nutrient supplementation, neurofeedback, occupational therapy; k = 1 each). Medications demonstrated consistent strong impact on ADHD symptoms and inconsistent impact on impairment. Diverse cognitive/behavioral treatments (C/BTs) demonstrated inconsistent impact on ADHD symptoms but strong and consistent impact on impairment and executive function skills, plus moderate benefits on internalizing symptoms. No interventions demonstrated significant safety concerns. Long-term maintenance (up to 3 years post-treatment) was demonstrated for C/BTs, though moderate quality of evidence was noted because participants cannot be fully blinded to receipt of treatment. The effects of C/BTs and medication appear complementary, not duplicative. Combining medication and C/BT is advised at treatment outset to maximize engagement, maintenance, and response breadth (i.e. improving both ADHD symptoms/cognitive performance and coping skills/functional impairments). Engagement strategies (e.g. motivational interviewing) may facilitate uptake. Novel treatments do not yet demonstrate effects on ADHD symptoms or impairments in adolescents but remain a promising area for research.

CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2017-2021.

The Central Brain Tumor Registry of the United States (CBTRUS), in collaboration with the Centers for Disease Control and Prevention and the National Cancer Institute, is the largest population-based registry focused exclusively on primary brain and other central nervous system (CNS) tumors in the United States (US) and represents the entire US population. This report contains the most up-to-date population-based data on primary brain tumors available and supersedes all previous reports in terms of completeness and accuracy. All rates are age-adjusted using the 2000 US standard population and presented per 100,000 population. Between 2017 and 2021, the average annual age-adjusted incidence rate (AAAIR) of all primary malignant and non-malignant brain and other CNS tumors was 25.34 per 100,000 population (malignant AAAIR=6.89 and non-malignant AAAIR=18.46). This overall rate was higher in females compared to males (28.77 versus 21.78 per 100,000) and non-Hispanic Black persons compared to persons who were non-Hispanic White (26.60 versus 25.72 per 100,000), non-Hispanic American Indian/Alaska Native (23.48 per 100,000), non-Hispanic Asian or Pacific Islander (19.86 per 100,000), and Hispanic persons of all races (22.37 per 100,000). Gliomas accounted for 22.9% of all tumors. The most commonly occurring malignant brain and other CNS histopathology was glioblastoma (13.9% of all tumors and 51.5% of all malignant tumors), and the most common predominantly non-malignant histopathology was meningioma (41.7% of all tumors and 56.8% of all non-malignant tumors). Glioblastomas were more common in males, and meningiomas were more common in females. In children and adolescents (ages 0-19 years), the incidence rate of all primary brain and other CNS tumors was 6.02 per 100,000 population. There were 87,053 deaths attributed to malignant brain and other CNS tumors between 2017 and 2021. This represents an average annual mortality rate of 4.41 per 100,000 population and an average of 17,411 deaths per year. The five-year relative survival rate following diagnosis of a malignant brain or other CNS tumor was 35.7%. For a non-malignant brain or other CNS tumor the five-year relative survival rate was 92.0%.

ANÁLISE DAS REPERCUSSÕES FETAIS, NEONATAIS E OBSTÉTRICAS RELACIONADAS A IDADE MATERNA AVANÇADA E PRECOCE

In Brazil, pregnancy at extreme ages, whether in adolescence or advanced age, poses significant challenges to maternal and neonatal health. In a country where one in every seven babies is born to adolescent mothers, and there has been a 70% increase in pregnancies among women aged 35 to 38 over the last two decades, it becomes essential to understand the obstetric and neonatal repercussions of these pregnancies. This study aimed to analyze the fetal, neonatal, and obstetric complications associated with early and advanced maternal age. It is an epidemiological study with data collected from TabNet of DataSUS, covering the period from 1996 to 2020. The variations found included maternal and fetal deaths, as well as sociodemographic characteristics of the mothers. The results show that adolescent mothers have a higher risk of newborns with low birth weight and fetal mortality, especially in the Northeast region. On the other hand, older mothers show lower fetal mortality but a higher prevalence of obstetric complications, particularly in the Southeast region. The research highlights the need for public policies focused on reducing risks in pregnancies with greater vulnerability and on training health professionals for better monitoring.

Death of a Parent, Racial Inequities, and Cardiovascular Disease Risk in Early to Mid-adulthood.

Black Americans experience the death of a parent much earlier in the life course than White Americans on average. However, studies have not considered whether the cardiovascular health consequences of early parental death vary by race. Using data from the National Longitudinal Study of Adolescent to Adult Health, we explore associations between early parental death and cardiovascular disease (CVD) risk in early to mid-adulthood (N = 4,193). We find that the death of a parent during childhood or adolescence (ages 0-17) or the transition to adulthood (ages 18-27) is associated with increased CVD risk for Black Americans, whereas parental death following the transition to adulthood (ages 28+) undermines cardiovascular health for both Black Americans and White Americans. These findings illustrate how a stress and life course perspective can help inform strategies aimed at addressing both the unequal burden of bereavement and high cardiovascular risk faced by Black Americans.

Evaluation and Surgical Management of Pediatric Cutaneous Melanoma and Atypical Spitz and Non-Spitz Melanocytic Tumors (Melanocytomas): A Report From Children's Oncology Group.

The purpose of this study was to develop recommendations for the diagnostic evaluation and surgical management of cutaneous melanoma (CM) and atypical Spitz tumors (AST) and non-Spitz melanocytic tumors (melanocytomas) in pediatric (age 0-10 years) and adolescent (age 11-18 years) patients. A Children's Oncology Group-led panel with external, multidisciplinary CM specialists convened to develop recommendations on the basis of available data and expertise. Thirty-three experts from multiple specialties (cutaneous/medical/surgical oncology, dermatology, and dermatopathology) established recommendations with supporting data from 87 peer-reviewed publications. (1) Excisional biopsies with 1-3 mm margins should be performed when feasible for clinically suspicious melanocytic neoplasms. (2) Definitive surgical treatment for CM, including wide local excision and sentinel lymph node biopsy (SLNB), should follow National Comprehensive Cancer Network Guidelines in the absence of data from pediatric-specific surgery trials and/or cohort studies. (3) Accurate classification of ASTs as benign or malignant is more likely with immunohistochemistry and next-generation sequencing. (4) It may not be possible to classify some ASTs as likely/definitively benign or malignant after clinicopathologic and/or molecular correlation, and these Spitz tumors of uncertain malignant potential should be excised with 5 mm margins. (5) ASTs favored to be benign should be excised with 1- to 3-mm margins if transected on biopsy. (6) Re-excision is not necessary if the AST does not extend to the biopsy margin(s) when complete/excisional biopsy was performed. (7) SLNB should not be performed for Spitz tumors unless a diagnosis of CM is favored on clinicopathologic evaluation. (8) Non-Spitz melanocytomas have a presumed increased risk for progression to CM and should be excised with 1- to 3-mm margins if transected on biopsy. (9) Re-excision of non-Spitz melanocytomas is not necessary if the lesion is completely excised on biopsy.

Nasal dermoid cyst

Abstract: Congenital midline lesions of the nose include nasal dermoids, encephaloceles, and gliomas. The nasal dermoid is least rare of these and is an uncommon midline developmental anomaly. Unlike encephalocoeles and gliomas ,craniofacial dermoids may present as a cyst, a sinus or a fistula (Setiyawan, 2013). In this patient, it was a cystic nasal swelling obscuring vision without any problem in visual acuity. He had this lesion from childhood but presented to the outpatient department in adolescent age. Diagnostic nasal endoscopy, ultrasonography, fin- needle aspiration cytology, and contrast-enhanced computed tomography of the nose and paranasal sinuses were done reporting it as a nasal dermoid without any bony erosions. All routine investigations were done, and the patient was planned for excision under general anesthesia (GA). Excision of the mass was done under GA and sent for histopathology. Histopathological examination report confirmed it as a dermoid cyst.

First Suicide Attempts in Early Adolescents: A Descriptive Outcomes Study

ObjectiveIn 2021, suicide was the second leading cause of death in early adolescent Americans ages 10-14. Research into suicidal behavior in this age group is limited. We report on prior psychiatric care, attempt method, and attempt outcomes in a cohort of 164 early adolescents accrued by first suicide attempt coming to medical attention. MethodsOur cohort constitutes a subsample from a previously reported retrospective-prospective study identified through the Rochester Epidemiology Project that recruited individuals making first suicide attempts coming to medical attention (index attempt, IA) during a 22-year period (1/1/1986-31/12/07). Among 1490 all-age index attempters followed until 12/31/2010, 164 (11.0%) were aged 10-14. Results3/164 died on IA (1.8% of the cohort; 2 females, 1 male). Nearly half (72/164, 43.9%) had no prior psychiatric history. Females were less likely than males to have seen a mental health provider (p=0.029) or been prescribed psychiatric medications (p<0.001) prior to IA. Medication overdose was the most common attempt method in females (81/128, 63.3%), while cutting or piercing wounds were the most common method in males (13/36, 36.1%). Females were significantly more likely than males to overdose (p=0.001). Of IA survivors, 19.9% (32/161) were initially medically hospitalized, 52.8% (85/161) were psychiatrically hospitalized—initially or in transfer—and 37.2% (60/161) were discharged without hospitalization. ConclusionMedication overdoses accounted for over half of all IAs and were significantly more common in females. While IA mortality was low relative to older patients from the all-age-cohort, morbidity was substantial with nearly a fifth of attempts severe enough to warrant medical hospitalization and more than half initial or eventual psychiatric hospitalization. These findings emphasize the importance of both means restriction and identification of early adolescents at risk before they make their first attempt.

Serum Carnitine Concentrations and Cardiac Function in Pediatric, Adolescent and Young Adult Oncology Patients Receiving High-Dose Anthracyclines

OBJECTIVE Anthracycline chemotherapy agents have significant dose-dependent cardiotoxic effects. ­Carnitine, a non-essential amino acid, is involved in long chain fatty acid oxidation, and carnitine deficiency can result in cardiomyopathy and cardiac arrhythmias. If administered concurrently with chemotherapy, carnitine supplementation could be a potential strategy to prevent cardiotoxicity. However, the association between serum carnitine concentrations and anthracycline cardiotoxicity during cancer treatment in the childhood, adolescent, and young adult (CAYA) age range has not been established. METHODS This prospective pilot cohort study characterized changes in serum carnitine concentrations and cardiac function before, during, and approximately 1 year after large-dose anthracycline therapy in newly diagnosed CAYA cancer patients. RESULTS Among 21 patients with a mean cumulative anthracycline dose exposure of 409 mg/m2 of ­doxorubicin equivalents, left ventricular ejection fraction and relative wall thickness decreased, indicating an overall decline in cardiac function. A reversible decrease in serum carnitine concentrations was also observed. A non-statistically significant positive correlation was observed; for every 1 mmol/L decrease in serum carnitine concentration, there was a 0.09% decrease in LVEF (p = 0.2). CONCLUSIONS These findings from this small pilot study suggest that there may be a relationship between serum carnitine concentrations and cardiac function after anthracycline therapy that should be evaluated in larger studies.

Male Gender Expressivity and Diagnosis and Treatment of Cardiovascular Disease Risks in Men

Male gender expressivity (MGE), which reflects prevalent sociocultural pressures to convey masculinity, has been associated with health. Yet, little is known about associations of MGE with the diagnosis and treatment of modifiable cardiovascular disease (CVD) risks. To investigate associations of MGE with modifiable CVD risk diagnoses and treatment in men. This population-based cohort study included data from waves I (1994-1995), IV (2008-2009), and V (2016-2018) of the US National Longitudinal Study of Adolescent to Adult Health (Add Health). Participants were male adolescents (age 12-18 years) followed up longitudinally through younger adulthood (age 24-32 years) and adulthood (age 32-42 years). Data were analyzed from January 5, 2023, to August 28, 2024. Male gender expressivity was quantified in adolescence and younger adulthood using an empirically-derived and validated measurement technique that incorporates participants' responses to existing Add Health survey items to capture how similarly participants behave to same-gendered peers. Outcomes included self-reported diagnoses of CVD risk conditions (hypertension, diabetes, or hyperlipidemia) in adult men with elevated blood pressure, hemoglobin A1c, or non-high-density lipoprotein cholesterol levels, and self-reported treatment with antihypertensive, hypoglycemic, or lipid-lowering medications in adults reporting hypertension, diabetes, or hyperlipidemia. Multivariable regression was used to examine associations of adolescent and younger adult MGE with adult CVD risk diagnoses and treatment, adjusting for sociodemographic covariates. Among 4230 eligible male participants, most were non-Hispanic White (2711 [64%]) and privately insured (3338 [80%]). Their mean (SD) age was 16.14 (1.81) years in adolescence, 29.02 (1.84) years in younger adulthood, and 38.10 (1.95) years in adulthood. Compared with participants whose younger adult MGE was below average, those with higher younger adult MGE were overall less likely to report hypertension (22% vs 26%; P < .001), diabetes (5% vs 8%; P < .001), and hyperlipidemia (19% vs 24%; P < .001) diagnoses and diabetes treatment (3% vs 5%; P = .02) as adults. In multivariable models, every SD increase in adolescent MGE was associated with lower probabilities of adult hypertension treatment (MGE,-0.11; 95% CI, -0.16 to -0.6) and diabetes diagnoses (MGE, -0.15; 95% CI, -0.27 to -0.03). Higher younger adult MGE was associated with lower probabilities of adult hypertension diagnoses (MGE, -0.04; 95% CI, -0.07 to -0.01), hypertension treatment (MGE, -0.07; 95% CI, -0.13 to -0.01), and diabetes treatment (MGE, -0.10; 95% CI, -0.20 to -0.01). Adolescent and younger adult MGE outcomes were not associated with other adult CVD outcomes. In this cohort study of US males, higher adolescent and younger adult MGE was associated with lower adult hypertension and diabetes diagnoses and treatment. These findings suggest that males with high MGE may bear distinctive risks and correspondingly benefit from tailored public health efforts to prevent downstream CVD.

The Experiences of Pregnancy Among Adolescent Girls in Jordan

ObjectiveTo explore the experience of pregnancy among adolescent girls ages 16 to 19 years in Jordan. DesignDescriptive exploratory qualitative design. SettingParticipants were recruited from antenatal clinics and postpartum wards in Ministry of Health primary health care clinics and hospitals across Jordan. This included a wide geographic area in Jordan that covered several cities: Amman, Zarqa, Irbid, As-Salt, and others. ParticipantsThe total number of participants was 13. Most participants were primiparous, and three were multiparous. Five participants were recruited during the postpartum period, seven in the second and third trimester, and one during the first trimester. MeasurementsData were collected using semistructured and audio-recorded interviews and analyzed concurrently. Thematic analysis was used. A total of 13 interviews were conducted. ResultsTwo core themes emerged from the study: Navigating the Change and Reflecting on the Experience of Pregnancy. The first theme included four subthemes: Making Adjustments, Seeking Support, Searching for Information, and Feeling the Responsibility. ConclusionConsidering the impact of pregnancy on adolescent girls and their fetuses, early marriages should be reconsidered in legal and health policies in Jordan and worldwide. Adolescents expressed a need for more information about pregnancy. Age-appropriate comprehensive sexual education that includes discussion of gender issues and women’s empowerment is needed. Online sources of pregnancy information targeting the needs of adolescents are also recommended. More research is needed to explore the needs of pregnant adolescents in different social and cultural contexts.

Assessing the Association Between Respiratory Symptoms and Nicotine and Cannabis Use Through Traditional and E-Product Devices in the U.S.

PurposeTo assess the association between past 30-day cigarette smoking, nicotine use with an e-product device (e.g., vape), cannabis smoking, cannabis use with an e-product device, and other forms of cannabis use and past-year respiratory symptoms in a nationally representative sample of people aged 12 and older in the U.S. during 2021. MethodsData from Wave 6 (2021) of the Population Assessment of Tobacco and Health (PATH) Study was used, a national probability sample of adolescents (ages 12-17; n=5,652) and adults (ages ≥18; n=30,516). Logistic regression was used to assess the association of past 30-day cigarette smoking, nicotine use with an e-product, cannabis smoking, cannabis use with an e-product, and other forms of cannabis use with past-year respiratory symptoms (a past-year respiratory symptom index was constructed and ranged 0-9; an index of 2+ was flagged as having functionally important respiratory impairment). ResultsThe odds of a past-year respiratory index score of 2+ was greater among respondents who indicated either past 30-day cigarette or cannabis smoking compared to respondents who did not use any nicotine or cannabis during the past 30 days. Past 30-day nicotine and cannabis use with an e-product device was not associated with a respiratory symptom index of 2+. The combination of past 30-day cigarette smoking and cannabis smoking had one of the strongest associations with experiencing a respiratory index score of 2+ among dual users of nicotine and cannabis. ConclusionsPast 30-day cigarette smoking and cannabis smoking was associated with higher odds of functionally important respiratory impairment. Additionally, this study provides robust evidence regarding the potential respiratory harms of single or dual nicotine and cannabis smoking as it relates to respiratory health.