Adolescent Population Research Articles

Effects of different exercise modalities on pediatric and adolescent populations with developmental disorders: a network meta-analysis of randomized controlled trials.

Combat sports, ball sports, neurodevelopmental motor training, and aquatic exercise may be effective exercise modalities for improving symptoms in children and adolescents with developmental disorders. However, the degree of improvement can vary among individuals with specific developmental disorders. Therefore, precise assessment of the individual symptoms of children or adolescents is crucial before selecting specific exercise interventions. PROSPERO (CRD42024545673). • Many studies indicate that exercise as an intervention can have positive effects on individuals with developmental disorders, such as ADHD and autism. However, reported effects vary, and there is no clear consensus on the optimal exercise intervention method yet. • Through a comprehensive network meta-analysis, various exercise interventions for children and adolescents with developmental disorders were compared to determine the optimal approach. The study found that combat sports, ball sports, neurodevelopmental motor training, and aquatic exercise could potentially be effective modalities for improving symptoms in this population.

Abstract 4112845: Trends in Cardiovascular Risk Factors Among Children and Adolescents by Race and Ethnicity and Socioeconomic Status, 1999-2020

Background: Recent findings from large-scale cohort studies indicate that risk factors such as body mass index (BMI), systolic blood pressure (SBP), total cholesterol (TC), triglyceride (TG), and smoking during youth, starting in early childhood and adolescence, are associated with cardiovascular events and cardiovascular-related mortality in adulthood. The secular trends of cardiovascular risk factors among US children and adolescents remain unclear. Objectives: To examine 20-year trends in cardiovascular risk factors in the children and adolescents population by race and ethnicity and by socioeconomic status. Methods: The primary objective of the NHANES is to evaluate the overall health and nutritional status of the U.S. population. In this analysis, data from ten NHANES survey cycles, conducted from 1999-2000 through 2019-2020, were utilized. We calculated the mean and proportion changes in cardiovascular risk factors, and used linear and quadratic tests to assess the linear and nonlinear trends in their changes. Results: A total of 27891 participants aged 6 to 19-year-olds were included. Mean BMI increased significantly from 20.61kg/m 2 in 1999 to 21.71kg/m 2 in 2020 (P for trend < 0.001). COT means decreased from 11.47 ng/ml to 6.17 ng/ml (P for trend < 0.001). The prevalence of high COT decreased from 14.64% to 8.68% (P for trend < 0.001). TC decreased from 4.22mmol/L to 4.02 mmol/L (P for trend < 0.001). In the study population, TG levels decreased from 0.9mmol/L to 0.79 mmol/L (P for trend < 0.001). Mean LDL levels decreased from 2.45 mmol/L to 2.27 mmol/L (P for trend < 0.001). Conclusion: Positive trends were observed in the levels of TG, TC, LDL, and COT in US children and adolescents. Mean BMI and the prevalence of obesity exhibited a gradually increasing unfavorable trend.

Implementing Screening for Eating Disorders in Adolescents and Young Adults with a History of Cancer.

Eating disorders are prevalent in the adolescent and young adult (AYA) population, with 2.7% of adolescents effected. AYAs with cancer possess several risk factors for eating disorders that may place them at an even higher risk. Since these patients see their oncology team frequently, oncology clinics are opportune settings for eating disorder screening. Here, we describe a study to implement screening for eating disorders in AYA patients in an oncology clinic. During regularly scheduled oncology visits, eligible patients were given the SCOFF questionnaire. A total of 163 eligible patients filled out the SCOFF questionnaire with 11 positive results (6.75%). Eating disorder screening was successfully implemented in our pediatric oncology clinic. With a rate more than double than the general population, we observed that AYA patients with a history of cancer are at a higher risk for eating disorders and should undergo routine screening in oncology clinics.

Visfatin and VEGF levels are not increased in adolescent girls with polycystic ovary syndrome

IntroductionPCOS is one of the most commonly occurring endocrinopathies among women and increasingly affects adolescent populations. The connection between PCOS and various endocrinological, psychological, and CVD is increasingly recognized. Some studies have shown elevated levels of visfatin and VEGF among patients with PCOS, which are markers of vascular endothelial dysfunction. In our study, we evaluated the concentration of these parameters, focusing solely on a group of adolescents with PCOS, to assess whether these early markers of CVD are present at an early stage of diagnosis.Material and methodsIn total, 80 adolescent girls participated in the study. 47 adolescents diagnosed with PCOS were included in the study group (mean age 15.68 ± 1.18 years, BMI 26.66 ± 6.41 kg/m2), while the remaining 33 regularly menstruating individuals (mean age 15.79 ± 1.22 years, BMI 25.44 ± 7.24 kg/m2) were assigned to the control group. Each participant underwent imaging, biochemical, and hormonal tests. Additionally, markers of endothelial dysfunction: VEGF and visfatin, were measured in all adolescents.ResultsBoth VEGF and visfatin levels did not differ significantly between PCOS and control group (p=0.30 and p=0.15, respectively). In the group of adolescent girls with PCOS, visfatin was significantly correlated with HDL, FSH, cortisol, and testosterone levels >55 ng/dl. VEGF was significantly correlated with fasting glucose, glucose levels after OGTT, estradiol, and waist circumference >80 cm.ConclusionIt can be indirectly inferred that both visfatin and VEGF should not be used as early markers for cardiometabolic complications among adolescent patients with PCOS. On the other hand, low visfatin levels, through their negative correlation with HDL, may have a protective effect on cardiovascular complications, while low VEGF levels, through their positive correlation with glucose levels, may have a protective influence on carbohydrate metabolism disorders.

Selfies, narcissism and oral health a cross - sectional study among adolescents and young adults in Mangaluru - India.

Background Selfies have been defined as “a photograph that one has taken of oneself, and are a continuing growing trend among Millennials and Gen Z”. Narcissism refers to a personality trait of an extraordinary self-awareness and adoration. Studies have shown a close relationship between selfie-taking behavior, narcissism and oral health. Hence, a study was conducted with aim of assessing correlations between perceived health, perceived oral health, selfie-taking behavior, narcissism and oral health behavior in an adolescent population. Methods An analytical cross-sectional questionnaire study was designed using relevant literature for collating information on sociodemographic characteristics, frequency of dental visits, selfie-taking behavior and perceived oral health. Oral health examination was performed to assess decay and plaque using DMFT index and Plaque index. Narcissism was assessed using The Five-Factor Narcissism Inventory Short Form. Results The study included a sample of 163 participants. The associations between selfies taken per day and perceived oral health was statistically significant (p value 0.047*). Binary logistic regression models were constructed, which were significant for perceived oral health and grandiose fantasy. Plaque Scores showed significant corelations between indifference, manipulativeness, thrill seeking and age. Step forward binary regression demonstrated a significant odds ratio for grandiose narcissism followed by selfie-taking behavior Conclusion This study revealed a correlation between perceived oral health and selfie-taking behaviour. Further studies are required to assess selfie-taking behaviour and oral health.

NCOG-23. CLINICIAN AND PATIENT REPORTED OUTCOMES IN YOUNG ADULTS WITH GLIOBLASTOMA: RESULTS FROM A MULTIMODAL PROSPECTIVE STUDY

Abstract The median age for glioblastoma (GBM) is 65 years old, however, younger patients have a similarly dismal prognosis. The adolescent and young adult (AYA) population (15-39 years) is a unique and understudied population. Our study aimed to identify survivorship needs in adult patients in AYA population (<40 yrs) with GBM through analysis of patient and clinician-reported outcomes (PROs and CROs). The Molecular, Imaging and Neurological assessment Database (MIND-CNS) captures Neurological Assessment in Neuro-Oncology (NANO) scores, MDASI-BT and FACIT-SP12 responses at first clinic visit and follow-ups for patients with GBM. We tested associations of the two age groups (18-39 vs. 40 years and older) with each domain of NANO, MDASI-BT and FACIT-SP12 at baseline and at follow-up visits using multivariate logistic regression models, adjusting for MGMT promoter methylation and extent of resection. There were 104 patients with GBM enrolled, including 11 young adults, (median =30 years) and 93 older adults (median =65 years). Young and older adults scored similarly in the domains of NANO, MDASI-BT, and FACIT-SP12 at baseline. MDASI domains at follow-up showed statistically significant lower scores on weakness, fatigue, distress, irritability, drowsiness, and disturbed sleep in younger vs. older adults (adjusted p<0.05). Younger adults had less difficulty with memory and concentration, and their symptoms interfered less with work, walking, and overall enjoyment of life. They also reported feeling more peaceful, finding greater comfort and strength in their faith and beliefs. A comparison of NANO score at baseline and progression will be performed at data maturation. While PROs were similar at baseline, young adults reported lower severity in their physical symptoms and higher spiritual well-being compared to older adults at follow-up visits, highlighting different survivorship experiences. Data maturation will allow for deeper analysis to better inform supportive strategies.

Cyber Dating Violence: How Is It Perceived in Early Adolescence?

Background: Reports on cyber dating violence in adolescent populations vary significantly depending on whether the focus is on directly aggressive behaviours or behaviours designed to control one’s partner. In contrast to direct aggression, which is often clearly identified by adolescents, there is a greater degree of ignorance, and even a certain degree of normalisation, of controlling behaviours. Such behaviours may include, for example, insisting on knowing the whereabouts of a partner at all times or sharing social media passwords. This study aims to explore adolescent perceptions of cyber dating violence and to identify the differential characteristics of cyber-violent relationships using the Iramuteq software program for text analysis. Methods: Participants were 466 second- and third-year secondary school students. Data were collected through surveys, and responses were analysed using the Iramuteq program. This software tool enabled the identification of common terms and themes linked to cyber dating violence, as perceived by participating adolescents. Results: The analyses revealed the repeated appearance of terms associated with violent behaviours, online media, toxic relationships, and victim coercion. However, there was a notable lack of recognition of controlling behaviours as a manifestation of cyber dating violence. Adolescents frequently normalised behaviours such as insisting on knowing a partner’s whereabouts at all times or sharing social media passwords. Conclusions: The findings suggest a significant gap in adolescents’ understanding of what constitutes cyber dating violence. In contrast to direct aggression, which is easily identified, controlling behaviours are often normalised, indicating a need for educational and preventive measures to address this issue. By improving adolescents’ understanding of controlling behaviours as a form of cyber dating violence, preventive efforts can be more effectively tailored to address and mitigate this problem. To prevent the normalisation of certain behaviours indicative of cyber dating violence, early education is recommended in areas such as healthy relationships, communication skills, respect for privacy, and recognition of signs of excessive control.

An integrated alcohol and suicide intervention for adolescents in inpatient psychiatric treatment.

Despite the bidirectional relationship between alcohol use and STB, the two issues are often treated separately in adolescent inpatient psychiatric hospitals, highlighting the need for brief interventions that address both alcohol use and STB in an integrated fashion. This study tested the feasibility, acceptability, and preliminary effectiveness of a brief integrated Alcohol and Suicide Intervention for Suicidal Teens (iASIST) with a post-discharge mHealth booster for adolescents in inpatient psychiatric treatment. We conducted an RCT of iASIST relative to an attention-matched comparison condition with adolescents hospitalized following STB (N = 40). iASIST demonstrated feasibility and acceptability and mixed models indicated that both groups had significant decreases in substance use over the 3-month follow-up, but post-intervention group differences were not significant. In terms of cannabis use, however, iASIST participants significantly improved over time. Intervention group participants showed a significant decrease in suicide plans from baseline to follow-up, which was not the case for control group participants. Study findings suggest a larger RCT is warranted to test the effectiveness of the iASIST intervention. iASIST shows promise in its ability to target the public health problems of alcohol use and STB in an integrated fashion with a high-risk adolescent population receiving acute psychiatric care.

Emergency psychiatric care for children and adolescents: factors associated with multiple visits and hospital admissions.

Given the increased demand for mental health resources in the child and adolescent population, this study aims to describe the emergency psychiatric care of the children and adolescents and to explore factors associated with multiple visits and hospital admissions. All patients < 18 years of age who visited the psychiatric ED(ED) of a University Hospital in Madrid, Spain, during 2022 were included. Data were collected by the attending psychiatrist upon first 2022 ED visit (index visit) and during any ED revisit. Electronic health records of all included patients were revised to contrast information and complete missing data. Logistic regressions and correlation analyses were used to explore factors associated with multiple ED visits and hospitalisations. N = 397 patients were included. Factors associated with multiple ED visits were: being LGTBQ+, having eating problems, substance use, consulting for psychosis upon first visit, having a history of suicidal behaviour, previous mental health service use or previous hospitalisations, having two or more psychiatric diagnoses, and being diagnosed of eating disorders or depression. Factors associated with hospitalisation include female gender, older age, LGTBQ+, family conflicts, first or second-generation migrants, history of abuse, eating problems, drug use, history of suicidal behaviour, previous mental health service use or previous hospitalisations, psychiatric comorbidity, and eating disorders diagnosis. Identifying predictors that lead to different clinical pathways and use of mental health services can improve clinical outcomes and resource use.

The Adolescent Mental Health Consequences of Social Media Usage

This paper looks into the impact of social media on an individual’s mental health status in the adolescent population. The scope of the study includes both addiction and recovery, addressing risks such as anxiety, depression, and distorted self-perception associated with the continuous use of social platforms like Instagram, TikTok, Facebook, etc. Besides recognizing the detrimental impacts of bullying, body image comparison, and excessive use of screens, the paper also underlines some advantages of social media, such as connecting people and access to assistance. In the present research, numerical indicators and empirical observations are used, i.e. the nvestigation is conducted on the basis of the mixed research method. It reveals variations in social media effects amongst adolescents based on the moderating variables of individual characteristics and situational context. The paper ends with solutions to alleviate the negative effects, such as digital literacy education, parental guidance, and mental health strategies while fostering the healthy usage of social media regarding mental health. These findings suggest the need for a longitudinal study in order to assess the changes over time in this somewhat new aspect.

Internal Validation of the Latvian Version of 16-Item Prodromal Questionnaire in A Help-Seeking Adolescent Population: Psychometric Analysis and Associated Factors.

The prodromal phase of a psychotic disorder is a period of altered functioning before the onset of the acute state; several interviews have been developed to determine whether individuals present with prodromal symptoms. The 16-item Prodromal Questionnaire (PQ-16) is a screening tool for evaluating those at risk of developing a psychotic disorder. The study aimed to evaluate the psychometric properties of the Latvian version of the PQ-16 in a sample of help-seeking adolescents referred for diagnostic assessment and look for possible associated socio-demographic and health-related factors. A cross-sectional study included patients admitted for evaluation between November 2022 and February 2023 in Riga's Children's Clinical University Hospital Child Psychiatry clinic. The data were collected during outpatient consultations by mental health professionals. We used the Latvian translation of PQ-16 and the socio-demographic and health-related factors questionnaire. Data were analysed with IBM SPSS 28; the scale's diagnostic accuracy and internal validity were examined. The study involved 107 adolescents aged 12% to 17%, 80.5% female, with a mean age of 14.98 (CI 14.70-15.26). Socio-demographic data and health-related variables did not significantly differ between the sexes (p > 0.05). The Latvian PQ-16 demonstrated excellent internal reliability with a Cronbach's alpha of 0.890. All 16 items were found to be valid with p < 0.001. A significant number of participants (73.8%) scored above the current cut-off of ≥ 6 with a mean of 9.17 (95% CI 8.41-9.93). Certain socio-demographic factors, such as female gender (p < 0.001), fair school performance (p = 0.048) and recent changes in school performance (p < 0.001), demonstrated a significant association with higher scores. Additionally, there were found significant associations between positive screening and health-related factors such as obstetric complications (p = 0.044), smoking (p = 0.002), alcohol consumption (p = 0.021), history of bullying in school (p < 0.001) and emotional abuse at home (p = 0.011). Latvian translation of PQ-16 showed high internal reliability and validity levels. Positive PQ-16 screening was associated with female gender, worsened school performance, obstetric complications, substance abuse and experienced emotional violence. The average score of 9.17 positive answers and 73.8% of participants screening positive for attenuated psychotic symptoms is significantly higher than in recent studies under similar conditions.

Quadrivalent Conjugate Vaccine and Invasive Meningococcal Disease in US Adolescents and Young Adults

Beginning in 2005, the US implemented routine immunization of adolescents with a quadrivalent conjugate vaccine (MenACWY) for the prevention of invasive meningococcal disease (IMD). To assess whether MenACWY immunization was associated with a reduced IMD burden among the US adolescent population and how the downward trajectory of IMD that began in the mid-1990s might have evolved in the absence of vaccination efforts. In this decision analytical study, a bayesian hierarchical Poisson regression model was developed to investigate the potential trajectory of IMD among US adolescents and young adults without vaccination and evaluate the direct association of vaccination with IMD burden. The model included the entire age-stratified US population and was fitted to national incidence data for serogroups C, W, and Y from January 1, 2001, to December 31, 2021, with stratification by vaccination status for IMD cases. Simulated counterfactual scenario of absent vaccination from 2005 to 2021, while retaining the incidence rate of IMD for unvaccinated individuals estimated during model fitting. The main outcomes were the estimated numbers of IMD cases and deaths averted by MenACWY vaccination among US adolescents and young adults aged 11 to 23 years. Among the entire US population from 2005 to 2021, MenACWY vaccination prevented an estimated 172 (95% credible interval [CrI], 85-345) cases of IMD among US adolescents 11 to 15 years of age and 328 (95% CrI, 164-646) cases of IMD among those aged 16 to 23 years. Absent vaccination, the cumulative incidence of IMD in these age groups would have been at least 59% higher than reported over the same period with vaccination. Using case fatality rates of unvaccinated individuals derived from national data, vaccination averted an estimated 16 (95% CrI, 8-31) deaths among adolescents aged 11 to 15 years and 38 (95% CrI, 19-75) deaths among those aged 16 to 23 years. This decision analytical model suggests that the MenACWY vaccination program in the US was associated with a reduced burden of meningococcal disease. Without vaccination, the incidence rates per 100 000 adolescents and young adults would have been substantially higher than those observed during the vaccine era.

Adolescent microsurgical varicocelectomy and changes in sperm parameters: A matched cohort analysis.

Varicocele, a common vascular abnormality surrounding the testis, is known to be associated with impaired semen parameters and male infertility in adults. However, its impact on the adolescent and young adult (AYA) population is less well known. The study aimed to assess the improvement in sperm parameters following varicocelectomy in the AYA population, comparing them to matched adult counterparts, and investigating potential advantages of early intervention. A retrospective analysis was conducted using a comprehensive database at the University of Miami spanning from 2012 to 2023. We included AYA (under 25 years of age) men who underwent varicocelectomy. To ensure comparability, they were matched with adult patients (over 30 years of age) based on preoperative follicle-stimulating hormone (FSH) values and varicocele grade in a 1:2 ratio. Semen parameters were evaluated before and after surgery, including sperm count, motility, morphology, and overall semen quality. We included 45 patients in the Adolescents and Young Adults (AYA) category, and matched them with 116 adults based on FSH and varicocele grade, all of whom underwent microsurgical varicocelectomy. The AYA group exhibited greater improvements post-varicocelectomy compared to the matched cohort. Furthermore, postoperative sperm concentration in the AYA men demonstrated a remarkable increase, with a 1.7-fold increase in mean concentration compared to the adult group (p<0.001). Additionally, motility also displayed significant enhancement among the AYA men, with a final mean total motile sperm count (TMSC) improvement of 2.25-fold compared to the adult cohort (p=0.002). This study highlights the potential benefits of varicocelectomy as a viable treatment option for adolescents and young adults with varicocele, particularly those with impaired semen parameters. By intervening at an earlier stage of development, patients in this age group can achieve significant improvements in semen quality, as compared to their adult counterparts. These findings underscore the importance of considering varicocelectomy as a valuable therapeutic approach for the younger demographic, potentially alleviating future fertility concerns.

Deliberate Absence: Mapping the Presence of Indian Transgender and Gender Diverse (TGD) Youth in Social and Medical Rights-Based Work Initiatives for the Community

Background: Adolescence, the transitional phase between childhood and adulthood, involves significant biological, social, cognitive and emotional changes. In India, adolescents (10–18 years) form 21% of the population, increasing to 33% when including those aged 10–24 years, making India home to the world’s largest adolescent population. The concept of adolescence, unlike the biological process of puberty, is culturally determined and influenced by globalisation and changing societal values. Objectives: This article aims to (a) elucidate the barriers hindering transgender and gender diverse (TGD) youth in India from accessing gender affirmation, including familial rejection, constraining legal provisions and inadequate public health infrastructure; (b) underscore the impact of socio-cultural and political attitudes on health disparities faced by TGD youth, emphasising the need for comprehensive and individualised healthcare and socio-cultural support; (c) advocate for a socio-medical approach to address the unique challenges of Indian TGD youth, focusing on collaborative efforts among healthcare professionals, social institutions and policymakers; (d) propose strategies for improving access to early gender-affirmative care, including training healthcare providers, promoting comprehensive medical support and advocating for the rights of TGD youth. Methods: A blind review of literature was conducted using PUBMED/MEDLINE, Google Scholar, Web of Science, PsycINFO and SCOPUS with keywords such as ‘transgender youth’, ‘nonbinary and gender diverse youth’, ‘gender-affirming medical care in India’ and ‘youth mental health’. The search eventually included peer-reviewed publications, books, reviews, editorials, opinion pieces, feature stories and individual case reports. Articles were screened and thematically analysed to synthesise findings. Results: The review highlights significant barriers to gender-affirming care for TGD youth in India, including familial rejection, restrictive legal frameworks and inadequate public health infrastructure. Socio-cultural and political attitudes contribute to health disparities, necessitating comprehensive healthcare and socio-cultural support. Conclusions: Addressing the challenges faced by TGD youth in India requires a socio-medical approach, emphasising collaborative efforts among healthcare providers, social institutions and policymakers. Strategies for improvement include training healthcare providers, promoting comprehensive medical support and advocating for the rights of TGD youth to ensure early and effective gender-affirmative care.

Things seen and unseen: 2. Anaemia affects urban rich Nigerian adolescents more than other socio‑economic status groups.

Background: Anaemia is very prevalent globally and is thought to be linearly associated with wealth and to affect females and rural residents more than males and urban residents. Objectives: This study was designed to investigate this thought in a population of adolescents in Ebonyi State, Nigeria. Methods: Standard clinical protocols were used. A total of 362 adolescents (63.5% females) were studied. Anaemia was diagnosed on the basis of the World Health Organization (WHO) criteria. Results: Aggregate anaemia was found in 50.0% of the general population (43.9% males, 53.5% females) and was most prevalent in the urban upper socio‑economic status (SES) group (62.3%; 70.0% females, 52.2% males). Severe anaemia was present in 7.2% of the general population (9.1% males, 6.1% females). It was most prevalent amongst the 10-11 years age bracket (15.6%). Moderate and mild anaemia were found in 22.4% and 20.4% of the general population and in 13.0%, 11.4%, 8.3% and 6.0% of the urban upper, rural, urban low and middle SES groups, respectively. But in the rural area group, severe anaemia existed without wide sex variations. Moderate anaemia was most prevalent in the urban middle and upper SES groups (29.0% and 26.4%, respectively) with a clear female preponderance. Mild anaemia was the least prevalent (15.3%) in the urban middle SES group. Conclusions: The higher prevalence of severe anaemia in boys and the higher burden in the urban higher SES group warrant a rethink of the public health interventions used in Nigeria. Adolescent boys and urban upper SES groups should be targeted in nutrition interventions related to anaemia.

Antithrombotic Agents After Free Tissue Transfer in the Pediatric and Adolescent Population.

Even for the experienced microsurgeon, free tissue transfer in pediatric patients is challenging, and large patient series remain scarce in the literature. Moreover, the added value of antithrombotic agents in pediatric free tissue transfer remains unclear. We conducted a retrospective outcome analysis of pediatric free tissue transfer with respect to postoperative antithrombotic treatment at our tertiary academic center. All patients aged 0 to 18 years who underwent free tissue transfer from 1998 to 2022 were included in the study. Seventy patients received 73 free tissue transfers. The most common indications were facial paralysis, trauma, and tumor (49.3%, 21.9%, and 20.5%, respectively). The most common recipient sites were the head and neck (56.1%) and lower extremity (32.8%). We observed a flap revision rate of 12.5% of the cases and one flap loss (1.4%). 58.9% of the population received post-operative antithrombotic agents. The rate of flap revision surgery was similar (11.6% and 10.0%, respectively), with and without antithrombotic treatment (p>0.05). There were no major bleeding complications or deep vein thrombosis. The antithrombotic treatment did not seem to affect the flap revision rate or the bleeding complications in our cohort. Hence, the data do not support the routine administration of antithrombotic treatment in pediatric free flap reconstruction. However, these findings should be solidified in prospective randomized trials.

Racial and ethnic disparities in outcomes of diffuse large B cell lymphoma in adolescent and young adults: a SEER database analysis.

Data regarding racial disparities in the incidence, treatment, and outcomes of diffuse large B-cell lymphoma (DLBCL) is limited in the adolescent and young adult (AYA) population. We utilized the surveillance, epidemiology, and end-result (SEER) registry research plus database to evaluate racial/ethnic disparities in 8605 AYA patients with DLBCL. Race/ethnicity was categorized into three main subsets: non-Hispanic Whites (NHW), non-Hispanic Blacks (NHB), and 'other races' that included Hispanics (H), American Indian/Alaskan Native (AI/AN), Asian or Pacific Islander (A/PI). NHB were more likely to present with advanced stage disease (p < 0.001) and B symptoms (p < 0.001) and were less likely to receive chemotherapy(p < 0.001) compared to non-Hispanic white (NHW) patients and other races respectively. NHB patients had inferior 5-year disease specific survival (DSS) (70% vs 85% vs 80%, p < 0.001) and 5-year overall survival (OS) (66% vs 82% vs 77%, p < 0.001) compared to NHW and other races respectively. Black race was independently associated with both inferior DSS (HR 1.55, 95% CI 1.17-2.05, p = 0.002) and OS (HR 1.41, 95% CI 1.10-1.83, p = 0.007) after adjusting for age, gender, stage, presence of B symptoms, receipt of chemotherapy and radiation. NHB-DLBCL patients also had a lower 1-year relative survival rate (RSR) compared to NHW and other races. The low RSR in NHB patients persisted up to 5 years from diagnosis unlike NHW and other races. Our study shows that despite significant therapeutic advances in DLBCL over the last two decades, NHB AYA patients with DLBCL continue to have inferior survival outcomes compared to other ethnic and racial groups with disparities arising as early as the first year of diagnosis.

Trauma, Resilience, and Substance Use in Adolescents: A Review Article

Background: Adolescence is a sensitive phase of human life featuring changes in physical, emotional, and social characteristics. Many teens experience stressful events and trauma, which can affect their mental health and increase their risk of initiating and continuing substance use. Genetic vulnerabilities impact this relationship. In the face of trauma, while some adolescents are vulnerable, others navigate similar experiences differently, show resilience, and generally fare better without developing substance use problems. Understanding the multiple contributory factors that impact this relationship is critical in informing clinical approaches and program development. Objective: To describe the intricate dynamics between trauma, resilience, and substance abuse among adolescents. This review attempts to offer a synopsis that clarifies existing perspectives on trauma and substance use in adolescents while indicating areas for future research, clinical, and intervention programs in this critical area of adolescent well-being. Methods: A literature review was conducted to reveal available studies related to trauma, adolescent substance use, and resilience. Synthesis of findings from empirical studies, a detailed discussion on trauma and developmental factors while also addressing resilience elements alongside patterns of substance use is presented. Conclusion: Trauma, resilience, and substance use are linked in a tri-directional relationship, which is complex and dynamic. Adolescents with trauma are at higher risk of initiating and continuing substance. Resilience impacts treatment-seeking and engagement and may reduce relapse risk. Future research recommendations include improving the cultural sensitivity of interventions, studying the effects of marginalized identities, and ensuring rigorous evaluation of and progressive development of intervention programs. Results: The review highlights the bidirectional connections between trauma and substance use in adolescents. We include the consideration of resilience in adolescent responses to trauma. Resilience may reduce the risk of substance use, improve treatment-seeking and engagement in the treatment of SUD in adolescents, and reduce the risk of relapse, thereby suggesting it is a third dimension in the relationship between trauma and substance use. This review also provides evidence-based interventions and policies that are tailored to the specific needs of a diverse population of adolescents. We uncover the gaps in research, especially regarding cultural specifics and intersectionality among marginalized identities.

Empirically Derived Dietary Patterns in Association with Asthma Symptoms in Children and Adolescents: A Cross-Sectional Study

Background: Limited data exists regarding the association between dietary patterns and asthma. This study aims to determine the relationship between empirically derived dietary patterns and the likelihood of asthma among a large population of children and adolescents living in central Iran. Methods: A total of 7667 of male and female students aged 6-14 from 48 public and private schools in YAZD urban areas entered the current cross-sectional study. Data on dietary intakes, as well as asthma symptoms and other possible confounders, were collected using a self-administered questionnaire filled by parents. Factor analysis was applied to find major dietary patterns. Multivariate logistic regression was performed to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for asthma development across quintiles of dietary patterns. Results: Two main dietary patterns were established. A “traditional diet” was determined by meat, fish, fruits, cooked vegetable, raw vegetable, legumes, cereals, bread, macaroni, rice, margarine, butter, olive oil, milk, yogurt, egg, nuts, potato, and a “western-like diet” was characterized by high intakes of simple sugars, fast food(hamburger), fast food (pizza), soft drinks, jelly, chocolate and biscuits of cocoa, ice cream, and sauce. After adjusting for potential confounders, individuals in the top quintile of traditional diet were 0.31 times less likely to have asthma than those in the lowest quintile (OR=0.69; 95% CI: 0.47-1.00). Moreover, individuals in the top quintile of traditional diet were 0.43 times less likely to have wheezing compared with those in the lowest quintile (OR=0.57, 95% CI: 0.46-0.70). However, individuals in the top quintile of the western diet were 0.35 times more likely to have wheezing than those in the lowest quintile (OR=1.35, 95% CI: 1.10-1.66). Conclusions: According to the results, a traditional diet might be associated with lower odds of asthma; however, a western-like diet might be adversely associated with asthma symptoms.

Prevalence of self-reported symptoms of reproductive tract infections and promoting an awareness of reproductive health among adolescent girls through education approach in Kumbakonam rural region of Tamil Nadu state

ABSTRACT Introduction: Adolescent females in India particularly from rural areas indicate sparse sexual and reproductive health (SRH) information and are at risk of unfavourable sexual and reproductive health outcomes. Objectives: The study was primarily intended to assess the effect of structured interventional education on awareness and practices of school-going adolescent girls about sexual and reproductive health. Methods: This was an interventional study comprising of interactive strategies, namely peer-led approach, flipped learning, skit, scenario-based discussion and puppetry. The pre- and post-test was conducted among 1232 girls in selected schools at rural block in Kumbakonam rural region of Tamil Nadu State of India. Results: The participants reported statistically significant gain in knowledge, attitudes and practices about reproductive health due to educational intervention (P &lt; 0.001). Nearly 50% of participants were aware about various contraceptive methods before intervention. The prevalence of self-reported symptoms of RTIs/STIs was 23.7%. Nearly more than half of participants were aware about various contraceptive methods. Conclusions: Peer-led education can be a potential health promotion strategy among adolescent population.