Adolescent Transition Research Articles

The Impact of Parenting Styles on Adolescents' Mental Health

The family is the primary environment where adolescents transition from being individuals to becoming members of society. During adolescence, the family atmosphere and parenting styles directly affect adolescents' physical and mental development. The family, akin to a small social unit, is the first environment for communication and the initial classroom for socialization. Within the family, various factors, such as parents' occupations, educational backgrounds, economic status, and family structure, play a significant role in shaping parenting styles. Therefore, parents should choose parenting methods based on adolescents' age and characteristics to foster a harmonious atmosphere that promotes adolescents' mental health development.

Validity of the Multigroup Ethnic Identity Measure for Māori, Pacific, Asian & European adolescents

Abstract Background Ethnic identity is important for positive health and wellbeing outcomes, especially for Indigenous youth and adolescents from minoritised ethnic groups. The Multigroup Ethnic Identity Measure (MEIM) is widely used to examine ethnic identity as a general phenomenon across ethnic groups. However, evidence regarding its validity for adolescents from different ethnic backgrounds is mainly limited to the US context. This study investigated psychometric properties of the MEIM, for the first time, within a large ethnically diverse population-based sample in New Zealand. Methods We used data from the Growing Up in New Zealand study. Participants were 4500 12-year-olds and included 22.4% Māori (the Indigenous people of New Zealand), 16.7% Pacific, 14.8% Asian and 51.9% European young people. 45.7% were cisgender boy, 37.4% were cisgender girl, and 16.4% were non-binary, trans or unsure. We conducted factor analysis for the 12-item MEIM. Results Confirmatory factor analysis model fit tended to be best for a solution with two factors representing two ethnic identity subcomponents of Exploration and Affirmation/Belonging. A single ‘ethnic identity’ factor showed a slightly weaker model fit. Exploratory factor analysis revealed a 2-factor structure with a slightly different item composition as compared to the original MEIM subscales. The findings were largely comparable across ethnic groups. Conclusions The MEIM appears to be a valid measure for Māori, Pacific, Asian and European young people. However, nuances may exist due to unique contexts including structural factors, societal norms and challenges, opportunities and access to cultural engagement. Ethnic identity is strongly linked to health and wellbeing including quality of life, self-esteem and life satisfaction. Therefore, we recommend acknowledging nuances of ethnic identity during an important time of development within diverse cultural contexts, by applying subscales and subgroup analyses where possible. Key messages • The Multigroup Ethnic Identity Measure is valid and appropriate to use at age 12-years among diverse ethnic groups including Māori, Pacific, Asian and European. • Nuances of ethnic identity should be acknowledged as an important factor for health and wellbeing, especially during critical times of transition for adolescents within diverse cultural contexts.

Adherence to Mediterranean diet in Moroccan school-age adolescents: sociodemographic, socioeconomic and lifestyle determinants

BackgroundDespite its benefits, the Mediterranean diet (MD) is abandoned or not adopted by the younger generations in most Mediterranean countries.ObjectiveThe aim here was to examine some factors determining adherence to MD in Moroccan school-age adolescents.Material and methodsA cross-sectional survey was conducted in a school setting among 386 students (148 boys and 238 girls), aged 14 to 18 years, randomly selected and from different socioeconomic strata. A structured questionnaire was used to collect sociodemographic, socioeconomic and lifestyle data. Physical activity was assessed using the short French version of the IPAQ questionnaire. The KIDMED test was used to assess adherence to the Mediterranean diet. Weight, height and waist circumference were measured according to WHO standards. Body mass index (BMI) and waist�to-height ratio (WHtR) were calculated. Statistical ANOVA test was used for to compare multiple means, Student’s t-test for independent samples, <i>Chi</i><sup>2</sup> test for categorical variables and multinomial logistic regression analysis to identify factors associated with adherence to the MD amongst adolescents sample.ResultsAdherence to the MD in this population was very low, with nearly 53% having poor adherence and only 7.7% reporting optimal adherence. Multinomial regression analyses showed that poor adherence is correlated with female gender (p=0.042), low paternal education (p=0.004), limited number of meals (p=0.006), advanced age (p=0.005) and inadequate sleep duration (p=0.027). In contrast, better adherence appears to be correlated with a high number of meals per day (p<0.001) and a better socio-professional class of the father (p<0.001).ConclusionsThis study revealed a low prevalence of good adherence to MD confirming a transition of the study adolescents towards a Westernized diet. Targeted nutritional intervention programs should be implemented to improve adherence to the MD among Moroccan adolescents, by promoting healthy eating habits.

Progressing "Positive epidemiology": A cross-national analysis of adolescents' positive mental health and outcomes during the COVID-19 pandemic.

"Positive epidemiology" emphasizes strengths and assets that protect the health of populations. Positive mental health refers to a range of social and emotional capabilities that may support adaptation to challenging circumstances. We examine the role of positive mental health in promoting adolescent health during the crisis phase of the COVID-19 pandemic. We used four long-running Australian and UK longitudinal cohorts: Childhood to Adolescence Transition Study (CATS; analyzed N=809; Australia); Longitudinal Study of Australian Children (LSAC) - Baby (analyzed N=1,534) and Kindergarten (analyzed N=1,300) cohorts; Millennium Cohort Study (MCS; analyzed N=2,490; UK). Measures included: (Pre-pandemic exposure): Positive mental health (parent-reported, 13-15 years) including regulating emotions, interacting well with peers, and caring for others; and pandemic outcomes: psychological distress, life satisfaction, and sleep and alcohol use outside of recommendations (16-21 years; 2020). We used two-stage meta-analysis to estimate associations between positive mental health and outcomes across cohorts, accounting for potential confounders. Estimates suggest meaningful effects of positive mental health on psychosocial outcomes during the pandemic, including lower risk of psychological distress (Risk Ratio [RR]=0.83 95%CI=0.71, 0.97) and higher life satisfaction (RR=1.1, 95%CI=1.0, 1.2). The estimated effects for health behaviors were smaller in magnitude (sleep: RR=0.95, 95%CI=0.86, 1.1; alcohol use: RR=0.97, 95%CI=0.85, 1.1). Our results are consistent with the hypothesis that adolescents' positive mental health supports better psychosocial outcomes during challenges such as the COVID-19 pandemic, but relevance for health behaviors is less clear. These findings reinforce the value of extending evidence to include positive health states and assets.

Barriers and facilitators of transition of adolescents living with HIV into adult care in under-resourced settings of Southern Ethiopia: a qualitative study

BackgroundAdolescence is commonly perceived as a distinct and typically healthy stage of life. However, in regions with a high prevalence of HIV, like Ethiopia, numerous adolescents are contracting the virus. Upon testing and diagnosis, they encounter care-related issues, particularly barriers and facilitators of the healthcare transition from adolescent to adult clinics. Hence, the study aimed to investigate the barriers and facilitators influencing the transition of adolescents living with HIV (ALWHs) in the resource-limited settings of Southern Ethiopia.MethodsThe research employed a phenomenological study design with a qualitative methodology. Purposive sampling was used to gather data through in-depth interviews (IDIs) and focus group discussions (FDGs) involving ALWHs and their parents. The data analysis followed Van Manen’s principles.ResultsFollowing Van Manen’s guidelines, the data analysis revealed a conceptual framework with two major themes: “Barriers” and “Facilitators”. The theme barrier was derived from three sub-themes including behavioral barriers, social barriers, and system barriers in the transition. The theme facilitator was derived from four sub-themes including self-acceptance as an adult, a desire to experience new things, a supportive family, and friendly healthcare services. The study identified three levels of factors influencing the transition into adult clinics: individual, family/peer, and healthcare-related factors. The barriers to transition included lack of knowledge, being in a romantic relationship, psychosocial struggles, perceiving us as immature, stigma, negative peer pressure, lack of timely disclosure, absence of transition guidelines, disrespectful treatment, and absence of separate clinics. On the other hand, facilitators such as self-acceptance as an adult, desire for new experiences, family support, informed support and promising outcomes, flexible appointment scheduling, and psycho-social support groups were found to improve the transition process and enhance the overall well-being of adolescents living with HIV.ConclusionThe study highlights the complex transition process for ALWHs into adult healthcare. Barriers such as lack of knowledge, stigma, and disrespectful treatment pose challenges during this critical period. Conversely, facilitators like self-acceptance, family support, and youth-friendly healthcare services can enhance the transition experience and well-being of ALWHs. Collaborative efforts among ALWHs, families, and healthcare providers are crucial for successful transitions and improved health outcomes. Separated clinics catering to the unique needs of ALWHs are recommended to address privacy concerns.

The Relationship Between Epidemic Perception and Cyberbullying Behaviors of Chinese Adolescents During the COVID-19 Pandemic: Cross-Sectional Study.

In response to the COVID-19 outbreak, the government initiated measures for social distancing, leading to a gradual transition of adolescents' social interactions toward web-based platforms. Consequently, web-based behaviors, particularly cyberbullying, have become a prominent concern. Considering that adolescents experience more intense feelings, the widely increased negative emotions and strains perceived from the COVID-19 pandemic may end up engaging in cyberbullying behaviors. In addition, during the COVID-19 pandemic, adolescents experiencing insomnia and negative affect are more prone to diminished self-control, which is associated with cyberbullying behaviors. This study aims to investigate the relationship between epidemic perception and cyberbullying behaviors, while also examining the serial mediating roles of insomnia and negative affect on the relationship between epidemic perception and cyberbullying behaviors. This study presents a large-scale web-based survey conducted during the period of concentrated COVID-19 outbreaks, encompassing 20,000 Chinese adolescents. A total of 274 submitted questionnaires were discarded because of high levels of missing data or their answers were clearly fictitious or inconsistent. The final count of valid participants amounted to 19,726 (10,371 boys, age range: 12-18 years; mean 14.80, SD 1.63 years). The Perceptions of COVID-19 Scale, Negative Affect Scale, Insomnia Scale, and Cyberbullying Behavior Scale were used to assess participants' responses on the Questionnaire Star platform. The results show that epidemic perception is positively correlated with cyberbullying behaviors (r=0.13; P<.001), insomnia (r=0.19; P<.001), and negative affect (r=0.25; P<.001). Insomnia is positively correlated with negative affect (r=0.44; P<.001) and cyberbullying behaviors (r=0.30; P<.001). Negative affect is positively correlated with cyberbullying behaviors (r=0.25; P<.001). And insomnia and negative affect play independent mediating and serial mediating roles in epidemic perception and cyberbullying behaviors. This study provides additional empirical evidence on the relationship between the perception of COVID-19 pandemic and cyberbullying in adolescents. In addition, the study offers recommendations for implementing interventions targeted at mitigating cyberbullying in adolescents during the COVID-19 pandemic.

Beyond delinquency and drug use: Links of peer pressure to long-term adolescent psychosocial development.

This study examined the predictors and sequelae of exposure to peer pressure from close friends in adolescence. Adolescents (99 female; 85 male) were followed from age 13 to 24 utilizing peer, parent, and romantic partner reports and observational data. Participants who were exposed to high levels of peer pressure as teens were more likely to experience higher levels of coercive behavior from romantic partners (as reported by those partners), as well as lower levels of parent-reported functional independence. All findings held even after accounting for baseline levels of teen assertiveness. Adolescents at risk for increasing exposure to peer pressure were characterized by poor-quality parent and peer relationships, as well as baseline deficits in ability to assert autonomy. Results suggest that exposure to peer pressure, aside from its potential effects on deviant or risky behavior, may reflect a powerful threat to the autonomy development process as adolescents transition from parents to peers as primary sources of support and interaction.

Math and German motivation transitions in early adolescence

BackgroundSome students are more motivated that others in one or multiple academic domains, and more motivated in one domain than another. These inner hierarchies of motivational beliefs are important because they can influence students’ achievement and study or career choices. However, little is known about the heterogeneity in inner hierarchies of motivational beliefs during early secondary school, when motivation typically declines. AimsThe aims of this study were to (1) identify profiles of self-concept and intrinsic value in mathematics and German during the first two years of secondary school, (2) explore stability and change in these profiles, and (3) explore how profile membership relates to student competence and gender, and perceived teacher behaviour. SampleParticipants were 721 secondary school students from Germany. MethodsStudents completed measures of self-concept, intrinsic value, and competence in grades 5 and 6, and measures of perceived teacher behaviour in grade 5. Data were analysed using latent transition analysis. ResultsFive profiles characterised by inter- and intraindividual differences in self-concept and intrinsic value were identified. Membership in these profiles was relatively stable. Inner hierarchies of self-concept and value were related to competence, with students demonstrating higher competence in domains they were more motivated in. Gender and perceived teacher behaviour were related to profile membership, but not profile transitions. ConclusionsWhen supporting the motivational development of students during the first two years of secondary school, teachers may need to adopt a holistic approach that recognises the heterogeneity in students’ inner hierarchies of motivational beliefs.

Bodily growth and the intervertebral disc: a longitudinal MRI study in healthy adolescents

BACKGROUND CONTEXTLow back pain (LBP) among children and adolescents is a growing global concern. Disc degeneration (DD) is considered a significant factor in the clinical symptom of LBP. Both LBP and DD become more prevalent as adolescents transition into emerging adulthood. However, the relationship between growth during the pubertal growth spurt and the morphology of lumbar discs has yet to be elucidated. PURPOSEThis study aimed to assess the relationship between bodily growth during the pubertal growth spurt and the morphology of lumbar discs at age 18. STUDY DESIGNThis study was a prospective longitudinal cohort study. PATIENT SAMPLEA randomly selected cohort of healthy children was examined at ages 8, 11, and 18. Participants with complete data sets (semi-structured interview, anthropometric measurements and lumbar spine MRI) at age 11 and 18 were included in this analysis (n=59). OUTCOME MEASURESThe morphological characteristics of lumbar discs were evaluated on MRI. Anthropometric measures including height, sitting height and weight were obtained to calculate the Body Surface Area (BSA) and the Body Mass Index (BMI). METHODSThe morphology of the lumbar discs was evaluated on T2-weighted mid-sagittal MRI using the Pfirrmann classification. A disc with a Pfirrmann grade of 3 or higher was considered degenerated at age 18. The relationship between relative growth between ages 11 and 18 (adjusted to sex and baseline values) and DD at age 18 was assessed. To analyze the relationship between the relative increase in BSA and DD, the participants were categorized into three equal-sized categories (tertiles). For all other anthropometric measures, the analysis was based on the relative increase in each measure between ages 11 and 18. RESULTSIn the highest tertile of relative increase in BSA (≥43%), 76% of participants had at least 1 disc with a Pfirrmann grade 3 or higher at age 18 while only 10% and 21% of participants in the lowest and medium tertiles had DD, respectively. The sex- and baseline-adjusted odds ratio (OR) for DD at age 18 for every additional 10% increase in BSA was 1.08 (1.02–1.15). The sex- and baseline-adjusted OR (95% CI) for DD at age 18 was 10.5 (1.60–68.7) and 7.92 (1.19–52.72) with every additional 10% increase in height and sitting height, respectively. For every additional 10% increase in weight, the adjusted OR for DD at age 18 was 1.51 (1.12–2.04) and for BMI 1.05 (1.01–1.09). CONCLUSIONSMore relative growth between ages 11 and 18 is significantly associated with the occurrence of DD in emerging adulthood. Among the measures investigated, height and sitting height are nonmodifiable. Maintaining an ideal body weight during the pubertal growth spurt may be beneficial for the health of the lumbar discs.

Adolescent reading characteristics and transition patterns: A latent transition analysis of individual, family, and school influences

Adolescent reading characteristics and transition patterns: A latent transition analysis of individual, family, and school influences

Mixed Methods Evaluation of a Youth-Friendly Clinic for Young People Living with HIV Transitioning from Pediatric Care.

(1) Background: Adolescents and young adults face challenges when transitioning to adult care due to emerging adulthood and changing providers and insurance. Young people living with HIV (YPLHIV) have additional obstacles with mental health and stigma. During transition, only 55% of YPLHIV are retained in care, and 65% are virally suppressed. To address these challenges, the Adolescent and Young Adult Health Care Transition Clinic (AYAHCTC) was created at Vanderbilt University Medical Center in 2017. This mixed methods study evaluates the initial cohort and solicits YPLHIVs' perspectives on transition barriers and facilitators. (2) Methods: Quantitative analyses (n = 21) characterized patients' demographics, clinical engagement, and retention. Qualitative interviews (n = 5) captured patients' transition experiences. (3) Results: This study, conducted in the Southeastern USA, included a cohort where 47.6% were born abroad, with all participants being US citizens by birth or naturalization. Patients' mean age at first visit was 19.6 years. The average AYAHCTC duration was 2.21 years. First-year engagement and retention were 100% and 95.5%, respectively. Viral suppression rates improved from 66.7% at the first visit to 81.0% at the last visit. Eleven patients transitioned out of AYAHCTC. Qualitative analyses indicate that barriers to transition include leaving trusted providers, reduced parental guidance, developing autonomy, and perceived loss of confidentiality in adult clinic environment. Transition was facilitated by youth-friendly services, clear communication, and strong relationships with AYAHCTC providers. (4) Conclusions: YPLHIV positively viewed AYAHCTC experiences. Future directions include optimizing services to build YPLHIVs' independence, supporting YPLHIV experiencing stigma, assuaging concerns about switching providers, collaborating with adult clinics to maintain confidentiality, and designing interventions focused on adherence during transition.

Adolescent transition preparation around the COVID-19 pandemic: A cross-sectional study

ObjectiveTo compare preparation for transition in adolescents in the United States prior to and during the COVID-19 pandemic. Study DesignWe used data from the 2019 and 2021 National Survey of Children’s Health to compare transition preparation before and after the COVID-19 pandemic among adolescents who had a medical care visit within the preceding year, controlled for relevant potential confounders. The association of demographic factors and survey year with a composite measure of adequate transition preparation was evaluated using univariable analysis and multivariable logistic regression. ResultsThe difference in transition preparation was not significant when comparing 2019 to 2021 (9.25 % in 2019 vs. 8.67 % in 2021, p = .556), despite changes in potential confounders, such as worse caregiver mental or emotional health and fewer adolescents having insurance or a usual source of preventive care. Older adolescents (odds ratio for each year 1.321, 95 % confidence interval 1.196 – 1.459), females (odds ratio 1.153, 95 % confidence interval 1.02 – 1.304) were more likely to have received adequate transition preparation. Adolescents from Spanish-speaking homes were less likely than adolescents from English-speaking homes to have received adequate transition preparation (odds ratio 0.529, 95 % confidence interval 0.329 – 0.849). ConclusionsThe proportion of adolescents in the United States who received adequate preparation to transition to adult care did not change during the COVID-19 pandemic. However, in both years studied, only a small minority of adolescents in the United States were adequately prepared.

Creating a data collection and management platform to support measurement of adolescent HIV care transition processes within low- and middle-income countries: The GRADUATE project.

Few national programs and research cohorts within low- and middle-income countries (LMICs) document transition-related processes and outcomes for adolescents and young adults living with HIV (AYLH) transitioning to adulthood. Between 2017-2020, The Global fRAmework of Data collection Used for Adolescent HIV Transition Evaluation (GRADUATE) project convened a collaborative advisory group to identify key variables and definitions capturing the process, predictors, and outcomes across the transition period. In total, 114 variables identified as essential to measuring AYLH transition-related data were identified and formatted into a GRADUATE Data Exchange Standard (DES), which was added to and harmonized with the existing International epidemiology Databases to Evaluate AIDS (IeDEA) DES. In 2019, the GRADUATE DES was pilot tested at four IeDEA facilities in Malawi, South Africa, and Thailand through a cross-sectional study. Upon comparing the variables to routine medical records, available data were too limited to adequately capture transition-related processes and outcomes. However, additional data collection using GRADUATE tools was feasible and improved completeness. Of the 100 (52% female) AYLH included in the pilot study, 71% had transitioned/transferred to adult care, with 42% transitioning from an adolescent-specific model of care within an integrated family clinic to having their clinic visits scheduled on a different day of the week while 58% transferred from a pediatric facility to one offering adult HIV care. While almost all (94%) had a transition-related discussion with their healthcare providers prior to the transition, we found that 69% (95% CI 49-85%) were somewhat or very satisfied/comfortable with the post-transfer clinic and the staff. Utilization of the GRADUATE DES better characterized AYLH transitioning to adulthood across LMICs, and optimally measured transition preparation activities and outcomes. Utilization of the GRADUATE DES in other settings could facilitate comparisons and identify gaps in the care of transitioning adolescents that need to be addressed.

Optimising healthcare transition of adolescents and young adults to adult care: a perspective statement of the Italian Society of Obesity

The transition to adult health care (HCT, Health Care Transition), is the purposeful, planned movement of patients from paediatric to adult services. For the adolescent living with obesity (ALwO), the HCT represents a crucial window for effective intervention that can help improve body weight, adiposopathy, and metabolic complications. Nevertheless, no transition guidelines, models, and tools have been developed for these patients. The present statement of the Italian Society of Obesity examines the critical transition of ALwO from paediatric to adult healthcare. It synthesises current knowledge and identifies gaps in HCT of ALwO. Drawing on successful practices and evidence-based interventions worldwide, the paper explores challenges, including disparities and barriers, while advocating for patient and family involvement. Additionally, it discusses barriers and perspectives within the Italian health care scenario. The need for specialised training for healthcare providers and the impact of transition on healthcare policies are also addressed. The conclusions underscore the significance of well-managed transitions. The SIO recognises that without proper support during this transition, ALwOs risk facing a gap in healthcare delivery, exacerbating their condition, and increasing the likelihood of complications. Addressing this gap requires concerted efforts to develop effective transition models, enhance healthcare provider awareness, and ensure equitable access to care for all individuals affected by obesity. The document concludes by outlining avenues for future research and improvement.

Resource use and costs of transitioning from paediatric to adult care for patients with chronic endocrine disease.

Structured transition of adolescents and young adults with a chronic endocrine disease from paediatric to adult care is important. Until now, no data on time and resources required for the necessary components of the transition process and the associated costs are available. In a prospective cohort study of 147 patients with chronic endocrinopathies, for the key elements of a structured transition pathway including (i) assessment of patients' disease-related knowledge and needs, (ii) required education and counselling sessions, (iii) compiling an epicrisis and a transfer appointment of the patient together with the current paediatric and the future adult endocrinologist resource consumption and costs were determined. One hundred and forty-three of 147 enroled patients (97.3%) completed the transition pathway and were transferred to adult care. The mean time from the decision to start the transition process to the final transfer consultation was 399 ± 159 days. Transfer consultations were performed in 143 patients, including 128 patients jointly with the future adult endocrinologist. Most consultations were performed by a multidisciplinary team consisting of a paediatric and adult endocrinologist, psychologist, nurse, and a social worker acting also as a case manager with a median of three team members and lasted 87.6 ± 23.7 min. The mean cumulative costs per patient of all key elements were 519 ± 206 Euros. In addition, costs for case management through the transition process were 104.8 ± 28.0 Euros. Using chronic endocrine diseases as an example, it shows how to calculate the time and cost of a structured transition pathway from paediatric to adult care, which can serve as a starting point for sustainable funding for other chronic rare diseases.

Predictors of successful transition of adolescents and young adults living with HIV from pediatric to adult-oriented care in southern Ethiopia: a retrospective cohort study

BackgroundThe introduction of highly active antiretroviral therapy has significantly improved the life expectancies of children and adolescents living with HIV, leading to an increased number transitioning to adult care. However, there has been a lack of studies in Ethiopia focusing on factors influencing the success of this transition. Therefore, this study aimed to determine predictors of a successful transition from pediatric to adult HIV clinics among adolescents and young adults living with HIV in health facilities in southern Ethiopia.MethodsA retrospective cohort study included 337 adolescents and young adults who transitioned to adult-oriented HIV care. Successful transition was defined as having a viral load of less than 1000 copies/ml and maintaining care during the first year post-transition. Patients’ antiretroviral therapy (ART) cards and monitoring charts were reviewed. Secondary data analysis was conducted using a multivariable binary logistic regression model to identify predictors of a successful transition. Using the variance inflation factor, we checked for multi-collinearity between variables and assessed model fitness with the Hosmer and Lemeshow goodness-of-fit test. Adjusted Odds Ratio (AOR) with 95% confidence intervals (CI) and P-value ≤ 0.05 measured the strength of association and statistical significance.ResultsOf 337 participants, 230 (68.25%) successfully transitioned (95% CI = 63.25, 73.25). Transitioning at age 18 or older (AOR = 4.25; 95% CI = 2.29, 7.87), residing in an urban area (AOR = 1.78; 95% CI = 1.04, 3.02), and being on antiretroviral therapy for more than two years (AOR = 4.25; 95% CI = 1.17, 4.94; P < 0.017) were identified as positive predictors and opportunistic infection (AOR = 0.34; 95% CI = 0.15, 0.75; P < 0.008) was identified as a negative predictor for a successful transition from pediatric to adult ART clinic.ConclusionThis study sheds light on the challenges faced by HIV patients transitioning from pediatric to adult care, with less than 70% successfully navigating this critical phase. Factors such as age at transition, residence, duration of ART, and the presence of opportunistic infections were identified as key predictors of successful transition. The findings underscore the urgent need for tailored interventions, including standardized transition plans that address age and urban/rural disparities, to enhance transition outcomes for adolescents and young adults living with HIV in the region.

Supporting healthy sleep: a qualitative assessment of adolescents with type 1 diabetes and their parents.

Poor sleep health is common in adolescence due to a combination of physiological, psychosocial, and environmental factors. Adolescents with type 1 diabetes (T1D) may be at increased risk for poor sleep health due to physiological and behavioral aspects of diabetes and its management. This article describes a qualitative analysis of interviews with adolescents with T1D and their parents about facilitators and barriers to sleep health and family strategies to balance teens' sleep with competing demands. Separate interviews were conducted with 20 adolescents with T1D and 20 parents. Interviews were recorded and transcribed verbatim and analyzed thematically. Participants were on average 15.8 ± 1.2 years old, 45% female, and 85% non-Hispanic White. Overnight diabetes management was the most frequently reported barrier to sleep. Families reported different strategies for taking responsibility of overnight diabetes management, which differentially impacted sleep. Families worked to balance diabetes management and sleep with other aspects of adolescent life, including school demands, social activities, and electronics use. Facilitators to healthy sleep identified by families included diabetes assistive technology and maintaining a consistent sleep/wake schedule. Both adolescents and parents voiced beliefs that their diabetes care team is not able to help with sleep health. Pediatric psychologists should be aware of the specific sleep barriers experienced by adolescents with T1D and their parents. A focus on overnight diabetes management strategies may facilitate psychologists' support of families in the adolescent's transition to independent diabetes management. Research is needed on the impact of optimizing sleep health in adolescents with T1D.

Where do we start? Health care transition in adolescents and young adults with chronic primary pain.

Where do we start? Health care transition in adolescents and young adults with chronic primary pain.

The Sorrows of the Old from the Gender of the Young: A Commentary on Korte, A. & Tschuschke, V. (2023). Media’s Stranglehold on Storm and Stress – The Sorrows of Generation Z about Sex and Gender

When Old People Suffer Because of the Sex of the Young: A Commentary on Korte, A. & Tschuschke, V. (2023). The Media's Stranglehold on Sturm und Drang - The Sorrows of Generation Z Regarding Sex and Gender Abstract: In their article "Sturm und Drang im Würgegriff der Medien - Die Leiden der jungen Generation am eigenen Geschlecht" in the Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie (volume 51, issue 5), our colleagues Korte and Tschuschke address the question of the extent to which the increase in gender identity deviations among adolescents "also results from upheavals the cultural landscape and, above all, in media technology." The authors look critically at the planned German "Self-Determination Law," the social transition of children and adolescents, the so-called puberty blockade, and hormone therapy in adolescents and justify their preference for a gender-critical over a transaffirmative therapy approach. Although the article introduces some interesting hypotheses from the perspective of cultural studies and philosophy (among others), it may contribute to uncertainty among colleagues in treating trans*people because of its trans-critical tone. This stems from linguistic devices, misleading and erroneous quotations, and incomplete or incorrect descriptions of facts. This contribution therefore takes a critical look at the article by Korte and Tschuschke, using critical linguistic analysis and examining the facts, data, and sources cited by the authors. It encourages our colleagues to engage in a joint, participatory, trans*respectful treatment process with gender-dysphoric children and adolescents while exploring the sizeable intermediate area between "gender-critical" and "transaffirmative" attitudes, which the authors Korte and Tschuschke barely touch on in their article.

Family Influence on Student Mental Health and Academic Achievement in University Transition

This study explores the crucial role of social support in facilitating the transition of adolescents from high school to university, focusing on two respondents, BM and MM. BM, in his second semester at a state university, struggles with the challenges of living independently in a boarding house, feeling significant emotional strain due to limited parental communication. MM, a student at a private university, maintains a close and supportive relationship with his father, despite the absence of his mother since he was two years old. The research highlights the importance of different types of social support—appraisal, belonging, and tangible—in aiding students' adaptation to university life. Appraisal support involves the availability of someone to discuss problems, while belonging support encompasses emotional and task-related assistance from family members. Tangible support refers to material assistance provided by parents. The findings indicate that effective social support, particularly from family, is essential for promoting mental health, academic success, and overall well-being during this critical transition period. The study underscores the need for future research to explore these dynamics further, considering broader cultural and socio-economic contexts that influence the availability and effectiveness of social support.