Adolescents Ages Research Articles

Worsening sleep predicts next-week suicidal ideation in a high-risk adolescent outpatient treatment sample.

Suicidal thoughts and behaviors often onset during adolescence, constituting a major public health concern. Despite rising rates in youth, psychotherapeutic and pharmacological treatment outcomes remain meager, indicating a need to identify modifiable risk factors. Experts suggest sleep may serve as a promising clinical indicator of risk and treatment progress, yet few studies have examined acute temporal associations between sleep and suicidal ideation. Participants were depressed and suicidal adolescents (age 13-19, n = 311) attending an intensive outpatient program (IOP). Patients completed weekly self-report assessments of sleep, depression, and suicidal ideation throughout IOP, with an average of 5 assessments over 30 days. Greater overall sleep difficulties, as well as within-person increases in sleep difficulties, were predictive of greater depression severity and suicidal ideation at subsequent assessments, above and beyond previous levels of symptoms. The reverse associations were not found. Inclusion of within-person changes in sleep difficulties significantly improved model fit compared to inclusion of overall sleep difficulties alone. This study provides additional evidence for a prospective relationship between worsening sleep difficulties and suicidal ideation in an IOP youth sample. Worsening sleep may be an important clinical indicator of subsequent depression and suicide risk among adolescents in treatment.

Knowledge on adolescent and reproductive health among secondary school students in Khulna City, Bangladesh

The main objective of this study was to investigate the depth and breadth of knowledge and ideas about adolescent health among secondary-level students. A concurrent mixed method approach, both quantitative and qualitative methods, was followed to carry out the study. Students enrolled in tenth grade under the Directorate of Secondary and Higher Education (DSHE) in Khulna City, Bangladesh, were chosen as the respondents of the study. Kotwali and Khanjahan Ali Thana of Khulna City were rationally chosen as the areas of the study. A total of 40 schools were randomly chosen, and 400 surveys, 10 surveys from each school, ideally 05 boys and 05 girls, were carried out, including 10 in-depth case studies. Findings indicated that, on average, more than half of the adolescents have knowledge gaps about adolescents and reproductive health, for example, misconceptions about the adolescent period and age range of puberty, vague understanding of the first sign(s) of physical appearances, and face critical emotional and social challenges. Both qualitative and quantitative data further showed that they hardly get sufficient cooperation and support from family and social environments in dealing with their challenges, display risky health behaviour, and make major decisions based on their self-discretionary assumptions to deal with crises. The findings of this study would provide important guidelines to parents and guardians, local and district and regional and national level GOs and NGOs health professionals who work with adolescent and reproductive health services, policymakers, academics, and researchers to create an adolescent-friendly environment.

New York cystic fibrosis consortium newborn screening quality improvement: Development and implementation of a statewide consensus recommendations for management of infants with CFTR-related metabolic syndrome.

New York (NY) State implemented a new cystic fibrosis (CF) newborn screen (NBS) algorithm in December 2017 with improvement in positive predictive value and unanticipated increased identification of infants with cystic fibrosis transmembrane conductance regulator (CFTR)-related metabolic syndrome (CRMS). Repeat sweat testing is recommended in infants with CRMS. During the COVID-19 pandemic infants with CRMS were lost to follow up. With this quality improvement (QI) initiative, we aimed to perform repeat sweat testing in 25% of infants lost to follow up. We also describe consensus recommendations for CRMS from the NY CF NBS Consortium. Our QI team identified the primary drivers contributing to absent follow up, outreached to families, and created a questionnaire to evaluate parental understanding of CRMS using QI-based strategies. Of 350 infants diagnosed with CRMS during the study period, 179 (51.1%) infants were lost to follow up. A total of 31 (17.3%) were scheduled for repeat sweat tests and followed up at CF Centers. Families reported high satisfaction with the CRMS knowledge questionnaire. With this QI-based approach, we effectively recaptured infants with CRMS previously lost to follow up during the COVID-19 pandemic. Ongoing concerns about infection risk and lack of understanding on the part of families and pediatricians likely contributed to patients with CRMS lost to follow up. Consensus recommendations for CRMS include annual visits with repeat sweat testing until 2-6 years of age and education for adolescents about clinical and reproductive implications of CRMS.

Prospective associations between early adolescent reward functioning and later dimensions of psychopathology.

Individual differences in reward functioning have been associated with numerous disorders in adolescence. Given relations with multiple forms of psychopathology, it is unclear whether these associations are disorder specific or reflective of shared variance across multiple disorders. In a sample of adolescents (N = 418), we examined associations between neural and self-reported indices of early reward functioning (age 12) with different levels of a hierarchical psychopathology model assessed later in adolescence (age 18). We examined whether prospective relationships between reward functioning are specific to individual disorders or better explained by transdiagnostic dimensions. We found modest results for prospective associations between reward indices and different dimensions of psychopathology, with most significant associations not surviving correction for multiple comparisons. We discuss the benefits and limitations of the modeling approach used to examine dimension-specific associations that future work can build on. Overall, more work is needed to better understand how reward functioning is specifically associated with different forms of and hierarchical levels of psychopathology. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Probing Neurophysiological Processes Related to Self-Referential Processing to Predict Improvement for Depressed Adolescents Receiving Cognitive Behavioral Therapy

BACKGROUNDCognitive Behavior Therapy (CBT) is a gold standard approach for treating major depressive disorder (MDD) among adolescents. However, nearly half of adolescents receiving CBT do not improve. In order to personalize treatment, it is essential to identify objective markers that predict treatment responsiveness. Toward addressing this aim, this study investigated neurophysiological processes related to self-referential processing that predicted CBT response among depressed, female adolescents. METHODSAt baseline, female adolescents ages 13-18-years-old (N=80) completed a comprehensive clinical assessment, and a self-referential encoding task was administered while electroencephalogram (EEG) data were recorded. Baseline EEG data were utilized to identify oscillatory differences between healthy (HC, n=38) and depressed (MDD, n=42) adolescents. Following the baseline assessment, depressed youth received up to 12-weeks of CBT. Baseline differences in EEG oscillations between healthy and depressed youth were used to guide CBT prediction analysis. Cluster-based event-related spectral perturbation analysis (ERSP) probed theta and alpha event-related synchronization/desynchronization (ERS/ERD) response to negative and positive words. RESULTSBaseline analyses showed that, relative to the healthy adolescents, depressed youth exhibited higher levels of frontal theta ERS and a greater posterior alpha ERD. Multilevel modeling identified primary neural pre-treatment predictors of treatment response: greater theta ERS in the right prefrontal cortex (PFC) after the onset of negative words and lower alpha ERD in both the right PFC and posterior cingulate cortex (PCC). ERS and ERD associations with treatment response remained significant, with baseline depressive and anxiety symptoms included as covariates in all analyses. CONCLUSIONSConsistent with prior research, results highlighted that relative to healthy youth, depressed adolescents are characterized by prominent theta synchronization and alpha desynchronization over PFC and PCC, respectively. Cluster-based ERSP analysis also identified key mechanisms underlying depression-related self-referential processing that predicted improved symptoms during the CBT course. Ultimately, a better characterization of the neural underpinnings of adolescent depression and its treatment may lead to more personalized interventions.

Emotion coupling across socialization contexts in adolescence: Differences in parent-child and peer interactions.

People spontaneously adjust their emotions to others when they interact. This temporal coupling of emotions is an adaptive process facilitating social bonding. The present study examined differences in coupling patterns during parent-child versus peer interactions in adolescence, a developmental period marked by evolving parent-child dynamics and bond formation with peers. Because adolescents prioritize peer bonding while gradually asserting their autonomy from parental influence, we hypothesized that peer dyads showed stronger coupling than parent-adolescent dyads. Adolescents (age 16) with diverse ethnic backgrounds (N = 615; 50.2% female; 46.8% European American, 31.2% African American, 5.0% Hispanic, 3.0% Asian or Pacific Islander, 2.0% Native American, and 12.0% multiple ethnic backgrounds) participated in two videotaped interaction tasks: one with a parent and one with a self-nominated peer. Parent and peer interactions included discussions on positive and negative topics. Both dyad members' emotions were coded in real time. Cross-recurrence quantification analyses and growth-curve modeling revealed concurrent emotion coupling patterns, with peer dyads showing stronger coupling than parent-adolescent dyads. Moreover, peer dyads showed the most pronounced coupling patterns when they discussed personal problems, while parent-adolescent dyads showed the most pronounced coupling patterns when they discussed the planning of a fun activity. Our findings emphasize the importance of microlevel emotion dynamics in understanding larger scale developmental shifts in relationships during adolescence. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Substance Use in Adolescent and Young Adult Cancer Survivors: An Integrative Review.

The adolescent and young adult (AYA) ages are a time when individuals are susceptible to risky behaviors, including binge drinking, tobacco, marijuana, and illicit drug use. AYAs are at an increased risk for developing chronic health problems compared with their healthy peers, and substance use can pose additional risks. The purpose of this review is to compare substance use in AYAs with their healthy peers and identify contributing factors. A literature search was conducted of PubMed, Scopus, and OVID databases using keywords substance*, adolescent*, adolescence*, teens*, teenager*, young adult*, pediatric*, childhood*, cancer*, and oncology*. The initial search yielded 148 articles. Inclusion criteria specified English language and articles from January 1, 2013, to December 31, 2023. Studies were excluded if they did not include participants aged <18 years and without a noncancer comparison group. Five relevant articles were included after review and appraisal. Substance use was examined by substance use type and contributing factors, including caregiver-AYA relations, age, and depression/coping. Findings were mixed for substance use, including tobacco and alcohol use. Findings indicate no consistent pattern-substance use was both more and less common in AYAs than in their noncancer peers, or substance use did not differ between AYAs and their noncancer peers. With mixed results, each study identified some level of substance use in AYAs. Given this knowledge, when treating AYAs, providers should be diligent about screening for substance use during each visit. AYAs should be educated about the risk of substance use, especially as a vulnerable, at-risk population.

Acceptability and Scalability of a Meditation App Among Adolescents With Type 1 Diabetes Mellitus.

Background Adolescents with type 1 diabetes mellitus (T1DM) experience stress from general life stressors and diabetes-specific stressors. This stress manifests in a range of ways, such as mood swings, heightened frustration, strained familial relationships, and difficulties in T1DM self-management, which then leads to worse health outcomes. There is small to moderate evidence that frequent use of mental health applications (MHapps) improves mental and physical health outcomes. Meditation apps may help reduce some of the stress associated with living with T1DM. This study explores the acceptability and scalability of a self-guided, smartphone-based meditation app, the Healthy Minds Program (HMP) app, among adolescents with T1DM using the Unified Theory of Acceptance and Use of Technology. Methods Eight adolescents ages 15-19 were recruited from a pediatric clinic in a Midwestern state and introduced to the HMP app. After using the HMP app for one week, they were invited to participate in three successive focus group meetings. During the meetings, they shared their perspectives on the content, navigation, and acceptability of the HMP app and strategies to introduce and scale app utilization among adolescents with T1DM. Researchers conducted conventional content analysis using a hybrid coding approach. Data was managed and analyzed using NVivo 10 (Lumivero, Denver, Colorado, USA). Findings Participants believed that the HMP app has the potential to enhance their stress management, mood, and coping abilities when dealing with the challenges of T1DM management. They found the app enjoyable and easy to use but expressed concerns about time constraints as a potential barrier. To address this, they shared recommendations for facilitating app uptake and usage. Conclusions This study's results provide an in-depth understanding of how positively this subset of adolescents with T1DM viewed the HMP app. The participants also offered valuable suggestions that can promote the adoption and sustained use of MHapps by adolescents living with T1DM.

Adult mental health outcomes of adolescent depression and co-occurring alcohol use disorder: a longitudinal cohort study

AbstractDepression and alcohol use disorder (AUD) are frequently co-occurring in adolescence, which often goes undetected in routine care. While this may potentially compromise treatment effectiveness and lead to a less favourable long-term prognosis, few longitudinal studies have followed this group into adulthood. The aim of this study was to explore the risk for adult depression, anxiety disorders, suicidality, and AUD in adolescents with concurrent depression and AUD. The study was based on the Uppsala Longitudinal Adolescent Depression Study (ULADS), a Swedish prospective cohort study. Diagnostic interviews were conducted in adolescence (age 16-17) and adulthood (around age 30). Adolescents with concurrent depression and AUD (n = 38) were compared with peers having only depression (n = 189) or neither of the conditions (n = 144). Logistic regression was used to calculate adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Adolescents with concurrent depression and AUD were more likely than their non-affected peers to experience adult depressive episodes (aOR, 5.33; 95% CI, 2.22–12.83), anxiety disorders (4.05; 1.77–9.27), suicidality (5.37; 2.28–12.66), and AUD (7.68; 2.59–22.81). Notably, 34% of adolescents with both depression and AUD subsequently experienced both these conditions as adults, compared to 7% of adolescents with only depression. Adolescents suffering only from depression were less likely than those with both conditions to experience suicidality (0.44; 0.21–0.95) and AUD in adulthood (0.18; 0.07–0.44). These findings underscore the clinical imperative to identify adolescents with this comorbidity. Recognition of the poor long-term prognosis can inform targeted interventions for this vulnerable group, ultimately improving health and well-being throughout the life course.

A Qualitative Assessment of Adolescent Symptom Report and Caregiver Concordance Following Outpatient Surgery

Objectives: Limited data exist regarding recovery from surgery from the adolescent’s perspective, or data regarding concordance between adolescent and caregiver symptom report preventing appreciation of adolescent needs and hindering the provision of appropriate care. Methods: We conducted semi-structured interviews with adolescents ages 12-17 and a parent caregiver two weeks following a variety of outpatient elective surgeries about recovery symptoms. We used latent manifest content analysis to analyze interview data. Caregiver-adolescent response concordance was assessed using Cohen’s Kappa (κ). Results: Interviews were conducted with 31 adolescent-caregiver pairs (median age: 15y). Fifty-eight percent of adolescents and 84% of caregivers were female; 71% of adolescents were white. Twenty-three percent of children reported severe pain, some of which was not expected given the surgery. Severe pain was associated with nausea (71%, P= 0.002), pain-related sleep disturbance (86%, P= 0.007), and severe anxiety (43%, P= 0.008). Fatigue was also common (58%), but not associated with severe pain (P = 0.484) or sleep disturbance (P = 0.577). Thirty-nine percent reported anxiety; 32% experienced anger/frustration. Caregiver-adolescent concordance was only substantial for severe pain (κ = 0.71) and anger/frustration (κ= 0.67). Caregiver report also often included psychological symptoms not reported by their children, with qualitative evidence supporting caregiver accuracy. Discussion: Adolescents may experience significant physical symptoms such as pain and fatigue, even after minor surgeries. Fatigue symptoms may be unrelated to pain or sleep. Caregiver report of adolescent psychological symptoms may be necessary to gain a complete understanding of those symptoms in this population.

Sensory Processing Measure Tools for Adolescents Aged 12 to 21 Years

Background and Objectives: Impairment in the way of sensory information by the central nervous system can cause functional problems in all areas of an adolescent’s activities, including education, self-care, social participation, and leisure. Therefore, in the presence of problems in such activities, it is necessary to evaluate and screen for sensory processing. In the present study, the sensory processing assessment tools that cover the adolescent age group were investigated. Methods: In this review, PubMed, Science Direct, Google, OTseeker, and Google Scholar databases were searched, and articles published between 2000 and 2022 on sensory processing assessment tools in adolescents and their psychometrics were selected. Keywords used included sensory integration dysfunction (SID), sensory processing disorder (SPD), adolescence, adolescent, assessment, measurement, reliability, validity, psychometry, environment, scale, and instrument. Results: The assessment tools identified to evaluate sensory processing in the adolescent age group include the “adolescent/adult sensory profile” (AASP), “Glasgow sensory questionnaire” (GSQ), “sensory processing measure (SPM)”, “sensory response in autism spectrum” (SR-AS) questionnaire, “sensory processing scale” (SPS), and “SPM-second edition” (SPM-2). Conclusion: The environment was considered as a factor that needs to be evaluated only in the second version of the SPM among the selected tools. The results of this review also showed that the only tool available in Persian in this field is the AASP, which does not seem to be a suitable tool for use in adolescence because the population studied in the psychometric evaluation of the Persian version was elderly people with dementia. Therefore, it seems necessary to prepare the Persian version and psychometric evaluation of an appropriate assessment tool for evaluating the sensory processing of Iranian adolescents.

Empirically exploring the association of health literacy with schoolchildren’s health behaviours

Abstract Background Health literacy (HL) is a modifiable factor contributing to the promotion and maintenance of health and well-being throughout an individual’s life. Identified as a priority in Wales, UK in 2010, progress has since stalled despite health and education as national policy priorities and international policy growth. There is a gap in understanding of children in Wales’ HL needs, particularly below adolescent age ( &amp;lt; =11 years). Methods This study aimed to scope a measure of children’s HL to be integrated into the existing HAPPEN Cohort Study survey, which collects self-reported health behaviours of children aged 8-11. A review identified the Health Literacy of School-Aged Children (HLSAC) tool which conceptualises health literacy as a learning outcome. A convenience sample of n = 15 primary schools were recruited in April 2023 through HAPPEN and n = 669 school children n = 669 completed the online survey between May-June 2023. Results Preliminary data using sum HLSAC scores show a proportion of children with low (20.5%), moderate (52.8%) and high HL (26.8%). Independent samples t-tests comparing mean HLSAC scores with binary self-reported health behaviours show higher HL scores for weekly behaviours (p &amp;lt; 0.05); feeling less tired (0-4 days: 15.1+-4.1, &amp;gt; =5 days 14.5+-3.4), can concentrate (0-4 days: 14.3+-3.6, &amp;gt; =5 days: 15.5+-4.0) and consume less fizzy drinks (0-4 days: 15.0+-3.9, &amp;gt; =5 days: 14.0+-3.8). Further, for can ride a bike (no: 14.3+-4.0, yes: 15.0+-3.9), can swim 25m (no: 14.6+-3.7, yes: 15.1+-4.0), someone active in the household (no: 14.3+-3.8, yes: 15.2+-4.0) and higher health well-being (&amp;lt;7/10: 13.9+-3.5, &amp;gt; =7/10: 15.3+-3.9). This preliminary data will be strengthened with further analyses including regression. Conclusions Associations appear between various important health behaviours spanning physical activity, nutrition, cognition and wellbeing. Capturing children’s HL and health behaviour needs enables targeted health promotion and education activities.

Implantable loop recorders in children and adolescents with Brugada syndrome: the YoungBruLoop study

Abstract Background Young (&amp;lt;18 years of age) patients with Brugada syndrome (BrS) are often underrepresented in BrS studies and their management, especially related to syncopal episodes, remains unclear. Purpose To describe the arrhythmia prevalence and clinical implication derived from continuous rhythm monitoring by implantable loop recorder (ILR) among patients younger than 18 years of age, and to assess the etiology behind syncope of undetermined origin. Methods A total of 147 BrS patients with ILR were enrolled in 12 international centers and divided into pediatric (age &amp;lt;12 years; n=77, 52%) and adolescents (age 13 to 18 years; n=70, 48%). Results Mean age was 11.3 years (36.1% females, 21.1% spontaneous type I ECG). Forty-six patients (31.2%) underwent ILR implant due to syncope. Over a median follow-up of 3.6 years, an arrhythmic event was recorded in 22.4% of patients and in the vast majority of cases it was of non-ventricular origin (44% atrial, 47% bradyarrhythmias). Predictors of arrhythmias at univariate Cox Regression analysis were spontaneous type I ECG (HR 2.1 - 95%C.I. 1.1-4.1), history of syncope (HR 3.1 - 95%CI 1.5-6.3) and age &amp;gt;12 years (HR 2.0 - 95%C.I. 1.0-3.3). Ventricular arrhythmias occurred in 4 patients, all with spontaneous BrS, and were related to fever in half of cases. In patients with recurrent syncope, the prevalence of truly arrhythmic syncope was 17.8%, and it was due to brady-, atrial- and ventricular arrhythmias in 40%, 20% and 40% of cases, respectively. Conclusions Continuous rhythm monitoring with ILRs in BrS pediatric patients detects a broad range of heart rhythm disturbances including life-threatening arrhythmias. Ventricular arrhythmias occur predominantly in patients with spontaneous type I ECG and in half of cases are fever-related. Despite the young age, brady- and atrial arrhythmias are overall frequent and represent the cause of arrhythmic syncope in 60% of patients. Young BrS patients with syncope of undetermined origin may benefit from ILR implant.

Adolescent well-being in time of crisis: The role of social and residential contexts

Abstract Background It is unknown whether social or residential context during the COVID-19 lockdowns may impact mental well-being. We identified classes of each of social and residential context during the lockdown and examined their associations with mental well-being among French adolescents one-year after the first lockdown. Methods We used data collected in a cross-sectional study design in 2021 from 387 adolescents ages 12 to 15 years enrolled in the school-based pilot study for EXIST. Participants reported social and residential characteristics during the lockdown retrospectively, and current mental well-being in self-report questionnaires. We used latent class analysis to identify classes of social and residential contexts, and linear regression models to study their association with mental well-being. Results Four social context classes were identified: class 1 ‘Low opportunities for social contacts at home’, class 2 ‘Moderate opportunities for social contact at home”, class 3 ‘High opportunities for social contact at home’, and class 4 ‘Very high opportunities for social contact at home’. Compared to class 4, lower levels of mental well-being were observed among adolescents in class 1 (b= -4.08, 95% CI [-8.06; -0.10]) one year after the lockdown. We identified four residential context classes, with differences across classes in proximity to nature, type of residence (e.g., apartment, house), and level of neighborhood deprivation. No association was found between residential context during the lockdown and adolescent mental well-being one year later. Conclusions An unsupportive social environment during the lockdown may have long-term effects on mental well-being among adolescents. Given the observed disparities in social support, future intervention should aim to strengthen social support for adolescents living in unsupportive environments (e.g., remote homework assistance, support for isolated parents, provision of virtual chat rooms for adolescents). Key messages • Mental well-being was challenged among youth with lower levels of social connectedness and support during lockdown, residential context was not associated with adolescent well-being after one year. • During crisis, a critical need among adolescents does not pertain to the physical attributes of their living environment, but rather to social support from friends or family within and outside home.

Social factors that promote resilience in adolescents with depression: a systematic review

Abstract Background A socially protective environment matters. Social factors can protect against the development of depression among adolescents in community samples. There is however scant knowledge about their buffering role on the impact of depressive symptoms in adolescents in a clinical setting. Understanding these factors can help explaining why some children function well despite of their depression symptoms. In this review, we aimed to identify which social protective factors mitigate impairment from depression in adolescents. Methods We included peer-reviewed, cross-sectional and longitudinal studies using the following search strategy: Social protective factors AND depression or depression symptoms AND adolescents AND daily impairment, yielding 1737 hits. Included studies focused on social protective factors in relation to a depression diagnosis or depression symptoms severity, in adolescents age 11-24. Preliminary results We found 6 studies that examined the relationship between social protective factors and impairment or severity of depression symptoms in adolescents with a clinical depression or elevated symptoms. In these studies, higher rates of parental attachment, parental monitoring and school belonging moderated the relation between depression symptoms and daily impairment. Higher rates of family support and peer belonging were associated with the low depressed mood group. The rest of the studies tested the association of social protective factors on the development of depression symptoms in non-clinical populations. Conclusions There are limited studies on the buffering role of social protective factors in adolescents with clinical depression. Next, we will focus on non-clinical, longitudinal studies to explore which social protective factors moderate the development of depression over time. We aim to identify social factors that can mitigate the development of depression in community samples and are potentially important for clinical settings. Key messages • There is a scarcity of studies that explored the relation between social protective factors in adolescents with elevated depression symptoms or depression diagnosis. • The role of social protective factors that moderate the development of adolescent depression symptoms over time should be prioritized in the development of intervention programs.

Assessment of psychosocial parameters in adolescents seeking orthodontic treatment

AimThe aim of this study was to investigate the psychosocial impact of malocclusion and the motivation for seeking orthodontic treatment among adolescents.MethodsA cross-sectional study included 102 adolescents (ages 11–18) whose malocclusion was rated using 3 occlusal indices: IOTN, DAI, and PAR. The participants answered three structured questionnaires selected to measure Oral Health Related Quality of Life (OHRQoL) through the short form of the Child Oral Health Impact Profile (COHIP), the patient's perceived impact related to orthodontics through the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), and self-esteem through the Rosenberg Self-Esteem Scale (RSES). Independent two-tailed t-tests, one-way mixed analysis of variance (ANOVA), and Spearman's correlations were used to test various associations.ResultsPatients with higher malocclusion scores displayed increased psychosocial impact with weak to moderate correlations (0.2 < r < 0.3; p < 0.05), but 98% wished their teeth looked better, and 70% were unhappy about their smile esthetics. The IOTN esthetic component AC was better associated with psychosocial implications of malocclusion (p < 0.01). Self-motivated patients (over 80%) had higher impactful psychosocial scores than patients whose parents were motivated for treatment. Sex did not influence the findings. Older adolescents and bullied individuals were more affected by the psychological burden of malocclusion.ConclusionThe results indicate the prevalence of psychosocial and esthetic impacts of malocclusion over oral and functional problems. PIDAQ discriminated better than COHIP between varying degrees of dental aesthetics. The results suggest that the orthodontist should explore patients' expectations of treatment outcomes, not only the chief complaint.

A systematic study on the elevated risk of ankylosing spondylitis in adolescents engaged in intense physical exercise

This study investigates the link between intense physical activity during adolescence and the onset of ankylosing spondylitis (AS), particularly in individuals having the human leukocyte antigen (HLA)-B27 antigen, a known genetic marker for AS. The systematic literature review included studies published between 2014 and 2024. . Keywords and search terms included combinations of "ankylosing spondylitis," "HLA-B27," "adolescence," "intense physical exercise," and "genetic predisposition. Inclusion criteria focused on studies involving adolescents aged 15-24 years with genetic predispositions such as HLA-B27. Exclusion criteria included studies with unrelated outcomes such as individuals not within the target adolescent age range, non-peer-reviewed articles, and those with insufficient data on the target population. Findings revealed that adolescents with the HLA-B27 antigen who engaged in heavy weight exercise were at a heightened threat of developing AS. The mechanical stress from intense physical activity potentially triggered or exacerbated inflammation at entheses in genetically predisposed individuals. However, the onset of AS was not universally observed in all HLA-B27 positive individuals who participated in strenuous exercise, suggesting other genetic and environmental factors’ involvement. The study suggests that strenuous exercise during adolescence may act as a significant contributing factor to the onset of AS in individuals having a genetic predisposition such as HLA-B27. While not all individuals having HLA-B27 develop AS, genetic and environmental factors’ combination, including intense physical activity, may accelerate disease progression.

Drinking firsts at home and with parental knowledge: Racial/ethnic differences in associations with later alcohol outcomes among underage youth.

Prior research has shown that early alcohol experiences, such as age of initiation and speed of progression between drinking milestones, vary across racial/ethnic groups. To inform culturally tailored prevention efforts, this longitudinal study examined racial/ethnic differences in the associations of drinking firsts at home and with parental knowledge with alcohol use outcomes among underage youth. The study included baseline and five follow-up surveys, collected every 6 months, from California adolescents (ages 12-16 years at baseline). The analytic sample was composed of the 689 adolescents who reported lifetime alcohol use at baseline or a follow-up survey (5% Black, 37% Latinx, 46% White, and 12% other/mixed racial/ethnic group; 54% female). Participants who reported consumption of a full drink, intoxication, or heavy episodic drinking (HED) were asked ages and contexts of these drinking firsts, including whether the initiation was at their own home and whether their parents/guardians knew about this drinking event. Outcomes included past-6-month alcohol frequency, alcohol quantity, and number of alcohol-related problems. Multilevel negative binomial regression analyses were conducted, controlling for demographics and age of initiation by type of drinking behavior. Moderation analyses examined racial/ethnic differences. For consumption of the first full drink, both drinking at home and parental knowledge were negatively associated with all outcomes; associations did not vary by race/ethnicity. First intoxication at own home was negatively associated with the number of drinks for Latinx youth and with the number of problems for Black youth. For first HED, drinking at own home was positively associated with drinking frequency across groups, and for Black youth specifically, parental knowledge of their first HED experience was significantly associated with greater later alcohol frequency and quantity. Results suggest that the association of family contexts of drinking first with later alcohol outcomes among underage youth varied by stage of alcohol use and race/ethnicity.

The effect of educational intervention based on self-efficacy theory on promoting adolescent oral health behaviors through mobile application: a randomized controlled trial study

BackgroundOral health is so important for the adolescent age group that the World Health Organization has listed oral health as a lifelong prerequisite for maintaining public health; Therefore, this research was carried out with the aim of the effect of educational intervention based on self-efficacy theory on the promotion of behaviors related to oral health of adolescents through mobile application.MethodsIn this clinical trial, 80 adolescents aged 13–15 years from Shushtar city were selected using a random cluster sampling method and assigned to either the test or control group. The data collection tools included a standard questionnaire for measuring Oral health behavior (awareness, attitude, behavior) and a standard questionnaire for measuring self-efficacy (self-efficacy in brushing teeth, self-efficacy in using dental floss, and self-efficacy in visiting the dentist), as well as demographic characteristics. Training was provided to the test group via a mobile application for 3 weeks. During the intervention, the control group did not receive any training. Questionnaires were distributed in both groups immediately after the intervention, as well as one month and three months post-intervention, and data were collected. In accordance with research ethics, at the end of the study, the educational content was provided to the control group. Collected data were analyzed using SPSS 22 software and Mann-Whitney and Friedman non-parametric tests.ResultsThe findings showed that the educational intervention through the mobile application was effective in improving the average scores of awareness, attitude, self-efficacy in brushing teeth, flossing, visiting the dentist, and the behavior of adolescents regarding oral health behaviors, and this statistical difference was significant compared to before the educational intervention (P < 0.05), while no change was observed in the control group (p > 0.05).ConclusionConsidering that adolescents aged 13–15 years are the age of starting behavioral habits, including oral health behaviors, and on the other hand, their interest in using technology and virtual spaces is high, it is suggested that part of the education of this age group should be designed and implemented in the platform of mobile application.Clinical TrialRegistration in Iran Clinical Trial Center with ID code (IRCT20200120046204N1) Date of.Registration: 2018-02-25.

Exploring European Parents’ Attitudes Towards the Age Appropriateness of Digital Sexuality Education for Adolescents

We conducted a multinational cross-sectional survey in Europe to explore parental attitudes toward the appropriate age for adolescents to receive sexuality education through an app interface. This was delivered via an online survey across Belgium (n = 479), the United Kingdom (n = 445), and Italy (n = 454). Parents from Belgium consistently accepted their children accessing digital material at the youngest ages, whereas Italian participants selected the oldest age groups. Most parents, however,endorsed a spiral curriculum, whereby topics are introduced sequentially throughout adolescents’ school careers. Thus, whilst on average participants were comfortable with adolescents having access to content on body anatomy younger ages (from 9–12 years to 12–15 years), they approved virtual content on relationships and sex at older school ages (from 12–15 years to 15–18 years). European ethnicity, liberal sociosexual attitudes, lower religiosity, and higher educational attainment were associated with parents approving adolescent exposure to digital sex education at younger ages. To our knowledge, this exploratory study is the first to quantitatively examine parental attitudes toward digital sex education curricula, as well as explore the parental characteristics that relate to these attitudes. This work should inform educators internationally on their future efforts to deploy virtual sexuality learning.