Course Of Adolescence Research Articles

Курение подростков как фактор риска снижения адаптационных ресурсов метаболизма нейтрофилов ротовой полости и прогрессирующего течения рецидивирующего бронхита

High prevalence of smoking among children and its early onset is an urgent problem in modern pediatrics. For proper health risk quantification, it is extremely important to understand and parameterize relationships between effects of adverse factors and physiological processes in the body, including the cellular level. The aim of this study was to analyze how tobacco smoking influences maladaptive changes in the mucosal immunity system of the oral cavity in adolescents and to assess kinetic trends in the clinical course of recurrent bronchitis (RB) in long-term outlook. The study included 92 patients with RB aged 16.8 ± 3.1 years. Two groups were created of them; the observation group was made of 64 patients, who admitted smoking as a habit, and the reference group included 28 people without nicotine addiction. The control group was made of 23 adolescents of the same age without any signs of the analyzed disease. Oral neutrophils (N) were selected as basic research material. N oxygen metabolism was registered by luminol-dependent chemiluminescence (LDCL) in spontaneous (sLDCL) and induced (iLDCL) variants. Functional N probing was performed using opsonized zymosan (Σ) and and peptidoglycan from S. aureus strain Cowan. Concentrations of antibodies (AT) to glycolipid (GLP) (Re-mutant Salmonella Minnesota), Candida albicans and S. аureus were determined by ELISA tests. The analyses made it possible to detect a close relationship between levels of ROS generation by neutrophilic granulocytes and the immune components of anti-endotoxic immunity. Immune changes were not established to be universal in the groups of examined patients and were shown to reflect the specificity of destabilizing effects produced by tobacco smoke. A direct moderate correlation was established in the observation group between sLDCL indicators and the concentration of anti-candidosis antibodies (r = +0.59, p = 0.0382), which reflects the level of bacterial stimulation involving dysbiotic shifts in gut microbiota. A direct correlation was detected between levels of biocidal parameters of neutorphil granulocytes and anti-glycolipid levels (r = +0.64 p = 0.417). Integral assessment of specific humoral immunity to glycolipid and the phagocytic link of the mucosal protection in the oral cavity reflects the degree of endogenous intoxication and kinetic trends in the RB clinical course in adolescents in subsequent years of life. These relationships may provide solid rounds for ‘exposure – response’ stage in the risk assessment procedure for assessing risks of respiratory diseases in smoking adolescents.

Human adolescent brain similarity development is different for paralimbic versus neocortical zones

Adolescent development of human brain structural and functional networks is increasingly recognized as fundamental to emergence of typical and atypical adult cognitive and emotional proodal magnetic resonance imaging (MRI) data collected from N [Formula: see text] 300 healthy adolescents (51%; female; 14 to 26 y) each scanned repeatedly in an accelerated longitudinal design, to provide an analyzable dataset of 469 structural scans and 448 functional MRI scans. We estimated the morphometric similarity between each possible pair of 358 cortical areas on a feature vector comprising six macro- and microstructural MRI metrics, resulting in a morphometric similarity network (MSN) for each scan. Over the course of adolescence, we found that morphometric similarity increased in paralimbic cortical areas, e.g., insula and cingulate cortex, but generally decreased in neocortical areas, and these results were replicated in an independent developmental MRI cohort (N [Formula: see text] 304). Increasing hubness of paralimbic nodes in MSNs was associated with increased strength of coupling between their morphometric similarity and functional connectivity. Decreasing hubness of neocortical nodes in MSNs was associated with reduced strength of structure-function coupling and increasingly diverse functional connections in the corresponding fMRI networks. Neocortical areas became more structurally differentiated and more functionally integrative in a metabolically expensive process linked to cortical thinning and myelination, whereas paralimbic areas specialized for affective and interoceptive functions became less differentiated, as hypothetically predicted by a developmental transition from periallocortical to proisocortical organization of the cortex. Cytoarchitectonically distinct zones of the human cortex undergo distinct neurodevelopmental programs during typical adolescence.

The Benefits and Challenges of Classroom-Based Surveys for the Study of Radicalization and Extremism among Adolescents

Classroom-based surveys are a proven method for studying adolescents since it is relatively easy and cost-effective to obtain a large number of participants from various backgrounds. They are also beneficial for research on youth radicalization and extremism. For example, they allow us to acquire information such as the percentage of students that hold extremist attitudes, factors that correlate positively or negatively with extremism, or how the process of radicalization develops over the course of adolescence. However, classroom-administered survey studies are not without challenges. In this paper, we describe various challenges we have encountered when using classroom-based surveys on extremism and radicalization in our research. We also present advice, including determining what sample design is appropriate, depending on the research question, when to employ a cross-sectional or a longitudinal design, how to measure general or ideology-specific youth extremism, how to achieve a sufficiently large sample size for quantitative analysis, and how to adapt the survey administration process when doing research on radicalization and extremism in a classroom environment.

The development of moral reasoning in urban, high-social class families from Gujarat, India: A longitudinal study from middle childhood to late adolescence.

The aims of the present study were to quantitatively test hypotheses based on the cultural-developmental approach among children and adolescents in Vadodara, India, and to use qualitative analyses to examine the use of indigenous moral concepts. The study included 72 participants who were interviewed at two different age points, separated by approximately 4.5 years. At Time 1, participants were in middle childhood (Mage = 8.22 years) and in early adolescence (Mage = 11.54 years). At Time 2, the same participants were in early adolescence (Mage = 12.87 years) and late adolescence (Mage = 15.77 years). Three findings stood out: (1) As expected, the degree of use of Autonomy increased over the course of adolescence, as did the types of moral concepts. (2) The degree of use of Community significantly increased from middle childhood to adolescence. Duty, within Community was evoked prominently and consistently across all age points suggesting that aspects of social membership emerge early in Indian children's moral reasoning and remain important through adolescence. (3) The use of Divinity was prominent in middle childhood and its use decreased significantly through early adolescence; with a trend for a decrease in its use from early to late adolescence. While much of the reasoning in middle childhood was dominated by a concern for Punishment Avoidance from God, by adolescence Customary Traditional Authority and God's Authority gained prominence. Findings highlight aspects of adolescent moral reasoning that are largely missing in Western studies and point to the utility of emic, indigenous approaches to study moral development.

Friendship changes differentially predict neural correlates of decision-making for friends across adolescence

Adolescents’ peer world is highly dynamic with constant dissolution of old friendships and formation of new ones. Though many of adolescents’ risky decisions involve their peers, little is known about how adolescents’ ever-changing friendships shape their ability to make these peer-involving risky decisions, particularly adaptive ones, and whether this association shifts over time. In a 5-wave longitudinal fMRI study, 173 adolescents (at wave 1: Mage = 12.8, SDage = 0.52; range = 11.9–14.5) made risky choices to win money for their best friend. We assessed whether participants nominated the same or different best friend as their previous participation year (a total of 340 data points of friendship maintenance / change). In early adolescence, adolescents with the same best friend took more adaptive risks for that best friend than those with a different best friend. In late adolescence, however, adolescents with a different best friend took more adaptive risks for the new best friend than those with the same best friend. Further, the amygdala was differentially sensitive to friendship maintenance / change during these peer-involving adaptive risks across time. This study has implications for how stable and flexible peer landscapes differentially modulate social motivation and social decision-making over the course of adolescence.

Ambient Teens Sleep Study: Protocol for a co-produced feasibility study in adolescents using a contactless radar-based sleep sensor.

Sleep is crucial for the healthy development of adolescents, yet many suffer from chronic sleep deprivation. Over the transition to and course of adolescence there are known changes to sleep patterns e.g. shifts towards evening chronotypes. To study changes and patterns of sleep over these critical developmental time-points, detailed longitudinal data is required over months/years rather than weeks/days, a typical limitation of current technology. The implementation of novel contactless sleep sensors offers significant opportunities for longer term data collection, but their application has yet to be explored in young people in terms of feasibility, acceptability, performance and operability. The Ambient Teens Sleep Study will assess the feasibility of a contactless sleep sensor with approximately 45 adolescents aged 8-18 years, for 4 weeks. The device will be compared with accelerometery and sleep diary data, collected concurrently (2 weeks). Young people will provide feedback in the form of online calls and questionnaires as well as citizen scientist and product reviewer activities. Baseline questionnaires, conducted online, will be used to determine acceptability in different cohorts such as age, sex, gender and geographic location. We aim to assess completeness of data, participant experience and performance of sleep timing measures across all three methods of sleep assessment (contactless radar, accelerometery and sleep diary). The results will be used to inform longitudinal methods of sleep data collection in future adolescent health studies, at scale, to explore links between sleep and essential health outcomes across adolescent development.

Change patterns of mother-adolescent perceived parenting and the corresponding trajectories in their internalizing symptoms.

Adolescence is a challenging and sensitive developmental period in which mothers and adolescents may be vulnerable to internalizing symptoms. The current study aimed to understand how patterns of changes in mother-adolescent perceived parenting (i.e., mother-adolescent perceived parenting transition profiles) corresponded with trajectories of mothers' and adolescents' internalizing symptoms from early to late adolescence. The current study utilized a three-wave longitudinal data set of 604 adolescents (54% female, Mage = 12.92, SD = 0.92) and 595 mothers (Mage = 38.89, SD = 5.74) from Mexican-origin immigrant families and adopted mother-adolescent perceived parenting transition profiles from a previous study. Multiple group analyses showed that mother-adolescent dyads who agreed on high levels of positive parenting across the course of adolescence (i.e., Stable Both High) experienced the lowest levels of internalizing symptoms, whereas dyads that showed an inconsistent pattern of mixed profile typologies over time (i.e., Fluctuated) experienced high levels of internalizing symptoms. For mother-adolescent dyads that consistently showed a pattern in which mothers reported more positive parenting compared to their adolescent children (i.e., Stable Mother High), mothers experienced low levels of (and even a decrease in) internalizing symptoms, while adolescents experienced considerably high levels of internalizing symptoms over time. The results for the other two parenting transition profiles (i.e., Change to Both High and Change from Both High) are also discussed. The findings highlight the importance of developing separate adaptive interventions to reduce internalizing symptoms for mothers and children by considering their change patterns of perceived parenting during the course of adolescence. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Aesthetic Outcomes in Cleft Care: Exploring Patterns in Patient-Reported Outcomes across Adolescence.

For patients with cleft lip/palate, adolescence is a time of maxillofacial growth and complex psychosocial stressors. The personal significance of facial differences may change, making patient-reported outcomes measures invaluable. In this study, we use several scales from the CLEFT-Q and FACE-Q to explore how aesthetic outcomes differ by age and by gender among patients with unilateral cleft lip/palate. This was a multicenter, cross-sectional study that prospectively collected CLEFT-Q and FACE-Q data across 6 cleft treatment centers during clinical appointments from 2019 to 2022. Subjects were aged 8 to 22 years, with unilateral cleft lip, alveolus, and palate, who had not undergone tertiary operative care (maxillary advancement or septorhinoplasty) at the time of survey response. Data cross-sections were prepared by age (8 to 10, 11 to 13, and 14 years or older), by gender, and by age and gender together. Older age groups reported poorer aesthetic outcomes and worse appearance-related distress compared with younger groups. Although male and female subjects reported similar aesthetic outcomes, female subjects reported more appearance-related distress. When considered simultaneously, age and gender appear to have an intersectional impact on perceived aesthetic outcome and appearance-related distress during adolescence. This exploratory project suggests that patients with cleft lip/palate may perceive worsening of facial aesthetics throughout the course of adolescence, the exact pattern of which may be dependent on gender. Future work will evaluate this hypothesis using longitudinal cohorts. It will be important to investigate psychosocial factors that may impact these outcomes, and also to quantify the impact of tertiary operative care on these outcomes. Risk, II.

Associations of sport participation with subjective well-being: a study consisting of a sample of Chinese school-attending students.

Past studies have illustrated that the impact of sports participation on school-attending students' well-being plays a significant role in the life course of adolescence, which is a golden period for developing sound psychological qualities. However, the relationship between sports participation and subjective well-being is not clear, particularly in Chinese primary and middle schools. Therefore, the current study was aimed to explore the relationship between sports participation and subjective well-being in elementary and middle schools in China. All involved children and adolescents were asked to conduct a self-report of their sociodemographic factors (e.g., sex, grade, and age), independence, and outcomes. The survey involved a two-stage sampling design (district school). Besides, in order to examine the relationship between participation in sports and subjective well-being, a self-report questionnaire was used. Logistic regression with 95% confidence interval and odds ratios (ORs), was conducted to investigate the relationship between sports participation and subjective well-being. A total of 67,281 participants in total provided complete data for the final analysis of the current study. The percentage of boys and girls was 51.9% and 48.1%, namely. The current study found that compared with children who never participate in sports, those children who participated sports in 1-3 times a month, 1-2 times a week, and 3 times a week and above were more likely to enjoy better well-being. Compared with children who never participate in sports, those children who in every grade participated sports in 1-3 times a month, 1-2 times a week, and 3 times a week and above were more likely to achieve better well-being. Our current study offered the positive effect of sports participation on children and adolescents' subjective well-being. For schools and governments, further studies are needed to focus on sports participation and positive feedback on adolescents' mental health, and the three parties' endeavors should be intervened.

Developmental trajectories of alcohol and cannabis concurrent use in a nationally representative sample of United States youths

BackgroundPrevious studies have identified common trajectories of single type substance use over the course of adolescence; however, no study to date has examined joint trajectories of cannabis and alcohol concurrent use. Given that expansion of legal cannabis has increased availability, it is important to understand patterns of concurrent use in adolescents and factors that place male and female youth at risk for harmful trajectories of concurrent use. The current study sought to identify joint trajectories of cannabis and alcohol use – and predictors of harmful use trajectories – among male and female adolescents. MethodWe used 4 waves of data from 6997 early adolescent participants (age 12–14 years at Wave 1) in the Population Assessment of Tobacco and Health, a nationally representative longitudinal study in the United States. Participants reported their cannabis and alcohol use reassessed yearly for 5 years (2013–2018). We used joint trajectory growth mixture modeling to identify trajectory groups as defined by changes in alcohol and cannabis use over time. ResultsFive classes of alcohol and cannabis concurrent use trajectories were identified. Both internalizing and externalizing symptoms at Wave 1 increased the odds of membership in trajectory groups characterized by more harmful use trajectories. Internalizing symptomatology was a stronger predictor of membership in escalating use trajectories among girls, whereas externalizing symptomatology stronger predictor among boys. ConclusionsThese findings underscore the utility of jointly considering alcohol and cannabis use when describing common developmental trajectories of use and identifying risk factors for trajectories characterized by harmful use.

Social Vulnerability and Psychosocial Resilience in Adolescents and Young Adults From a Community Art Network.

Adolescence is a stage of transition with multiple changes and transformations. It is a critical phase to potentiate or disrupt the life course of human beings. In Latin America, adolescents and young adults from countries like Colombia have unequal access to socioeconomic resources, education, and the job market. This may generate social disadvantages and vulnerability. We aimed to identify conditions of social vulnerability and psychosocial resilience in the life course of adolescents and young adults from a community art network in Bogota, Colombia. We conducted a qualitative study with a multivocal design supported by the ethnic-social life history construction. The data were collected using narrative interviews. The interviews were transcribed, coded, categorized, and triangulated according to the principles of grounded theory as an analytical method. We adhered to the consolidated criteria for reporting qualitative research (COREQ) checklist. Eight adolescents and young adults between the ages of 12 and 24 years participated in the study. Five categories emerged: social vulnerability, social environment, artistic processes, psychosocial resilience, and life course. Social vulnerability and psychosocial resilience coexist during the life course of adolescents and young adults. Social support networks and community art processes have the potential to promote psychosocial resilience in adolescents and young adults.

Stress and self-esteem in young high school students

IntroductionThe course of adolescence is marked by feelings of insecurity, vulnerability and can be accompanied by the emergence of several mental health problems.Having a good self-esteem brings many benefits such as security, well-being and a strong sense of confidence. Low self-esteem is often accompanied by psychological distress such as stress.ObjectivesTo assess the level of stress and self-esteem in young high school students and to identify the risk factors associated with low self-esteem in these adolescents.MethodsThis was a cross-sectional, descriptive and analytical study conducted among a sample of adolescents randomly collected in 6 schools in the region of Sfax-Tunisia, during the month of February 2022. The level of stress was assessed using the Lovibond Depression Anxiety Stress Scale (DASS-21) and self-esteem by the Rosenberg Self-Esteem Scale, both scales are validated in Arabic.ResultsWe collected 396 adolescents. The mean age was 16.65+/-0.897 years and the sex ratio was 0.82.Of these adolescents, 102 had stress symptoms according to the DASS-21 scale, i.e. 26% of the sample. Stress was severe to extremely severe in 37.2% of cases.Low to very low self-esteem was found in 65.7% of cases compared to 14.7% with high self-esteem.In addition to the association with high levels of stress in these adolescents (p=0.002), low self-esteem was associated with other psycho-social factors such as intra-family relationship problems (p=0.014), a history of repeating a year (p=0.026), low to average school performance (p=0.027) and behavioural problems in the school environment (p=0.032).ConclusionsThese results suggest that the association of stress with certain psycho-social factors helps the deterioration of self-esteem in adolescents and vice versa.Having high self-esteem may protect the individual from psychological vulnerabilities such as stress and help him/her to cope with them.Disclosure of InterestNone Declared

Sex differences in the course of autistic and co-occurring psychopathological symptoms in adolescents with and without autism spectrum disorder.

There is an ongoing debate as to whether autism spectrum disorder (ASD) is expressed differently in women than men. Studies on sex differences in autistic symptoms and symptoms of other psychiatric problems present in individuals with autism generally do not include a general population comparison group, making it unclear whether differences are specific to autism or merely reflecting development in the general population. In this study, we compared sex differences in the course of autistic and at the same time present symptoms of other psychiatric problems in adolescents with milder forms of ASD to those in a group of the general population with an equal intelligence quotient (IQ) and socioeconomic status. Data of five assessment moments from ages 11 to 22 years were analyzed using a statistic procedure that allowed us to determine which factors affect the course of symptoms over time. We found that in adolescence, sex differences in the course of psychopathological symptoms specific for autism are confined to the repetitive stereotyped domains. Males had higher scores on the sensory/stereotypic and resistance to change domains, the latter difference disappeared during the course of adolescence due to an increase of these problems in autistic females. Other sex differences, among which an increase over time in mood and anxiety problems in females was the most outstanding, were also observed in females without autism. These sex-specific differences have relevance in the clinical care of autistic men and women, although they are subtle compared to differences between individuals with and without autism.

К ВОПРОСУ О СОКРАЩЕНИИ ДЛИТЕЛЬНОСТИ ЛЕЧЕНИЯ ТУБЕРКУЛЕЗА ОРГАНОВ ДЫХАНИЯ У ПОДРОСТКОВ ПРИ ПОЛУЧЕНИИ ТЕСТА ЛЕКАРСТВЕННОЙ ЧУВСТВИТЕЛЬНОСТИ НА ЭТАПЕ ХИМИОТЕРАПИИ

We carried out a cohort retrospective study to justify the possibilities to continue the main TB treatment course in adolescents with determined drug susceptibility during treatment (without return to treatment commencement) in order to reduce the total duration of treatment. Out of 123 patients who completed treatment in 2019–2022 we selected 31 patients with drug susceptibility test (DST) results obtained by only cultural studies using BACTEC MGIT 960 after 1.5-2 months of treatment. We established that DST results obtained using BACTEC MGIT 960 during treatment would determine further treatment tactics. We compared two groups of patients. Group 1 included 17 patients susceptible to at least 3 TB drugs and positive clinical and X-ray dynamics; their treatment regimens were corrected without return to the intensive phase. Group 2 included 14 patients susceptible to 1-2 TB drugs of the administered regimen without positive clinical and X-ray dynamics; after treatment correction they received the intensive phase of treatment again. The comparison of the main chemotherapy course duration showed that the patients of group 2 received treatment for a significantly longer period of time as compared to the patients of group 1 (the Mann–Whitney U test – 30.5, the critical value 67; р < 0.05).

Behavioral phenotyping of young Scn1a haploinsufficient mice

Dravet syndrome is a rare, severe, infancy-onset epileptic encephalopathy associated with a high premature mortality. In most patients, Dravet syndrome is caused by a heterozygous loss-of-function mutation in the SCN1A gene encoding the alpha 1 subunit of the sodium channel. Of the variety of SCN1A variants identified in patients with Dravet syndrome, SCN1A missense mutations occur in one-third of cases. The novel Scn1a-A1783V mouse model of Dravet syndrome carries the human Ala1783Val missense variant. Recently, the behavioral phenotype of Scn1a-A1783V haploinsufficient adult mice has been characterized, which may provide a valuable basis for assessment of novel therapeutic approaches. However, there is still limited information on the developmental course of behavioral alterations in the Scn1a-A1783V mouse model, which is of particular relevance for conclusions about face validity and severity classification of the model. Based on reference data from young wildtype mice, we analyzed selected behavioral parameters and fecal corticosterone metabolites in the Scn1a-A1783V mouse model during post-weaning development. Differences in the preference for a sweet saccharin solution between Dravet mice and wildtype mice were observed once mice reached sexual maturity. Nest building behavior was already influenced by the Scn1a genotype during prepubescence. Sexually mature Dravet mice showed a significantly reduced burrowing performance as compared to their wildtype littermates. In the open-field test, pronounced hyperactivity and increased thigmotactic behavior were evident in prepubescent and sexually mature Dravet mice. Analysis of Irwin scores revealed several genotype-dependent changes in handling-associated parameters during the course of adolescence. The information obtained provides insight into the age-dependence of behavioral patterns in the novel Scn1a-A1783V mouse model of Dravet syndrome. In addition, the dataset confirms the suitability of the applied behavioral composite measure scheme for evidence-based assessment of cumulative severity in genetic mouse lines.

Myocarditis following COVID-19 vaccination in adolescents: Cardiac magnetic resonance imaging study.

IntroductionVaccination-associated myocarditis was reported following COVID-19 vaccine initially among persons aged 16 or older and recently among adolescents aged 12–15.ObjectivesTo describe the clinical and cardiac magnetic resonance (CMR) characteristics of adolescents aged 12–15 with myocarditis following the administration of the BNT162b2 mRNA COVID-19 vaccine.MethodsCMR of adolescents (age 12–15) with a clinical diagnosis of myocarditis within 42 days following the first COVID-19 vaccine were analyzed.ResultsA total of 182,605 adolescent were vaccinated, out of which 9 were diagnosed with clinically adjudicated myocarditis while CMR was performed in 5/9 patients (56%). Median age was 15 years (range 13–15), 4/5 (80%) males. All the patients we previously healthy. The ECG upon presentation was abnormal in 3/5 (60%) of patients. All cases were classified as clinically mild and no patient required inotropes or mechanical circulatory support treatment. The median follow-up time, for the 5-included patients, was 206 (IQR 192–229, range 179–233) days. During the follow-up, no re-admissions, deaths, or any other cardiac events have occurred.The median time between the diagnosis to the CMR was 104 days (range 27–149). The median left ventricular ejection fraction was within normal range 65% (range 62–69). Native T1 was available in four patients, the local T1 value was increased in three of them. T2 values were available in two patients and were all within normal range. The median late gadolinium enhancement (LGE) was 2% (range 0–6%) with inferolateral wall being the most common location (3/5). The patterns of the LGE were as following: (i) mid-wall in 3 patients; (ii) epicardial in 1-patient. LGE in the pericardium was present in 2/5 patients with pericardial effusion present in 4/5 patients with a median diameter of 4 mm (range 3–5 mm) at end-systole.ConclusionsCMR findings and clinical course of adolescents with COVID-19 vaccination associated myocarditis, are similar to those of older patients, being relatively mild and potentially implying favorable outcomes.

Evaluation of differences across age groups in the incidence, severity, and recovery of concussion in adolescent student-athletes from 2009 to 2019.

Concussion incidence is known to be highest in children and adolescents; however, there is conflicting evidence about the effect of age on concussion risk and recovery within the adolescent age range. The heterogeneity of results may be partially due to the use of age groupings based on convenience, making comparisons across studies difficult. This study evaluated the independent effect of age on concussion incidence, severity, and recovery in student-athletes aged 12-18 years using cluster analysis to define groupings. Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) scores of 11,403 baseline tests and 4922 postinjury tests were used to calculate the incidence rates for adolescent student-athletes grouped into 3 age bands (12-13, 14-15, and 16-18 years of age) on the basis of clustering analysis. The recently created Severity Index was used to compare concussion severity between groups. Follow-up tests for subjects who sustained a concussion were used to evaluate recovery time. The chi-square test and 1-way ANOVA were used to compare differences in demographic characteristics and concussion incidence, severity, and recovery. Multivariable logistic and linear regressions were used to evaluate the independent effects of age on concussion incidence and severity, respectively. Multivariable Cox hazard regression was used to evaluate differences in recovery time. Further analyses were conducted to directly compare findings across studies on the basis of the age groupings used in prior studies. Multivariable regression analyses demonstrated that the 14- to 15-year-old age group had a significantly higher concussion incidence than both the 12- to 13-year-old (14- to 15-year-old group vs 12- to 13-year-old group, OR 1.57, 95% CI 1.16-2.17, p = 0.005) and 16- to 18-year-old (16- to 18-year-old group vs 14- to 15-year-old group, OR 0.79, 95% CI 0.69-0.91, p = 0.0008) age groups. There was no difference in incidence between the 12- to 13-year-old and 16- to 18-year-old groups (16- to 18-year group vs 12- to 13-year group, OR 1.26, 95% CI 0.93-1.72, p = 0.15). There were also no differences in concussion severity or recovery between any groups. This study found that concussion incidence was higher during mid-adolescence than early and late adolescence, suggesting a U-shaped relationship between age and concussion risk over the course of adolescence. Age had no independent effect on concussion severity or recovery in the 12- to 13-, 14- to 15-, and 16- to 18-year-old groups. Further analysis of the various age groups revealed that results may vary significantly with minor changes to groupings, which may explain the divergent results in the current literature on this topic. Thus, caution should be taken when interpreting the results of this and all similar studies, especially when groupings are based on convenience.

Uyku Kalitesi ile Yeme Bozuklukları Arasındaki İlişkide Sorunlu Telefon Kullanımı ve Dürtüselliğin Aracı Rolü

Objective: Both sleeping and eating habits have a major influence on the development of psychopathology and its course in adolescents. Studies have examined the relationships between sleep quality, impulsivity that is defined as acting without thinking and eating disorders (ED). The importance of using mobile phones in our daily lives is a well-known fact. However, in recent years, psychiatric disorders related to problematic mobile phone use (PMPU) have also attracted attention. The present study examined impulsivity and PMPU as two factors that can mediate the relationship between ED and sleep quality. Method: The sample comprised 108 adolescents aged between 12 to 18 years. They completed self-report questionnaires that assessed their impulsivity, sleep quality, symptoms and severity of ED, and PMPU. Results: Binge-eating and impulsivity were significantly higher in adolescents with sleep disorders. The PMPU scores were similar in adolescents with and without sleep disorders. The PMPU scores, motor and non-planning scales of impulsivity, and total scores of impulsivity, were similar in both adolescents with and without eating problems. Linear regression analysis revealed that binge eating was significantly positively correlated with sleep quality and the total impulsivity scores. Conclusion: Thus, sleep disturbance and impulsivity were associated with binge-eating disorder directly. Sleep disturbance mediated only binge-eating behavior through impulsivity. The PMPU did not mediate any association between sleep disturbances and eating disorders.

10 years of myocarditis in children – a single-centre retrospective study

Introduction: Myocarditis in children still poses diagnostic difficulties. Aim of the paper: Assessment of the course of myocarditis in children. Materials and methods: Retrospective study (2009–2019) included 81 patients with myocarditis with analysis of the clinical course, biomarker levels, electrocardiogram, echocardiography and magnetic resonance imaging. Results: The most frequently reported symptom of myocarditis was chest pain in 73 (90%) patients. In 66 (81.5%) patients, the serum troponin I concentration was above the norm (the sensitivity 81.5%), the mean 12,539 ± 11,394 ng/L. In 24 out of 25, the concentration of N-terminal pro-brain natriuretic peptide was above the limit (mean of 866 ± 976 pg/mL). 71 patients had an abnormal electrocardiogram (sensitivity 88%). In echocardiography, 23 (28%) patients had left ventricular ejection fraction below normal limit, the mean 64.5 ± 7.1%. In the subgroup of patients treated with an angiotensin converting enzyme inhibitor, an improvement in left ventricular ejection fraction and end-diastolic dimension was observed. In the subgroup of overweight and obese subjects, 93.3% of patients showed abnormalities in control cardiac magnetic resonance after 6 months, including 33.3% with signs of active inflammation. 60% patients in the subgroup with a body mass index <20 kg/m2 had normal cardiac magnetic resonance imaging. Conclusion: Myocarditis course in adolescents is usually mild. In the overweight and obese patients the occurrence of the disease is more frequent and myocardial abnormalities last longer. The use of an angiotensin converting enzyme inhibitor improves the left ventricular systolic function and the end-diastolic dimension of the left ventricle in patients with myocarditis.

Cultural stressors, internalizing symptoms, and parent-child alienation among Mexican-origin adolescents.

The current study investigated the relation of various cultural stressors, parent-child alienation, and Mexican-origin adolescents' internalizing symptoms at both between- and within-person levels across the course of adolescence. Positive parent-child relationships can be a critical buffer against cultural stressors for Mexican-origin adolescents. However, it is unclear whether low levels of parent-child alienation (a) buffer the negative effects of different types of cultural stressors on internalizing symptoms and (b) function at the individual level more generally or during specific periods when adolescents experience high cultural stressors. The current study used a three-wave longitudinal dataset of 604 Mexican-origin adolescents (Wave 1: Mage = 12.41, SD = 0.97, 54% female, 75% born in the United States) and conducted multilevel regression analysis. At the between-person level, overall low parent-child alienation buffered the adverse effects of ethnic discrimination on anxiety and cultural misfit on depressive symptoms. There were no significant within-person-level interactions of parent-child alienation and cultural stressors on adolescent internalizing symptoms. The findings suggest that interventions should aim to reduce parent-child alienation throughout the course of adolescence to alleviate the impact of cultural stressors on internalizing symptoms among Mexican-origin adolescents.