Adolescent Health Research Articles

The Effects of High-Intensity Interval Training on Cardiometabolic Health in Children and Adolescents: A Systematic Review and Meta-Analysis

High-intensity interval training (HIIT) interventions are typically prescribed according to several laboratory-based parameters and fixed reference intensities to accurately calibrate exercise intensity. Repeated all-out printing efforts, or sprint interval training, is another form of HIIT that is prescribed without individual reference intensity as it is performed in maximal intensities. No previous study has performed a systematic review and meta-analysis to investigate the effect of HIIT and SIT on cardiometabolic health markers in children and adolescents. Moreover, previous studies have focused on single risk factors and exercise modalities, which may restrict their ability to capture a complete picture of the factors that could be affected by different interval interventions. The present study aimed to conduct a novel meta-analysis on the effects of HIIT and SIT on multiple cardiometabolic health markers in children and adolescents. An electronic search was conducted in three main online databases including PubMed, Web of Science, and Scopus were searched from inception to July 2024 to identify randomized and non-randomized control trials comparing HIIT and SIT versus the non-exercise control group in children and adolescents with mean age ranges from 6 to 18 years old on cardiometabolic health markers including fasting glucose and insulin, insulin resistance, triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), systolic blood (SBP) and diastolic blood (DBP) pressures. Standardized mean differences (SMD), weighted mean differences (WMD), and confidence were calculated using a random effect model. HIIT decreased insulin, insulin resistance, TG, TC, LDL, and SBP and increased HDL but did not decrease glucose and DBP. Furthermore, subgroup analyses show that insulin and insulin resistance were decreased by sprint interval training (SIT) and in those with obesity. Lipid profile mainly is improved by SIT and in those with obesity. Also, SBP was decreased by SIT and in those with obesity. Our results prove that HIIT is an effective intervention for improving cardiometabolic health in children and adolescents, mainly those with obesity. Specifically, SIT is an effective interval training mode in children and adolescents.

Association between adolescent lifestyle factors and high-energy traumas in early adulthood: A longitudinal study

IntroductionLongitudinal studies investigating lifestyle factors as risk factors for high-energy traumas from adolescence to adulthood are lacking. The aim of this study was to investigate the influence of 14 to 18-year old adolescent health-related behaviours, overweight, chronic disease, family socioeconomic status (SES), and adulthood education level on the risk of high-energy traumas during the average 27-year follow-up in Finland. Materials and methodsThe baseline data were surveys gathered biennially from 1981-1997 (the Adolescent Health and Lifestyle Survey) and individually linked with outcome data on high-energy traumas retrieved from the Care Register for Health Care until the year 2018. A logistic regression model was used to analyse the associations between the exposure variables in adolescence (frequent physical activity, overweight, smoking, monthly drunkenness, chronic disease, family SES, adulthood education level) and the overall risk for high-energy traumas. Adjusted odds ratios (aOR) with 95% confidence intervals (CIs) were computed. ResultsA total of 876 persons (1.8%) had a high-energy trauma during the follow-up. High-energy trauma diagnoses overall were more common among males than among females (2.8% vs 1.0%). Follow-up showed that those who smoked (aOR 1.49, CI 1.40-1.58), were drunk monthly (aOR 1.49, CI 1.39-1.59), had a chronic disease (aOR 1.22, CI 1.12-1.34) in adolescence or had attained only low education level in adulthood (aOR 1.39, CI 1.30-1.48) had higher odds for high-energy traumas. Frequent physical activity or overweight in adolescence were not related to the higher odds for high-energy traumas. ConclusionSmoking, monthly drunkenness, self-reported chronic diseases in adolescence, and low educational level in adulthood increased the risk of high-energy traumas during the mean follow-up of 27-years. Frequent physical activity and overweight in adolescence did not predict the occurrence of high-energy traumas. Intervention programs should also focus on the long-term consequences of these risk factors.

The influence of social media on adolescent mental health and substance abuse patterns

Adolescents' widespread use of social media has become a serious public health issue, especially considering its effects on substance abuse and mental health. The aim of this review is to examine the complex relationship between the use of social media, mental health issues, and the rise in substance abuse among teenagers. An overview of social media engagement trends is given at the start, emphasising that teenagers are among the most frequent users and that platforms such as Instagram, TikTok, and Snapchat are essential to their social lives. According to recent studies, high social media use has been linked to a rise in mental health conditions, such as anxiety, depression, and low self-esteem. The prevalent behaviours of social comparison, cyberbullying, and validation-seeking in online interactions exacerbate mental health challenges. The review also explored the patterns of substance abuse among adolescents, with particular attention to the use of alcohol, tobacco, and illegal narcotics. Peer pressure, family dynamics, early substance exposure, and other factors have been identified as contributing factors to substance misuse. A critical analysis is conducted on the function that social media plays in normalising substance use, since media portrayals of substance use can glamourise these behaviours and make them seem socially acceptable to impressionable teens. The ways in which peer pressure and heightened stress are two of the methods through which social media impact substance abuse are examined, offering a thorough grasp of the difficulties that young people today face. The urgent need for multifaceted interventions that address social media use and mental health education is emphasised in the review's conclusion. Along with programs to promote digital literacy and ethical social media usage, recommendations are made for parents, schools, and policymakers to reduce the risks associated with social media use. The results highlight the need for additional investigation into the complex interactions among social media, mental health, and substance addiction and support cooperative endeavours aimed at safeguarding and enabling young people in the digital age.

Enhancing adolescent mental health through cognitive and social support: Insights from study on depression in Chinese adolescents

Adolescent depression is a growing global health concern, affecting 14% of adolescents and leading to severe consequences such as academic failure, substance abuse, and suicidal ideation. The study by Yu et al , investigates the cognitive and social factors influencing depression in 795 Chinese adolescents. Findings reveal that negative life events (NLEs) and dysfunctional attitudes are strongly associated with depressive symptoms, while social support moderates the impact of NLEs but not dysfunctional attitudes. The study highlights the need for cognitive-behavioural interventions targeting perfectionism and autonomy, and the importance of strengthening social support systems in schools and communities. Culturally sensitive, holistic approaches to adolescent mental health are crucial for addressing both the internal vulnerabilities and external pressures contributing to depression. Further research is needed to explore the roles of peer and parental support and the long-term effects of these factors across diverse cultural contexts.

The patient and the family: investigating parental mental health problems, family functioning, and parent involvement in child and adolescent mental health services (CAMHS)

AbstractParental mental health problems can impact child mental health, as well as treatment of child mental health problems. The aim of this study was to investigate self-reported mental health problems in parents of children referred to outpatient child and adolescent mental health services (CAMHS) and to compare child mental health problems, family variables, treatment received and parent participation in treatment planning between parents above and below the cut-off for elevated mental health problems. The sample included N = 111 parents of N = 98 children. Parental reports covering their own and their children’s mental health problems, family functioning, adult relationship satisfaction, and previous treatment for mental health problems were collected at the time of the child’s intake appointment. Questions concerning contact with CAMHS were completed one year later. At the time of the intake appointment, 44% of the children had a parent who reported elevated mental health problems. In these families, children reportedly had significantly more mental health problems and problematic family functioning was more common than in families where parent mental health problems were not elevated. Parents with elevated mental health problems received group-based parent support/education to a greater extent during the first year of contact with CAHMS and reported less participation in treatment planning compared to parents without elevated mental health problems. To conclude, findings indicate that co-occurring mental health problems are common in parents when their child is referred to CAMHS, and in these families, it is reported that children have more symptoms, and more families experience problematic functioning. These factors merit consideration in assessment and treatment planning, indicating increased treatment needs in this group of families.

A Scoping Review of Existing Policy Instruments to Tackle Overweight and Obesity in India: Recommendations for a Social and Behaviour Change Communication Strategy

Background The Indian government is committed to addressing various manifestations of malnutrition, including overweight and obesity, inorder to improve individual health and well-being. The scoping review aims to map existing national policy instruments (programmes, schemes, regulations and guidelines) addressing overweight and obesity in India and analysing them for Social and Behaviour Change Communication (SBCC) strategies. Methods Systematic identification and selection of policy instruments using ‘Arksey and O’Malley’ framework was conducted from central government ministry websites, between March and June 2023. These instruments focused on nutrition and/or physical activity, targeting specific demographic groups like pregnant women, lactating mothers, children (0-5 years and 5-9 years), or adolescents (10-19 years); excluding those focusing on specific diseases like micronutrient deficiencies, wasting, and stunting. Based on search strategy six policy instruments were included and analysed for SBCC strategies. Results While many policy instruments incorporated SBCC plans; the ‘National Programme for Prevention of Non-Communicable Diseases (NP-NCD)’ stands out as a significant policy initiative specifically targeting the prevention of overweight and obesity within the broader context of Non-Communicable Diseases. It adopts a comprehensive approach addressing key drivers contributing to overweight/obesity across multiple levels of behavioural influence i.e., individual, interpersonal, community and organisation for health promotion. However, there’s need to strengthen SBCC strategies related to prevention and management of obesity, especially screening and counselling, to cover all age groups with a particular focus on adolescents and youth. SBCC strategies can also be incorporated into India’s Integrated Nutrition Support Programme (POSHAN 2.0) and/or Reproductive, Maternal, New-born, Child, Adolescent Health and Nutrition (RMNCAH+N) under the National Health Mission. Conclusion This paper underscores the necessity for comprehensive strategies to address multifaceted origins of overweight and obesity. The NP-NCD stands out as a noteworthy initiative, and there is considerable potential for other programmes to emulate SBCC strategies to bolster their overall effectiveness. Note : *Policy instruments throughout the paper have been used to cover programmes, schemes, regulations and guidelines.

Moderation of sex in the Association between School Bullying Behaviors and problematic gaming among Chinese adolescents: a cross-sectional study.

Problematic gaming (PG) is a serious issue among adolescents worldwide, and there is evidence suggesting that school bullying behaviors may be associated with increased rates of PG. This study aimed to examine the associations between school bullying behaviors and PG among adolescents, with a focus on sex effects. A total of 20,197 participants were recruited from the 2023 School-based Chinese Adolescents Health Survey. Information about school bullying behaviors and PG was measured. Sampling weights were utilized to estimate the prevalence, and weighted logistic regression models were executed. Stratified analyses by sex were performed. Among Chinese adolescents, the weighted prevalence of PG was 4.2%, 8.1% were identified as victims, 1.8% as bullies, and 3.4% as bully-victims. A higher frequency of school bullying behaviors corresponds to a higher prevalence of PG. After adjusting for covariates, victims (AOR = 1.34, 95% CI = 1.03-1.73), bullies (AOR = 2.08, 95% CI = 1.39-3.11), and bully-victims (AOR = 2.75, 95% CI = 2.09-3.61) were associated with PG. Moreover, the severity of PG tended to increase with the number of involved in school bullying behaviors. The interaction terms of bully-victims and sex were significant. Further stratified analyses by sex indicated that the association of school bullying behaviors with PG was stronger for females than males, especially those identified as bully-victims. School bullying behaviors are associated with PG among adolescents, with a stronger association found in female adolescents, particularly those identified as bully-victims. These findings suggest that implementing prevention and control measures for school bullying could help reduce PG among adolescents.

Gene-environment interactions in the influence of maternal education on adolescent neurodevelopment using ABCD study.

Maternal education was strongly correlated with adolescent brain morphology, cognitive performances, and mental health. However, the molecular basis for the effects of maternal education on the structural neurodevelopment remains unknown. Here, we conducted gene-environment-wide interaction study using the Adolescent Brain Cognitive Development cohort. Seven genomic loci with significant gene-environment interactions (G×E) on regional gray matter volumes were identified, with enriched biological functions related to metabolic process, inflammatory process, and synaptic plasticity. Additionally, genetic overlapping results with behavioral and disease-related phenotypes indicated shared biological mechanism between maternal education modified neurodevelopment and related behavioral traits. Finally, by decomposing the multidimensional components of maternal education, we found that socioeconomic status, rather than family environment, played a more important role in modifying the genetic effects on neurodevelopment. In summary, our study provided analytical evidence for G×E effects regarding adolescent neurodevelopment and explored potential biological mechanisms as well as social mechanisms through which maternal education could modify the genetic effects on regional brain development.

Addressing social norms for adolescent timing and spacing of pregnancy in low and middle-income countries: Developing a global research agenda.

Social norms shape adolescent sexual and reproductive health behaviours contributing to contraceptive and pregnancy outcomes. No global research agendas exist to guide research on adolescent social norms shifting in low- and middle-income countries (LMICs). We developed a social norms research agenda to improve adolescent healthy timing and spacing of pregnancy in LMICs. We adapted and applied the Child Health and Nutrition Research Initiative (CHNRI) method. A group of researchers guided the process, and consulted with diverse experts to develop a list of 21 research questions for global stakeholders to score via an online survey. Survey participants scored each research question according to four criteria (fills key gap, feasible, impactful, equitable). Research priority scores (RPS) and average expert agreement (AEA) statistics were calculated for each question and analysed overall and by stakeholder region and profession. We received 185 survey responses. Participants were, on average, 44 years old, 64% were women, 70% were from LMICs and 47% were implementers. The RPS ranged from 52 to 81% (74% median) and the AEA ranged from 49 to 70% (58% median). Nearly 70% of stakeholders gave the same score to each of the top five research questions. The top five research priorities focused on effective norm-shifting interventions (NSIs) strategies, processes and indicators to NSIs, and NSI adaptation and scale-up. Using a collaborative and rigorous process with diverse representation from LMICs and implementers, we reached consensus on five priority research questions to guide future adolescent social norms research to improve healthy timing and spacing of pregnancy in LMICs.

An online survey of perspectives towards the impact of the covid-19 pandemic amongst caregivers of adolescents with ASD.

The coronavirus disease (COVID-19) pandemic has had a negative impact on the health and mental health of adolescents and adolescents with autism spectrum disorders (ASD) and their caregivers, have been disproportionally affected. The purpose of this study was to investigate the impact of COVID-19 on Thai caregivers and adolescents with ASD. This study used an online survey with closed and free text questions to investigate how the pandemic had impacted on social skills development and psychological variables, and perceived needs for support. The survey link was shared to parents via the Yuwaprasart Withayopathum Child and Adolescent Hospital and the social media platforms of known ASD stakeholder networks in Thailand. Binary logistic regression was used to investigate the relationships between sociodemographic characteristics, service use, and social skills problems experienced by adolescents during the pandemic. Content analysis was applied to analyse free-text data. A total of 376 caregivers of adolescents with ASD aged 10-19 years completed the survey, of which 364 were included in the analysis. In total, 38.7% of caregivers reported that during the pandemic the social skills of their adolescent family member had worsened. Most families reported that they were able to continue to access support from healthcare and educational services, albeit in different ways than pre-pandemic, during the acute stages of the pandemic which benefited the maintenance of ASD symptoms and social skills. Factors identified as reducing the odds of a worsening in social skills during the pandemic included; regular access to treatment for adolescents (odds ratio [OR] = 0.55, confidence interval 95% (CI) 0.32-0.98, p = 0.044), caregivers feeling that they had sufficient support from hospitals (OR = 0.46, 95% CI 0.26-0.81, p = 0.007) and older age of adolescents (OR = 0.53, CI 0.29-0.99, p = 0.047). The qualitative free text comments showed that the caregivers felt that greater information on managing adolescent behaviours, opportunities for adolescents to practice social skills, and the provision of greater emotional support and material assistance from healthcare professionals during the pandemic would have helped them to care for the adolescents with ASD. Regular access to services, support from hospitals during the pandemic and older age in adolescence may have helped prevent the worsening of the social skills problems of adolescents with ASD.

Dance for Wellness: Indigenous adolescents’ Perspectives on Mental Health, Wellness, and Dance

ABSTRACT Purpose Indigenous adolescents living on reservations in Canada experience mental health disparities, and there is an urgent need to address this as mental illness and suicide increase. Therefore, a dance program was initiated to attempt to improve mental health and wellness for Indigenous adolescents The reaearch purpose was to gain insight into theexperiences of mental health and wellness in Indigenous adolescents and identify if and how a four-week dance program affected their mental health and wellness. Design A trauma-informed, qualitative, single-case study design was used. Method Semi-structured interviews and symbol-based data were used to interview eight adolescents aged 11 – 16 years living in a Denesuliné community from February to June 2022. Findings Three multidimensional themes emerged: It Helped My Mental Health and Everything (Dance Helps Me Escape, Dance Makes Me Feel Good, and Dance Is Just Really Fun); A Little Bubble Around Me When I Dance (I Can Be More Confident and I Can Be Myself), and We Won’t Judge You Here (Creation of Friendship, He Said I Was Really Good, and Improved School Attendance). Conclusions The dance program impacted the participants’ mental health and wellness by providing positive activities to engage the adolescents. Clinical Evidence Community health nurses (CHNs) assist in promoting health and wellness in Indigenous adolescents living on reservation and can use these findings to advocate for funding for the development of dance-based mental health and wellness programs.

"Instead of Building More Buildings, They Should Plant More Trees", a Photovoice Study of Determinants of Happiness and Sadness Among East London Adolescents.

Globally, mental health problems in adolescents, alongside associated morbidity and mortality, have never been higher. Local living, working and environmental conditions, socio-economics, and intra-individual and inter-individual processes impact mental health. The risk of developing mental health problems is higher in certain areas, including East London. However, limited research explores East London adolescents' experiences of mental health. An in-depth and locally situated understanding of determinants shaping East London adolescents' happiness and sadness is needed. This study used Photovoice, a qualitative method within a community-based participatory research methodology, to generate photographic and textual data, which was analyzed using reflexive thematic analysis. This method allows participants to be part of knowledge production and authors to present the data. Our findings underscore the bidirectional interplay between environmental factors and adolescents' happiness and sadness. Gratitude for nature was described as increasing happiness: adolescents connected to nature to memories, appreciation, and leisure opportunities. Adolescents were concerned about the fragility of nature in response to urban development. The urban environment was perceived as imposing, inspiring, and offering therapeutic benefits blighted by pollution. Beautiful areas were described as paradisical and lacking, revealing urban development and economic productivity disparities. Our research documents the voices of an under-researched group, revealing novel insights while empowering adolescents as co-producers of mental health research. This study indicates participatory research is valuable for granting adolescents autonomy and addressing misrepresentation. The findings implicate multiple stakeholders, including "Health in All Policies." By deepening our understanding of adolescent mental health in East London, our study can be leveraged to bolster the effectiveness and relevance of interventions for East London adolescents.

Running, walking, and cross-country skiing: how to shape adolescents’ personalities through physical activity?

Adolescence is crucial for personality development, and sports play a significant role. This study investigates the impact of various sports on the personality traits of junior high and high school students in Shandong Province, focusing on neuroticism, extraversion, openness, agreeableness, and conscientiousness. Utilizing data from the “Database of Youth Health,” we employed Seemingly Unrelated Regression (SUR) and Generalized Structural Equation Modeling (GSEM) to analyze the effects of physical activity on personality development. Findings reveal that walking significantly enhances openness and decreased neuroticism, while jogging/running substantially improves extraversion, agreeableness, and conscientiousness. Cross-country skiing, however, negatively impacts all assessed personality traits. In addition, the importance of gender differences in the relationship between physical activity and personality development was revealed. The results offer insights for promoting adolescent personality development through targeted sports activities.

Abstract 4134962: Association between Chronotype and Psychological Health in South Korean Adolescents

Background: Chronotype influences general health, with late chronotypes often linked to psychological problems. However, longitudinal studies on this topic are limited. This study assessed the association between chronotype and adolescent mental health, focusing on depression and somatic symptoms through cross-sectional and longitudinal analyses. Methods: This longitudinal study used data from the Korean Children and Youth Panel Survey (KCYPS), targeting middle school students aged 13. Participants were assessed annually over four years (2018-2021). Chronotype was determined by analyzing sleep onset and wake times. Depression and somatic symptoms were evaluated using preexisting questionnaires like the SCL-90. Multilevel linear regression analyses were conducted both concurrently and prospectively, with gender stratification. Covariates included sleep quality, physical activity, smartphone usage, breakfast and friendship. Results: The study included 1,882 students who completed all follow-ups. Students with a late chronotype, short sleep duration, and low sleep quality reported more mental health symptoms. Late chronotype was associated with higher levels of depression (β=0.062, p<.001) and somatic symptoms (β=0.056, p=.018) within the same year, and predicted somatic symptoms one year later (β=0.055, p=.019). For males, insufficient sleep worsened the effects of late chronotype on depression one year later (β=0.100, p=.042), and late chronotype predicted somatic symptoms one year later (β=0.072, p=.024). In females, late chronotype was associated with depression (β=0.061, p=.025) and somatic symptoms (β=0.075, p=.005) within the same year but did not predict future symptoms. Conclusions: Late chronotype negatively impacted depression and somatic symptoms and predicted future somatic symptoms. In females, late chronotype was related only to current mental health issues, whereas in males, it predicted future mental health problems, especially when combined with insufficient sleep. These findings highlight the impact of chronotype on adolescent mental health and suggest that its negative effects can be moderated by factors like sleep duration.

Relationship between maltreatment and mental health in adolescents: A school-based study in Indonesia.

Maltreatment affects emotional development in adolescents and inhibits social adjustment. This study aimed to analyze the relationship between maltreatment and mental health among adolescents. A cross-sectional study was conducted on adolescents in the first and second grades of middle school (12-14 years old) and high school (15-17 years old) in eight cities and municipalities in the province, selected through several stages of simple random sampling (N = 1837). The International Society for the Prevention of Child Abuse and Neglect (ISPCAN) Child Abuse Screening Tool for Children (ICAST-C) questionnaire for detecting maltreatment was translated, simplified, and validated by an expert based on a theoretical framework that involved pediatricians, public health, and medicolegal perspectives. The Strengths and Difficulties Questionnaire (SDQ) was used to assess emotional states. ICAST-C and SDQ scores were transformed to logit values using Rasch model analysis. Distribution frequency and linear regression were used for data analysis. The results indicated that 85.6% of adolescents aged 12-14 and 83% of those aged 15-17 experienced physical maltreatment, while 89.4% of the 12-14 age group and 82.9% of the 15-17 age group experienced psychological maltreatment. The emotional states of the two groups were 52.8% and 59.2%, respectively. There was a significant correlation between the experience of physical maltreatment and emotions among 12-14 (r1 = 0.148 (0.190-0.257)) and 15-17 years old (r1 = 0.047 (0.084-0.156)). There was a significant correlation between the experience of psychological maltreatment and emotions among 12-14 years old '(r2 = 0.191 (0.270-0.350)) and 15 to 17 years old (r2 = 0.097 (0.167-0.252)). In conclusion, physical and psychological maltreatment were correlated with mental health states among adolescent students in West Java, Indonesia.

O PAPEL DO PROFISSIONAL DE ENFERMAGEM NA ATENÇÃO A CRIANÇAS E ADOLESCENTES COM TRANSTORNO DO ESPECTRO AUTISTA: UMA REVISÃO SISTEMÁTICA

Among the professionals involved in the health care of children with Autism Spectrum Disorder (ASD), nurses stand out as the first to establish contact, maintaining significant proximity with this patient. However, the theme of nursing care aimed at childhood autism is still little disseminated in the scientific community and in the practice of nursing professionals, especially when the focus is the mental health of children and adolescents with ASD. The objective of this study is to investigate the fundamental role of nursing professionals in the care of children and adolescents with Autism Spectrum Disorder (ASD), with an emphasis on promoting the mental health of both these individuals and those who live directly with them. To this end, a qualitative and descriptive research was carried out based on a systematic bibliographic review using the descriptors “Autism Spectrum Disorder”, “Nursing”, “Mental health”, "Child", "Adolescent" in the scientific platforms Google Scholar, PUBMED, LILACS, SCIELO and MEDLINE. A total of 1,098 articles were identified, of which 1,090 were obtained from the Google Scholar database, 4 from MEDLINE, 3 from SCIELO, 1 from PUBMED and none from LILACS. Of this total, 28 were considered eligible after applying the inclusion and exclusion criteria. A huge gap was found in Brazilian research regarding the promotion of mental health of children and adolescents with ASD by nursing professionals. Therefore, it is considered urgent to conduct scientific studies that offer nurses more knowledge about ASD, helping them to develop a critical, analytical and humanized perspective.

Life Skills and Adolescent Mental Health; Can Kids Be Taught to Master Life?

Life Skills and Adolescent Mental Health; Can Kids Be Taught to Master Life?

Associations of generalized anxiety and social anxiety symptoms with sleep duration, amount of intense exercise, and excessive internet use among adolescents.

Among adolescents, symptoms of generalized anxiety disorder (GAD) and social anxiety disorder (SAD) are not only clinically significant but also continuingly increasing. During adolescence, individuals begin to establish distinct, self-determined lifestyle patterns. This study seeks to identify the associations between such lifestyle factors and the prevalence of GAD and SAD symptoms. The analyzable sample was based on a cross-sectional, nationally representative survey of Finnish 14-18 year old students from comprehensive schools, general upper secondary schools, and vocational institutions. The sample consisted of 60,252 boys and 71,118 girls, with the mean age of 16.05 years (standard deviation 1.06). Symptoms were identified using the GAD-7 (cutpoint of 10), the Mini-SPIN (cutpoint of 6), and the PHQ-2 (cutpoint of 3). Logistic regression models for both GAD and SAD symptoms were stratified by comorbidity group variables. GAD symptoms were closely related to excessive internet use and decreased sleep duration among adolescents, regardless of comorbidity with depression or SAD. SAD symptoms were associated with excessive internet use and a lack of intense exercise, independent of comorbid depression or GAD. The findings underscore the importance of considering lifestyle factors when developing interventions to mitigate GAD and SAD symptoms in adolescents. Interventions and policy recommendations aiming at improving adolescents' health behaviour and mental health should take into account the intertwining of these factors.

How do social and gender norms influence the sexual and reproductive health of younger adolescents in sub-Saharan Africa? A scoping review protocol

Introduction Younger adolescents (aged 10–14 years) in sub-Saharan Africa (SSA) have disproportionate sexual and reproductive health (SRH) outcomes due to structural, behavioural, socioeconomic and other factors. Social and gender norms have important consequences for the SRH and wellbeing of younger adolescents both now and over their life course. SRH programming often focuses on older adolescents (aged 15–19 years), overlooking younger ones. This scoping review sets out to explore how gender and social norms influence younger adolescents’ SRH in SSA, to inform tailored interventions. Methods The Arksey and O'Malley strategy will be used to review the available literature. Online databases (PubMed/MEDLINE, CINHAL, EMBASE, PsycINFO, Cochrane Library, and African Index Medicus) will be searched for original studies published between 1 January 2000 and 30 September 2024. Further, a manual search to include relevant grey literature will be performed. The steps in the review are: 1) defining the research question, 2) identifying relevant studies, 3) selecting studies, 4) charting the data, and 5) collating, summarising, and reporting the results. Results Findings will be reported in accordance with the guidance provided in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement. Discussion The review will generate the most up-to-date evidence and identify gaps in literature in addition to informing future research on how gender and social norms influence younger adolescents’ SRH in SSA. Findings will inform and influence future interventions and evaluations in this area.

The potential utility of cord blood DNA methylation in pediatric clinical practice.

Our understanding of the origins of noncommunicable diseases has evolved over the years with greater consideration given to the lasting influence exposures and experiences during the preconceptional and prenatal periods can have. Research highlights the associations of parental exposures (e.g., diet, obesity, gestational diabetes, lipid profile, toxic exposures and microbiome) with the infant/fetal methylome and suggest associations with infant, child and/or adolescent chronic health outcomes. Thus, epigenetics and specifically cord blood DNA methylation may have utility as biomarkers for disease risk identification and stratification in pediatrics. However, for cord blood DNA methylation analyses to be leveraged as biomarkers of disease risk in pediatric clinical practice, the results must be replicable, validated and clinically meaningful. Challenges and opportunities to this prospect are herein discussed.