Adolescent Outcomes Research Articles

Two Decades of Child Welfare System Contact in the Global North: A Research Note on Trends in 44 Countries.

Child maltreatment and child welfare system contact are both associated with an elevated risk of adverse outcomes in childhood, adolescence, and adulthood. Yet, data on variation in system contact are available for only a handful of countries, limiting knowledge about the societal correlates of system contact. As reported in this research note, we identified, collected, and harmonized administrative data on child welfare agency investigations, confirmed maltreatment, and placements into out-of-home care for 44 countries in the Global North. We analyzed 15 sociodemographic factors commonly associated with child maltreatment and child welfare system contact. Results support three core conclusions. First, data are much more available on late-stage system contact (e.g., foster care caseloads) than for early-stage system contact (e.g., investigations). Second, whereas early-stage contact tended to be on the rise in most countries, late-stage contact was stable or declining. Cross-national variation in these trends was generally less substantial than cross-national variation in levels of child welfare system contact, indicating relatively stable cross-national differences. Third, cross-national variation in out-of-home care largely reflected, but was not reducible to, regional and sociocultural variation: we find little evidence for universal drivers of foster care caseloads across the Global North.

Metabolic Syndrome Spectrum in Children with Classic Congenital Adrenal Hyperplasia—A Comprehensive Review

Children with a classic form of congenital adrenal hyperplasia (CCAH) have a potentially increased risk of unfavorable cardiometabolic events due to the interplay of corticosteroid treatment, hyperandrogenism, and other factors. Although readily recognized in adults, these aspects are frequently overlooked in children and youth with CCAH; Aim: To review the evidence available from studies regarding cardiometabolic health outcomes in CCAH patients; Methods: A review of the literature was performed following PRISMA guidelines, including studies published between 2000 and 2024. We included studies reporting cardiometabolic outcomes in children and adolescents (<18 years) with CCAH. Where pediatric data were sparse, additional data were obtained from studies with older adolescents and young adults (15–25 years). Cardiometabolic outcomes included risk factors, such as obesity, insulin resistance, lipids, blood pressure, and vascular markers; Results: Twenty-five studies were analyzed. The prevalence of obesity was found to be higher in children with CCAH, as well as of increased visceral adiposity. Higher indices of insulin resistance were also a frequent finding in children with CCAH. CCAH patients had higher systolic blood pressure and more frequently loss of nocturnal blood pressure dipping, particularly among salt-wasting subtypes and in younger children. Subclinical atherosclerosis was indicated by increased carotid intima–media thickness, elevated hs-CRP, and impaired endothelial function. Other findings suggested changes in lipid profiles, particularly decreased HDL-c and increased triglycerides, although the findings were less consistent; Conclusions: Compared with the general pediatric population, children with CCAH were found to have an increase in multiple cardiometabolic risk factors. It is therefore vital to monitor these risk factors in pediatric CCAH, as well as tailoring treatment with cardiometabolic health in mind, to achieve better long-term cardiovascular and metabolic outcomes. Future research should focus on longitudinal studies of cardiometabolic outcomes and innovative therapeutic approaches to reduce these risks in patients with CCAH.

Understanding the Relationship Between Empathy, Theory of Mind (ToM), and Parenting Styles Among Children With Disruptive Behaviour.

Disruptive behaviour has been recognized as one of the most common and persistent forms of childhood maladjustment, and predictive of a range of negative adolescent and adult outcomes including continuing aggression, failure in school and work settings, substance abuse, and late-onset psychopathology. As a child grows many factors influence the child's development like genetic factors, parenting styles, attachment patterns, environmental factors etc. These factors help in the development of empathy, theory of mind (ToM), emotional and behaviour regulation. We need to understand the relation between these factors among children with disruptive behaviours, inorder to develop targeted interventions and support strategies tailored to the unique needs of this population. A sample of 70 children and their mothers completed validated psychometric scales. Pearson correlation & regression analysis were conducted to determine the relation between variables. Results indicated that a significant negative correlation was observed between the permissive parenting style of the father and ToM among children with disruptive behaviour. Empathy was considered a significant inverse predictor of disruptive behaviour among children with disruptive behaviour. Another finding suggests that there is no significant difference in disruptive behaviour between boys and girls and no evident association between parenting styles and disruptive behaviours in children. While this could imply that inherent factors (nature) may have a more notable influence on disruptive behaviour in this sample, it is important to consider that this does not rule out the potential impact of environmental factors (nurture). The results should be viewed as part of a complex interplay between nature and nurture, and further investigation, particularly through longitudinal studies, is needed to clarify their respective contributions. This study builds upon existing research in providing a better understanding of contributors to disruptive behaviour among children, which may assist in the development of interventions to promote positive socio-emotional development and enhance the overall well-being of children.

Characteristics of children and adolescents with multidrug-resistant and rifampicin-resistant tuberculosis and their association with treatment outcomes: a systematic review and individual participant data meta-analysis.

There are few data on the treatment of children and adolescents with multidrug-resistant (MDR) or rifampicin-resistant (RR) tuberculosis, especially with more recently available drugs and regimens. We aimed to describe the clinical and treatment characteristics and their associations with treatment outcomes in this susceptible population. We conducted a systematic review and individual participant data meta-analysis. Databases were searched from Oct 1, 2014, to March 30, 2020. To be eligible, studies must have included more than five children or adolescents (0-19 years of age) treated for microbiologically confirmed or clinically diagnosed MDR or RR tuberculosis within a defined treatment cohort, and reported on regimen composition and treatment outcomes. Abstracts were screened independently by two authors to identify potentially eligible records. Full texts were reviewed by two authors independently to identify studies meeting the eligiblity criteria. For studies meeting eligiblity criteria, anonymised individual patient data was requested and individiual level data included for analysis. The main outcome assessed was treatment outcome defined as treatment success (cure or treatment completed) versus unfavourable outcome (treatment failure or death). Multivariable logistic regression models were used to identify associations between clinical and treatment factors and treatment outcomes. This study is registered with Prospero (CRD42020187230). 1417 studies were identified through database searching. After removing duplicates and screening for eligibility, the search identified 23 369 individual participants from 42 studies, mostly from India and South Africa. Overall, 16 825 (72·0%) were successfully treated (treatment completed or cured), 2848 died (12·2%), 722 (3·1%) had treatment failure, and 2974 (12·7%) were lost to follow-up. In primary analyses, the median age was 16 (IQR 13-18) years. Of the 17 764 (87·1%) participants with reported HIV status, 2448 (13·8%) were living with HIV. 17 707 (89·6%) had microbiologically confirmed tuberculosis. After adjusting for significant factors associated with treatment outcome, the use of two (adjusted odds ratio [OR] 1·41 [95% CI 1·09-1·82]; p=0·008) or three (2·12 [1·61-2·79]; p<0·0001) WHO-classified group A drugs (bedaquiline, moxifloxacin, levofloxacin, and linezolid) compared with the use of no group A drugs at all was positively associated with treatment success. Younger and clinically diagnosed children are underrepresented among those treated for MDR and RR tuberculosis and should be a focus for case-finding efforts. Overall treatment outcomes in our analysis were better than in adults but lower than the international targets of 90% or more individuals successfully treated. Treatment with more group A drugs was associated with better treatment outcomes in children and adolescents, highlighting the need for more rapid access to these drugs and improved regimens. Unitaid.

Essential micronutrients in children and adolescents with a focus on growth and development: a narrative review.

This comprehensive review examines the crucial role of micronutrients in the health of children and adolescents, focusing on their growth and development. Micronutrients, including vitamins and trace elements, are essential for various biochemical processes and biological functions. We explored the roles, assessment methods, deficiency patterns, and intervention strategies for six essential micronutrients: iron, zinc, vitamin A, vitamin D, iodine, and folate. These nutrients were selected based on their fundamental importance in pediatric development. By analyzing the current literature from PubMed, Embase, and Web of Science databases, we synthesized findings regarding the impact of these micronutrients on health outcomes in children and adolescents, examining both regional and global prevalence data, with particular attention paid to Korean population data. This review provides evidence-based insights into the assessment and management of micronutrient status in children and adolescents and offers recommendations for clinical practice.

A Preamble to Prevention of Adolescent Substance Use: Pediatric Resident Screening for Caregiver Substance Use.

Caregiver problematic substance use (SU) is a common adverse childhood experience that is associated with the development of SU disorders in adolescence and poor health outcomes. Most pediatricians do not currently screen for caregiver SU, missing an opportunity to provide targeted prevention counseling to at-risk youth and their families. The objective of this study was to assess whether pediatric residents' screening-related competencies, beliefs, and training were associated with current screening practices and/or preparedness to screen in the future. Baseline surveys from a quality improvement initiative to increase screening for household SU in pediatric primary care were e-mailed to all pediatric residents at an academic medical center. Surveys assessed residents' current screening practices, preparedness to screen in the future, screening-related competencies, receipt of SU training, beliefs about screening, perceived caregiver acceptability of screening, and stigma about caregiver SU. Residents agreed screening for household SU is a pediatrician's responsibility and beneficial for patients and families, yet only 5% universally screened. Preparedness to screen in the future was positively associated with reported screening-related competencies and receipt of training on SU screening during residency. Most residents did not universally screen for household SU, thereby missing opportunities for targeted secondary prevention of adolescent SU. Trained residents who reported competence in addressing families' concerns were more likely to feel prepared to screen in the future, suggesting education that addresses caring for affected families, reviews available resources, and improves pediatrician confidence may be particularly impactful.

Prognostic Modeling for Bone Sarcomas Based on a Large Prospective Cohort From a Tertiary Care Cancer Center in India

PURPOSE Outcomes of adolescents and young adults (AYA) with bone sarcomas including osteosarcoma (OGS) and Ewing sarcoma (ES) are affected by various factors including inadvertent previous treatment and poor compliance. We aimed to develop a risk-scoring system derived and validated at a tertiary care cancer center in India. METHODS All AYA OGS and ES cases treated at our institute with OGS-12 and Ewing’s family of tumors-2001 (EFT-2001) protocols from 2011 to 2021 and 2013 to 2018, respectively, were prospectively analyzed. Weighted scores provided to each prognostic variable on the basis of approximate ratios of the beta coefficients of each factor in the multivariable model were summated to divide patients into three clinically discriminatory risk groups, validated by applying separately to derivation, validation, and whole cohorts. RESULTS Among 606 (81.0%) of 748 AYA with nonmetastatic OGS, significant factors included in the prognostic model were failure to complete protocol (hazard ratio [HR], 2.65), previous treatment (HR, 2.93), necrosis &lt;90% (HR, 1.63), joint involvement (HR, 2.0), and serum alkaline phosphatase &gt;median (204 U/L; HR, 1.63). Of 104 (39.5%) of 263 AYA with ES, significant factors were failure to complete protocol (HR, 2.84), previous treatment (HR, 6.37), necrosis &lt;100% (HR, 8.73), and tumor size &gt;8 cm (HR, 2.64). For 142 (38.8%) of 366 AYA with metastatic OGS, significant factors were failure to complete protocol (HR, 5.29), metastases not amenable to local treatment (HR, 1.96), necrosis &lt;90% (HR, 1.96), and &gt;10 metastases (HR, 2.44). For 38 (43.6%) of 82 AYA with metastatic extremity ES, significant factors were failure to complete protocol (HR, 3.88) and metastases not amenable to local treatment (HR, 10.6). CONCLUSION We developed simple, effective prognostic models for AYA with bone sarcomas with specific potential relevance for low- and middle-income countries.

Laser Interstitial Thermal Therapy for the Treatment of Mesial Temporal Lobe Epilepsy in Children.

Few studies have explored the efficacy of laser interstitial thermal therapy in pediatric epilepsy surgery. This study aims to evaluate seizure-free outcomes in children and adolescents with mesial temporal lobe epilepsy who underwent laser interstitial thermal therapy. This was a retrospective cohort study performed at a level 4 epilepsy center. All patients had comprehensive presurgical epilepsy evaluations with a consensus treatment decision made by a multidisciplinary team. Brain magnetic resonance imaging (MRI) data were used to determine lesional vs nonlesional groups. All laser interstitial thermal therapy procedures were performed using Visualase laser ablation systems by the neurosurgical team. Seizure-free outcomes were measured according to the Engel surgical outcome scale. This study included 19 patients (12 girls, 7 boys). Age of epilepsy onset ranged from 2 to 17 years (mean 9.9 years), and age at time of surgery ranged from 8 to 20 years (mean 15.1 years). Ten patients (52.5%) had signs of hippocampal sclerosis on MRI (lesional group), and 9 patients (47.5%) had a normal brain MRI (nonlesional group). Engel 1 score was achieved by 14 of 19 patients (73.5%): 9 of 10 patients (90%) in the lesional group and 5 of 9 patients (55.5%) in the nonlesional group. Younger age of seizure onset was a predictor of better postsurgical outcome, but no other outcome predictors could be established. Laser interstitial thermal therapy is safe and effective for the treatment of drug-resistant mesial temporal lobe epilepsy in children, rendering more favorable seizure-free outcomes in pediatric patients with hippocampal atrophy than in those with nonlesional mesial temporal lobe epilepsy.

Treatment outcomes among children and adolescents with extensively drug-resistant (XDR) and pre-XDR tuberculosis: Systematic review and meta-analysis.

Extensively drug-resistant (XDR) and pre-XDR- tuberculosis (TB) account for approximately a third of pediatric MDR-TB cases globally. Clinical management is challenging; recommendations are based on limited evidence. We assessed the clinical outcomes for children and adolescents treated for XDR-and pre-XDR-TB. We performed a systematic review and meta-analysis of published studies reporting treatment outcomes for children and adolescents with XDR-and pre-XDR-TB. MEDLINE, EMBASE, Scopus, Web of Science, Google Scholar, and trial registries up to 31 December 2023 were searched. Eligible studies included children and adolescents aged <18 years with XDR-or pre-XDR-TB. The primary outcome was treatment success, defined as a composite of cure and treatment completion. Secondary outcomes were death, failure/ lost to follow-up and adverse events. We identified 34 population-based studies and 14 case studies, which reported treatment outcomes for a total of 656 patients. Treatment durations ranged from 6 to 27 months; follow-up after treatment completion ranged from 2 months to 4 years. The pooled estimate for treatment success in XDR-and pre-XDR-TB was 88·9% (95%CI: 59·7-100%) and 65·4% (95%CI: 27·7-100%), respectively. Drug adverse effects were reported in 56.4% (95%CI: 9.9-100%) and 68.2% (95%CI: 0-100%) of children respectively. Few childhood XDR- and pre-XDR-TB cases are reported. The relatively good treatment outcomes in children compared to adults may be partly due to publishing bias. Drug adverse effects are common.

P-2212. Nasal microbiota differences in young infants and early childhood neurobehavior: a pilot study

Abstract Background The etiology and mediators of childhood neurobehavioral conditions are poorly understood. The early life microbiome is implicated in neurodevelopment. In contrast to gut microbiota, however, the relationship between nasal microbiota and early behavior remains unknown. Olfaction serves critical functions in neonates. Murine data suggests that nasal inoculation of E. coli in neonates drives different adolescent behavior outcomes. We hypothesized that the newborn nasal microbiota influences olfactory perception and early life behavioral development. Study design and data acquisition a) Microbiota data from nasal, oral, and fecal samples at newborn, 1 month, and 5 month timepoints; olfactory fMRI brain imaging at 1 month; and parent neurobehavioral assessment at 1 and 5 months. b) Infant olfactory MRI setup and respiration trace during odor delivery via spirometer on nasal mask. Methods In this prospective pilot study, thirteen vaginally-delivered infants were enrolled. Nasal, oral, and fecal microbiome specimens were collected at three time points: newborn (1-2 days), 1 month, and 5 months of age. Neurobehavioral assessments were performed at 1 and 5 months. At 1 month, infants had an olfactory brain fMRI scan in a natural sleep state during which pleasant and unpleasant odors were delivered via nasal mask (Fig 1). Extracted biospecimen DNA was subjected to 16S rRNA next generation sequencing (V1-V3 region, 27F-534R primers). Bioinformatics analysis of diversity, differential microbial features, and correlations were conducted in R. Nasal microbiota profiles for infants 16S rRNA next generation sequencing of nasal samples of patients (n=13) at newborn, 1 month, and 5 month time points at the a) taxonomic level of phylum and b) taxonomic level of genus with top ten taxa shown. Results Alpha-diversity of nasal microbiota did not vary by age. Beta-diversity differences were observed between newborn and 1 month (PERMANOVA; p = 0.0521) and newborn and 5 months (p = 0.0027). At the taxonomic level of phylum, the relative abundance of Actinomycetota and Bacteroidota was significantly lower and that of Pseudomonadota significantly higher at 5 months compared to newborns. At the genus level, the relative abundance of Moraxella increased from newborn to 5 months (p&amp;lt; 0.0001), and Streptococcus relative abundance was significantly higher at 5 months (Fig 2). Infants with high irritability (n=4, Fig 3) demonstrated nasal microbiota differences compared to those without (n=9) at newborn, 1 month, and 5 month time points. Analysis of odor-evoked cortical activation on fMRI and toddler behavioral assessments are in process. Infant behavioral dysregulation scores Distribution of the Multidimensional Assessment Profiles Temper Loss (MAPS-TL) Scales scores for n=13 infants at 5-6 months. X-axis is the numerical MAPS-TL score and y-axis is number of infants. Infants with high irritability (n=4) cluster with higher scores. Conclusion Nasal microbiota differences in early infancy are associated with behavioral dysregulation. Further investigation of how nasal microbiota may impact neurobehavioral health, potentially via olfaction, is warranted. Disclosures All Authors: No reported disclosures

Core Patient-Centered Outcomes for Adolescents and Young Adults with Cancer: A Comprehensive Review of the Literature from the STRONG-AYA Project

Background: In adolescents and young adults (AYAs) with cancer, the importance of patient-centered research outcomes is increasingly acknowledged and there is a need for consensus on the most relevant outcomes. This review provides a comprehensive overview of outcomes relevant to AYAs with cancer in order to develop an AYA-specific core outcome set (COS) as part of the European project STRONG-AYA. Methods: A literature search was conducted to identify relevant articles in five databases. Each article was reviewed by two independent researchers, using Rayyan (an online tool) to screen articles by their title/abstract and then by their full text. Subsequently, the data were extracted using a predefined, tailored extraction framework. Results: In total, 17,301 articles were screened, of which 1631 were included in the analyses. Registry studies (52.9%) were the most used study type. Well-represented continents were North America (50.3%) and Europe (27.8%). Of the five core areas, functioning (47.0%) and epidemiology (44.9%) were covered most often, followed by physiological/clinical (42.4%), resource use (6.1%), and adverse events (4.5%). The outcome domains that were represented the most include mortality/survival (43.1%), delivery of care (23.4%), outcomes relating to neoplasms (22.7%), and emotional functioning/well-being (19.2%). Conclusions: This literature review provides a foundation for the development of an AYA-specific COS for improving the relevance and efficiency of measuring outcomes, the pooling of (international) research data, and the value of care for current and future AYAs with cancer. Finalization and refinement of the COS should be a priority for future research.

Socioeconomic inequalities in health behaviors in children and adolescents: evidence from an Australian cohort

BackgroundUnderstanding the association between socioeconomic inequalities and health behaviors is imperative for elucidating and effectively addressing health inequities among children and adolescents. Despite the wealth of literature on social gradients in health behaviors, longitudinal analyses of socioeconomic inequalities in the health behaviors of children and adolescents are relatively limited, particularly in the Australian literature. Therefore, this study aimed to investigate the association between socioeconomic inequalities and health behaviors among Australian children and adolescents.MethodsThis study utilized the secondary data from the Longitudinal Study of Australian Children (Waves 2–8), which included participants aged 2 to 15 years. Relative index inequality (RII) methods were used to investigate the associations between socioeconomic inequalities and the health behaviors of children and adolescents.ResultsCompared with their counterparts, children and adolescents with high socioeconomic status (SES) are 84% more likely to consume fruits and vegetables (RII = 1.84, 95% CI = 1.63–2.09) and 19% less likely to consume sugary beverages (RII = 0.81, 95% CI = 0.77–0.86), but more likely to consume sweet and savory foods (RII = 1.09, 95% CI = 1.01–1.19). Children and adolescents with high SES were less likely to spend their free time on screens (RII = 0.86, 95% CI = 0.81–0.91) and more inclined toward outdoor activities (RII = 1.75, 95% CI = 1.53–1.98).ConclusionThis study provides useful insight into socioeconomic inequalities and health behavior outcomes in children and adolescents. These findings stress the need for tailored interventions designed to improve the health behaviors of families from lower socioeconomic backgrounds. Additionally, addressing unhealthy dietary behaviors, such as the higher consumption of sweet and savory foods among children from higher SES backgrounds, is equally critical. Such comprehensive interventions have the potential to reduce socioeconomic disparities in health behaviors and improve the well-being of the broader population.

Subjective and objective stress during body exposure: a comparison of adolescents with anorexia nervosa versus high body dissatisfaction.

Body dissatisfaction (BD) is a risk factor for the development of an eating disorder (ED) and a negative predictor for treatment outcome in adolescents with anorexia nervosa (AN). As a clinical core symptom and a relevant maintaining factor of AN, body image disturbance and BD are highly relevant target variables for therapeutic interventions. Body exposure (BE) was found as being effective for reducing BD in adolescents with EDs and high BD. However, the underlying mechanisms of BE are still not clear, with habituation processes being discussed as one possible mechanism. Affective and neurobiological processes during a four-session computer-based BE intervention were investigated. Within a controlled design comparing adolescents with AN (n = 34) vs. adolescent patients with high BD (n = 17) but without a diagnosed ED, subjective (stress ratings; 11-point Likert scale) and objective (salivary cortisol and alpha-amylase [sAA]) stress measures were assessed at four time points at each exposure session (start, +10 min, +30 min/end, +60 min/recovery). ED and depressive psychopathology were assessed via self-rating questionnaires. A between-session habituation effect was found for subjective stress ratings and sAA levels with decreasing scores throughout the four sessions. A within-session habituation was found for cortisol levels. Higher psychopathology was associated with subjective stress ratings. There were no group differences between AN and BD regarding ED psychopathology or subjective or objective stress measures. Subjective and objective stress measures were mainly not associated with each other. Habituation processes were found for subjective and objective stress, which might enhance motivation to continue BE interventions and thus increase their impact. BD seems to be a transdiagnostic phenomenon with BE as a successful intervention independent of psychiatric diagnosis. Current findings should be validated in larger samples, and the hypothesis of a transdiagnostic BD should be investigated in future research.

Promising Predictors of Adolescent Sexual Behavior Outcomes: ASystematic Review of Longitudinal Research.

This review examined research to identify longitudinal predictors of adolescent sexual behavior outcomes. These predictors hold promise as potential outcomes for teen pregnancy prevention program evaluations when measuring sexual behavior outcomes is infeasible or theoretically, methodologically, or developmentally inappropriate. We conducted a systematic review using a prespecified search strategy and processes consistent with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We examined 32 research studies published between 2008 and 2024. Four categories of predictors of sexual behavior during adolescence emerged across the reviewed studies. Variables within the caregiver control, self-regulation, sexting, and substance use categories each predict future sexual behavior outcomes, with findings consistent across 3 or more studies for each category. This systematic review documents the current evidence base for precursors of sexual behavior outcomes among adolescents and specifies which predictors have promising, potentially promising, mixed, and limited evidence. This review is the first step in gathering information that will eventually inform an avenue for teen pregnancy prevention program developers and researchers to highlight the promise of programs when evaluating impacts on sexual behavior outcomes is infeasible or inappropriate.

Health information orientation and health literacy as determinants of health promotion behaviors in adolescents: a cross-sectional study.

This cross-sectional study aimed to identify the impact of health information orientation and health literacy on adolescents' health-promoting behaviors. We enrolled 149 middle school students from an urban city in South Korea through convenience sampling. The data was collected in October 2022 using a self-reported questionnaire. Health information orientation was measured using the Health Information Orientation Instrument (Cronbach's α = 0.86). Health literacy was assessed with the Korean Adolescent Health Literacy Scale (KR-20 = 0.66), and health promotion behaviors were evaluated using the Adolescent Health Promotion Scale-Short Form (Cronbach's α = 0.89). Analysis methods included independent t-tests, one-way ANOVA, and multiple regression. Results indicated significant differences in health promotion behaviors based on perceived health status, economic status, primary health-related information provider, and health literacy. Health information orientation showed a strong positive correlation with health promotion behaviors. The factors that influenced health promotion behaviors were health information orientation, primary information provider, economic status, and health literacy. Findings suggest that school and community health promotion programs should engage adolescents and parents to enhance health literacy and proactive information-seeking behaviors for improving the health outcomes of adolescents.

Associations Between Sugar-Sweetened Beverage Taxes and Weight Outcomes Among US Adolescents.

Given the recent implementation and preemption of sugar-sweetened beverage taxes across the United States, we aimed to evaluate the associations between sugar-sweetened beverage (SSB) taxes and adolescent weight-related outcomes using data on 364,540 adolescents drawn from 1999 to 2021 district Youth Risk Behavior Surveys. We used difference-in-differences models to assess the associations and the potential mediating roles of SSBs, milk, and 100% fruit juice consumption. We found that a one cent per ounce increase in SSB taxes was associated with a 0.26 lower body mass index (P <.01), and a 2.19 (P <.01) and 1.68 (P <.01) percentage point decrease in the probability of being affected by overweight and obesity, respectively. SSB consumption had a mediating role, as tax increases were associated with a 2.45 (P <.01) percentage point decrease in adolescents' probability of drinking any SSB. Milk and 100% fruit juices likely also played a role, as we found changes in their consumption in response to tax increases.

Effects of eHealth exercise on paediatric suppurative lung diseases: a systematic review and meta-analysis

BackgroundUtilizing information and communication technologies through eHealth in exercise programs could support their delivery and improve clinical outcomes in children and adolescents with chronic suppurative lung diseases (CSLDs). This study aimed to systematically investigate the effects of eHealth exercise programs on clinical outcomes for this population.MethodsFive databases were searched from inception to April 12, 2024. Two researchers independently screened the retrieved results and rated the methodological quality of the included studies using the revised Cochrane Risk of Bias tool for randomized trials and the Risk of Bias in Non-Randomized Studies – of Interventions tool. The quality of evidence was graded using the GRADE approach. A narrative synthesis of findings was performed, and a meta-analysis was conducted to evaluate the effects of eHealth exercise programs on clinical outcomes that had data from ≥2 studies.ResultsSeven studies used eHealth exercise programs through active video games (n=3), videoconferencing (n=3), and a digital spirometer (n=1) lasting from 3 to 12 weeks. Five studies had participants with cystic fibrosis (CF). Results showed a greater improvement in the 6-minute walk test following the intervention compared to the control group; pooled estimate mean difference [37.2 meters (95%CI: 7.91 to 66.48), p=0.013]. Pulmonary function, exercise capacity, balance, peripheral and respiratory muscle strength, and HRQoL were also improved. Still, most studies involved a considerable risk of bias.ConclusionseHealth exercise programs can improve clinical outcomes in children and adolescents with CF. Further research is needed for other pediatric populations with CSLDs and also for comparisons with conventional exercise programs.

Characteristics and Outcome of Children and Adolescents Diagnosed With Ewing Sarcoma Treated at a Tertiary Cancer Center in India: A Single-Institution Experience

Characteristics and Outcome of Children and Adolescents Diagnosed With Ewing Sarcoma Treated at a Tertiary Cancer Center in India: A Single-Institution Experience

The Self-Compassion Scale Short Form for Children Aged 8-12: Validation of the Italian Version.

Although self-compassion has been consistently linked to positive outcomes in adults and adolescents, only a few studies have explored self-compassion in children and early adolescents due to a lack of measures specifically designed for younger populations. The current study explored the psychometric properties of the Italian translation of the Self-Compassion Scale for Children (SCS-C) in a sample of 230 children (mean age = 10.52, SD = 1.33). The results revealed a two-factor solution for our data, with a positive self-compassion factor and a negative self-compassion factor, which were shown to be internally consistent. The SCS-C scores correlated with the children's mindfulness, self-esteem, and narcissistic traits in the assumed directions. Overall, our study preliminarily supports the reliability and validity of the Italian version of the SCS-C.

Bone Composition Changes and Calcium Metabolism in Obese Adolescents and Young Adults Undergoing Sleeve Gastrectomy: A Systematic Review.

Background/Objectives: Sleeve gastrectomy (SG) is increasingly used to treat severe obesity in adolescents, but its effects on bone health during this critical period of bone accrual are not fully understood. This systematic review aims to evaluate the impact of SG on the bone mineral density (BMD), bone microarchitecture, marrow adipose tissue (MAT), and bone turnover markers in adolescents. Methods: A comprehensive literature search was conducted to identify studies assessing bone health outcomes in adolescents undergoing SG. Nine studies met the inclusion criteria, comprising prospective cohorts, observational cohorts, and one randomized controlled trial, with sample sizes ranging from 10 to 197 participants aged 13 to 25 years, and a total sample size of 597 individuals. Data were extracted and synthesized into tables summarizing changes in BMD, bone microarchitecture, MAT, and bone turnover markers. Results: SG in adolescents is associated with significant reductions in areal BMD at critical skeletal sites, particularly the femoral neck and total hip, with decreases ranging from -4.7% to -8.9%. Studies utilizing high-resolution peripheral quantitative computed tomography (HRpQCT) reported deteriorations in bone microarchitecture, including a decreased trabecular number, increased trabecular separation, and reduced cortical thickness. Two studies observed significant increases in MAT at the lumbar spine post-SG. Elevated bone turnover markers, particularly C-terminal cross-linking telopeptide (CTX), indicate increased bone resorption following SG. Conclusions: SG leads to negative effects on bone health in adolescents, including reductions in BMD, deterioration of the bone microarchitecture, increases in MAT, and elevated bone resorption markers. These findings highlight the need for careful monitoring of bone health and the development of strategies to mitigate bone loss in adolescents undergoing SG.