Percentage Of Adolescents Research Articles

In Case You Haven't Heard…

Youth mental illness has reached crisis levels in America, Forbes reported June 26. The percentage of adolescents who have experienced at least one major depressive episode increased by 60% from 2007 to 2019. Rates of anxiety, self‐harm, and attempted suicide were skyrocketing even before the COVID‐19 pandemic, and since then matters have only gotten worse. Filmmaker Ken Burns has executive produced a powerful new two‐part documentary film on this subject. Hiding in Plain Sight: Youth Mental Illness began airing on June 27 and 28 at 9:00 pm ET on PBS and will be available for streaming on the PBS app. The film was directed and edited by Burns' long‐time colleagues Erik Ewers and Christopher Ewers. It shares the voices of 21 diverse youth across America who are living with mental health challenges, addressing issues of stigma, discrimination, awareness, and silence. Hiding in Plain Sight is part of a larger public media mental health initiative called Well Beings. The documentary was screened at the White House by First Lady Jill Biden.

NEGATIVE BINOMIAL REGRESSION AND GENERALIZED POISSON REGRESSION MODELS ON THE NUMBER OF TRAFFIC ACCIDENTS IN CENTRAL JAVA

Traffic accidents that always increase along with the increasing population growth and the number of vehicles impact the national economy. The number of traffic accidents is a count data that a Poisson distribution can approximate. The Poisson regression model often found violations of the overdispersion assumption by modeling the factors that affect the number of traffic accidents. Alternative models proposed to overcome the emergence of overdispersion in the Poisson regression model are the Generalized Poisson Regression and Negative Binomial Regression Models. Based on the analysis results, it was found that the overdispersion assumption violates the Poisson regression model, and the Generalized Poisson regression model is the best because it has the smallest AIC value of 485.50. Factors that significantly affect the number of traffic accidents in Central Java Province are the percentage of adolescents and the percentage of accidents occurring in the road area of the district/city.

Association of urine phthalate metabolites, bisphenol A levels and serum electrolytes with 24-h blood pressure profile in adolescents

BackgroundAmong the possible causes of hypertension in adolescence, electrolyte imbalances and environmental pollutants are drawing increasing attention. We aimed to examine the relationship between bisphenol A (BPA), phthalate metabolites, and serum electrolytes and blood pressure.MethodsEighty-six participants aged 12–15 years were included in the study. Body mass index (BMI), office blood pressure and 24-h ambulatory blood pressure measurements (ABPM), and carotid intima-media thickness were determined. Blood samples were taken for hemogram, renal function tests, and serum electrolytes. Free- and total-BPA and phthalate metabolites were analyzed from urine samples.ResultsOf the participants, 34 were evaluated as normal blood pressure profile, 33 as white-coat hypertension (WCHT), and 19 as ABPM-hypertension. Adolescents in ABPM- hypertension groups had higher BMI-standard deviation score (SDS), leucocyte, platelet count; but lower serum chloride, compared to the normal blood pressure profile group. The percentage of adolescents with detectable urinary mono-benzyl phthalate (MBzP) was higher in ABPM-hypertension (42.1%) and WCHT groups (33.3%), compared to the normal blood pressure profile group (5.9%, p = 0.004). Associations between MBzP and ABPM- hypertension and WCHT were remained after confounding factor adjustment. Adolescents with detectable MBzP levels had also higher “albumin-corrected calcium” and lower serum phosphate and “albumin-corrected calcium x phosphate product” compared to others. Adolescents with detectable urinary MBzP levels had higher blood pressure profiles in some 24-h (mean arterial pressure-SDS, systolic blood pressure-SDS), daytime (systolic blood pressure-SDS), and night-time (mean arterial pressure-SDS, systolic blood pressure-SDS, and diastolic blood pressure-SDS) measurements, compared to others. WCHT was found to be associated negatively with monomethyl phthalate and the sum of dibutyl phthalate metabolites and ABPM-HT with MCPP. There was no significant association between blood pressure profiles and free- and total-BPA status.ConclusionMBzP was associated with adverse blood pressure profiles in adolescence. Additive follow-up studies are necessary for cause-effect relations.

EXPENDITURE OF IRON DEFICIENCY SCREENING IN ADOLESCENTS BY DETERMINATION OF BLOOD FERRITIN

The aim: Substantiation of the expediency of screening for iron deficiency in adolescents of Ukraine, determining the relationship between blood ferritin levels and erythrocyte indices. Materials and methods: The literature data analizys and laboratory examinations of 699 patients in medical records throughout Ukraine in children aged 10-19 who applied for medical care in 2018. Results: According to the obtained data we found that there is no significant difference between the ferritin level (p = 0.728) between groups of urban and rural territory of inhabitance (p = 0.728)/ Total amount of children aged 10-15 years with ferritin below normal 7 ng / ml was 16.3%, of which men 7.7%, women 92.3%. According to European guidelines for the determination of iron deficiency, the number of children with ferritin levels less than 30 ng / ml in this group is 63%, of which men 15.9% and women 84.1%. in a group aged 16 (297 results) the number of male children with ferritin levels less than 22 ng / ml is 12%, and female children with ferritin levels less than 10 ng / ml – 31%. According to WHO recommendations with a rate of 30 ng / ml, the number of people with lower rates was 24% males 69% females. Conclusion: When using the reference values recommended by the WHO for the European region as a criterion for iron deficiency, the percentage of adolescents with iron deficiency increases mainly by 2 times in both the male and female groups.

Association Between Breakfast Consumption and Anthropometrically Determined Nutritional Status of Secondary-School Adolescents in Lagos, Southwest Nigeria.

Background and Objectives:Breakfast skipping has been associated with obesity among adolescents in some studies but little is known about the relationship between breakfast consumption and obesity among secondary-school adolescents in Nigeria. This study contributes to the empirical literature by analyzing the relationship between breakfast consumption and anthropometrically determined nutritional status of secondary-school adolescents in Lagos, Nigeria.Methods:This was a descriptive cross-sectional study in which multi-stage sampling was used to select 397 secondary-school adolescents (10 to 19 years, mean = 13.8 ± 1.7 years). They were classified into student groups from public or private schools in Lagos. Data were collected using a semi-structured self-administered questionnaire and analyzed using Epi-info version 7. The independent variables were the proportion of adolescents who had a high level of knowledge about breakfast consumption, while the outcome variable was the proportion of adolescents who were overweight or obese. World Health Organization (WHO) AnthroPlus software was used to determine the nutritional status of adolescents. Mean and standard deviations were computed for continuous variables, and frequency tables were generated for categorical variables. Significant associations between variables were obtained using Chi-square with the level of significance set at p < 0.05.Results:Only 17% of the adolescents had good knowledge of breakfast consumption. More than half (57.4%) of the participants ate a daily breakfast. The percentage of adolescents who skipped breakfast was higher among older 16-19 years (52.2%) and middle 13-15 years (43%) than the younger adolescents (34.7%). Girls skipped breakfast more than boys. Most respondents were in the normal Body Mass Index (BMI) ranges for their genders. Prevalence of overweight and obesity were 7.1% and 3.3% among males and 7.1% and 2.8% among females respectively. The mean BMI of those who skipped breakfast (19.33 ± 3.27kg/m2) was significantly higher than the BMI of those who ate breakfast (18.56 ± 3.05 kg/m2) (p=0.019). Most of the adolescents who ate a daily breakfast had mothers who had completed only primary school education although the relationship was not statistically significant (χ2 =5, p=0.172).Conclusion and Global Health Implications:Breakfast knowledge was low, while breakfast consumption was average. Adolescents who skipped breakfast had a significantly higher BMI (19.33 ± 3.27kg/m2) than those who ate breakfast (18.56 ± 3.05 kg/m2) (p=0.019). Nutrition education that emphasizes the importance of breakfast consumption with the purpose of behavioral change should be intensified among adolescents.

SMARTPHONE USAGE TIME, POSTURE OF THE CERVICAL REGION, AND ASSOCIATED FACTORS IN TEENAGE UNIVERSITY STUDENTS

Objective: This study aimed to assess the relationship between smartphone usage time and postural alignment in teenage university students and the associated factors. Methods: We carried out a cross-sectional study with 133 teenage university students (18-19 years old) between April and November 2018 in Fortaleza, Ceará, Brazil. Questionnaires were used to collect information on socioeconomic status, health conditions, smartphone usage time and level of physical activity. The alignment of the cervical region was assessed using photogrammetry in anatomical position and while texting on the smartphone. Horizontal alignment of the head (HAH), horizontal alignment of the acromion (HAA) and vertical alignment of the head (VAH) were measured. Bivariate and multivariate analyses were performed to check for factors associated with smartphone usage time (&gt;6 hours a day). Results: There were higher rates of girls (66.9%; n=89), people in the lower social class (71.4%; n=95), frequent drinkers (66.9%; n=89), people who complained of headache (83.5%; n=111) and people who used smartphones for more than 6 hours a day (72.9%; n=97). The multivariate analysis showed an association of smartphone usage time (&gt;6 hours a day) with cervical anteriorization, estimated by measuring the VAH (OR=1.053; p=0.007 – left side), female gender (OR=2.729; p=0.046), frequent drinking (OR=2.636; p=0.038) and complaint of headache (OR=5.617; p=0.002). Conclusions: There was a high percentage of adolescents who excessively used smartphones for more than 6 hours a day. Prolonged smartphone use was associated with female gender, alcohol consumption, headache and changes in cervical alignment.

Psychosocial Factors Associated With Increased Adolescent Non-suicidal Self-Injury During the COVID-19 Pandemic.

Non-suicidal self-injury (NSSI) in adolescents hospitalized with psychiatric disorders continues to increase after the outbreak of COVID-19. This study aimed to explore the relationship between the pandemic and NSSI among adolescents and whether the composition of psychosocial factors related to NSSI has changed during the pandemic. Through the retrospective analysis of medical records retrieved from the electronic system of the psychiatric hospital located in Chengdu from January 2016 to March 2021, 609 medical records of adolescents were obtained. The main potential psychosocial factors were determined by deductive content analysis. Among the 609 adolescents, 420 subjects had engaged in NSSI, while 189 did not. We found that the percentage of adolescents who had engaged in NSSI in 2016 was only 29.2%, reaching 34.5% in 2017, 45.7% in 2018, 61.3% in 2019, 92.5% in 2020, and 95.9% in 2021. In the binary logistic regression model, female sex (OR = 0.073, 95% CI: 0.028–0.186), older age (OR = 1.234, 95% CI: 1.030–1.478), having a single parent (OR = 7.865, 95% CI: 3.997–15.476), having experienced trauma (OR = 2.192, 95% CI: 1.032–4.654), having experienced social isolation from peers (OR = 8.139, 95% CI: 4.037–16.408), having experienced body-focused bullying (OR = 3.078, 95% CI: 1.295–7.318), overuse of a mobile phone in the parents' opinions (OR = 4.354, 95% CI: 1.380–13.738), having attempted suicide (OR = 9.120, 95% CI: 4.492–18.512), and during the pandemic (time point is January 30, 2020) (OR = 5.399, 95% CI: 1.679–17.357) were the factors that were significantly associated with NSSI. When comparing the differences in psychosocial factors between the pre-pandemic and the during-pandemic groups, the results showed that the family constitution, parent–child relationships, mobile phone overuse, and stressful learning were important factors. Tailored interventions geared towards changed psychosocial factors should be formulated.

01. Serum Bactericidal Activity Against Circulating and Reference Strains of Meningococcal Serogroup B in the United States: A Review of Meningococcal Serogroup B (MenB) Vaccines in Adolescents and Young Adults

BackgroundUS adolescents and young adults are at particular risk of invasive meningococcal disease (IMD). In 2018, menincococcal serogroup B was responsible for 36% of IMD cases in the US overall and for 66% of cases in adolescents and young adults. This age group is at high risk of IMD during outbreaks, which result in significant response-related costs. MenB vaccine efficacy against IMD relies on its ability to provide broad protection against diverse disease-causing strains. MenB-FHbp (Trumenba) and MenB-4C (Bexsero) are MenB vaccines licensed in the US as 2-dose series with an interval of 6 mo or 1 mo, respectively, recommended in healthy adolescents and young adults. We review available data on vaccine coverage of serogroup B strains.MethodsA literature review identified relevant information from peer-reviewed publications, congress presentations, and ClinicalTrials.gov. Previously presented but unpublished data from phase 2/3 studies were included.ResultsAfter 2 MenB-FHbp doses, percentages of adolescents and young adults achieving serum bactericidal activity assay using human complement (hSBA) titers ≥1:8 were 79%–99% for 4 heterologous representative test strains and 71%–97% for 10 additional strains, confirming cross-protection against a diverse strain panel (Figure 1; unpublished data). These 14 heterologous strains collectively represent ~80% of disease-causing strains in the US and Europe. In a published study with limited sample size, 44%–78% of subjects had hSBA titers ≥1:8 against strains from 4 US college outbreaks after 2 MenB-FHbp doses. After 2 MenB-4C doses, percentages of 10–25-year-olds achieving hSBA titers ≥1:5 against 3 reference strains homologous to the vaccine antigen were 82%–93% (published data); 15%–100% of adolescents achieved hSBA titers ≥1:4 against a panel of 14 strains (unpublished data). Of college students who received 2 MenB-4C doses, 53%–93% achieved hSBA titers ≥1:4 against 5 US outbreak strains (4/5 strains had antigenic similarity to MenB-4C; published data). ConclusionMenB-FHbp and MenB-4C protect against various serogroup B strains. As for the breadth of coverage provided by these vaccines, available data show that MenB-FHbp elicits robust immune responses to a wide variety of disease-causing strains prevalent in the US (Figure 2). Disclosures Tamera Coyne-Beasley, MD, MPH, Pfizer Inc and GlaxoSmithKline (Advisor or Review Panel member) Joseph Bocchini, MD, Pfizer Inc and Dynavax (Advisor or Review Panel member) Alejandro Cane, M.D., Pfizer Inc (Employee, Shareholder) Cindy Burman, PharmD, Pfizer Inc (Employee, Shareholder) Maria J. Tort, PhD, Pfizer Inc (Employee, Shareholder) Jessica Presa, MD, Pfizer Inc (Employee, Shareholder)

Cross-Sectional Descriptive Pilot Study on the Risk of Psychotic Disorders among Adolescents.

Background: Adolescence is a key stage for the development of different mental disorders, particularly psychotic disorders. This stage of life is accompanied by new habits or behaviours that can make a person more vulnerable to developing a psychotic disorder or, on the contrary, play a protective role. Objective: To study the vulnerability to developing a psychotic disorder in adolescents and to analyse the main risk factors. Materials and methods: This is an observational, descriptive and cross-sectional study. The data collection was conducted using the Prodromal Questionnaire Brief Version (PQ-B) test and a self-developed questionnaire based on the vulnerability–stress model. Results: Of the total sample (n = 44), 65.9% were male and 100% lived in a rural environment. In general, among risk factors (stress, alcohol and cannabis consumption, history, bullying, traumatic event and sedentary lifestyle), alcohol consumption and the presence of stress were found to have high values. Furthermore, a risk of psychosis was found in 38.6% of the studied population. Of this percentage of adolescents at risk, 64.7% consumed alcohol (p = 0.99) and 82.4% suffered from stress (p = 0.7161). The protective factor (physical activity) was found in more than half (59% p = 0.16). Conclusions: There is a high risk of psychosis among the young adolescents assessed in this study, where the explanatory factors identified with higher values were alcohol consumption and the presence of stress.

Харчова поведінка та якість життя школярів старших класів м. Львова

Актуальність. Негативна динаміка захворюваності дитячого населення та щорічне її збільшення свідчать про необхідність посилення уваги до проблеми, передусім до забезпечення дієвого профілактичного компонента. Аналізуючи причини негативної динаміки показників стану здоров’я дітей та молоді в Україні, не можна ігнорувати спосіб життя, що в структурі чинників впливу на формування стану здоров’я займає провідні позиції. Мета дослідження — вивчення особливостей способу життя, харчової поведінки школярів старших класів та їх впливу на основні показники якості життя. Матеріали та методи. Спосіб життя та харчову поведінку 80 здорових дітей віком 14–17 років було вивчено за допомогою анкети, що містила питання про сімейний анамнез, житлово-побутові умови, харчування та режим дня. Для оцінки основних параметрів якості життя було використано опитувальник MOS SF-36. Результати. Аналіз опитування показав, що 45 % дітей щоденно вживають м’ясні продукти промислового виробництва. Страви з риби в щоденному раціоні дітей наявні лише в 13,8 % випадків. Молоко і молочні продукти відзначені в щоденному раціоні менше ніж у половини опитаних дітей (35 %). Виявлено високий відсоток вживання підлітками слабоалкогольних напоїв (15 %). З’ясовано, що 45 % дітей проводять більше 3 годин на день за комп’ютером або біля телевізора, лише 22,5 % гуляють на свіжому повітрі більше 2 годин на добу. Показники якості життя були вірогідно вищі за шкалою життєздатності в дітей при тривалості прогулянок більше 2 годин на день. У дітей, які повноцінно обідають щодня, вірогідно вищі показники соціальної активності, значення за шкалою психологічного здоров’я і шкалою життєздатності. Відзначено вірогідне зниження показника життєздатності в групі дітей із тривалим перебуванням біля комп’ютера (3 години і більше). У школярів, які займаються в спортивних секціях, вірогідно вищі показники якості життя за шкалою психологічного здоров’я і шкалою загального здоров’я. У дітей із тривалістю нічного сну 8 годин відзначена вірогідно вища емоційна стабільність за шкалою емоційного функціонування (р &lt; 0,05). Висновки. Раціон харчування сучасних школярів не відповідає встановленим нормативам. Це може бути фактором ризику гастродуоденальної патології в майбутньому, тому потребує систематичної корекції. Крім раціонального харчування, чинниками, що впливають на самопочуття та психоемоційний статус школярів, є дозовані фізичні навантаження, регулярні прогулянки на свіжому повітрі та обмежене користування комп’ютером. Оцінка якості життя є простим та інформативним методом комплексного вивчення стану здоров’я школярів і може бути рекомендована до широкого застосування в педіатрії.

National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13-17 Years - United States, 2020.

The Advisory Committee on Immunization Practices (ACIP) recommends that adolescents aged 11-12 years routinely receive tetanus, diphtheria, and acellular pertussis (Tdap); meningococcal conjugate (MenACWY); and human papillomavirus (HPV) vaccines. Catch-up vaccination is recommended for hepatitis B (HepB); hepatitis A (HepA); measles, mumps, and rubella (MMR); and varicella (VAR) vaccines for adolescents whose childhood vaccinations are not current. Adolescents are also recommended to receive a booster dose of MenACWY vaccine at age 16 years, and shared clinical decision-making is recommended for the serogroup B meningococcal vaccine (MenB) for persons aged 16-23 years (1). To estimate coverage with recommended vaccines, CDC analyzed data from the 2020 National Immunization Survey-Teen (NIS-Teen) for 20,163 adolescents aged 13-17 years.* Coverage with ≥1 dose of HPV vaccine increased from 71.5% in 2019 to 75.1% in 2020. The percentage of adolescents who were up to date† with HPV vaccination (HPV UTD) increased from 54.2% in 2019 to 58.6% in 2020. Coverage with ≥1 dose of Tdap, ≥1 dose (and among adolescents aged 17 years, ≥2 doses) of MenACWY remained similar to coverage in 2019 (90.1%, 89.3%, and 54.4% respectively). Coverage increased for ≥2 doses of HepA among adolescents aged 13-17 years and ≥1 dose of MenB among adolescents aged 17 years. Adolescents living below the federal poverty level§ had higher HPV vaccination coverage than adolescents living at or above the poverty level. Adolescents living outside a metropolitan statistical area (MSA)¶ had lower coverage with ≥1 MenACWY and ≥1 HPV dose, and a lower proportion being HPV UTD than adolescents in MSA principal cities. In 2020, the COVID-19 pandemic disrupted routine immunization services. Results from the 2020 NIS-Teen reflect adolescent vaccination coverage before the COVID-19 pandemic. The 2020 NIS-Teen data could be used to assess the impact of the COVID-19 pandemic on catch-up vaccination but not on routine adolescent vaccination because adolescents included in the survey were aged ≥13 years, past the age when most routine adolescent vaccines are recommended, and most vaccinations occurred before March 2020. Continued efforts to reach adolescents whose routine medical care has been affected by the COVID-19 pandemic are necessary to protect persons and communities from vaccine-preventable diseases and outbreaks.

Ludens: A Gambling Addiction Prevention Program Based on the Principles of Ethical Gambling

Gambling is legal in most countries. However, despite having some economic benefits, certain characteristics of gambling can have health consequences, rendering it a public health issue. The effects can be summarized according to the following three “laws” of ethical gambling: “Gambling Dynamics Law”: companies’ economic gains come directly from players’ losses; “Expected Loss Law”: the more one gambles, the greater the probability of losing; and “Addiction Law”: the more one gambles, the greater the need to play again, leading to further losses. Ludens is a gambling addiction prevention program that has four goals: inform participants about gambling and gambling addiction; sensitize participants to the risk of gambling for health, especially addiction; promote a change in attitudes toward gambling; and alert participants to risky behaviors that can lead to addiction. The prevention program was implemented during 2017 to 2019. Fourteen psychologists presented it to 2372 adolescents (48.8% females, 51.2% males) aged 14–19 years, none of whom were university students, recruited from 42 Spanish high schools in 132 groups taking different courses. The main dependent variables analyzed were the monthly frequencies of gambling, at-risk gambling, and gambling addiction (as measured by the National Opinion Research Center DSM-IV Screen for Gambling Problems, adapted to diagnose gambling disorder according to DSM-5, in which pathological gambling is considered an addictive disorder). Given that all of the gamblers were adolescents (most were minors), fulfilment of 1–3 the DSM-5 diagnostic criteria was considered to indicate a risk of problem gambling. After the administration of Ludens, statistically significant reductions were observed in the three variables of interest: monthly frequency of gambling, percentage of adolescents with risky gambling, and percentage of adolescents with gambling disorder. The results were analyzed according to sex and age (minors vs. adolescents between 18 and 19 years old). The results obtained after applying the prevention program indicate that Ludens is effective as a universal prevention program for gambling addiction.

Community- and individual-level risk factors of past month e-cigarette use among adolescents in France

PurposeStudies of adolescent e-cigarette use infrequently consider how environmental effects impact use. Adolescent e-cigarette use in France is also understudied, yet an important contrast since e-cigarette use rarely precedes conventional tobacco use and daily tobacco use is common. We examine whether there is significant variation in e-cigarette use across the geographic unit of départements (n = 95), and whether community factors explain these differences and individual-level probabilities of e-cigarette use. MethodsThe ESCAPAD survey is a cross-sectional, nationally representative survey collected at a day of civic and military information mandatory for French 17-year-olds. We use the 2014 (n = 22,023) and 2017 (n = 39,115) surveys and geographic information from Eurostat and INSEE. Multilevel, multiple logistic regression models examine any and daily past month e-cigarette use. ResultsWe find significant département-level variation in both outcomes, with a considerable proportion of this variation explained by département-level factors. Net of numerous significant individual-level covariates, département-level unemployment (OR = 1.049, p < .05), poverty (OR=0.975, p < .05), age structure (OR=0.720, p < .01), and population growth (OR=0.987 p < .01) were associated with any past month use. The département-level percentage of adolescents using conventional tobacco daily was associated with individual-level any (OR=1.029, p < .001) and daily (OR=1.033, p < .01) e-cigarette use. Predicted probabilities demonstrate that département-level and individual-level tobacco use together were associated with e-cigarette use. ConclusionsResearchers should incorporate community effects into studies of e-cigarette use. Particularly, the tobacco use environment contributes to risk of e-cigarette use. For policymakers, resources may be mobilized to address local socioeconomic, demographic, and tobacco use patterns to potentially affect adolescent e-cigarette use.

Gender differences between adolescents with autism in emergency psychiatry.

Among adolescents seen for psychiatric emergency consultation, the percentage of adolescents with autism is increasing over the years. This applies even more to girls than to boys. We collected data of 1378 adolescents aged 12-18 years who were seen for urgent consultation by mobile psychiatric emergency services in the Netherlands. Among these, there were 64 autistic girls and 125 autistic boys. We wanted to know more about differences in problems between autistic and typical developing adolescents in crisis, both to prevent crisis and to improve services. The percentage of adolescents with autism increased over the years studied. Autistic adolescents experienced more severe impairment in functioning compared to typically developing adolescents. Compared to other adolescents, both boys and girls on the autism spectrum were diagnosed less frequently with mood disorders, behavioral disorders, relational problems, and abuse. Autistic girls had a higher suicide risk and suffered more often from anxiety disorders than autistic boys, while autistic boys had a longer history of problems. Outpatient care for children with autism should include easy access to specialized professionals who aim to reduce anxiety and help young people with autism to cope with the challenges of adolescence. Because possibly signs were missed during the emergency consultation, we recommend that as part of the routine procedure in crisis situations adolescents with autism are asked about mood and behavioral problems explicitly, as well as about negative life events.

Risk of eating disorders in a representative sample of Italian adolescents: prevalence and association with self-reported interpersonal factors

PurposeAdolescence represents a critical period for the onset of eating disorders (EDs). The present study aimed to provide the prevalence of individuals at risk for EDs psychopathology in a representative population of adolescents aged 14–19 and to characterize this population regarding interpersonal and psychological factors.MethodsThe percentage of participants at risk for EDs in a representative high school population was assessed through the SCOFF screening questionnaire (cut-off score: 3) in the total sample (N: 6551) and in gender-based subgroups for different body mass index (BMI) categories. Odds ratios for being at risk of ED (SCOFF ≥ 3) were esteemed in a multivariable analysis including self-reported parental education, quality of family and peer relationships, bullying victimization, age at first sexual intercourse, and psychological distress.ResultsA SCOFF score ≥ 3 was found in 31.0% of participants (boys: 19.4%; girls: 44.6%), with a greater prevalence among higher BMI categories. Bad family relationships, being bullied, having the first sexual intercourse before the age of 14, and experiencing high distress were associated with this risk condition. Among girls, bad peer relationships were associated with a low-risk SCOFF score.ConclusionA remarkable percentage of adolescents reported significant body image or eating concerns. Screening programs are deeply needed, and particular attention should be devoted to interpersonal factors, such as the quality of family relationships and interactions with peers, which represent potential indicators of this vulnerability.Level of evidenceLevel V – Cross-sectional study.

School time is associated with cardiorespiratory fitness in adolescents: The HELENA study

ABSTRACT We assessed the association between school time and physical fitness in adolescents. The study included 2,024 adolescents, aged 12.5–17.5 years, who participated in the Healthy Lifestyle in Europe by Nutrition in Adolescence study. Health-related physical fitness components were assessed using the physical fitness tests battery. Cardiovascular risk was categorized using the sex-specific cut-offs for a healthy cardiorespiratory fitness level in adolescents proposed by FitnessGram®. School time was classified as short or long. Multivariate analysis accounted for confounding factors such age, sex, body mass index, time spent in moderate to vigorous physical activity, pubertal status, and parents’ educational level. Cardiorespiratory fitness was higher in adolescents with a long school time than in those with a short school time (42.0 ± 7.6 vs 40.7 ± 7.2 mL.kg–1.min–1, respectively; p < 0.05). The percentage of adolescents at cardiovascular risk in adulthood was higher in the short than in the long time group (45.2% vs 31.7%, respectively) (p < 0.05). These findings suggest that a long school day is associated with higher cardiorespiratory fitness in adolescents and that school time should be considered in interventions and health promotion strategies.

Changes in tooth brushing frequency and its associated factors from 2006 to 2014 among French adolescents: Results from three repeated cross sectional HBSC studies.

This study aimed to evaluate in the changes in the percentage of adolescents who brush their teeth twice a day and the association with socio-economic status and health behaviors between 2006, 2010 and 2014 among adolescents from the French cross-sectional studies of the Health Behavior in School-aged Children (HBSC) survey. Our sample included 18727 adolescents aged 11, 13 or 15 years old (y/o). The relationship between toothbrushing frequency (TBF) and eating habits, health and socio-economic status markers, family status, school perception, substance use, sedentary lifestyle and physical activity, together with their evolution over the 3 studies, were investigated using multivariate logistic regression. The proportion of adolescents brushing twice a day increased from 68.8% in 2006 to 70.8% in 2010 and 78.8% in 2014 (p<0.0001). Notable associated factors (p<0.0001) were: being a girl (adjusted Odds Ratio = 1.5) and, even more, an older girl (aOR 1.5 for 15 y/o vs 11 y/o girls), having breakfast (aOR 1.4) and eating fruits daily (aOR 1.6), excellent perceived health (aOR 1.2), obesity or overweight (aOR 0.6), being bullied at school (aOR 0.8), and perceived family wealth (aOR 1.4 for High vs Low). No impact from any associated factor changed over the 3 studies. Among French adolescents, TBF improved from 2006 to 2014. TBF was significantly associated with other health behaviors. These associations stayed similar in 2006, 2010 and 2010. This increase in TBF may be linked with global prevention programs developed during this time period. These programs should be maintained and associated with more specific ones targeting and adapted to disadvantaged populations, in order to reduce inequalities in oral hygiene and oral health.

Associations of lifestyle risk factors with overweight or obesity among adolescents: a multicountry analysis

About 35% of the global burden of disease has roots in adolescence. Health in adolescence is an important determinant of health in adulthood. This study aimed to generate risk scores for lifestyle behaviors among adolescents and to estimate the country-specific prevalence of these risk scores. The study also examined the relations of lifestyle risk scores with overweight or obesity among adolescents. We used the most recent data available from 20 nationally representative Global School-based Student Health Surveys. Our analytical sample size was 51,597. The outcome of interest was overweight or obesity. We developed 4 lifestyle risk scores (dietary habits, physical activity, sedentary behavior, and tobacco use), which were used as the exposure variables in this study. Multilevel logistic regression models were used to estimate adjusted ORs with 95% CIs. In total, 18.2% of the participants were overweight or obese. Across countries, the percentage of adolescents with unhealthy dietary habits ranged from 76.7% (the Cook Islands) to 94.2% (Timor-Leste), physical inactivity ranged from 47.5% (Bangladesh) to 90.1% (the Philippines), and sedentary behavior ranged from 34.5% (Nepal) to 88.2% (Kuwait). Girls engaged in less physical activity than did boys. Increased odds of overweight or obesity were found among participants with high risk scores for physical inactivity (OR: 1.19; 95% CI: 1.11, 1.27) and for unhealthy sedentary behavior (OR: 1.25; 95% CI: 1.16, 1.35) compared with participants with low risk scores. Girls with high tobacco risk scores had higher odds (OR: 1.30; 95% CI: 1.02, 1.65) of overweight or obesity than did girls with low risk scores for tobacco use, whereas there were no significant differences in risk in boys. Unhealthy lifestyle behaviors were quite prevalent among adolescents, and higher lifestyle risk scores increased the risk of overweight or obesity.

Pilot Study of the Cost-Effectiveness of Youth F-ACT in the Netherlands.

Mental healthcare costs are rising. Community-based interventions often are being implemented without sufficient evidence for the effectiveness in terms of care and cost. In this pilot study, we evaluated the cost-effectiveness of youth Flexible Assertive Community Treatment (F-ACT) compared to treatment as usual (TAU). In total 28 adolescents (12-18years) participated in F-ACT (N = 13) and TAU (N = 15). The outcome measures were the percentage of adolescents with a significant improvement in quality of life and Quality Adjusted Life Years (QALYs). Costs were measured using a retrospective cost-questionnaire. Outcomes were assessed at the start and after three months of care. Compared to TAU, F-ACT resulted in a significantly higher quality of life as reported by adolescents. There was no significant difference in quality of life reported by the parents. The incremental cost-effectiveness ratio (ICER) demonstrated that youth F-ACT is more effective but with higher costs. This study may help to make evidence-based decisions in terms of who benefits the most from youth F-ACT interventions.

The Role of Technology and Social Media Use in Sleep-Onset Difficulties Among Italian Adolescents: Cross-sectional Study.

BackgroundThe use of technology and social media among adolescents is an increasingly prevalent phenomenon. However, there is a paucity of evidence on the relationship between frequency of use of electronic devices and social media and sleep-onset difficulties among the Italian population.ObjectiveThe aim of this study is to investigate the association between the use of technology and social media, including Facebook and YouTube, and sleep-onset difficulties among adolescents from Lombardy, the most populous region in Italy.MethodsThe relationship between use of technology and social media and sleep-onset difficulties was investigated. Data came from the 2013-2014 wave of the Health Behavior in School-aged Children survey, a school-based cross-sectional study conducted on 3172 adolescents aged 11 to 15 years in Northern Italy. Information was collected on difficulties in falling asleep over the last 6 months. We estimated the odds ratios (ORs) for sleep-onset difficulties and corresponding 95% CIs using logistic regression models after adjustment for major potential confounders.ResultsThe percentage of adolescents with sleep-onset difficulties was 34.3% (1081/3151) overall, 29.7% (483/1625) in boys and 39.2% (598/1526) in girls. It was 30.3% (356/1176) in 11-year-olds, 36.2% (389/1074) in 13-year-olds, and 37.3% (336/901) in 15-year-olds. Sleep-onset difficulties were more frequent among adolescents with higher use of electronic devices, for general use (OR 1.50 for highest vs lowest tertile of use; 95% CI 1.21-1.85), use for playing games (OR 1.35; 95% CI 1.11-1.64), use of online social networks (OR 1.40 for always vs never or rarely; 95% CI 1.09-1.81), and YouTube (OR 2.00; 95% CI 1.50-2.66).ConclusionsThis study adds novel information about the relationship between sleep-onset difficulties and technology and social media in a representative sample of school-aged children from a geographical location that has not been included in studies of this type previously. Exposure to screen-based devices and online social media is significantly associated with adolescent sleep-onset difficulties. Interventions to create a well-coordinated parent- and school-centered strategy, thereby increasing awareness on the unfavorable effect of evolving technologies on sleep among adolescents, are needed.