Risk Factors In Adolescents Research Articles

Oral L-Citrulline Supplementation Improves Fatty Liver and Dyslipidemia in Adolescents with Abdominal Obesity: A Parallel, Double-Blind, Randomized Clinical Trial

Obesity in adolescents is associated with non-communicable risk factors and diseases like metabolic-associated fatty liver disease (MAFLD), which is the liver manifestation of metabolic syndrome. L-citrulline is a non-protein amino acid that has shown positive effects on the degree of steatosis in animals with non-alcoholic fatty liver disease (NAFLD). The aim of the study was to evaluate the effect of oral L-citrulline supplementation on liver function and cardiovascular risk factors in adolescents with abdominal obesity and MAFLD. A prospective, double-blind clinical trial in adolescents with abdominal obesity was randomized into two groups: forty-two adolescents were supplemented with L-citrulline (6 g of L-citrulline/day) (n = 22) and placebo (n = 20) for eight weeks. The variables evaluated were anthropometry, blood pressure, glucose, insulin, HOMA-IR, L-citrulline, L-arginine, malondialdehyde, lipid profile, liver profile, urea, uric acid, and hepatic steatosis by ultrasound. After supplementation, the L-citrulline group had a decrease in liver fat accumulation (p = 0.0007); increases in body weight (p = 0.02), glucose (p = 0.03), and HOMA-IR (p = 0.03); and decreases in BMI (p = 0.002), total cholesterol (p = 0.001), HDL-C (p = 0.01), LDL-C (p = 0.002), and alkaline phosphatase (p = 0.05). L-citrulline for eight weeks decreases hepatic fat accumulation and LDL-C levels in adolescents with abdominal obesity and MAFLD.

Adolescent suicide risk factors and the integration of social-emotional skills in school-based prevention programs.

Adolescents are considered one of the most vulnerable groups affected by suicide. Rapid changes in adolescents' physical and mental states, as well as in their lives, significantly and undeniably increase the risk of suicide. Psychological, social, family, individual, and environmental factors are important risk factors for suicidal behavior among teenagers and may contribute to suicide risk through various direct, indirect, or combined pathways. Social-emotional learning is considered a powerful intervention measure for addressing the crisis of adolescent suicide. When deliberately cultivated, fostered, and enhanced, self-awareness, self-management, social awareness, interpersonal skills, and responsible decision-making, as the five core competencies of social-emotional learning, can be used to effectively target various risk factors for adolescent suicide and provide necessary mental and interpersonal support. Among numerous suicide intervention methods, school-based interventions based on social-emotional competence have shown great potential in preventing and addressing suicide risk factors in adolescents. The characteristics of school-based interventions based on social-emotional competence, including their appropriateness, necessity, cost-effectiveness, comprehensiveness, and effectiveness, make these interventions an important means of addressing the crisis of adolescent suicide. To further determine the potential of school-based interventions based on social-emotional competence and better address the issue of adolescent suicide, additional financial support should be provided, the combination of social-emotional learning and other suicide prevention programs within schools should be fully leveraged, and cooperation between schools and families, society, and other environments should be maximized. These efforts should be considered future research directions.

Assessing Temperament Risk Factors in Late Childhood and Early Adolescence: Development and Validation of the Integrative Late Childhood Temperament Inventory.

Childhood temperament has a well-documented influence on later life outcomes, notably behavior problems, quality of interpersonal relationships, and academic achievement. However, there is at present a lack of brief measures that assess temperament characteristics which are represented across models of temperament in the late childhood and early adolescence period. To redress this gap, the aim of the current study was to develop and validate a short questionnaire that extends an earlier integrative measure of temperament, the Integrative Child Temperament Inventory (ICTI) to the late childhood period. The new measure (named Integrative Late Childhood Temperament Inventory, ILCTI) includes all five components of the ICTI (frustration, behavioral inhibition, attention/persistence, activity level, sensory sensitivity), plus affiliation. German- or English-speaking parents rated a total of 525 children, aged 8 to 14years. Confirmatory factor analyses supported the predicted structure of the new measure. Examination of fit indices and psychometric analyses showed that 24 items are sufficient to capture all six dimensions reliably. Next to convergent validity with established measures of temperament and personality, we also present analyses of associations with measures of externalizing problems, internalizing problems, and school failure all of which support the instrument's clinical utility. Thus, despite its brevity, the ILCTI is a reliable and valid measure of late childhood temperament that can be helpful in assessing risk of developing behavior problems or school failure.

The Health4Life e-health intervention for modifying lifestyle risk behaviours of adolescents: secondary outcomes of a cluster randomised controlled trial.

To investigate the effectiveness of a school-based multiple health behaviour change e-health intervention for modifying risk factors for chronic disease (secondary outcomes). Cluster randomised controlled trial. Students (at baseline [2019]: year 7, 11-14 years old) at 71 Australian public, independent, and Catholic schools. Health4Life: an e-health school-based multiple health behaviour change intervention for reducing increases in the six major behavioural risk factors for chronic disease: physical inactivity, poor diet, excessive recreational screen time, poor sleep, and use of alcohol and tobacco. It comprises six online video modules during health education class and a smartphone app. Comparison of Health4Life and usual health education with respect to their impact on changes in twelve secondary outcomes related to the six behavioural risk factors, assessed in surveys at baseline, immediately after the intervention, and 12 and 24 months after the intervention: binge drinking, discretionary food consumption risk, inadequate fruit and vegetable intake, difficulty falling asleep, and light physical activity frequency (categorical); tobacco smoking frequency, alcohol drinking frequency, alcohol-related harm, daytime sleepiness, and time spent watching television and using electronic devices (continuous). A total of 6640 year 7 students completed the baseline survey (Health4Life: 3610; control: 3030); 6454 (97.2%) completed at least one follow-up survey, 5698 (85.8%) two or more follow-up surveys. Health4Life was not statistically more effective than usual school health education for influencing changes in any of the twelve outcomes over 24 months; for example: fruit intake inadequate: odds ratio [OR], 1.08 (95% confidence interval [CI], 0.57-2.05); vegetable intake inadequate: OR, 0.97 (95% CI, 0.64-1.47); increased light physical activity: OR, 1.00 (95% CI, 0.72-1.38); tobacco use frequency: relative difference, 0.03 (95% CI, -0.58 to 0.64) days per 30 days; alcohol use frequency: relative difference, -0.34 (95% CI, -1.16 to 0.49) days per 30 days; device use time: relative difference, -0.07 (95% CI, -0.29 to 0.16) hours per day. Health4Life was not more effective than usual school year 7 health education for modifying adolescent risk factors for chronic disease. Future e-health multiple health behaviour change intervention research should examine the timing and length of the intervention, as well as increasing the number of engagement strategies (eg, goal setting) during the intervention. Australian New Zealand Clinical Trials Registry: ACTRN12619000431123 (prospective).

Social vulnerability and cardiovascular risk factors in adolescents

BackgroundSocial vulnerability can influence in the development of cardiovascular risk factors in adolescents (CRF). For this reason, the objective of our study was to evaluate the presence of CRF in adolescents, according to social vulnerability.MethodsThis is a cross-sectional study with 517 adolescents of both sexes, from 10 to 19 years of age, classified into 2 groups by social vulnerability, according to socioeconomic characteristics collected by means of questionnaires, where adolescents who did not have access to drinking water, sewage network, and adequate per capita income were classified as vulnerable. Anthropometric, biochemical, and blood pressure data were evaluated. Level of physical activity was assessed by an adapted questionnaire, and food intake was assessed by a 3-day food record. Independent T, Mann-Whitney, and χ2 tests were used, according to the scale of measurement of the variables, on the statistical program SPSS, version 25, at a significance level of 5%.ResultsAdolescents had median age of 14 (11 to 15) years; 58.4% were female; 32.4% were overweight, and 52.4% were physically inactive in leisure. Mean consumption of ultra-processed food was observed to account for 45.0% of calorie intake. Adolescents classified as vulnerable had lower weight, body mass index, waist circumference, hip circumference, and neck circumference when compared to non-vulnerable adolescents. Both groups had cholesterol concentrations above the normal level. Non-vulnerable adolescents had higher triglyceride concentrations, higher alcohol consumption, and lower fiber intake compared to vulnerable adolescents.ConclusionsAdolescents with social vulnerability are less likely to have cardiovascular risk factors.

Dyslipidemia: the association between risk and protective fac-tors in adolescence

Objective: Assessing risk and protective factors associated with dyslipidemia in adolescents. Materials and Methods: The study population comprised 77.833 schoolchildren of Montes Claros Country - MG, whereas the final sample comprised 635 adolescents (10 to 16 years old). Socio-demographic, biological, behavioral and family history variables were herein analyzed. Metabolic parameters encompassed total cholesterol (TC), triglycerides (TG), low-density lipoprotein choles-terol (LDL-C) and high-density lipoprotein cholesterol (HDL-c). Results: The female sex (p-0.008) and the age groups 10-11 / 12-13 years (p-0.008 and p-0.035) presented changes related to mixed hyperlipidemia. Overweight was associated with changes in TG (p-0.000) and with low HDL-c (p-0.000). Family history of dyslipidemia showed association (p-0.016) with undesirable LDL-c. However, sexual maturation was associated as protective factor with the development of hyper-triglyceridemia (p-0.001), and with-low HDL-c in the female sex. Conclusion: The identification of frequencies and factors presented in the current research is a potential tool to help subsidizing the elaboration and implementation of public policies addressing the adoption of preventive measures and health promotion in adolescence.

The Effect of Happiness Educational Program of Fordyce on the Sense of Coherence and Psychological Well-being of Adolescents with a Parent with Cancer: A Randomized Clinical Trial.

Having a parent with cancer is one of the risk factors for adolescents, which makes them face many psychological problems. Therefore, this study aimed to determine the effect of Happiness Educational Program of Fordyce on the sense of coherence and psychological well-being of adolescents who have a parent with cancer. In this randomized clinical trial study, 92 adolescents whose diagnosed parents have referred to the oncology ward of Shahid Rajaei Hospital in Yasuj, from June to September 2021, were selected through the convenience sampling method; however, they were randomly assigned to one of the two groups of the intervention or control. The number of sessions in the intervention group was 6, each consisting of 60 minutes and performed one day a week for 6 weeks. In addition to the demographic information form, the Antonovsky's Sense of Coherence Questionnaire-13 and the Ryff's scale of Psychological Well-being-18 were used before and immediately after the intervention. Data were analyzed through SPSS software, version 21, using statistical tests of Chi-square, t-test, Fisher's exact, Mann-Whitney, and Wilcoxon. After the intervention, statistically significant differences were observed in the median scores of the sense of coherence (P<0.001) and psychological well-being (P<0.001) between the two groups of intervention and control. Although the Happiness Educational Program of Fordyce could improve the sense of coherence and psychological well-being of adolescents who have a parent with cancer, more investigations are recommended to be conducted.Trial Registration Number: IRCT20210331050795N1.

Cardiometabolic Risk Profiles of Adolescents Living With Perinatally Acquired HIV in South Africa.

We assessed the Pathological Determinants of Atherosclerosis in Youth (PDAY) score and other potential cardiovascular disease risk factors in adolescents previously enrolled in the Children with HIV Early antiRetroviral (CHER) and International Maternal Pediatric Adolescent AIDS Clinical Trials Network P1060 clinical trials. Coronary artery and abdominal aorta (AA) PDAY scores were calculated for 56 participants over 15 years of age using a weighted combination of dyslipidemia, cigarette smoking, hypertension, obesity, and hyperglycemia. A PDAY score ≥1 is associated with early atherosclerosis. Fifty-six participants were enrolled: 46 (82.1%) on a single-tablet regimen of tenofovir disoproxil fumarate, lamivudine and dolutegravir. Median time on antiretroviral therapy was 15.8 [interquartile range (IQR): 15.8-16.5] years and median time on dolutegravir was 14 (IQR: 10.0-19.0) months. Fasting median high-density lipoprotein cholesterol was 20.1 mg/dL (IQR: 16.0-23.7) and median non-high-density lipoprotein cholesterol was 38.3 mg/dL (IQR: 30.8-44.3). The median systolic blood pressure was 115 mm Hg (IQR: 107-121). Median body mass index was 21.3 kg/m 2 (IQR: 19.5-24.7) and median fasted serum glucose was 82.0 mg/dL (IQR: 75.7-87.3). Only 1 (2%) participant smoked cigarettes, but 5 (9%) smoked hookah pipe and 26 (46.4%) smoked cannabis. Thirty-one (55.4%) participants had coronary artery PDAY scores ≥1 and 33 (58.9%) had AA PDAY scores ≥1. Age was associated with an AA PDAY score ≥1 ( P = 0.02) with a 0.06 increase in AA PDAY score for every month of age (95% confidence interval: 0.01-0.12, P = 0.01). Adolescents with perinatally acquired HIV appear at risk for cardiovascular disease. Specific tools for monitoring this risk are needed to institute appropriate preventive interventions.

The Research on Risk Factors for Adolescents' Mental Health.

There is a growing tendency for mental health disorders to emerge during adolescence. These disorders impair emotional, cognitive, and behavioral functioning, such as unsatisfying peer relationships, disruptive behavior, and decreased academic performance. They also contribute to vulnerability in later adulthood which negatively influences life-long well-being. Thus, research into etiology is imperative to provide implications for prevention and intervention within family and school practices. It is suggested that the onset of psychological disorders, such as depression and anxiety, is closely related to stress levels and patterns of stress reaction. Therefore, considerable research has investigated the link between hereditary factors, economic status, dispositional vulnerability, social relationships, and stress levels. The current study examines existing evidence and identifies multifaceted risk factors for adolescents' mental problems across three layers, including individual traits and personality, family status and practices, as well as peer relationships, and school climate. It is also suggested that factors from these three perspectives interact and are closely interconnected, directly or indirectly contributing to adolescent psychopathology. The implications for future development of prevention and intervention programs, as well as therapy, are discussed.

School climate and connectedness predict problematic smartphone and social media use in Italian adolescents

ABSTRACT Adolescents and young adults are most at risk for developing problematic smartphone and social media use that negatively impacts their mental health and well-being. Students’ perceptions of their school environment are likely a key area of potential risk and protective factors for adolescents’ problematic smartphone and social media use, but more scientific evidence is needed. To examine the associations between school climate, connectedness, affective engagement, and problematic smartphone and social media use, 529 Italian high school students were surveyed. Statistical methods (Pearson correlation coefficient and multiple regression analysis) were used to analyze the data. The results of the study showed that all variables in the study were significantly correlated with each other. There was a negative correlation between school climate, connectedness to school, affective school engagement, and problematic smartphone and social media use. Among the predictor variables, school climate and connectedness to school were the only predictors of both problematic smartphone and social media use. Studies using an experimental design should be conducted to confirm our findings and demonstrate directionality. Mobile media education in school, combined with adolescents’ sense of well-being at school, could play an important role in preventing problematic smartphone and social media use.

Tracking correlations and predictors of plasma glucose in young adulthood: A comprehensive analysis from adolescence to young adulthood in TLGS study

AimsWe investigated the tracking correlations between fasting plasma glucose (FPG) in adolescence with both FPG and 2-hour post-load glucose (2 h-PG) in adulthood, and identified the predictors of FPG and 2 h-PG in young adulthood using traditional risk factors during adolescence and adulthood. MethodsWe included 2188 participants (1033 male) from the Tehran lipid and glucose study within the age ranges 11–18 and 19–40 years during 1999–2018. The area under the curve (AUC) was computed using the growth curve models, and predictors were identified by the linear regression model. ResultsThe partial correlation between AUCs of FPG in adolescence and adulthood was 0.37 (P < 0.001). The correlation between AUCs of FPG in adolescence and 2 h-PG in adulthood was 0.17 (P < 0.001). The AUC of FPG was a significant positive predictor for both FPG and 2 h-PG in young adulthood. Other predictors of adult FPG included sex, as well as BMI and the ratio of triglycerides to HDL-cholesterol during both adolescence and adulthood. ConclusionsTracking correlation was observed for FPG, suggesting that monitoring and managing risk factors in adolescence may have implications for future glucose metabolism in young adulthood.

Cohort profile: Life-course experiences and pregnancy (LEAP)-A retrospective pregnancy cohort for life-course reproductive health research.

Life course factors may be associated with pre-pregnancy body mass index and gestational weight gain; however, collecting information on pre-pregnancy exposures and pregnancy health in the same cohort is challenging. The Life-course Experiences And Pregnancy (LEAP) study aims to identify adolescent and young adult risk factors for pre-pregnancy weight and gestational weight gain (GWG). We built upon an existing cohort study to overcome challenges inherent to studying life course determinants of pregnancy health. Participants in an ongoing prospective cohort study of weight-related health who identified as women. Retrospective cohort study. In 2019-2020, 1,252 women participating since adolescence in a cohort study of weight-related health were invited to complete an online reproductive history survey. Participants who reported a live birth were invited to release their prenatal, delivery, and postpartum medical records for validation of survey reports. Descriptive analyses were conducted to assess the characteristics of the overall cohort and the medical record validation subsample, and to describe adolescent and young adult characteristics of those with high (>80th percentile), moderate (20th-80th percentile), and low (<20th percentile) GWG z-score for gestational age and pre-pregnancy weight status. Nine hundred seventy-seven women (78%) completed the LEAP survey and 656 reported a live birth. Of these, 379 (58%) agreed to release medical records, and 250 records were abstracted (66% of the 379). Of the 977 survey respondents 769 (79%) reported attempting a pregnancy, and 656 (67%) reported at least one live birth. The validation subsample was similar to the overall cohort. Women with a high GWG had a higher adolescent BMI percentile and prevalence of unhealthy weight control behaviors than those with moderate or low GWG. LEAP offers a valuable resource for identifying life course factors that may influence the health of pregnant people and their offspring.

The bidirectional longitudinal association between academic performance and cardiovascular disease risk factors in adolescents.

The limited prior research examining the association between academic performance and cardiovascular disease (CVD) risk factors in youth did not explore the reciprocal association between these constructs, and analyzed CVD risk factors individually. Thus, the aim of the present study was to explore the bidirectional longitudinal association between clustered CVD risk score and academic performance in adolescents over a 24-month interval. A total of 237 adolescents (45.6% girls), aged 13.9 ± 0.3 years old at baseline, from DADOS (Deporte, ADOlescencia y Salud) study were included in this study. A clustered CVD risk score was created by calculating the mean age- and gender-standardized z-scores of waist circumference, systolic blood pressure, total cholesterol to high-density lipoprotein cholesterol ratio, triglycerides, homeostatic model assessment of insulin resistance, and cardiorespiratory fitness (inversed). Academic performance was assessed through the final academic grades and the test of educational abilities. Our results showed that the clustered CVD risk score at baseline was not associated with academic performance 24 months later (all p > .05). Nevertheless, except for physical education, academic grades at baseline were inversely associated with clustered CVD risk score at follow-up in adolescents (β ranged from -0.140 to -0.102; all p < .05). No associations were found between academic abilities at baseline and clustered CVD risk score at follow-up (all p > .05). Academic grades could help predict CVD risk 24 months later during adolescence. Education professionals should foster adolescents' academic performance not only to improve academic results but also to maximize future cardiovascular health benefits.

Negative life events and their association with anxiety in adolescents with subthreshold depression

Subthreshold depression (SD) is a serious mental health problem in adolescents, and there is increasing evidence that depressive symptoms frequently occur alongside anxiety. Despite this, the extent to which negative life events (NLEs) are an associated factor in adolescents with SD comorbid with anxiety remains unclear. A total of 371 Chinese adolescents with SD were recruited (204 girls, 166 boys and missing data), ranging in age from 14 to 19 years (M = 16.34, SD = 0.96). All subjects were rated on the Centre for Epidemiological Studies Depression Scale (CES-D), the Multidimensional Anxiety Scale for Children (MASC), the Individualism-Collectivism Scale (ICS), the Adolescent Life Events Questionnaire (ALEQ), and the Neuroticism Extraversion-Openness Five-Factor Inventory (NEO-FFI-N). The SD adolescents with higher anxiety had higher neuroticism scores, more self-reported negative life events and vertical individual orientation than those with low anxiety, and more of them were female than male (all p < 0.05). Further logistic regression indicated that gender, severity of depressive symptoms, vertical individualism orientation, and neuroticism were significantly associated with anxiety symptoms (p < 0.05). Our cross-sectional study could not explain the causal relationship between the severity of individual anxiety and risk factors in SD adolescents. Our results suggest that SD adolescents with high anxiety are more likely to experience NLEs than SD adolescents with low anxiety. Gender, severity of symptoms, vertical individualism orientation, and neuroticism are independent risk factors for anxiety in SD adolescents.

The role of sex on the prevalence of cardiovascular risk factors in children and adolescents with Type 1 diabetes: The SWEET international database

ObjectiveTo assess the prevalence of cardiovascular risk factors (CVRFs) in children and adolescents with type 1 diabetes (T1D) in the International SWEET registry and the possible role of clinical variables in modifying the risk of having single or multiple CVRFs. Study designThe study is a cross-sectional study. Cut-off points for CVRFs were fixed according to International Society for Pediatric and Adolescent Diabetes (ISPAD) guidelines and WHO parameters: LDL cholesterol (LDL-C) > 100 mg/dL; Systolic Blood Pressure (BP-SDS) > 90th percentile for sex, age, and height; BMI-SDS > 2SD for sex and age. Logistic regression models were applied to evaluate variables associated with at least 1 or 2 CVRFs among registry children and adolescents. Results29,649 individuals with T1D (6–18 years, T1D ≥ 2 years) participating in the SWEET prospective multicenter diabetes registry were included. In the cohort, 41 % had one or more CVRFs, and 10 % had two or more CVRFs. Thirty-five percent of enrolled individuals had LDL-C > 100 mg/dL, 26 % had BMI-SDS > 2SD, and 17 % had Systolic BP-SDS > 90th percentile. Females had higher frequency than males of having 1 or 2 CVRFs (45.1 % vs 37.4 %, 11.8 % vs 7.8 %; p < 0.001). Multivariable logistic regression models showed that sex (female), HbA1c category (>7.0 %), and age (>10 years) were associated with a higher chance of having at least 1 or 2 CVRFs (p < 0.001). ConclusionsIn children and adolescents with T1D, female sex, in addition to HbA1c above 7 %, and older age (>10 years) was associated with a higher risk of having at least a CVRF (LDL-C, BMI-SDS, BP) according to internationally defined cut-offs.

Once in NEET, always in NEET? Childhood and adolescent risk factors for different NEET patterns.

Young adults in Neither in Employment, Education nor Training (NEET) are at risk of adverse labour market outcomes. Earlier studies often measured NEET status at one time point or compared persistent NEETs with non-NEETs, neglecting other patterns of NEET status. Evidence on early life factors associated with NEET patterns is lacking. This study aims to (i) identify patterns of NEET status over time and (ii) examine whether factors in childhood and adolescence are associated with these patterns. Data were used from 1499 participants of the TRacking Adolescents' Individual Lives Survey (TRAILS), a Dutch prospective cohort study with 15-year follow-up. NEET status was assessed at ages 19, 22 and 26. Socioeconomic status of parents (SES), intelligence and negative life events were measured at age 11, educational attainment at age 26 and mental health problems at ages 11, 13.5 and 16. Data were analyzed using multinomial logistic regression analysis. Four NEET patterns were identified: (i) non-NEETs (85.2%), (ii) early NEETs (4.5%), (iii) late NEETs (5.7%) and (iv) persistent NEETs (4.5%). Reporting internalizing problems at age 11 was a risk factor for early and late NEETs [odds ratio (OR) 2.77, 95% confidence interval (CI) 1.16-6.62; OR 5.00, 95% CI 2.22-11.3, respectively]. Low parental SES, lower intelligence scores and negative life events (≥3) were risk factors for persistent NEETs (OR 4.45, 95% CI 2.00-9.91; OR 0.96, 95% CI 0.94-0.98; OR 4.42, 95% CI 1.62-12.08, respectively). The results highlight the importance of timing and duration of NEET status and emphasize the need for tailored interventions to prevent specific NEET patterns.

Diminished Adolescent Social Well-Being During the COVID-19 Pandemic

Managing the COVID-19 pandemic involved implementing public health policies that disrupted students’ lives, creating conditions that substantially influenced their mental health and well-being. Subsequently, research focused on the mental health sequelae of increased depression and anxiety, but the possible impacts on adolescents’ social well-being have been largely unexamined. Social well-being is essential to youth’s overall mental health and can be diminished even without symptoms of depression and anxiety. This report explored heterogeneities in changes in adolescents’ social well-being from pre-COVID-19 to post-restrictions using longitudinal data from adolescents attending middle and high schools in California (N = 1,299; 49.9% female). Data collection involved four observations. Participants completed a school-based mental health wellness survey annually from 2019 to 2022. A latent profile analysis identified five profiles demonstrating distinctive social well-being trajectories. Two ordered profiles included Stable-High (28%) and Stable-Low (26%) patterns. Three groups represented nonordered profiles labeled as Succumbing (20%), Languishing (14%), and Recovering (12%). Pervasive decreases in social well-being were observed, and a significant portion of the adolescents did not recover to their pre-COVID-19 level by 2022. Adolescents in the Stable-High and Recovering profiles showed better psychological well-being, optimism, and school connectedness and less distress than their counterparts in the other three profiles. Mental health professionals should be aware of the pandemic’s effects on adolescents’ social well-being. Lower levels of social well-being may be a risk factor for adolescents developing generally jaded attitudes about their social networks and diminishing their potential engagement with sources of social support.

A framework for national-level prevention initiatives in Indian schools: A risk reduction approach

India's mental health policies predominantly prioritize treatment and rehabilitation. While acknowledging the significance of youth well-being, the initiatives undertaken are fragmented, lacking comprehensive data on reach and utilization. Mounting evidence supports the preventability of mental illnesses, highlighting the cost-effectiveness of prevention initiatives, particularly within school-based programs. This paper aims to delineate a preventive framework centered on schools, employing the six-step OrigAMI (Origins of Adult Mental Illnesses) model. This model targets modifiable risk factors to stop the development of mental illnesses. Each step of this model is dissected and examined within the context of the school environment, elucidating the unique and influential role that educational institutions can undertake in preventive initiatives in India. In the initial step, the paper identifies modifiable risk factors in children and adolescents that can be addressed within the school environment. The second and third steps involve pinpointing the target demographic and utilizing data from comprehensive reviews of mental health initiatives. The fourth and fifth steps delineate the workforce structure, advocating for task shifting to non-specialists, engaging school stakeholders and parents, and establishing a systematic workforce framework. The final step delves into policy implications, exploring the potential to reduce the prevalence of mental illness by focusing on risk factors with a high Population Attributable Fraction. This section also contrasts the proposed approach in terms of expenditure against the current budget allocations. The paper culminates with a recommendation to integrate these preventive programs into existing healthcare policies, positioning schools as central to these prevention efforts. The integration of prevention programs into healthcare policies aims to reduce prevalence rates and alleviate the burden on the healthcare system.

Early-life exposure to ambient air pollution with cardiovascular risk factors in adolescents: Findings from the “Children of 1997” Hong Kong birth cohort

BackgroundLong-term exposure to ambient air pollution is associated with cardiovascular disease (CVD) risk. Little is known about the impact of early-life exposure to air pollutants on CVD risk factors in late adolescence, which may track into adulthood. To clarify, we examined this question in a unique setting with high air pollution and a high level of economic development. MethodsThis study leveraged the “Children of 1997” Hong Kong birth cohort (N = 8327), including here 3350 participants. We estimated ambient air pollutant exposure including inhalable particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2) and nitrogen monoxide (NO) by growth phase (in utero, infancy, childhood) and overall based on residential address. Generalized linear regression was used to assess the associations of air pollutants exposure by growth phase and sex with CVD risk factors (fasting blood glucose, glycosylated hemoglobin, lipid profile, blood pressure, and body mass index) at 17.6 years. We also assessed whether associations varied by sex. ResultsEarly life exposed had little association with glucose metabolism, blood pressure or body mass index, but after considering multiple comparisons early exposure to PM10 was associated with low density lipoprotein (LDL) in boys, with β and 95 % confidence intervals (95 % CI) of 0.184 (0.069 to 0.298) mmol/l, 0.151 (0.056 to 0.248) mmol/l, and 0.157 (0.063 to 0.252) mmol/l by per interquartile range (IQR) increment of PM10 for in utero, infancy, and overall, respectively. No such associations were evident for girls, differences by sex were evident. ConclusionsOur study suggested sex-specific associations of early-life PM10 exposure with elevated LDL in adolescence, especially exposure in utero and infancy.

Nonalcoholic Fatty Liver Disease and Continuous Metabolic Syndrome in Adolescents with Overweight/Obesity.

Nonalcoholic fatty liver disease is the leading cause of pediatric chronic liver disease. Although nonalcoholic fatty liver disease is closely associated with obesity, its relationship with metabolic syndrome in children is not fully understood. The main aim of this study was to evaluate the association between nonalcoholic fatty liver disease and a combination of cardiometabolic risk factors in adolescents with overweight/obesity, using a pediatric metabolic syndrome score (PsiMS) to predict metabolic syndrome. A retrospective cohort study was conducted. Subjects with overweight/obesity aged 10 to 17 followed at two clinical centers in Portugal (2018 - 2021) were enrolled. The independent association of nonalcoholic fatty liver disease with PsiMS, and of other potential predictors, was tested through multiple regression analyses. Receiver operator characteristic curve analysis was performed to estimate the optimal cutoff of PsiMS to discriminate metabolic syndrome. Eighty-four subjects were included (median age at baseline 11.5 years). The prevalence rate of nonalcoholic fatty liver disease was 51% and the prevalence rate of metabolic syndrome was 7%. The mean PsiMS was 2.05 ± 0.48 at the first evaluation, and 2.11 ± 0.52 at the last evaluation (mean follow-up time was 15 months). The nonalcoholic fatty liver disease group had significantly (p < 0.05) higher weight and body mass index z-scores, higher rate of severe obesity and higher waist circumference percentile. PsiMS was highly accurate in predicting metabolic syndrome (area under the curve = 0.96), with an optimal cutoff of 2.46 (sensitivity 100%, specificity 89%). In the univariate analysis, no statistically significant association was observed between nonalcoholic fatty liver disease and PsiMS. In the multiple regression analysis, female sex had a negative association with PsiMS (first and last evaluation). Independent predictors of a higher PsiMS at first evaluation were: ≥ 2 metabolic syndrome criteria, body mass index z-score, insulin resistance and dyslipidemia. At the last evaluation, independent predictors of a higher PsiMS were: nonalcoholic fatty liver disease, baseline PsiMS and body mass index increase from baseline. The results suggest a good performance of the PsiMS to assess metabolic syndrome and that nonalcoholic fatty liver disease is associated with PsiMS at follow-up.