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Background: Inaccessible services and poor communication are barriers to successful transitions between adolescent and adult mental health services, for which digital communications (DC) offer a possible solution. Aims: To investigate the role of DC, including smartphone apps, email and text, given the known barriers and facilitators of mental health service transitions reported in the literature. Methods: Use of Neale's (2016) iterative categorisation technique to undertake a secondary analysis of qualitative data collected for the Long-term conditions Young people Networked Communication (LYNC) study. Results: DC were used successfully by young people and staff in ways that ameliorated known barriers to service transitions. They engendered responsibility in young people, promoted service access and contributed to client safety, particularly in times of crisis. DC risks included over-familiarity between young people and staff, and the possibility that messages could go unread. Conclusions: DC have the potential to facilitate trust and familiarity during and after transition to adult mental health services. They can strengthen young people's perceptions of adult services as supportive, empowering and available. DC can be used for frequent 'check-ins' and remote digital support for social and personal problems. They provide an additional safety net for at-risk individuals, but require careful boundary setting. [ABSTRACT FROM AUTHOR]

Purpose. Using the Problem Oriented Screening Instrument for Teenagers (POSIT), the effect of mode of administration on (1) students' willingness to disclose sensitive information and (2) response rates was investigated. Design. A 2 × 2 unequal N factorial analysis of variance (ANOVA) design was employed. Mode of administration (paper-and-pencil vs. Web-based) was crossed with grade level (middle vs. high school). Setting. The study was conducted in two middle and two high schools. Subjects. A total of 628 middle and high school students completed the survey. Measures. The POSIT is a self-report measure with 139 yes/no items that identifies stressors in 10 functional areas (e.g., Substance Use). Analysis. An unequal N 2 (mode) × 2 (grade level) factorial ANOVA was employed. Results. No statistically significant differences were found for self-reported risk across modes of administration. Students completing the Web-based version of the survey were four times more likely to skip an item. Conclusions. Effect of Mode on Reporting of Sensitive Information—Students computed the Web-based surveys in computer labs with other students. The intent of the Web-based survey was to increase perceived privacy but the environment likely negated any effect. Effect of Mode on Response Rates—The higher response rate for the paper-and-pencil survey was the opposite of what was expected and revealed that students were more likely to ship sensitive items on the Web survey. [ABSTRACT FROM AUTHOR]

The authors examined whether paper-and-pencil and Web surveys administered in the school setting yield equivalent risk behavior prevalence estimates. Data were from a methods study conducted by the Centers for Disease Control and Prevention (CDC) in spring 2008. Intact classes of 9th- or 10th-grade students were assigned randomly to complete a survey via paper-and-pencil or Web. Data from 5,227 students were analyzed using logistic regression to identify associations of mode with reporting of 74 risk behaviors. Mode was associated with reporting of only 7 of the 74 risk behaviors. Results indicate prevalence estimates from paper-and-pencil and Web school-based surveys are generally equivalent. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the influence of mode of administration (internet-based, web survey format versus pencil-and-paper format) on responses to the Dimensions of Tobacco Dependence Scale (DTDS). Responses from 1,484 adolescents that reported using tobacco (mean age 16 years) were examined; 354 (23.9%) participants completed a web-based version and 1,130 (76.1%) completed a paper-based version of the survey. Both surveys were completed in supervised classroom environments. Use of the web-based format was associated with significantly shorter completion times and a small but statistically significant increase in the number of missing responses. Tests of measurement invariance indicated that using a web-based mode of administration did not influence the psychometric functioning of the DTDS. There were no significant differences between the web- and paper-based groups' ratings of the survey's length, their question comprehension, and their response accuracy. Overall, the results of the study support the equivalence of scores obtained from web- and paper-based versions of the DTDS in secondary school settings. [ABSTRACT FROM AUTHOR]

Background: Advance care planning discussions are crucial in the management and support of individuals with life-limiting or life-threatening conditions. Few studies have examined best practices for advance care planning with adolescents and young adults. Aim: To identify core components of current guidelines, frameworks and tools for advance care planning discussions with adolescents and young adults with life-limiting or life-threatening conditions and their families. Design: A scoping review of the literature was conducted followed by a thematic analysis of the included papers. The scoping review was reported according to the Joanna Briggs Institute approach to the conduct of scoping reviews. Data sources: Five databases [Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews, PsycInfo, PubMed and Scopus] were searched for English-language papers published between inception until January 2023. Results: The search yielded 2976 papers, of which 9 met the inclusion criteria. Five main themes were identified: (i) utilisation of standardised documents and protocols; (ii) shared decision-making between the adolescents and young adults, their families and the healthcare team; (iii) the importance of open and honest communication with adolescents and young adults during advance care planning discussions; (iv) individualisation and flexibility in the advance care planning process and (v) timing of advance care planning initiation. Conclusions: Results highlight the importance of engaging adolescents and young adults in advance care planning and considering their unique needs when initiating and framing these discussions. Our findings can be used by healthcare professionals to inform advance care planning in this group. [ABSTRACT FROM AUTHOR]

Background: Strategies to improve sexual health outcomes have evolved over the years due to technology's evolution to ensure that they are relevant. Challenges have been noticed in different systems that run parallel, particularly in Low-Income Countries where the majority utilise Indigenous Health Systems. Optimisation of resources and minimisation of conflicts could be realised through integrated health systems in the management of adolescents' sexual health issues. This study sought to develop strategies to facilitate Indigenous Health System and Modern Health System integration to improve the management of Adolescent Sexual Health issues, leveraging results from 3 papers. Methods: A multi-stage approach was utilised, with Phase 1 focussing on a preliminary assessment through merging findings from the 4 papers. The Strengths, Weaknesses, Opportunities, and Threats analyses were then used, followed by the Basic Logic Model to identify critical aspects that needed to be considered in building the strategies. The second phase used the Build, Overcome, Eliminate and Minimise framework to build the strategies. Results: A total of 5 strategies were proposed to facilitate this integration, and these included revival of committees that were inclusive of all stakeholders; allocating Indigenous Health System space in clinics to work in; establishing adolescent-friendly clinics; intensifying information dissemination on sexual health-related issues, and developing clear Terms of Reference and procedures to govern this integration and ensure it is a success. Conclusions: Implementing these strategies could facilitate this integration and ensure that programs are planned and implemented in a complementary manner, thereby reducing conflicts between the 2 systems and ensuring collaborative efforts towards shared goals that would transform to better Sexual Health Outcomes for adolescents. [ABSTRACT FROM AUTHOR]

Shared decision-making is a well-recognized model to guide decision-making in medical care. However, the shared decision-making concept can become exceedingly complex in adolescent patients with varying degrees of autonomy who have most of their medical decisions made by their parents or legal guardians. The complexity increases further in ethically difficult situations such as terminal illness. In contrast to the typical patient-physician dyad, shared decision-making in adolescents requires a decision-making triad that also includes the parents or guardians. The multifactorial nature of these cases can overwhelm treatment teams, with minimal guidance on how to best approach the patient–parents–physician dynamic in an ethically appropriate manner. Estimated time left to live is the paramount ethical consideration for such cases with respect to shared decision-making. This paper offers a sliding scale to serve as a grounding reference for clinicians who care for terminally ill adolescents and hospital ethics committee members for initiating and guiding the ethical discussion for these patients. This paper also elucidates several other ethically salient features inherent to many of these cases, including quality of life, treatability of disease, cultural influences, among others. Yet how each of these variables is weighed is dependent upon the specific circumstances of each individual case. Ultimately, shared decision-making in adolescent patients with terminal illnesses must be a collaborative and ongoing process that thoughtfully weighs the values and ethical responsibilities of the patient, parents, and physician to ideally reconcile differences and come to a consensus on the best management option for each individual patient. [ABSTRACT FROM AUTHOR]

Background : Many children and young people (CYP) presenting with mental health crises are admitted to hospital due to concerns around illness severity and risk. Whilst inpatient admissions have an important role for such children, there are a number of burdens associated with them, and safe avoidance of admissions is favourable. We systematically reviewed the literature for studies of interventions reported as alternatives to a hospital admission in CYP presenting with mental health crises, in any inpatient setting. Methods : Three databases (PsychInfo, PubMed and Web of Science) were searched for peer-reviewed papers in October 2020, with an updated search in May 2021. Results : We identified 19 papers of interventions delivered in the emergency department, the home, outside of home but outside of clinics and in hospital clinics. The quality of most included studies was low, with less than half being randomised controlled trials and only half of these at low risk of bias. The best quality studies and greatest evidence for efficacy came from in-home interventions, in particular multisystemic therapy, which improved psychological outcomes, and though a large number of CYP still ended up being admitted, there appeared to be decreased length of stay. Conclusions : Overall, we could not recommend a particular intervention as an alternative to inpatient admission; however, our review describes benefits across a range of types of interventions that might be considered in multi-modal treatments. We also provide recommendations for future research, in particular the evaluation of new interventions as they emerge. [ABSTRACT FROM AUTHOR]

Introduction: Adolescent access to quality healthcare is key to prevention and early intervention for health risk behaviors. This paper provides a healthcare provider perspective on barriers and facilitators to youth accessing care. Methods: Five focus groups were conducted from November to December 2020 with providers from a variety of healthcare settings. Participants were asked to describe their respective adolescent patient populations, adolescent-specific health concerns, and organizational accommodations specific for youth services. Transcripts were analyzed using Inductive Thematic Analysis and themes were grouped using a social-ecological framework. Results: At an individual level, providers noted that an adolescent's knowledge and ability to navigate services varied greatly across settings. Providers identified provider trust and parent/guardian support as key interpersonal factors that support adolescents' access to services. Organizational factors included bureaucratic barriers and the clinic's reputation among youth. Community factors centered on mistrust within healthcare systems and stigmatization of seeking certain types of services. Participants also described how state-level policies influence parent/guardian consent requirements, which can limit adolescents' access to care. Conclusion: Adolescent access to and utilization of healthcare in the United States is a complex problem requiring systems-level change. Healthcare organizations and providers have the opportunity and capacity to positively influence adolescents' healthcare access and experiences, however a lack of standardized, clinic-level priorities and guidelines can limit adolescent-centered care. [ABSTRACT FROM AUTHOR]

Background: No systematic summary exists on childhood physical activity and later-life multimorbidity risks. We primarily investigated the association of physical activity in childhood and adolescence and the development of multimorbidity in adulthood. Secondarily, we examined whether physical activity level differ in children and adolescents with and without multimorbidity and whether there is a cross-sectional association between physical activity and multimorbidity. Methods: Following Cochrane Handbook guidelines and adhering to PRISMA recommendations, we included cross-sectional, case-control and longitudinal studies that investigated the association between physical activity in children and adolescents and development of multimorbidity. Results were summarized narratively and we assessed the certainty of the evidence using the GRADE approach. The protocol was registered in PROSPERO, CRD42023407063. Results: Of 9064 studies identified, 11 were included in 13 papers. Longitudinals studies suggested that being physically active in childhood and adolescence was associated with a lower risk of multimorbidity in adulthood. Three out of five studies reported lower physical activity level in children and adolescents with multimorbidity compared to those without, and two did not find a between-group difference. Cross-sectional evidence on the association between multimorbidity and lower physical activity was uncertain. Overall, the evidence certainty for all outcomes was considered low due to the indirectness and inconsistency in findings. Conclusions: Childhood and adolescence physical activity appeared to be linked with a reduced risk of later-life multimorbidity but the certainty of the evidence is low. These results support the promotion of physical activity during childhood and adolescence. [ABSTRACT FROM AUTHOR]

This paper shares the results of a meta-analysis on the parental-expectations component of parental –involvement and its relationship with the student outcomes of urban students. Special attention is paid to parental expectations, because in many past studies, parental expectations has been the most salient component of parental involvement. This meta-analysis includes 54 quantitative studies that examined the relationship between the parental expectations component of parental involvement and the academic achievement of students. The results indicated that statistically significant effects emerged across students of different age groups, races, genders, and nationalities. The results were also substantial in the highest quality studies. [ABSTRACT FROM AUTHOR]

A strong relation between adverse childhood experiences (ACE) and aggression has been established in adult populations, with less research examining this relation earlier in development. The purpose of this study was to complete a scoping review of the current evidence available on the relation between ACE and aggression and subtypes of aggression within a child and adolescent population. Inclusion criteria for the review included publications in English between 1998 and 2023, use of a child/adolescent population, and peer-review and quantitative publications. Databases searched included PubMed, APA PsycINFO, Scopus, and EBSCO, and search terms included words related to ACE and aggression. Initial selection was based on title and abstract, with 32 papers meeting eligibility criteria for inclusion. Two authors extracted the relevant characteristics of the studies independently and conferred on any disagreements. The overall findings from the scoping review suggest that there is a strong link between aggression and ACE; however, this link may not be as strong for specific subtypes of aggression. Additionally, characteristics of ACE may play role in understanding this relation, but little research is available within a child and adolescent population. A few studies have attempted to examine potential mediators and moderators of this relation; however, none have been replicated within a child and adolescent population. The findings from this review support the need for additional research in this area and identify significant gaps in the literature that need to be addressed within a child and adolescent population. [ABSTRACT FROM AUTHOR]

Background: Phenomena including early sport specialization and year-round training and competition have contributed to an increase in pediatric sports injuries. There has been a concomitant increase in clinical studies focusing on physically active children and adolescents. These studies include investigations of patient-reported outcome measures (PROMs). While the use of PROMs in pediatric orthopaedics has been increasing, PROMs are often inappropriately applied to study populations for whom they are not specifically validated. Purpose: The purpose of this study was to establish a comprehensive list of pediatric- and adolescent-validated PROMs and catalog their psychometric properties as a resource for clinicians and researchers. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review of articles in PubMed, Embase, and the Cochrane library was performed to identify articles developing and validating PROMs appropriate for use in pediatric sports medicine research. The inclusion criteria were as follows: age <18 years, the use of surveys and questionnaires, and the presence of sports-related injuries. The psychometric properties of included PROMs were entered into an electronic database. Results: Our search strategy identified 14,708 unique articles, among which 139 studies (0.9%) were included in the final data analysis. Forty-seven distinct PROMs were identified, as well as 160 cross-cultural adaptations. While all identified PROMs were validated in physically active young participants, only 12 (26%) were specifically created initially for active children. Thirty (64%) PROMs were health-related quality-of-life measures; 13 (28%) were psychosocial measures; and 4 (9%) were activity scales. No studies validated PROMs for use with wrist/hand injuries, and only 1 PROM each was valid for hip, back/spinal, and foot/ankle injuries in pediatric sports. Conclusion: This systematic review yielded 47 unique PROMs reliable and valid for use in pediatric and adolescent sports medicine. This list will unify clinicians and researchers in using these age-appropriate measures while identifying areas that are still in need of appropriate PROMs for young athletes. [ABSTRACT FROM AUTHOR]

This qualitative study was conducted to explore the experiences of youth living with bronchiectasis in New Zealand (NZ). Semi-structured interviews were conducted with youth with bronchiectasis. Key themes were identified using an inductive approach through constant comparative analysis and guided by Thorne's interpretive description (ID). Fifteen young people of mixed ethnicity (nine females and six males) aged between 13 and 23 years participated. Three key themes 'sore and tired', 'life interrupted and 'looking after self' were identified. This paper will focus on 'sore and tired' and its three subthemes which describe the participants symptom experience. While there was variability in physical symptom patterns, cough, soreness and fatigue were prominent features impacting physical, emotional and social aspects of day-to-day life. All identified pervasive and profound fatigue as significant. The identification of prodromal symptoms provides opportunity for greater appreciation of the varied and personal symptom experience of young people with bronchiectasis. Early identification of these symptoms and inclusion within management plans for escalating treatment has the potential to improve outcomes, reducing delays in seeking additional medical management and preventing further exacerbation. [ABSTRACT FROM AUTHOR]

Youth participatory action research (YPAR) provides a model for youth leadership in research aimed at tangible improvements to their lives. We employed YPAR with queer and trans young adults in a qualitative study about trans high school youth. In this paper, we highlight the importance of relationships, dialog and reflexivity to ensuring ongoing critical reflection on the ethical nature of what often appear as methodological and operational issues. Our research underscores the tensions, contradictions, and limitations of sharing power that emerge in collaborations across age, race, educational attainment, and lived experience. [ABSTRACT FROM AUTHOR]

Objective: This paper analyses changes in the family dynamics of the participants of a family prevention program, taking into consideration possible differences between the mothers and fathers and differences according to the sex of the participating adolescents. Background: Fostering family communication and resilience, parent–child relations, and family cohesion is fundamental in positive family dynamics. Method: The study has a quasi-experimental design, with pretest and posttest assessments of the experimental and control groups. A total sample of 252 families took part in the program. Results: In the data reported by the mothers, differences were identified between the experimental group and the control group in the three factors that were analyzed (improvements in family resilience and communication, parent–adolescent relations, and family cohesion), while in the data reported by the fathers, there were differences in two factors (family resilience and communication and parent–adolescent relations). No differences were observed according to the sex of the participating adolescents. Conclusion: In comparison with the control group, better outcomes were achieved by the families who took part in the program on its completion. Implications: Preventive family interventions are a tool in improving family dynamics and in boosting protective factors for all the members of a family. They should be included in strategic social, educational, and healthcare intervention plans. [ABSTRACT FROM AUTHOR]

Background: Nurses play an integral role in the care of children hospitalised with a serious illness. Although information about diagnostics, treatments, and prognosis are generally conveyed to parents and caregivers of seriously ill children by physicians, nurses spend a significant amount of time at the child's bedside and have an acknowledged role in helping patients and families understand the information that they have been given by a doctor. Hence, the ethical role of the nurse in truth disclosure to children is worth exploring. Methods: A systematic academic database and grey literature search strategy was conducted using CINAHL, Medline Psych Info, and Google Scholar. Keywords used included truth, children, nurse, disclosure, serious illness, and communication. A total of 17 publications of varying types were included in the final data set. Ethical Considerations: As this was a review of the literature, there were no direct human participants. Empirical studies included in the review had received ethics approval. Results: Of the 17 articles included in the review, only one directly reported on the experiences of nurses asked to withhold the truth from patients. Empirical studies were limited to HIV-positive children and children diagnosed with cancer and the dying child. Conclusion: A paucity of literature exploring the experiences, attitudes, and beliefs of nurses with regard to truth-telling to seriously ill children is evident. Little consideration has been given to the role nurses play in communicating medical information to children in a hospital setting. The 17 articles included in the review focused on cancer, and HIV, diagnosis, and end-of-life care. Further research should be undertaken to explore the experiences and attitudes of nurses to clinical information sharing to children hospitalised with a wide range of serious illnesses and in diverse clinical scenarios. [ABSTRACT FROM AUTHOR]

Aims: Preventing smoking and aiding cessation among youth and young adults carries the possibility of reducing future smoking prevalence significantly. This paper estimates the impact on future smoking prevalence of 25 year olds by increasing tobacco prices, securing indoor smoke-free homes and implementing school-based multi-tiered interventions. Methods: Utilizing a multi-state Markov model, a status quo projection of the smoking prevalence from years 2017 to 2030 were compared with projections of the smoking prevalence in 2030 considering the impact of the three prevention strategies. Results: In a status quo projection, 27.0% of Danish 25-year-old females are expected to be smokers in 2030, while 13.2% would be smokers in 2030 were all three prevention strategies in effect from 2019. By itself, increasing tobacco prices by 50% reduced the prevalence of smokers among 25-year-old females to 14.8% in 2030, a relative reduction of 47.5%. For 25-year-old males in 2030 the reductions were similar, with a prevalence of 16.6% when all three prevention strategies were in effect, a relative reduction of 51.5%. Conclusions: Implementing increasing tobacco prices, indoor smoke-free homes and school-based multi-tiered interventions in Denmark is likely to significantly decrease youth smoking prevalence in the future. However, these three strategies will not produce a smoke-free generation without other initiatives. [ABSTRACT FROM AUTHOR]

Background: Little has been reported in the literature regarding surgical treatment of posterior cruciate ligament (PCL) injuries in pediatric patients. Purpose/Hypothesis: The purpose was to evaluate presentation, injury pattern, outcomes, and complications of surgically managed PCL injuries in pediatric patients. It was hypothesized that pediatric patients would have good patient-reported outcomes and no significant radiographic changes or complications. Study Design: Systematic review; Level of evidence, 4. Methods: A literature search was performed using PubMed, Medline, EMBASE, Scopus, and Cochrane databases between 1975 and December 16, 2019. Search terms included "posterior cruciate ligament," "peel-off injury," "avulsion," "PCL," "pediatric," "skeletally immature," and "adolescent." Included were studies on pediatric patients with PCL injuries managed operatively. Exclusion criteria included case reports, studies not reporting clinical results, reviews, abstract or conference papers, or papers not in the English language. Quality assessment was performed on all included studies using the MINORS (Methodological Index for Non-Randomized Studies) criteria. Results: Four articles comprising 43 knees in 42 patients met the criteria and were included. Motor vehicle accidents were the most common mechanism of injury (39.5%; n = 17/43), followed by sports-related injuries (35%; n = 15/43). All studies commented on tear pattern, with the following distribution: 42% (n = 18/43) midsubstance tears, 37% (n = 16/43) tibial avulsions, and 21% (n = 9/43) femoral avulsions. Overall, good patient-reported outcomes (Knee injury and Osteoarthritis Outcome Score and Pediatric International Knee Documentation Committee, Tegner, and Lysholm scores) and return to activity, as well as satisfactory posterior stability (KT-1000 arthrometer, posterior drawer test, and kneeling radiographs) and range of motion, were reported. There was no significant leg-length discrepancy or angular deformity reported. Arthrofibrosis was reported in 7% of postoperative knees and was the most commonly reported complication. Osteoarthritis was reported in 21% (n = 9/43) of knees. The average MINORS score was 7 (range, 6-8) for noncomparative studies and 10 for comparative studies. Conclusion: Good patient-reported outcomes and return to activity can be obtained using repair or reconstruction. This evidence was limited by the quality of the included studies and overall small sample size; however, this review serves as a baseline for futures studies on PCL repair/reconstruction in pediatric patients. [ABSTRACT FROM AUTHOR]

Background: Middle childhood and adolescence are critical times for the growth, development, and establishment of healthy eating habits. The Europe and Central Asia (ECA) region has been through economic and nutrition transitions over the past 20 years, which are likely to have affected the nutritional status of this group. Objective: This review aimed to collate data on the nutritional status and dietary patterns of school-aged children (SAC) and adolescents (5-19 years) across the ECA region in order to inform policy and programming decisions. Methods: A systematic search of the literature in Pubmed, Cochrane, and ScienceDirect databases was conducted (April 2019), complemented by a systematic review of nationally representative surveys. Inclusion criteria were any data on micronutrient deficiencies, overweight, stunting, wasting, thinness, or dietary patterns in SAC and adolescents in the 21 UNICEF-defined countries of ECA, published since the year 2000. Results: Results included 134 published papers and 6 sources of survey data. The majority of studies were conducted in Turkey (56%), with all other countries having fewer than 10 studies each; 8 countries in the region having no studies on this age group at all. The most significant nutrition issue was overweight and obesity. Micronutrient deficiencies, particularly anemia, emerge as a further challenge. Dietary patterns were worse in urban areas and boys. Conclusions: The findings of this review suggest that there are 3 critical areas that need immediate attention: the promotion of healthy diets and physical activity to address high levels of overweight/obesity, anemia prevention efforts, and addressing the considerable data gaps for SAC and adolescent nutrition. [ABSTRACT FROM AUTHOR]

The proliferation of digital technology within the lives of children and young people (CYP) provides arguably one of the most significant clinical and ethical paradigm shifts in Child and Adolescent Psychiatry. One can argue that mental health research has taken a myopic approach to understanding the interaction between young people's technology use and their mental health. Mental health clinicians also need a better understanding of the digital lives of CYP and how technology may be supporting or harming their mental health. Within this paper, we argue that greater longitudinal research is required, particularly in vulnerable groups, and that there is an essential need for a standardised digital use assessment (DUA) tool, which assimilates CYP use of technology and their vulnerabilities/resilience to online risks. We subsequently offer a series of questions clinicians can use to explore technology use by CYP. Such an aide memoire may empower clinicians to have wider discussions around digital technology use with CYP, while also helping to develop appropriate safety and management plans. [ABSTRACT FROM AUTHOR]

A substantial minority of adolescents experience and use dating violence in their sexual and/or romantic relationships. Limited attention has been paid to exploring theory-driven questions about use and experience of adolescent dating violence (ADV), restricting knowledge about promising prevention targets for diverse groups of youth. To address this gap, this paper investigates whether factors tied to power imbalances (bullying, risk of social marginalization) are associated with patterns of ADV victimization and perpetration in a large sample of Canadian mid-adolescents. We used data from the 2017/2018 Health-Behavior in School-Aged Children (HBSC) study, a nationally representative sample of Canadian youth. Our study was comprised of adolescents who were in grades 9 or 10, and who had dated in the past 12 months (N = 3779). We assessed multiple forms of ADV and bullying victimization and perpetration. We also included six variables assessing adolescents' risk of social marginalization: gender, race/ethnicity, immigration status, family structure, food insecurity, and family affluence. We used latent class analysis to explore the ways adolescents experience and use different forms of ADV, and then examined whether factors tied to power imbalances (bullying, social marginalization) were associated with classes of ADV. Three ADV classes emerged in our sample: uninvolved (65.7%), psychological and cyber victimization only (28.9%), and mutual violence (5.4%). Bullying was most strongly associated with the mutual violence class, suggesting a transformation of power from peer to romantic contexts. Social marginalization variables were associated with ADV patterns in different ways, highlighting the need to use a critical and anti-oppressive lens in ADV research and prevention initiatives. [ABSTRACT FROM AUTHOR]

The number of unaccompanied asylum-seeking children (UASC) is increasing, and unlike those who arrive with their parents, UASC are subject to interview to determine refugee status. The limited amount of objective evidence available in most asylum claims means that the UASC’s account of their experiences often becomes key in deciding whether or not the young person is granted protection. Research indicates that assumptions about human memory influence decision-makers’ views on asylum seekers’ accounts; however, these do not necessarily appear to fit with the published research on autobiographical memory and may lead to an unfair decision. Therefore, understanding the nature and limitations of autobiographical memory is key to a fair refugee determination process. A literature review of published research on autobiographical memory among adolescents was undertaken across four databases. In total, 45 papers were identified which were thematically organised into three areas: development of autobiographical memory, contextual influences and impact of psychopathology. From this review, conclusions are drawn about what can be reasonably expected of an adolescent’s autobiographical memory generally and more specifically when the unique characteristics of UASC are taken into account. We also discusss how commonly used credibility indicators in refugee status determinations for minors are problematic in light of this research. It is important that the psychological evidence on the nature of autobiographical memory in adolescents is considered in asylum processing of UASC. [ABSTRACT FROM AUTHOR]

This article begins with the fundamental premise that Indigenous adolescent girls are writers. Indigenous adolescent girls speak and write in multitudes of voices, yet their physical and literary presence is often unaccounted in educational research and writing. Guided by the theoretical insights of Chicana Feminist Epistemology and Tribal Critical Race Theory this paper illuminates how Indigenous Writing Pedagogies (IWP) emerged to acknowledge land and gendered relationships in urban schools. The author presents implications for Indigenous notions of literacies and relationships that can be elevated by educators working in and out of urban school spaces. [ABSTRACT FROM AUTHOR]

Dissociative/conversion disorders affect almost 31% of children and adolescents in a clinical setting. These children experience significant impairments in their academics, and daily functioning, with high chances of developing other psychiatric comorbidities such as anxiety and depression. However, there are no studies that explore the experiences of suffering from dissociative/conversion disorders from perspective of the sufferer. Therefore, the paper has aimed at exploring the subjective experiences of dissociative and conversion disorders among adolescents in the Indian context by examining their understanding about the illness and the reason they ascribe to the cause of their illness. The study used a qualitative semi-structured interview to understand their illness. In total, 10 adolescents of age group between 12 and 16 years participated. Eight out of the 10 participants were female and the mean age was 12 years. All of them were in-patients in the department of Child and Adolescent Psychiatry, NIMHANS, which is the tertiary mental health care Institute India and pioneer Institute of mental health in Asia. All participants have had at least one or more consultation history either with a traditional healer or/and physician. Thematic analysis identified vital themes such as (1) Adolescents' attributing factors of the illness, (2) Cognitive and emotional appraisal of stressful situation/s, (3) Adolescents' appraisal of different explanatory model, (4) Living with the Impact of the illness. This analysis about dissociative/conversion disorders from adolescents' perspective has a major contribution in enhancing the clinical knowledge and practice in planning and managing children/adolescents diagnosed with dissociative/conversion disorders. [ABSTRACT FROM AUTHOR]

When planning paediatric trials, it is important to consider how best to communicate with children and young people (CYP) so they understand what they are taking part in. It is also important to consider what information they need. Involving CYP as research participants leads to research that is more relevant although it can be difficult to engage CYP in qualitative research to improve trial materials due to the topic area. This paper describes how a visual ranking exercise within qualitative interviews acted as a helpful conduit to engaging discussions to inform a co-designed website with information for trial participants. 40 people participated in interviews during which the ranking exercise was used (11 CYP aged 9–18 years, 14 parents, 15 professionals). We found the ranking exercise supported participant engagement and prevented them feeling that particular responses were expected. It also enabled participants to discuss their ranking (and decisions behind this) with other participants and the researcher. Co-design interviews with CYP that use interactive exercises such as ranking are likely to elicit richer data than those relying on traditional questioning techniques. [ABSTRACT FROM AUTHOR]

The objective of this paper was to examine the school-related experiences of youth during the COVID-19 pandemic. Participants represented both clinical and community youth aged 14 to 28 who were sampled as part of a larger study. Feedback from youth attending school during the pandemic was qualitatively examined and youth who planned to attend school prior to the pandemic and did (n = 246) and youth who planned to attend but did not (n = 28) were compared quantitatively. Youth appreciated the flexibility of online learning and some also reported experiencing a lack of support from their school and the need for instructor training on how to deliver virtual classes effectively. Future studies should examine what factors influence student engagement with virtual learning, what strategies could improve supports for student in their long-term career development, and the longitudinal experiences of youth who may have chosen not to go back to school due to the pandemic. This survey was conducted in Ontario, Canada. A more diverse sample collected outside of Ontario would improve generalizability. Qualitative data were based on survey responses and not interviews. Thus we were unable to discern the reasons youth decided to attend school, or not, during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

The present study examined the effects of tootling, a peer-mediated positive behavior intervention, on students' classwide disruptive and academically engaged behavior in three general education high school classrooms. A withdrawal design was used to assess the effects of the intervention. Students wrote tootles anonymously on paper slips and placed them into a marked container. A randomized independent group contingency was used to reward students. At the end of the class period, teachers randomly drew three of the submitted tootles and rewarded students about whom the tootles were written. Teachers also randomly drew the names of two students who submitted a tootle and rewarded them as well. All three classrooms displayed decreases in classwide disruptive behavior and increases in academically engaged behavior during intervention phases. Effect size calculations for both disruptive and academically engaged behavior indicated very large overall effects. The results of this study suggest that a modified tootling procedure utilizing a randomized independent group contingency can be an effective intervention for teachers to improve the classwide behavior of students in high school classrooms. Teachers found the intervention at least moderately socially valid and students rated it highly acceptable. [ABSTRACT FROM AUTHOR]

Existing studies evaluate zero tolerance policies and the school-to-prison pipeline. Additional research identifies the role of criminal justice systems in deporting immigrants. Our work bridges these two literatures by discussing how immigrant students navigate the criminal justice system within schools. Using interviews with immigrant students, teachers, and administrators, we address the question: How is the school-to-deportation pipeline maneuvered by stakeholders? Our study identifies how school authority figures react to and even use the fear of the pipeline to (1) either protect students from becoming criminalized or (2) exclude students from standardized exam participation so as to maintain funding sources. [ABSTRACT FROM AUTHOR]

Background: This paper describes pseudo-seizure as an atypical presentation of attention-deficit hyperactivity disorder (ADHD) in an adolescent female in the context of psychosocial difficulties. We present the case, which explains the clinical dilemma in such situations, along with selective literature review. Case Presentation: An adolescent female, who is an academic high achiever, living with parents, presented with unresponsive spells which were initially treated with antiepileptics by the paediatrician without any significant improvement. Later, after further assessments and revision of her diagnosis to conversion disorder, she was referred to the child and youth mental health service team. Further evaluation revealed her symptoms to be a result of multiple psychosocial stressors in the context of her having undiagnosed ADHD. Individual therapy, treatment with stimulant, resulted in significant improvement in her school and home adjustments. Conclusions: This case demonstrates the diagnostic challenges that high-functioning girls with ADHD coloured by psychosocial stressors can pose and raises the need for reviewing our diagnostic approaches in these situations. [ABSTRACT FROM AUTHOR]

Objective: The ability of schools, school leaders and teachers to promote critical health literacy in teaching and learning is central to the development of health literacy in schools. However, research focusing on teachers and planning for health literacy through health programmes in school is minimal. This paper describes how one school Health and Physical Education (HPE) department planned for and implemented health literacy learning across Years 7–10 as part of the first-year delivery of the Australian Curriculum: Health and Physical Education in New South Wales, Australia. Design: Single setting case study. Setting: A Years 7–10 Catholic school for boys. The HPE department comprised five teachers and one head of department. Method: Thirty-four lessons and 61 learning activities were analysed using Nutbeam's health literacy hierarchy and the Australian Curriculum: Health and Physical Education outcomes and content. Results: A large number of learning activities were categorised as interactive (n = 37, 60.7%) and a smaller number of learning activities categorised as critical (n = 16, 26.2%). The number of learning activities categorised as functional was the smallest (n = 5, 8.1%). Conclusion: Findings suggest that school-based health programmes that lack a connection to a whole school approach may fail to provide opportunities for students to achieve the critical understandings of health literacy that will provide them with the capability to enhance the health of others. [ABSTRACT FROM AUTHOR]

Fatigue is among the most common, debilitating, and distressing symptoms associated with chronic condition in pediatric population. The purpose of this study was to identify non-pharmacological fatigue interventions in children and adolescents with cancer. For this, we carried out an integrative review of the literature from January 2000 to December 2016. A comprehensive search of four databases was conducted: Cumulative Index to Nursing and Allied Health Literature, Psychology Information, Medline via PubMed, and Web of Science. Randomized controlled trial, quasi-experimental, case-control and cohort studies were included in this review. Thirteen relevant studies were included for analysis. Seven papers reported positive outcomes for exercise, exercise plus leisure activities, healing touch and acupressure. In another six papers using exercise, exercise plus psychological intervention and massage, no effectiveness was found. Effective management of fatigue in children and adolescents is important but research in this area is limited, so the results of this review should be interpreted cautiously. Future researchers are encouraged to test the effective interventions in homogenous cancer populations and in other groups where fatigue is a common concern. [ABSTRACT FROM AUTHOR]

In Vietnam, great efforts have been made in sexual and reproductive health (SRH) information provision, education, communication, as well as service provision for the adolescent and youth (A&Y) over the last 10 years. This paper aimed to examine the content and implementation of SRH policies for A&Y between 2006 and 2017. Case studies were conducted, including interviews and historical documentation. Qualitative data were collected in Hai Duong, Hue, and Dong Thap provinces through 34 in-depth interviews with representatives of central/provincial agencies and 9 focus group discussions with representatives of communal agencies and beneficiaries. SRH policies for A&Y during 2006 to 2017, along with other related national policies, were developed cohesively, however, the gaps in information provision, education, communication as well as service provision remained unresolved. The contents of policies and program implementation did not cover comprehensively, especially regarding disadvantaged groups such as disabled people, migrants, ethnic minorities, and people aged 10 to 14 years. The A&Y SRH policies and program implementation had faced some challenges relating to governance, service delivery, health workforce, health information system, and health financing. The SRH policy for A&Y in the next period needs to be focused on interventions/services for disadvantaged groups. While the human resource is of great importance for the capacity and feasibility to tackle SRH's challenges, strengthening the advocacy to ensure policies/programs should be prioritized and committed for effective implementation. An appropriate financing system to run information provision, education, communication, and support services for A&Y must be considered during policy development and implementation. [ABSTRACT FROM AUTHOR]

Background: The understanding of pediatric anterior cruciate ligament (ACL) injuries and optimal treatment has evolved significantly. Influential articles have been previously evaluated using article citations to determine impact. Purpose: To identify and characterize the 50 most cited and recent influential articles relating to pediatric and adolescent ACL injuries, to examine trends in publication characteristics, and to evaluate correlations of study citations with quality of evidence. Study Design: Cross-sectional study. Methods: The top 50 most cited articles on pediatric and adolescent ACL injuries were gathered using the Web of Science and Scopus online databases by averaging the number of citations from each database. Articles from recent years were also aggregated and sorted by citation density (citations/year). Publication and study characteristics were recorded. Level of evidence and methodologic quality were assessed where applicable using the modified Coleman Methodology Score (mCMS), modified Jadad scale, and Methodological Index for Non-Randomized Studies (MINORS). Spearman correlation was used to evaluate the association between citation data and level of evidence or methodologic quality scorings. Results: The top 50 cited papers had a mean of 117.5 ± 58.8 citations (range, 58.5-288.5 citations), with a mean citation density of 9.4 ± 5.4 citations per year (range, 2.9-25.8 citations/year); 80% were published in 2000 or later, and 6% were considered basic science. Articles were mainly level 4 evidence (27/42; 64.3%), and none was level 1. There were moderate, significant associations between publication year and level of evidence (r S = −0.45; P =.0030) and citation density and publication year (r S = 0.59; P <.001). Mean methodologic quality scores were as follows: mCMS, 53 ± 7.2 (range, 39-68); modified Jadad scale, 3.2 ± 1.1 (range, 2-6); and MINORS, 11.2 ± 3.2 (range, 6-20). There was a significant, strong correlation between rank of mean citations and modified Jadad scale (r S = 0.76; P <.0001), suggesting poorer score associated with more mean citations. Conclusion: Influential articles on pediatric and adolescent ACL injuries were relatively recent, with a low proportion of basic science–type articles. Most of the studies had a lower evidence level and poor methodologic quality scores. Higher methodologic quality did not correlate positively with citation data. [ABSTRACT FROM AUTHOR]

Background: Advance care planning for children with palliative care needs is an emotionally, legally and complex aspect of care, advocated as beneficial to children, families and health professionals. Evidence suggests healthcare professionals often avoid or delay initiation. An overview of evidence on the factors that influence and impact on the health care professional's initiation of paediatric advance care planning process is lacking. Aim: To review and synthesise evidence on the factors associated with health care professional's decision to initiate paediatric advance care planning. Design: Systematic integrative review using constant comparison method. Data Sources: Electronic databases (CINAHL, PubMed, PsycINFO, Ovid MEDLINE, EMBASE, Web of Science and Cochrane) using MeSH terms and word searches in Oct 2019. No limit set on year of publication or country. Grey literature searches were also completed. Results: The search yielded 4153 citations from which 90 full text articles were reviewed. Twenty-one met inclusion criteria consisting of quantitative (n = 8), qualitative (n = 6) and theoretical (n = 7) studies. Findings revealed overarching and interrelated themes ' The timing of initiation', 'What makes an initiator, 'Professionals' perceptions' and 'Prerequisites to initiation'. Conclusions: This review provides insights into the complexities and factors surrounding the initiation of advance care planning in paediatric practice. Uncertainty regarding prognosis, responsibility and unpredictable parental reactions result in inconsistent practice. Future research is required to inform intervention to assist health care professionals when initiating paediatric advance care planning conversations. [ABSTRACT FROM AUTHOR]

Background: Although the death of a parent during childhood is relatively commonplace, the voices of children affected by parental life-limiting illness are under-represented in research evidence. Guidance for healthcare professionals is largely based upon professional opinion rather than the experience of children themselves. Aim: To synthesise and appraise the literature from primary research with children about their experience of having a parent with a life-limiting illness. Design: Integrative review and thematic synthesis. Registered on PROSPERO (CRD42019094581). Data sources: PsychINFO, Medline, Embase, Scopus and Web of Science were searched, supplemented by searches of grey literature and systematic reviews. There were no restrictions on publication date, and study quality was appraised using the Hawker checklist. Studies reporting the findings of primary research with participants under 18, whose parent has a life-limiting illness, were eligible for inclusion. Results: Twenty-one papers met the inclusion criteria (n = 13 qualitative; n = 8 quantitative), reporting on n = 18 studies from high-income countries. Findings reveal that throughout parental life-limiting illness, children strive for agency, but are often shielded and excluded by adults. The experience of living with a dying parent is emotionally demanding for children and involves significant caregiving responsibilities. However these children are not passive, developing strategies to cope with the situation and wanting to be involved. Conclusions: The review has enabled the voices of children affected by parental life-limiting illness to be heard and will inform the development of guidance for parents and professionals. [ABSTRACT FROM AUTHOR]

Background: Health literacy research for adolescents and young people has been growing in importance. However, conceptualisation has been largely limited to concepts of adult health literacy in healthcare and disease prevention settings. The challenge for the future lies in developing a coherent concept that combines adolescent development, educational theory, whole school action and change, and critical health literacy. Such an approach needs to be both enabling and positive for students currently, and should also help facilitate health literacy outcomes in the future. Objective: This paper describes the process used to develop a conceptualisation of adolescent health literacy and to summarise what is known about health literacy in schools. Method: Guided by an international expert panel, we identified, reviewed, summarised and re-constructed key literature and resources to identify key components and principles necessary for adolescent health literacy in schools. Results: The proposed conceptualisation of adolescent health literacy initially had three areas of focus: adolescent development, whole school change and health literacy. The concepts of adolescent learning, health-literate organisation and critical health literacy emerged from the review as key components for health literacy in school settings. Pedagogy was found to be the crucial mechanism for health literacy development in the school setting and the resultant concept of adolescent health literacy. Conclusion: The focus on health-literate organisations, critical health literacy and pedagogy in the school setting distinguishes this conceptualisation from other health literacy work. [ABSTRACT FROM AUTHOR]

Background: India is diverse in culture, with multiple aspects that may not match with the Western societal picture. Hence, it has often been seen that therapists encounter unique aspects of therapy that is faced during actual practice, which is never written in any textbook or research papers. Substantial information is present through both outcome (efficacy and effectiveness) studies and process research, but it has very little impact of actual Marital and Family Therapy (MFT) practice. This paper throws light into "how" and "what" of family therapy with parents of children/adolescents having psychiatric disorders. Materials and Methods: Focused group discussion was conducted with practicing family therapists and mental health professionals working in Psychiatric Tertiary Hospital (National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India). Qualitative analysis was done to disseminate process issues in therapy. Results: Aspects that are vital for families having children and adolescent with psychiatric disorders include: Academic decline and loss of parental control as main reasons for seeking help, integration of models is noted to be beneficial, therapeutic alliance, intake sessions, conjoint sessions and individual sessions are important, cultural issues like gender of therapist, their cultural belief model, therapist's cultural competence need to be taken into consideration. Conclusions: Challenges and way-outs to overcome these has been mentioned and implications discussed. [ABSTRACT FROM AUTHOR]

Eliciting adolescents' voices through qualitative research necessitates research methods which challenge the power dynamics that marginalize young people and thus inhibit them from sharing their perspectives. In lower- and middle-income countries where younger adolescents in particular are often discouraged from expressing their voices, this is especially important. Methodological tools which are adaptable, interesting and create space within the research process for participation and freedom of expression are critical when eliciting the "voices" of young people aged 10–14 years, who are often less visible or accessible and thus marginalized both socially and within research processes. For example, adolescents with disabilities or those out of school may require methodological adaptations to ensure meaningful participation. This article focuses on the ethical, practical and data quality issues that emerge when engaging with young adolescents that are marginalized both in research and within their own communities, and the need to ensure complementarity between the process of the research and its broader objective of expanding adolescent capabilities. Bearing in mind these challenges, this paper reflects on the methodological toolkit developed by the Gender and Adolescence: Global Evidence (GAGE) research project as a means for eliciting a diversity of adolescent voices and ensuring that socially excluded adolescents are not "left behind," nor included on a merely tokenistic basis. We suggest that the strengths of the GAGE methodological toolkit lie in its grounding within broader research objectives vis-à-vis expanding adolescent capabilities and challenging structures and norms which marginalize young people. The flexibility, reflexivity and importantly the enjoyability of these methods led to adolescents both feeling at ease, able and willing to contribute their voices to the research—as well as empowered to use their voices in other areas of their lives. [ABSTRACT FROM AUTHOR]

Historians have examined the role of psychiatric institutions in the USA and addressed whether this form of care helped or harmed patients (depending on the perspective of the time period, historical actors, and historians). But the story for children's mental institutions was different. At the time when adult institutions were in decline, children's mental hospitals were expanding. Parents and advocates clamoured for more beds and more services. The decrease in facilities for children was more due to economic factors than ideological opposition. This paper explores a case study of a hospital in Michigan as a window into the different characteristics of the discussion of psychiatric care for children. [ABSTRACT FROM AUTHOR]

The parents of adolescents with autism spectrum disorder have a vital and proactive role in encouraging healthy physical activity habits, and they possess important knowledge about the adolescents' needs when it comes to enhancing participation in physical activity. But promoting healthy physical activity habits in adolescents can be difficult. The purpose of this study was thus to describe parents' perceptions of their adolescent child's participation in physical activity and to describe the parental role in promoting such participation. Twenty-eight parents of adolescents aged 12–16 years with autism spectrum disorder were interviewed. The interviews were analyzed using an inductive content analysis approach. The parents described how challenging participation in physical activities could be for their adolescents. Despite this, they wanted to see their children participate more in physical activity but found the promotion of physical activity to be an overwhelming task that was difficult to cope with on their own. The results reveal a need for support and collaborative efforts among different actors to give these issues increased priority in order to promote the adolescents' physical activity participation. What is already known about the topic? The parents of adolescents with autism spectrum disorder have a vital and proactive role in encouraging healthy physical activity habits. But promoting healthy physical activity habits in adolescents can be difficult. The purpose of this study was thus to describe the parental perceptions of their adolescent child's participation in physical activity and to describe the parental role in promoting such participation. Twenty-eight parents of adolescents aged 12–16 years with autism spectrum disorder were interviewed. What this paper adds? The parents described how challenging participation in physical activities could be for their adolescents. Despite this, they wanted to see their children participate more in physical activity but found the promotion of physical activity to be an overwhelming task that was difficult to cope with on their own. Implications for practice, research, or policy. The results reveal a need for support and collaborative efforts among different actors to give these issues increased priority in order to promote the adolescents' physical activity participation. [ABSTRACT FROM AUTHOR]

Background: Limited data suggest that adolescents with multiple sclerosis (MS) frequently discontinue school. While it is known that cognitive impairment occurs in 30% to 50% of children with MS, the functional impact of childhood MS on academic achievement is virtually unknown. Objective: To that end, this paper builds an evidence-based argument for evaluating educational outcomes in children with MS. Methods: This will be accomplished through (a) a review of pediatric MS and its cognitive consequences; (b) a selective review of the utility of neuropsychological batteries in assessing academic outcomes in pediatric populations in general; and (c) a brief overview of modifiable factors that have a potential benefit on school outcomes in children with MS. Conclusion: Scholastic achievement should be assessed as part of the routine cognitive screening of children and adolescents with MS. [ABSTRACT FROM AUTHOR]

Adolescent and emerging adult risk behavior is a concern globally. Discussing health promotive and risk behaviors with adolescents and young adults can be challenging regardless of the country of data collection and dominant culture. In the United States, event history calendars have been used in both research and clinical settings to identify healthy and risky behaviors among adolescents and emerging adults, and contextual factors that may influence their behavior. After an unsuccessful attempt to employ a particular event history calendar on family life, negative and positive events, sexual behavior and substance use in data collection in rural fishing villages in Western Uganda, the current study aimed to modify the United States validated event history calendar for use with adolescents in Uganda, as a first step to cultural adaptation. Focus groups with 24 college students provided information about ways to modify the event history calendar for Ugandan youth. This paper discusses the modifications of the event history calendar for Ugandan young people. [ABSTRACT FROM AUTHOR]

This research sought to uncover challenges that arose in the implementation of the Reflective Educational Approach to Character and Health (REACH) after-school programme in a low-income public school in New York City. Additionally, we wanted to find and share some of the lessons learned, to help others avoid our pitfalls when implementing quality after-school programming. At the conclusion of the year-long REACH programme that was preceded by a year-long pilot, the lead researcher interviewed six key stakeholders: (a) the coach; (b) an academic tutor; (c) the director of REACH; (d) two after-school teachers/leaders within the school; and (e) the assistant principal of P.S. 780 (pseudonym). We employed a qualitative case study approach. Field notes from observations, researcher journals, emails, and multiple interviews were used to triangulate data. Two coders first independently coded and analyzed the data using the constant comparison method, followed by a peer reviewer to further establish credibility and trustworthiness. Three themes are presented from the data analysis: (a) bridging community dynamics and REACH; (b) needing community involvement; and (c) role modeling through cultural competence. These three themes are analyzed through a lens of culturally responsive pedagogy and a new theory of positive youth development through sport. These data present a detailed account of the implementation of a sport-based after-school programme in an urban environment. The paper presents the challenges faced in the implementation of such programmes as well as lessons learned in the process. [ABSTRACT FROM AUTHOR]

HIV self-testing (HIVST) offers an alternative to facility-based voluntary counseling and testing (VCT) services, particularly for vulnerable populations such as adolescents. This study aimed to determine the sociodemographic factors associated with adolescents preferring home-based HIVST over facility-based VCT in Kisangani, Democratic Republic of the Congo. A representative cross-sectional study using random sampling in clusters at three levels was conducted among adolescents (aged 15–19 years) to assess their hypothetical preference in home-based HIVST over facility-based VCT by a face-to-face, paper-based, semi-structured questionnaire, and logistic regression for statistical analysis. In 353 households, 754 adolescents were assessed for eligibility, of whom 628 were eligible. A total of 597 adolescents completed the study questionnaire. A majority of participants were aged 18–19 and of female gender. More than two-thirds of participants had never been tested for HIV and had no knowledge about HIVST before this survey. Among 597 adolescents who had completed the study questionnaire, a slight majority of participants (323/597; 54.1% [95% CI: 50.0–58.0]) preferred home-based HIVST over facility-based VCT. In a multivariate analysis, male gender (adjusted OR: 1.5, 95% CI: 1.1–2.1), marriage or partnered civil status (adjusted OR: 1.8, 95% CI: 1.1–3.1), and previous knowledge about HIVST (adjusted OR: 4.2, 95% CI: 2.6–6.8) were associated with preference for home-based HIVST over facility-based VCT. This study demonstrates that more adolescents preferred home-based HIVST over facility-based VCT in Kisangani. These observations suggest the existence of a specific sociodemographic profile associated with the acceptance of HIVST in adolescents living in sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is associated with various quality of life concerns including poor sleep. Sleep impairments in children with AD are associated with increased risk of short stature, metabolic syndrome, mental illness and neurocognitive dysfunction. Although the association between AD and sleep disturbance is well established, the specific types of sleep disturbance in pediatric AD patients and their underlying mechanisms are not fully understood. A scoping literature review was performed to characterize and summarize the types of sleep disturbance in children (less than 18 years of age) with AD. 31 papers met inclusion criteria and extracted data were analyzed in an iterative manner. Two types of sleep disturbances were found to be more prevalent in pediatric AD patients in comparison to controls. One category was related to loss of sleep (increased frequency or duration of awakenings, increased sleep fragmentation, delayed sleep onset, decreased total sleep duration, and decreased sleep efficiency). Another category was associated with unusual behaviors during sleep (restlessness/limb movement/scratching, sleep-disordered breathing including obstructive sleep apnea and snoring, nightmares, nocturnal enuresis and nocturnal hyperhidrosis). Some mechanisms underlying these sleep disturbances include pruritus and induced scratching and increased proinflammatory markers induced by sleep loss. Sleep disturbance appears to be associated with AD. We recommend clinicians to consider interventions that may reduce sleep disturbances in children with AD. Further investigation of these sleep disturbances is needed to elucidate pathophysiology, develop additional treatments, and reduce negative impacts on the health outcomes and quality of life in pediatric AD patients. [ABSTRACT FROM AUTHOR]

Introduction: Occupation-based interventions could help to address a growing mental health crisis among young people and adolescents. To develop new interventions and avoid research waste, a review of the academic literature is needed that systematically identifies and describes interventions designed to improve the mental health and wellbeing of 11–25 year-olds. Aim: The scoping review aims to systematically review the academic, literature to identify and describe key characteristics of intervention studies using occupation to improve adolescents' and young people's mental health and wellbeing, exploring the range of interventions, reviewing reporting quality and illuminating gaps for further research. Method: An iteratively developed scoping review protocol informs a systematic database search and review of the literature. Core characteristics are extracted and described, using the TIDIER guidelines and the CASP assessment tool. Results: Five occupational therapy-based interventions, and 69 other occupation-based studies representing a wide breadth of approaches, outcomes and settings were identified. Conclusions: Robust development, testing and reporting of occupation-based and occupation-focused intervention studies to promote and support mental health and wellbeing in adolescents and young people are needed. Interventions should be co-designed, developmentally appropriate and scaffold development. However, better agreement is needed about core outcomes measurement in this area. [ABSTRACT FROM AUTHOR]

Objective: COVID-19 has led to disruptions to the lives of Australian families through social distancing, school closures, a temporary move to home-based online learning, and effective lockdown. Understanding the effects on child and adolescent mental health is important to inform policies to support communities as they continue to face the pandemic and future crises. This paper sought to report on mental health symptoms in Australian children and adolescents during the initial stages of the pandemic (May to November 2020) and to examine their association with child/family characteristics and exposure to the broad COVID-19 environment. Methods: An online baseline survey was completed by 1327 parents and carers of Australian children aged 4 to 17 years. Parents/carers reported on their child's mental health using five measures, including emotional symptoms, conduct problems, hyperactivity/inattention, anxiety symptoms and depressive symptoms. Child/family characteristics and COVID-related variables were measured. Results: Overall, 30.5%, 26.3% and 9.5% of our sample scored in the high to very high range for emotional symptoms, conduct problems and hyperactivity/inattention, respectively. Similarly, 20.2% and 20.4% of our sample scored in the clinical range for anxiety symptoms and depressive symptoms, respectively. A child's pre-existing mental health diagnosis, neurodevelopmental condition and chronic illness significantly predicted parent-reported child and adolescent mental health symptoms. Parental mental health symptoms, having a close contact with COVID-19 and applying for government financial assistance during COVID-19, were significantly associated with child and adolescent mental health symptoms. Conclusion: Our findings show that Australian children and adolescents experienced considerable levels of mental health symptoms during the initial phase of COVID-19. This highlights the need for targeted and effective support for affected youth, particularly for those with pre-existing vulnerabilities. [ABSTRACT FROM AUTHOR]

A significant number of children and adolescents are insufficiently physically active and have a sedentary lifestyle, which is associated with adverse health outcomes, necessitating effective interventions. Using a participatory approach, which engages youth in intervention development, may enhance intervention effectiveness, as such interventions are believed to be more tailored to the needs of the target group. This scoping review aimed to provide an overview of the results of process and effect evaluations of studies that developed school-based physical activity and/or sedentary behaviour interventions using a participatory approach among children and adolescents.Six databases (MEDLINE, Embase, Web of Science, CENTRAL (Cochrane Central Register of Controlled Trials), Scopus and SPORTDiscus) were searched. Studies were included when they evaluated the participatory process, intervention implementation or health-related intervention effects. A quality assessment was completed using two QualSyst checklists. Extracted data included characteristics of studies, interventions, and participatory processes; characteristics of participants from whom data were collected; outcomes measured and measurement methods used; and key findings.Twenty-five papers, covering 18 original studies, were included. Studies suggested that participatory processes were generally perceived positively, resulting in pupils feeling empowered, experiencing ownership and gaining certain skills. Participatory developed interventions also seemed to be generally well received, although the intervention dose delivered and intervention reach seemed to vary between studies. Finally, studies generally tended to report no effects on health. Although a participatory approach could be promising in empowering pupils and promoting intervention acceptance, apparent differences in intervention implementation and limited effectiveness highlight the need to enhance participatory processes and intervention effectiveness. [ABSTRACT FROM AUTHOR]

In a sample of youth aged 10–16 years with chronic physical illness, this study examined psychometric properties of a modified Psychological Sense of School Membership (m-PSSM) scale; described longitudinal trends in perceptions over 24 months; and, identified factors associated with school belonging. Youth were recruited from a pediatric hospital in Canada. A total of 105 youth attended school in the past year and provided self-reports. The four-item m-PSSM had a unidimensional structure which was measurement invariant between youth in elementary (10–13 years) versus secondary school (14–16 years). Internal consistency was (ω >.80). There was no evidence that m-PSSM scores changed significantly over time (η2 = 0.05). Predictors of lower perceived school belonging were being in secondary school, having psychopathology, reporting lower quality of life in the domains of social support and school environment, experiencing peer victimization, and living in a community with higher residential instability and lower material deprivation. [ABSTRACT FROM AUTHOR]