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Objective: To describe the needs and evidence-based practice specific to care of the pregnant adolescent in Canada, including special populations., Outcomes: Healthy pregnancies for adolescent women in Canada, with culturally sensitive and age-appropriate care to ensure the best possible outcomes for these young women and their infants and young families, and to reduce repeat pregnancy rates., Evidence: Published literature was retrieved through searches of PubMed and The Cochrane Library on May 23, 2012 using appropriate controlled vocabulary (e.g., Pregnancy in Adolescence) and key words (e.g., pregnancy, teen, youth). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. Results were limited to English or French language materials published in or after 1990. Searches were updated on a regular basis and incorporated in the guideline to July 6, 2013. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, national and international medical specialty societies, and clinical practice guideline collections., Values: The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1). BENEFITS/HARMS/COSTS: These guidelines are designed to help practitioners caring for adolescent women during pregnancy in Canada and allow them to take the best care of these young women in a manner appropriate for their age, cultural backgrounds, and risk profiles., Recommendations: 1. Health care providers should adapt their prenatal care for adolescents and offer multidisciplinary care that is easily accessible to the adolescent early in the pregnancy, recognizing that adolescents often present to care later than their adult counterparts. A model that provides an opportunity to address all of these needs at one site may be the preferred model of care for pregnant adolescents. (II-1A) 2. Health care providers should be sensitive to the unique developmental needs of adolescents through all stages of pregnancy and during intrapartum and postpartum care. (III-B) 3. Adolescents have high-risk pregnancies and should be managed accordingly within programs that have the capacity to manage their care. The unique physical risks of adolescent pregnancy should be recognized and the care provided must address these. (II-1A) 4. Fathers and partners should be included as much as possible in pregnancy care and prenatal/infant care education. (III-B) 5. A first-trimester ultrasound is recommended not only for the usual reasons for properly dating the pregnancy, but also for assessing the increased risks of preterm birth. (I-A) 6. Counselling about all available pregnancy outcome options (abortion, adoption, and parenting) should be provided to any adolescent with a confirmed intrauterine gestation. (III-A) 7. Testing for sexually transmitted infections (STI) (II-2A) and bacterial vaginosis (III-B) should be performed routinely upon presentation for pregnancy care and again in the third trimester; STI testing should also be performed postpartum and when needed symptomatically. a. Because pregnant adolescents are inherently at increased risk for preterm labour, preterm birth, and preterm pre-labour rupture of membranes, screening and management of bacterial vaginosis is recommended. (III-B) b. After treatment for a positive test, a test of cure is needed 3 to 4 weeks after completion of treatment. Refer partner for screening and treatment. Take the opportunity to discuss condom use. (III-A) 8. Routine and repeated screening for alcohol use, substance abuse, and violence in pregnancy is recommended because of their increased rates in this population. (II-2A) 9. Routine and repeated screening for and treatment of mood disorders in pregnancy is recommended because of their increased rates in this population. The Edinburgh Postnatal Depression Scale administered in each trimester and postpartum, and more frequently if deemed necessary, is one option for such screening. (II-2A) 10. Pregnant adolescents should have a nutritional assessment, vitamins and food supplementation if needed, and access to a strategy to reduce anemia and low birth weight and to optimize weight gain in pregnancy. (II-2A) 11. Conflicting evidence supports and refutes differences in gestational hypertension in the adolescent population; therefore, the care usual for adult populations is supported for pregnant adolescents at this time. (II-2A) 12. Practitioners should consult gestational diabetes mellitus (GDM) guidelines. In theory, testing all patients is appropriate, although rates of GDM are generally lower in adolescent populations. Practitioners should be aware, however, that certain ethnic groups including Aboriginal populations are at high risk of GDM. (II-2A) 13. An ultrasound anatomical assessment at 16 to 20 weeks is recommended because of increased rates of congenital anomalies in this population. (II-2A) 14. As in other populations at risk of intrauterine growth restriction (IUGR) and low birth weight, an ultrasound to assess fetal well-being and estimated fetal weight at 32 to 34 weeks gestational age is suggested to screen for IUGR. (III-A) 15. Visits in the second or third trimester should be more frequent to address the increased risk of preterm labour and preterm birth and to assess fetal well-being. All caregivers should be aware of the signs and symptoms of preterm labour and should educate their patients to recognize them. (III-A) 16. It should be recognized that adolescents have improved vaginal delivery rates and a concomitantly lower Caesarean section rate than their adult counterparts. (II-2A) As with antenatal care, peripartum care in hospital should be multidisciplinary, involving social care, support for breastfeeding and lactation, and the involvement of children's aid services when warranted. (III-B) 17. Postpartum care should include a focus on contraceptive methods, especially long-acting reversible contraception methods, as a means to decrease the high rates of repeat pregnancy in this population; discussion of contraception should begin before delivery. (III-A) 18. Breastfeeding should be recommended and sufficient support given to this population at high risk for discontinuation. (II-2A) 19. Postpartum care programs should be available to support adolescent parents and their children, to improve the mothers' knowledge of parenting, to increase breastfeeding rates, to screen for and manage postpartum depression, to increase birth intervals, and to decrease repeated unintended pregnancy rates. (III-B) 20. Adolescent women in rural, remote, northern, and Aboriginal communities should be supported to give birth as close to home as possible. (II-2A) 21. Adolescent pregnant women who need to be evacuated from a remote community should be able to have a family member or other person accompany them to provide support and encouragement. (II-2A) 22. Culturally safe prenatal care including emotional, educational, and clinical support to assist adolescent parents in leading healthier lives should be available, especially in northern and Aboriginal communities. (II-3A) 23. Cultural beliefs around miscarriage and pregnancy issues, and special considerations in the handling of fetal remains, placental tissue, and the umbilical cord, must be respected. (III).

Background: Seeing portrayals of tobacco and alcohol in music videos (MVs) may reduce perceived risks, increase susceptibility, and lead to the initiation of tobacco and alcohol use among adolescents and young adults. Previous studies have predominantly concentrated on assessing tobacco and alcohol contents in English-language MVs within Western countries. However, many other countries have not only been influenced by the English music market but have also produced music in their native languages, and this content remains underexamined. Objective: This study aims to investigate the prevalence of tobacco- and alcohol-related content in top Vietnamese MVs on YouTube from 2013 to 2021, to describe how tobacco and alcohol are portrayed in these MVs, and to examine associations between these portrayals and MV characteristics. Methods: A total of 410 Vietnamese MVs, including the top 40 or 50 most viewed released each year between 2013 and 2021, were analyzed. General information, such as the song name, its release date and ranking, age restriction, musical genre, and type of MV, was collected. We examined tobacco and alcohol content in the MVs, with specific details such as tobacco types, their brands, as well as the number, age, sex, and roles of individuals smoking or drinking. Results: Among the 410 MVs, 36 (8.8%) contained tobacco-related content and 136 (33.2%) featured alcohol-related content. Additionally, 28 (6.8%) out of 410 MVs included both tobacco and alcohol content. The prevalence of videos with tobacco and alcohol content fluctuated over the years. In MVs with tobacco-related content, a higher proportion of hip-hop or rap songs contained tobacco-related content (n=6, 30%) compared to other music genres. In MVs with tobacco-related content, cigarettes were the most frequently shown product (n=28, 77.8%), and smoking scenes were often depicted at parties (n=13, 36.1%) and during dancing and singing scenes (n=12, 33.3%). Among the 31 MVs portraying actual tobacco use, tobacco use was typically depicted with 1 person, often a young adult male, while 38.7% (n=12) showed singer(s) smoking. For MVs with alcohol-related content, there was a high proportion showing alcohol images at parties, bars, or pubs (n=96, 70.6%). Among 87 MVs containing drinking scenes, 60.9% (n=53) involved groups of young adults of both sexes, and 64% (n=56) depicted singers drinking. Additionally, only 2 (5.6%) MVs included health warnings about tobacco harm, and 2 MVs (1.5%) included warnings about drinking restricted to individuals 18 years and above. Conclusions: The notable prevalence of tobacco and alcohol content in leading Vietnamese YouTube MVs raises concerns, especially as most of this content is portrayed without any warnings. The study underscores a regulatory gap in addressing such content on the internet, emphasizing the urgent need for stricter regulations and age restrictions on platforms such as YouTube. [ABSTRACT FROM AUTHOR]

Background: Although adolescents report high levels of stress, they report engaging in few stress management techniques. Consequently, developing effective and targeted programs to help address this transdiagnostic risk factor in adolescence is particularly important. Most stress management programs for adolescents are delivered within schools, and the evidence for these programs is mixed, suggesting a need for alternative options for stress management among adolescents. Objective: The aim of the study is to test the short-term effects of a self-guided digital mental health intervention (DMHI) designed for adolescents on perceived stress and rumination (ie, brooding). Methods: This was a 12-week, 2-arm decentralized randomized controlled trial of adolescents aged 13 to 17 years who presented with elevated levels of perceived stress and brooding. Participants were randomly assigned to engage with a self-guided DMHI (Happify for Teens) or to a waitlist control. Participants assigned to the intervention group were given access to the program for 12 weeks. Happify for Teens consists of various evidence-based activities drawn from therapeutic modalities such as cognitive behavioral therapy, positive psychology, and mindfulness, which are then organized into several programs targeting specific areas of concern (eg, Stress Buster 101). Participants in the waitlist control received access to this product for 12 weeks upon completing the study. Participants in both groups completed measures of perceived stress, brooding, optimism, sleep disturbance, and loneliness at baseline, 4 weeks, 8 weeks, and 12 weeks. Changes in outcomes between the intervention and waitlist control groups were assessed using repeated-measures multilevel models. Results: Of the 303 participants included in data analyses, 132 were assigned to the intervention and 171 to the waitlist. There were significantly greater improvements in the intervention condition for perceived stress (intervention: B =–1.50; 95% CI –1.82 to –1.19; P <.001 and control: B =–0.09; 95% CI –0.44 to 0.26; P =.61), brooding (intervention: B =–0.84; 95% CI –1.00 to –0.68; P <.001 and control: B =–0.30; 95% CI –0.47 to –0.12; P =.001), and loneliness (intervention: B =–0.96; 95% CI –1.2 to –0.73; P <.001 and control: B =–0.38; 95% CI: –0.64 to –0.12; P =.005) over the 12-week study period. Changes in optimism and sleep disturbance were not significantly different across groups (P s≥.096). Conclusions: Happify for Teens was effective at reducing perceived stress, rumination, and loneliness among adolescents over 12 weeks when compared to a waitlist control group. Our data reveal the potential benefits of DMHIs for adolescents, which may present a more scalable, destigmatized, and cost-effective alternative to school-based programs. Trial Registration: ClinicalTrials.gov NCT04567888; https://clinicaltrials.gov/ct2/show/NCT04567888 International Registered Report Identifier (IRRID): RR2-10.2196/25545 [ABSTRACT FROM AUTHOR]

Background: Valid assessment tools are needed when investigating adherence to national dietary and lifestyle guidelines. Objective: The relative validity of the new digital food frequency questionnaire, the DIGIKOST-FFQ, against 7-day weighed food records and activity sensors was investigated. Methods: In total, 77 participants were included in the validation study and completed the DIGIKOST-FFQ and the weighed food record, and of these, 56 (73%) also used the activity sensors. The DIGIKOST-FFQ estimates the intake of foods according to the Norwegian food–based dietary guidelines (FBDGs) in addition to lifestyle factors. Results: At the group level, the DIGIKOST-FFQ showed good validity in estimating intakes according to the Norwegian FBDG. The median differences were small and well below portion sizes for all foods except "water" (median difference 230 g/day). The DIGIKOST-FFQ was able to rank individual intakes for all foods (r =0.2-0.7). However, ranking estimates of vegetable intakes should be interpreted with caution. Between 69% and 88% of the participants were classified into the same or adjacent quartile for foods and between 71% and 82% for different activity intensities. The Bland-Altman plots showed acceptable agreements between DIGIKOST-FFQ and the reference methods. The absolute amount of time in "moderate to vigorous intensity" was underestimated with the DIGIKOST-FFQ. However, estimated time in "moderate to vigorous intensity," "vigorous intensity," and "sedentary time" showed acceptable correlations and good agreement between the methods. The DIGIKOST-FFQ was able to identify adherence to the Norwegian FBDG and physical activity recommendations. Conclusions: The DIGIKOST-FFQ gave valid estimates of dietary intakes and was able to identify individuals with different degrees of adherence to the Norwegian FBDG and physical activity recommendations. Moderate physical activity was underreported, water was overreported, and vegetables showed poor correlation, which are important to consider when interpreting the data. Good agreement was observed between the methods in estimating dietary intakes and time in "moderate to vigorous physical activity," "sedentary time," and "sleep." [ABSTRACT FROM AUTHOR]

Background: Real-time surveillance of emerging infectious diseases necessitates a dynamically evolving, computable case definition, which frequently incorporates symptom-related criteria. For symptom detection, both population health monitoring platforms and research initiatives primarily depend on structured data extracted from electronic health records. Objective: This study sought to validate and test an artificial intelligence (AI)–based natural language processing (NLP) pipeline for detecting COVID-19 symptoms from physician notes in pediatric patients. We specifically study patients presenting to the emergency department (ED) who can be sentinel cases in an outbreak. Methods: Subjects in this retrospective cohort study are patients who are 21 years of age and younger, who presented to a pediatric ED at a large academic children's hospital between March 1, 2020, and May 31, 2022. The ED notes for all patients were processed with an NLP pipeline tuned to detect the mention of 11 COVID-19 symptoms based on Centers for Disease Control and Prevention (CDC) criteria. For a gold standard, 3 subject matter experts labeled 226 ED notes and had strong agreement (F 1-score=0.986; positive predictive value [PPV]=0.972; and sensitivity=1.0). F 1-score, PPV, and sensitivity were used to compare the performance of both NLP and the International Classification of Diseases, 10th Revision (ICD-10) coding to the gold standard chart review. As a formative use case, variations in symptom patterns were measured across SARS-CoV-2 variant eras. Results: There were 85,678 ED encounters during the study period, including 4% (n=3420) with patients with COVID-19. NLP was more accurate at identifying encounters with patients that had any of the COVID-19 symptoms (F 1-score=0.796) than ICD-10 codes (F 1-score =0.451). NLP accuracy was higher for positive symptoms (sensitivity=0.930) than ICD-10 (sensitivity=0.300). However, ICD-10 accuracy was higher for negative symptoms (specificity=0.994) than NLP (specificity=0.917). Congestion or runny nose showed the highest accuracy difference (NLP: F 1-score=0.828 and ICD-10: F 1-score=0.042). For encounters with patients with COVID-19, prevalence estimates of each NLP symptom differed across variant eras. Patients with COVID-19 were more likely to have each NLP symptom detected than patients without this disease. Effect sizes (odds ratios) varied across pandemic eras. Conclusions: This study establishes the value of AI-based NLP as a highly effective tool for real-time COVID-19 symptom detection in pediatric patients, outperforming traditional ICD-10 methods. It also reveals the evolving nature of symptom prevalence across different virus variants, underscoring the need for dynamic, technology-driven approaches in infectious disease surveillance. [ABSTRACT FROM AUTHOR]

The growing amount of screen time among adolescents has raised concerns about the effects it may have on their physical and psychological health. Although the literature is divided on whether the effects are mostly positive, neutral, or mostly negative, it is likely that the impacts will be highly individualized with a mixture of good and bad consequences for each person. Understanding behavioral and neurobiological phenomena of adolescence may help to guide research and interventions to optimize the benefits and minimize the risks. Particular aspects of adolescent development relevant to the issue include: (i) hunger for human connectedness; (ii) appetite for adventure; and (iii) desire for data.
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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]

Background: Breakfast skipping has previously been associated with worse diet quality among adolescents; the latter increases the risk of chronic disease. However, many studies do not consider diet quality as a function of calories, which is problematic as skippers tend to consume less energy than consumers. Additionally, due to the lack of one accepted definition of both breakfast skipping and diet quality, it is unclear how differences found may change when using varying definitions. Objectives: We aimed to compare the Healthy Eating Index-2015 (HEI-2015) scores and nutrient intakes of teen breakfast skippers and consumers in Southwestern Ontario, Canada. Methods: Cross-sectional, baseline data were used from SmartAPPetite, an ongoing nutrition intervention study. Singular 24-h dietary recalls and sociodemographic data from 512 adolescents aged 13-19 y were used to compare HEI-2015 scores and nutrient intakes via multivariable linear regression. Results: Previous day breakfast skippers had significantly lower HEI-2015 scores (-4.4; 95% CI: -8.4, -0.4) and significantly lower intakes of calories, saturated fat, and vitamin C, as well as significantly higher intake of sodium and total fat. Conclusions: Previous day breakfast consumers had significantly higher diet quality scores and better nutrient intakes than breakfast skippers, although, on average, both had poor diet quality. Consequently, it is unlikely that simply advising teens to consume breakfast will result in meaningful change in diet quality, and more effort should be placed on promoting nutritious breakfasts. [ABSTRACT FROM AUTHOR]

Background: Inuit youth in Northern Canada show considerable resilience in the face of extreme adversities. However, they also experience significant mental health needs and some of the highest adolescent suicide rates in the world. Disproportionate rates of truancy, depression, and suicide among Inuit adolescents have captured the attention of all levels of government and the country. Inuit communities have expressed an urgent imperative to create, or adapt, and then evaluate prevention and intervention tools for mental health. These tools should build upon existing strengths, be culturally appropriate for Inuit communities, and be accessible and sustainable in Northern contexts, where mental health resources are often scarce. Objective: This pilot study assesses the utility, for Inuit youth in Canada, of a psychoeducational e-intervention designed to teach cognitive behavioral therapy strategies and techniques. This serious game, SPARX, had previously demonstrated effectiveness in addressing depression with Maori youth in New Zealand. Methods: The Nunavut Territorial Department of Health sponsored this study, and a team of Nunavut-based community mental health staff facilitated youth's participation in an entirely remotely administered pilot trial using a modified randomized control approach with 24 youths aged 13-18 across 11 communities in Nunavut. These youth had been identified by the community facilitators as exhibiting low mood, negative affect, depressive presentations, or significant levels of stress. Entire communities, instead of individual youth, were randomly assigned to an intervention group or a waitlist control group. Results: Mixed models (multilevel regression) revealed that participating youth felt less hopeless (P=.02) and engaged in less self-blame (P=.03), rumination (P=.04), and catastrophizing (P=.03) following the SPARX intervention. However, participants did not show a decrease in depressive symptoms or an increase in formal resilience indicators. Conclusions: Preliminary results suggest that SPARX may be a good first step for supporting Inuit youth with skill development to regulate their emotions, challenge maladaptive thoughts, and provide behavioral management techniques such as deep breathing. However, it will be imperative to work with youth and communities to design, develop, and test an Inuit version of the SPARX program, tailored to fit the interests of Inuit youth and Elders in Canada and to increase engagement and effectiveness of the program. [ABSTRACT FROM AUTHOR]

To characterize opioid prescribing over a 5-year period to adolescents upon discharge from one urban pediatric medical center. A retrospective cross-sectional analysis of 4354 adolescents discharged with a pain medication after an admission of ≤5 days between January 2015 and December 2019 was performed. Two outcome groups, based on the analgesics prescribed at discharge, were compared: those discharged with a prescription for a non-opioid only and those discharged with an opioid prescription. The association between year of discharge and receipt of opioid, while adjusting for relevant demographic and clinical characteristics, was also explored. Approximately 64% of the sample was discharged with an opioid prescription. Of those, the median daily dosage was 45.0 morphine milligram equivalents (MME) [IQR: 32.4, 45.0]. Year of discharge was associated with decreased odds of receiving an opioid when adjusting for age, race, sex, insurance, pain scores, opioid exposure during hospitalization, length of stay, and undergoing surgery. The odds of being discharged with an opioid decreased each year by 29% (Adjusted Odds Ratio [AOR] = 0.71, CI:0.68–0.73). Concurrently, the proportion of patients discharged with nonopioid pain medication increased from 25% of adolescent patients in 2015 to 50% in 2019. Overall, opioid prescribing to adolescents at time of discharge decreased over time in our sample. While prescribing has decreased opioid analgesics are dispensed to young patients. Risk of opioid use disorder and overdose is rare in this population, but adolescence is good opportunity for nursing to promote safe prescribing and analgesic use. [ABSTRACT FROM AUTHOR]

E-cigarette use among youth remains a significant public health concern. In 2018, The Real Cost campaign began disseminating messages about the harms of vaping, primarily using digital media. We sought to determine the prevalence of aided recall of The Real Cost e-cigarette prevention ads and identify potential differences by participant characteristics. Participants were a nationally representative sample of adolescents living in United States (US) households recruited by the National Opinion Research Center (NORC) at the University of Chicago’s AmeriSpeak panel in September and October of 2020. A total of 623 adolescents completed the survey. Analyses were weighted to represent the distribution of youth in the US, and effect sizes for individual characteristics were estimated using an adjusted marginalized two-part model. Seventy-one percent of adolescents recalled at least one of the five The Real Cost e-cigarette prevention ads, with individual ad recall ranging from a low of 38.8% (for Magic) to a high of 50.1% (for Narrative). Adjusted estimates of aided recall identified significantly higher recall among Black adolescents and those that used social media at medium or high frequencies (p

Adolescent girls are vulnerable to many problems, undernutrition being the most common. This results in growth restriction resulting in stunting, wasting, underweight and last but not the least iron-deficiency anaemia. Nutritional needs are high during puberty which later leads to complications during pregnancy and its outcomes. A field based cross-sectional study was carried out to assess the nutritional status of the girls and to determine the various factors responsible for undernutrition. After clearance from the Institution Ethical Committee (IEC) and permission from Child Development Programme Officer (CDPO), the study was conducted in the anganwadi centres (AWC) of urban slums in the field practice area of the Department of Community Medicine from the 1st October 2014 to the 31st October 2016. All the adolescent girls enlisted in the seven anganwadi centres were included as study subjects with their consent. A pre-designed, pre-tested and semi-structured questionnaire was used to collect data on following sections. (a) socio-demographic profile and (b) nutritional status. Dietary intake was taken using the 24-h recall method. Anthropometry was measured and haemoglobin (Hb) was estimated. SPSS version 21 was used for descriptive and analytic statistics. Among the 160 girls 98(61.3%), 69(43.1%), 53(33.1%) were underweight, stunted and wasted, respectively. Anaemia was present among 144(90%) of the girls. Strict monitoring of weekly iron and folic acid supplementation (WIFS) as well as nutrition education are essential measures to solve the problem of undernutrition among adolescent girls. [ABSTRACT FROM AUTHOR]

Objectives: This meta-analysis examines the efficacy of programs at increasing knowledge about dating violence, changing attitudes, increasing bystander behaviors, and reducing incidents of dating violence perpetration and victimization. Methods: A systematic search yielded 38 studies contributing 73 independent effect sizes. Studies were pooled by outcome measure and ten moderators were used to examine the impacts of program and study characteristics. Results: Prevention programs had a significant, positive impact on measures of knowledge (ES = 0.566, z = 3.59), attitudes (ES = 0.191, z = 3.88), and violence perpetration (ES =.157, z = 3.11), but did not significantly impact experiences of victimization or bystander behaviors. Conclusions: Results indicate that dating violence prevention programs are effective at improving knowledge, attitudes, and some behaviors, providing support for the continued implementation of these programs with adolescent populations. Future research should investigate the impact of specific program content and long-term behavioral outcomes. [ABSTRACT FROM AUTHOR]

Sleep in adolescents was significantly impacted by the COVID-19 pandemic. We present a commentary on a range of articles exploring COVID-19's impact on sleep in teenagers, exploring the variety of effects internationally, interactions with sleep biology and the environment, mental health, online learning and Long COVID. We conclude with vicious and virtuous flowers suggesting ways to mitigate the impacts of COVID-19 on adolescent sleep. [ABSTRACT FROM AUTHOR]

Les écrans apportent un élément nouveau dans l'environnement de l'enfant et plus encore de l'adolescent. Nouveau partenaire de leur développement, retenant de plus en plus leur attention, ils ont des effets multiples. Ils modifient la relation à l'espace, au temps, à l'attention et introduisent une nouvelle donne dans la construction de la sexualité des jeunes par la place de la pornographie dans les contenus librement accessibles par tous sur Internet. Ils mettent en difficulté–pour le moment–les pratiques pédagogiques. Mais, les conséquences des écrans sur les jeunes dépendent aussi beaucoup du contexte d'utilisation et de l'environnement dans lequel ils vivent. À côté de l'enfant, il y a les parents, avec leurs pratiques éducatives et leur propre utilisation des écrans, et il y a la société, avec ses valeurs, les repères qu'elle offre à ses membres, sa culture et ses modèles. Dans cet article, nous tentons de cerner certains effets de l'utilisation importante des écrans par les enfants et adolescents sur la construction de l'espace et sur le rapport à leur corps en l'illustrant de vignettes cliniques. En effet, l'interaction corps-environnement est à la base de la construction de la représentation du corps propre, comme de celle de l'espace, essentielles à la construction de l'identité. Screens bring a new element to the environment of the child and even more to that of the adolescent. As a new partner in their development, screens are increasingly retaining the child's attention, and have multiple effects. They alter the relationship to space, time and attention and introduce a new dimension in the construction of the sexuality of young people. They are challenging–for the moment–educational practices. But the impact of screens on young people also depends a lot on the context of use and the environment in which they live. Alongside the child, there are parents, with their educational practices and their own use of screens, and there is society, with its values, the benchmarks it offers to its members, its culture and its models. Screens have become ubiquitous and invite humans to interact through their accessibility, the amusing simplicity of their job and their possibilities of interactivity. This tool will promote and even stimulate the child's empowerment vis-à-vis parents in his discovery and exploration of the world. Access to a screen connected to the Internet explodes the possibilities of interactions and exploration of a virtual space that is almost infinite. More and more, there is a striking contrast between the increasing spatial framing of the child confined in socially dedicated places, the room, the parental apartment, then the school, spaces set up for his protection... and his freedom to explore and interact with the virtual environment made possible by the connected screens that parents offer him. For safety reasons, children, especially younger ones, are no longer being opened to the streets, and they spend less and less time in parks or natural spaces (forests, fields, rivers, etc.). Children are increasingly reclusive in the interior spaces of homes and in playgrounds designed for their safety, which sanitizes the encounter with the natural environment. In contrast to this physical framing, the child's framing in the discovery and exploration of the virtual world increasingly escapes parents, despite the "parental control" devices. In this article, we try to identify some of the effects of the significant use of screens by children and adolescents on the construction of space and on the relationship to their bodies illustrating it in clinical vignettes. Indeed, the body-environment interaction is at the basis of the construction of the representation of one's own body, as well as that of space, essential for the building of identity. [ABSTRACT FROM AUTHOR]

Among U.S. adolescents, Latinxs have the highest levels of depression and the lowest access to treatment. Educational resources on the World Wide Web have potential to redress disparities by improving mental health literacy, but little is known about the availability and quality of web documents about depression targeting Latinx teens. We conducted a qualitative content analysis of search-engine results to inform future research. Of the 330 results, the majority (48%) were news stories, most with breaking news in Spanish about youth suicides. Only two documents targeted Latinx youth, including one that was depression-specific. A critique of this document revealed that although it met some indicators of web-resource quality, it did not meet its potential to empower Latinx teens to raise their depression literacy. We argue that such scarcity is an access barrier to preventive care and contributes to existing disparities. We highlight the need for web documents aiming to enhance depression literacy among Latinx teens that are both easily discoverable as well as socio-politically and culturally tailored. [ABSTRACT FROM AUTHOR]

There is growing advocacy for use of long-acting reversible contraception among sexually active adolescents. Our primary aims were to evaluate the etonogestrel subdermal contraceptive implant (SCI) insertion trends among adolescents, as well as SCI retention at 1, 2, and 3 years, indications for removal, and to identify pregnancies that occurred during SCI use. A retrospective cohort study was conducted of adolescents aged 13-19 years with SCI insertions in 2008-2014 within a large integrated health care system. Demographic and clinical characteristics included age, race/ethnicity, body mass index, gravidity, parity, insertions, reinsertions, indications for removal, and pregnancy. Electronic medical record review was conducted on a randomized sample of 540 adolescents with insertions during 2008-2011 for the retention objective to validate electronically extracted variables. Analyses included descriptive statistics, survival analysis with Kaplan-Meier estimates for implant retention and Cochran-Armitage trend test for insertions according to year during 2008-2014. Most adolescent SCI users were non-Hispanic white (43%), or Hispanic (34.2%) and 16 years or older (84.2%) at the time of insertion. Overall, 1-, 2-, and 3-year retention rates were 78.6%, 59.4%, and 26.2%, respectively, with retention at 44.3% at 2 years 9 months (indicative of removal of method for near expiration of 3-year device). The insertion rate trend showed statistically significant increases annually, from 0.14% in 2008 to 0.91% in 2014; P <.0001. No pregnancies were documented during implant use. The most common indication for SCI removal was device expiration. SCI insertions increased annually among adolescents, with more than a sixfold increase over the 6-year study period, and more than half of the SCIs were retained through 2 years of use. The most common indication of SCI removal was completion of Food and Drug Administration-approved duration. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this exploratory descriptive correlational study was to examine relationships between adolescent screen time and social anxiety. A secondary purpose was to explore sex-specific relationships between adolescent screen time and social anxiety. Method: Screen time habits, as well as the Kutcher Social Anxiety Disorder Scale scores, were collected from 84 high school health students (ages 14 to 17 years). Exploratory analysis included independent t tests and Pearson's r correlations between demographics and the K-GSADS-A. Additional subgroup analysis was conducted by sex to further explore the K-GSADS-A. Results: The majority of parents of students surveyed do not limit screen time for their teens. Both males and females had higher levels of social anxiety reported with higher screen time (p < 0.001). Males that spent less time on screens and thought their parents spent more time on screens had higher fear and anxiety scores (p = 0.02). Females in particular scored higher on the anxiety scale when reporting more than three hours daily on social media (p > 0.05). Conclusion: Using the information obtained in the surveys, teen mental health is impacted by screen use, especially social media, and by parental involvement, including limit setting and parental use of screens in the home. [ABSTRACT FROM AUTHOR]

SUMMARY: In California, more than 2 million adolescents (58%) drink soda or other sugar-sweetened beverages every day, and more than 1.6 million adolescents (46%) eat fast food at least twice a week. Adolescents who live and go to school in areas with more fast food restaurants and convenience stores than healthier food outlets such as grocery stores are more likely to consume soda and fast food than teens who live and go to school in areas with healthier food environments. State and local policy efforts to improve the retail food environment may be effective in improving adolescents’ dietary behaviors.

The UK has the highest rate of teenage pregnancies in Western Europe and within the UK higher rates are found amongst women with certain social risk factors, such as those who live in areas of higher deprivation. Teenage pregnancy can be a positive event for some young women. However, there are a number of adverse social outcomes associated with teenage motherhood in the UK, including being more likely to live in poverty, being unemployed or having lower salaries and educational achievements than their peers. Furthermore, children of teenage mothers are more likely to become teenage parents themselves. Strategies to tackle social issues associated with teenage pregnancy need to involve concurrent interventions, including education, skill building, clinical and social support for teenage mothers and contraception services for young people and pregnant teenagers. [ABSTRACT FROM AUTHOR]

Gifted adolescents may identify as "gamers" who create avatars to navigate video games and cell phone apps. Avatars provide a unique venue through which gifted teens can explore the issues of self and identity in a critical time of their development. The purpose of this article is to (a) provide an overview of what avatars are, (b) explain how avatars can be a venue to explore concepts of identity for gifted students, and (c) suggest how educators can utilize the concept of avatars in their classroom activities. We provide questions that educators can use to facilitate dialogue with their gifted adolescents about avatars and identity. [ABSTRACT FROM AUTHOR]

A large proportion (50%-75%) of youth (younger than 21 years old) who become pregnant gain more weight during pregnancy than is recommended by the National Academy of Medicine. Excess weight gain during pregnancy is a strong risk factor for long-term obesity among mothers and their infants. There is a significant gap in our understanding of youth's knowledge and behavior related to weight gain during pregnancy. To develop effective interventions for pregnant youth, it is necessary to understand their distinct needs and preferences. Using a youth-centered qualitative approach, the purpose of this study was to explore the knowledge, behaviors, and social factors that influence weight gain during pregnancy for youth. Participants completed weekly text message surveys and semistructured interviews to explore their perspectives of weight gain during pregnancy. Data were analyzed using qualitative thematic analysis on the basis of grounded theory. Pregnant youth ages 16-24 years old recruited from 2 urban, low-income, primary care clinics in Southeast Michigan. Among our sample (N = 54) 4 themes emerged. First, many youths were knowledgeable about healthy behaviors in pregnancy. However, the second theme showed that many youths reported barriers to engaging in these healthy behaviors, including stress, poor motivation, and issues of convenience. Third, they showed inadequate knowledge about exercise in pregnancy, and fourth, many endorsed food cravings that significantly influenced diet choices. Many pregnant youths have appropriate knowledge about healthy behaviors during pregnancy, but face many youth-specific barriers to achieving these behaviors. Interventions should address logistical challenges (eg, food access, cost, transportation) to healthy behaviors in pregnancy to make healthy diet and exercise more convenient for pregnant youth. [ABSTRACT FROM AUTHOR]

Self-harm (SH) is a risk factor for suicide. We aimed to determine whether internet addiction and internet exposure to confided suicidal ideation are associated with SH in adolescents. Methods: This study was a cross-sectional survey of students who self-completed a series of online questionnaires including a sociodemographic information questionnaire, questionnaire for suicidality and SH, Chen Internet Addiction Scale (CIAS), Patient Health Questionnaire (PHQ-9), multi-dimensional support scale (MDSS), Rosenberg self-esteem scale (RSES), Alcohol Use Disorder Identification Test-Consumption (AUDIT-C), and questionnaire for substance abuse. Results: A total of 2479 students completed the questionnaires (response rate = 62.1%). They had a mean age of 15.44 years (range 14–19 years; standard deviation 0.61), and were mostly female (n = 1494; 60.3%). The prevalence of SH within the previous year was 10.1% (n = 250). Among the participants, 17.1% had internet addiction (n = 425) and 3.3% had been exposed to suicidal content on the internet (n = 82). In the hierarchical logistic regression analysis, internet addiction and internet exposure to suicidal thoughts were both significantly related to an increased risk of SH, after controlling for gender, family factors, exposure to suicidal thoughts in the real life, depression, alcohol/tobacco use, concurrent suicidality, and perceived social support. However, the association between internet addiction and SH weakened after adjusting for the level of self-esteem, while internet exposure to suicidal thoughts remained significantly related to an increased risk of SH (odds ratio = 1.96; 95% confidence interval: 1.06–3.64). Conclusion: Online experiences are associated with SH in adolescents. Preventive strategies may include education to increase social awareness, to identify the youths most at risk, and to provide prompt help.

The film ratings system employed by the Motion Picture Association of America (MPAA) has been criticized by LGBTQ critics who claim the system discriminates by holding queer content to a higher ratings standard than content in other films. The MPAA argues the constituency for its ratings system is parents in traditional families who may find queer themes inappropriate for their children. Paradoxically, a number of organizations serving adolescents identifying as LGBTQ or as questioning their sexualities have created lists of recommended films, many of whose MPAA ratings make them virtually off-limits to teens unless their parents approve. Cyberspace is also populated with lists of films recommended for teens regardless of their sexuality and gender identity. This article compares ratings distributions for lists of films recommended for queer teens and those recommended for mainstream teens and finds evidence of negative impact on access by queer teens to potentially helpful film content. [ABSTRACT FROM AUTHOR]

Background: Homeless, runaway, and transgender youth are at high risk for commercial sexual exploitation in the United States. Research examining this phenomenon is growing but requires synthesis to facilitate its use by professionals who serve this population. The purpose of this review was to aggregate the qualitative evidence regarding commercially sexually exploited youth (CSEY) in the United States. Methods: The search included published and unpublished qualitative studies with current or former CSEY who reside in the United States. Results: There were 19 studies included in the review with a total of 795 participants. Eight themes were identified and grouped into three broader categories: experiences that preceded sex work entry, experiences that facilitated sex work continuation, and experiences that facilitated sex work exit. Conclusions: Understanding the barriers and facilitators of commercial sexual exploitation can inform the development of interventions that address the needs of CSEY and youth at risk for exploitation. The results of this review highlight the social and economic influences as well as the role of positive and negative reinforcements involved in sex work entry, its continuation, and exit. Needs for services, research, and advocacy are also discussed. [ABSTRACT FROM AUTHOR]

Asthma is the most common chronic disease of childhood in the United States, disproportionately affecting urban, poor, and minority children. Adolescents are at high risk for poor asthma outcomes and for depressive symptoms. The purpose of this study is to investigate associations between depressive symptoms and asthma-related clinical and functional outcomes among urban teens. We used baseline data from a 3-arm randomized trial, School-Based Asthma Care for Teens, in Rochester, NY. We used the Center for Epidemiological Studies Depression Scale with a standard cutoff score of 16 to identify subjects at risk for clinical depression. We used structured in-home surveys and validated scales to assess clinical and functional outcomes and conducted bivariate and multivariate analyses to evaluate differences between groups. We identified 277 eligible teens (ages 12 to 16, 80% participation, 54% black, 34% Hispanic, 45% female, 84% on Medicaid). Overall, 28% reported depressive symptoms. Teens with depressive symptoms experienced greater asthma symptom severity and more acute health care utilization for asthma (all P <.001); however, there was no difference in preventive care use between groups. Teens with depressive symptoms also reported lower asthma-related quality of life (P <.001), less sleep (P <.001), and more limitation in mild (adjusted odds ratio [aOR], 2.60; 95% confidence interval [CI], 1.34–5.02) and moderate (aOR, 2.56; 95% CI, 1.41–4.61) activity and in gym (aOR, 2.33; 95% CI, 1.30–4.17). Depressive symptoms are prevalent among urban teens with asthma and are associated with worse asthma-related clinical outcomes, functional limitation, and quality of life. Providers should consider depression as a significant comorbidity that may impact multiple aspects of daily life for this population. [ABSTRACT FROM AUTHOR]

Teen pregnancy is depicted around the world as an important cause of health disparities both for the child and the mother. Accordingly, much effort has been invested in its prevention and led to its decline in the northern hemisphere since the mid-1990s. Despite that, high rates are still observed in the circumpolar regions. As Inuit communities have granted better understanding of teenage pregnancy a priority for the coming years, this article comprehensively reviews this multidimensional issue. By depicting current prevalence, likely determinants and possible impacts documented among Inuit of Canada, Alaska and Greenland, and contrasting them to common knowledge that has emerged from other populations over the years, great gaps surface. In some regions, the number of pregnancies per number of Inuit women aged between 15 and 19 years has increased since the turn of the millennium, while statistics from others are either absent or difficult to compare. Only few likely determinants of teenage pregnancy such as low education and some household factors have actually been recognized among Inuit populations. Documented impacts of early pregnancy on Inuit women and their children are also limited compared to those from other populations. As a way to better address early pregnancy in the circumpolar context, the defence for additional scientific efforts and the provision of culturally adapted sexual health prevention programmes appear critical.

Background An overall increase has been reported in vaccination rates among adolescents during the past decade. Studies of vaccination coverage have shown disparities when comparing foreign-born and U.S.-born populations among children and adults; however, limited information is available concerning potential disparities in adolescents. Methods The National Immunization Survey-Teen is a random-digit–dialed telephone survey of caregivers of adolescents aged 13–17 years, followed by a mail survey to vaccination providers that is used to estimate vaccination coverage among the U.S. population of adolescents. Using the National Immunization Survey-Teen data, we assessed vaccination coverage during 2012–2014 among adolescents for routinely recommended vaccines for this age group (≥1 dose tetanus and diphtheria toxoids and acellular pertussis [Tdap] vaccine, ≥1 dose quadrivalent meningococcal conjugate [MenACWY] vaccine, ≥3 doses human papillomavirus [HPV] vaccine) and for routine childhood vaccination catch-up doses (≥2 doses measles, mumps, and rubella [MMR] vaccine, ≥2 doses varicella vaccine, and ≥3 doses hepatitis B [HepB] vaccine). Vaccination coverage prevalence and vaccination prevalence ratios were estimated. Results Of the 58,090 respondents included, 3.3% were foreign-born adolescents. Significant differences were observed between foreign-born and U.S.-born adolescents for insurance status, income-to-poverty ratio, education, interview language, and household size. Foreign-born adolescents had significantly lower unadjusted vaccination coverage for HepB (89% vs. 93%), and higher coverage for the recommended ≥3 doses of HPV vaccine among males, compared with U.S.-born adolescents (22% vs. 14%). Adjustment for demographic and socioeconomic factors accounted for the disparity in HPV but not HepB vaccination coverage. Conclusions We report comparable unadjusted vaccination coverage among foreign-born and U.S.-born adolescents for Tdap, MenACWY, MMR, ≥2 varicella. Although coverage was high for HepB vaccine, it was significantly lower among foreign-born adolescents, compared with U.S.-born adolescents. HPV and ≥2-dose varicella vaccination coverage were low among both groups. [ABSTRACT FROM AUTHOR]

Aim To describe the central experiences of teens living with food-induced anaphylaxis as a first step in responding to healthcare needs in this population. Background As prevalence of allergy increases and commonly outgrown allergies persist longer, chronic management for teens becomes increasingly important. Synthesizing existing research helps to recognize management needs specific to teens with food allergy. Design Meta-aggregation for qualitative systematic review, to create synthesis for clinical improvement; guided by Joanna Briggs Institute methods and their Qualitative Assessment and Review Instrument. Data sources Seven relevant databases were searched for original qualitative research July 2015; 10 studies (published 2007-2015) met inclusion criteria. Review methods Both authors undertook critical appraisal, with consensus by discussion. Findings from line-by-line extraction were grouped into categories and syntheses. In studies with mixed populations, we included only teens (age 12-19) with food-induced anaphylaxis. Results We developed three syntheses from nine categories and 64 subcategories to reflect central experiences of teens with food-induced anaphylaxis, including: (1) defining the allergic self; (2) finding a balance and (3) controlling the uncontrollable. The syntheses encompass importance of allergic identity/understanding, difficulties in coping with burdens of food allergy and reflect the complex risk interactions teens must negotiate in social contexts. Conclusion There is a need to respect teens as active participants in managing food-induced anaphylaxis, while recognizing that social expectations and a lack of public awareness/safety can dangerously affect one's needs and decisions. This helps broaden how we conceptualize the needs of teens living with food-induced anaphylaxis, informing ongoing care and management. [ABSTRACT FROM AUTHOR]

The UK has the highest rate of teenage pregnancies in Western Europe and within the UK higher rates are found amongst women with certain social risk factors, such as those who live in areas of higher deprivation. Teenage pregnancy can be a positive event for some young women. However, there are a number of adverse social outcomes associated with teenage motherhood in the UK, including being more likely to live in poverty, being unemployed or having lower salaries and educational achievements than their peers. Furthermore, children of teenage mothers are more likely to become teenage parents themselves. Strategies to tackle social issues associated with teenage pregnancy need to involve concurrent interventions, including education, skill building, clinical and social support for teenage mothers and contraception services for young people and pregnant teenagers. [ABSTRACT FROM AUTHOR]

Résumé La mort fait partie de la vie, mais reste une réalité difficilement pensable surtout lorsqu’elle touche un enfant et qu’il s’agit alors d’envisager le processus psychique consécutif à cette perte définitive qu’est le deuil. Le fait qu’un enfant, surtout très jeune, puisse souffrir psychiquement de la perte d’un proche reste difficile à admettre et bien des enfants endeuillés se retrouvent seuls face à un monde d’adulte indifférent à sa détresse, car convaincu qu’il ne peut pas être touché comme eux puisqu’il n’exprime pas son chagrin de la même façon. Cette méconnaissance de la clinique du deuil chez l’enfant et ses spécificités selon les âges, n’est pas sans conséquence pour leur devenir, comme en témoignent les souffrances psychiques d’adultes endeuillés dans leur enfance et confrontés, enfants, au déni de leur entourage. Notre pratique clinique nous amène à intervenir auprès d’enfants endeuillés à différents moments de cette épreuve, que ce soit dès le moment de l’annonce du décès ou de leur prise en charge quand ils ont été confrontés à cette mort, dans les jours ou les mois qui suivent ; mais également des années plus tard quand, devenus adultes, leur deuil infantile est réactivé à l’occasion de la confrontation à un autre événement traumatique. Cette expérience nous a permis de constater combien il est essentiel de connaître les spécificités des manifestations cliniques du deuil selon les âges car, trop souvent, la souffrance des enfants endeuillés n’est pas comprise pour ce qu’elle est. Nous aborderons dans un premier temps ce qui fait du deuil infantile une réalité impensable ; nous discuterons ensuite de la pluralité contextuelle de ces deuils et de leurs manifestations selon la période infantile où ils surviennent ; enfin, à partir des éléments repérés dans notre pratique clinique nous envisagerons, à la lumière de l’état actuel des publications sur ce sujet, les éléments qui apparaissent comme source de survictimisation du deuil infantile et ceux qui permettent de renforcer les ressources résilientes individuelles et collectives. Summary Death is a part of life but remains difficult to think about, especially when it affects a child and when it is then a question of the psychic process precipitating the definitive loss, which is grief. The fact that a child, especially a very young one, can suffer psychically from the loss of a parent is difficult to admit, and many grieving children find themselves alone and facing an indifferent adult's world: the adults convinced that children can’t be affected as they are because they doesn’t express their pain in the same way. This misunderstanding of the clinical sense of mourning in the child and its age-specificities has consequence for their future; witness the psychic suffering of adults who, as children grieving, met with denial from those around them. Our clinical practice leads us to intervene with children at different times during these periods, whether at the moment of the death announcement or their care in the days and months that follow the confrontation with death, but also years later when, now adults, their infantile grief is reactivated by another traumatic event. This experience showed us how essential it is to know the specific details of clinical demonstrations of grief by age, because too often the suffering of bereaved children is not understood for what it is. We shall first discuss what makes infantile mourning an unthinkable reality; we shall then discuss the contextual plurality of these mourning processes according to the age period in which they happen; finally, from elements noted in our clinical practice we shall consider, in the light of current publication on this subject, the elements which appear to be at the source of over-victimization of child grief and those who allow the strengthening of resilience in individual and collective contexts. [ABSTRACT FROM AUTHOR]

Purpose Little is known about the risk factors for nonmedical use (NMU) of prescription stimulants among adolescent girls. We aimed to measure the association of nonmedical prescription stimulant use with empirically linked risk factors, including weight control behavior (WCB), gambling, and depressed mood, in pre-teen and teenaged girls. Methods We assessed the relationship between age and race, gambling, WCB, depressive mood, and nonmedical prescription stimulant use using multivariable logistic regression. The study sample included 5,585 females, aged 10–18 years, recruited via an entertainment venue intercept method in 10 U.S. metropolitan areas as part of the National Monitoring of Adolescent Prescription Stimulants Study (2008–2011). Results NMU of prescription stimulants was reported by 6.6% (n = 370) of the sample. In multivariable logistic regression, 1-year increase in age was associated with a 21% (95% confidence interval [CI]: .15, .28) increase in risk for NMU. Whites and other race/ethnicity girls had 2.67 (CI: 1.85, 3.87) and 1.71 (1.11, 2.65) times higher odds for NMU, compared to African-Americans. Depressive mood (adjusted odds ratio: 2.69, CI: 2.04, 5.57) and gambling (adjusted odds ratio: 1.90, 1.23, 2.92) were associated with increased odds for NMU. A dose-response was identified between WCB and NMU, where girls with unhealthy and extreme WCB were over five times more likely to endorse NMU. Conclusions We contribute to the literature linking WCB, depression, gambling, and the NMU of prescription stimulants in any population and uniquely do so among girls. [ABSTRACT FROM AUTHOR]

Background/purpose Self-harm (SH) is a risk factor for suicide. We aimed to determine whether internet addiction and internet exposure to confided suicidal ideation are associated with SH in adolescents. Methods This study was a cross-sectional survey of students who self-completed a series of online questionnaires including a sociodemographic information questionnaire, questionnaire for suicidality and SH, Chen Internet Addiction Scale (CIAS), Patient Health Questionnaire (PHQ-9), multi-dimensional support scale (MDSS), Rosenberg self-esteem scale (RSES), Alcohol Use Disorder Identification Test-Consumption (AUDIT-C), and questionnaire for substance abuse. Results A total of 2479 students completed the questionnaires (response rate = 62.1%). They had a mean age of 15.44 years (range 14–19 years; standard deviation 0.61), and were mostly female ( n = 1494; 60.3%). The prevalence of SH within the previous year was 10.1% ( n = 250). Among the participants, 17.1% had internet addiction ( n = 425) and 3.3% had been exposed to suicidal content on the internet ( n = 82). In the hierarchical logistic regression analysis, internet addiction and internet exposure to suicidal thoughts were both significantly related to an increased risk of SH, after controlling for gender, family factors, exposure to suicidal thoughts in the real life, depression, alcohol/tobacco use, concurrent suicidality, and perceived social support. However, the association between internet addiction and SH weakened after adjusting for the level of self-esteem, while internet exposure to suicidal thoughts remained significantly related to an increased risk of SH (odds ratio = 1.96; 95% confidence interval: 1.06–3.64). Conclusion Online experiences are associated with SH in adolescents. Preventive strategies may include education to increase social awareness, to identify the youths most at risk, and to provide prompt help. [ABSTRACT FROM AUTHOR]

Résumé Nous proposons dans cet article d’apporter une nouvelle lecture de la prévalence du recours à l’acte suicidaire au sein de la population homosexuelle. En effet, à partir de l’analyse clinique et projective de Lucas, jeune homosexuel suicidaire, nous soutenons que la répétition des passages par l’acte suicidaire masquait d’anciens traumas, mettant ainsi, en réalité, au second plan la problématique de l’orientation sexuelle comme facteur causal et initiateur des actes suicidaires. Nous avons alors repéré la force des traumas précoces vécus durant l’enfance de Lucas, leur réactualisation dans l’économie psychique sur le développement identitaire et sexuel et dégagé leurs aménagements psychiques. Nous posons alors l’hypothèse que l’acte suicidaire pourrait être, en réalité, révélateur de traumas précoces. We suggest in this research to provide a new approach for the prevalence of the use of the suicidal act within the homosexual population. Indeed, from the Lucas's clinical and projective case, a suicidal young homosexual, we have identified that the repetition of the passages by the suicidal act masked old traumas so putting, in reality, in the background the problem of the sexual orientation as causal factor and initiator of the suicidal acts. We strength of the traumas experienced during Lucas's childhood, their updating in the psychic economy on the identity and sexual development, and highlighted their psychic renewal. We propose then the assumption that the suicidal attempt and homosexuality could be in fact indicative of early traumas. [ABSTRACT FROM AUTHOR]

Background: Previous research has demonstrated emotional, psychological and educational harm to young mothers following unintended conceptions. The UK has one of the highest rates of pregnancies in adolescence in Western Europe with a high proportion of these being repeat pregnancies, making it a topic of interest for public health policy makers, and health and social care practitioners. As part of a wider mixed-methods systematic review, realist principles were applied to synthesise evidence about interventions aiming to reduce repeat pregnancies in adolescence.Methods: A multi-streamed, mixed-methods systematic review was conducted searching 11 major electronic databases and 9 additional databases from 1995 onwards, using key terms such as pregnancy, teen or adolescent. The principles of realist synthesis were applied to all included literature to uncover theories about what works, for whom, how and in what context. Initial theory areas were developed through evidence scoping, group discussion by the authors and stakeholder engagement to uncover context + mechanism = outcome (CMO) configurations and related narratives.Results: The searches identified 8,664 documents initially, and 403 in repeat searches, filtering to 81 included studies, including qualitative studies, randomised controlled trials, quantitative studies and grey literature. Three CMO configurations were developed. The individual experiences of young mothers' triggered self-efficacy, notions of perceived risks, susceptibility and benefits of pregnancy, resulting in the adolescent taking control of their fertility and sexual encounters. The choice between motherhood and other goals triggered notions of motivations, resulting in the adolescent managing their expectations of motherhood and controlling their fertility and sexual encounters. Barriers and facilitators to accessing services triggered notions of connectedness and self-determination; resulting in interventions that are tailored so they are relevant to young persons, and improve access to services and engagement with the issue of pregnancy in adolescence.Conclusions: Pregnancy in adolescence is a complex issue with many factors to consider. The conceptual platform described here could help guide policy makers and professionals towards a number of areas that need to be attended to in order to increase the likelihood of an intervention working to prevent rapid repeat pregnancy in adolescence.Trial Registration: PROSPERO CRD42012003168. [ABSTRACT FROM AUTHOR]

Background: Accumulating evidence suggests that the benefits seen in adult bariatric surgery can be reproduced in adolescents. In contrast with North America, bariatric surgery in adolescents is still not well accepted in Europe and indications and protocols have still to be formulated. Methods: This prospective study tested the gastric banding procedure in 49 patients operated in a single French institution since 2008. The mean age at surgery was 16.2 ± 0.9 years with a weight of 118.8 ± 22.3 kg and body mass index of 42.5 ± 5.9 kg/m. Results: At 6, 12 and 24 months after surgery, weight was 103.7 ± 20.8 kg, 98.7 ± 21 kg and 93.6 ± 19.3 kg, respectively ( p < 0.001), corresponding to excess weight loss (EWL) of 31.6 ± 17.2 %, 41.8 ± 21.4 % and 59.1 ± 24.9 % ( p < 0.001), respectively. Multivariate analysis showed that the number of consultations per year was the only variable significantly associated to weight loss. Metabolic disorders were corrected, with a decreased prevalence of insulin resistance from 100 to 17 % and normalisation of homeostasis model assessment-insulin resistance (HOMA-IR) at 24 months (2.09 ± 0.95). Band-related complications were five slippages, one psychological intolerance and two ports repositioning. Six patients (12 %) had the device explanted. The death of a patient was an exceptionally severe adverse event. Conclusion: Given frequent follow-up support by a multidisciplinary team, laparoscopic adjustable gastric banding (LAGB) surgery in adolescent results in sustained weight loss. However, even exceptional, potentially serious complications are possible and long-term follow-up is needed to evaluate the risk/benefit ratio at 5 or 10 years after LAGB surgery. [ABSTRACT FROM AUTHOR]

Technology, including mobile technologies and social media, offers powerful tools to reach, engage, and retain youth and young adults in HIV prevention and care interventions both in the USA and globally. In this report, we focus on HIV, technology, and youth, presenting a synthesis of recently published (Jan 2014-May 2015) observational and experimental studies relevant for understanding and intervening on HIV risk, prevention, and care. We present findings from a selection of the 66 relevant citations identified, highlighting studies that demonstrate a novel approach to technology interventions among youth in regard to content, delivery, target population, or public health impact. We discuss current trends globally and in the USA in how youth are using technology, as well as emergent research issues in this field-including the need for new theories for developing technology-based HIV interventions and new metrics of engagement, exposure, and evaluation. [ABSTRACT FROM AUTHOR]

The UK has the highest rate of teenage pregnancies in Western Europe and within the UK higher rates are found amongst women who live in areas of higher deprivation and have other factors such as lower educational achievement or living in state care homes. Teenage pregnancy can be a positive event for some young women. However, there are a number of adverse social outcomes associated with teenage motherhood in the UK, including being more likely to live in poverty, being unemployed or having lower salaries and educational achievements than their peers. Furthermore, children of teenage mothers are more likely to become teenage parents themselves. Strategies to tackle social issues associated with teenage pregnancy need to involve concurrent interventions, including education, skill building, clinical and social support for teenage mothers and contraception services for young people and pregnant teenagers. [ABSTRACT FROM AUTHOR]

Copyright of Dirasat: Shar'ia & Law Sciences is the property of University of Jordan and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To examine feasibility and utilization of a mobile asthma action plan (AAP) among adolescents.Methods: Adolescents (aged 12–17 years) with persistent asthma had their personalized AAP downloaded to a smartphone application. Teens were prompted by the mobile application to record either daily symptoms or peak flow measurements and to record medications. Once data were entered, the application provided immediate feedback based on the teen’s AAP instructions. Asthma Control Test (ACT®) and child asthma self-efficacy scores were examined pre- and post-intervention.Results: Adolescents utilized the mobile AAP a median 4.3 days/week. Participant satisfaction was high with 93% stating that they were better able to control asthma by utilizing the mobile AAP. For participants with uncontrolled asthma at baseline, median (interquartile range) ACT scores improved significantly from 16 (5) to 18 (8) [p = 0.03]. Median asthma attack prevention self-efficacy scores improved from 34 (3.5) to 36 (5.3) [p = 0.04].Conclusions: Results suggest that personalized mobile-based AAPs are a feasible method to communicate AAP instructions to teens. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)