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Walmisley U, Kinney MV, Kiendrébéogo JA, Kafando Y, George AS. Any better? A follow-up content analysis of adolescent sexual and reproductive health inclusion in Global Financing Facility country planning documents. Glob Health Action 2024; 17:2315644. [PMID: 38962875 PMCID: PMC11188955 DOI: 10.1080/16549716.2024.2315644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/03/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND The Global Financing Facility (GFF) supports national reproductive, maternal, newborn, child, adolescent health, and nutrition needs. Previous analysis examined how adolescent sexual and reproductive health was represented in GFF national planning documents for 11 GFF partner countries. OBJECTIVES This paper furthers that analysis for 16 GFF partner countries as part of a Special Series. METHODS Content analysis was conducted on publicly available GFF planning documents for Afghanistan, Burkina Faso, Cambodia, CAR, Côte d'Ivoire, Guinea, Haiti, Indonesia, Madagascar, Malawi, Mali, Rwanda, Senegal, Sierra Leone, Tajikistan, Vietnam. Analysis considered adolescent health content (mindset), indicators (measure) and funding (money) relative to adolescent sexual and reproductive health needs, using a tracer indicator. RESULTS Countries with higher rates of adolescent pregnancy had more content relating to adolescent reproductive health, with exceptions in fragile contexts. Investment cases had more adolescent content than project appraisal documents. Content gradually weakened from mindset to measures to money. Related conditions, such as fistula, abortion, and mental health, were insufficiently addressed. Documents from Burkina Faso and Malawi demonstrated it is possible to include adolescent programming even within a context of shifting or selective priorities. CONCLUSION Tracing prioritisation and translation of commitments into plans provides a foundation for discussing global funding for adolescents. We highlight positive aspects of programming and areas for strengthening and suggest broadening the perspective of adolescent health beyond the reproductive health to encompass issues, such as mental health. This paper forms part of a growing body of accountability literature, supporting advocacy work for adolescent programming and funding.
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Affiliation(s)
- Ulla Walmisley
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Mary V. Kinney
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Joël Arthur Kiendrébéogo
- Department of Public Health, University Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
- Recherche pour la Santé et le Développement (RESADE), Ouagadougou, Burkina Faso
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
- Institute of Tropical Medicine, Department of Public Health, Antwerp, Belgium
| | - Yamba Kafando
- Recherche pour la Santé et le Développement (RESADE), Ouagadougou, Burkina Faso
| | - Asha S. George
- School of Public Health, University of the Western Cape, Cape Town, South Africa
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Wallace AL, Courtney KE, Wade NE, Doran N, Delfel EL, Baca R, Hatz LE, Thompson C, Andrade G, Jacobus J. A preliminary investigation of physical and mental health features of cannabis & nicotine co-use among adolescents and young adults by sex. Addict Behav 2024; 156:108064. [PMID: 38821010 DOI: 10.1016/j.addbeh.2024.108064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 05/09/2024] [Accepted: 05/11/2024] [Indexed: 06/02/2024]
Abstract
INTRODUCTION Cannabis and nicotine/tobacco products (NTP) are commonly co-used in adolescence and young adulthood; however, limited research has been done on predictive health behaviors to co-use. The current study is a preliminary investigation into the relationships of modifiable health behaviors on cannabis and NTP co-use in adolescents and young adults. METHOD 221 participants (ages 16-22) were characterized into cannabis use only (N = 55), NTP use only (N = 20), cannabis and NTP co-use (used cannabis and NTP; N = 96) and control (no use; N = 50) groups based on past 30-day use. Self-report measures for physical activity, sleep quality, mental health, and reward responsivity were utilized. Participants were given a comprehensive neurocognitive battery. Logistic regressions of self-report measures and fluid intelligence composite scores on substance use group status were run stratified by sex. RESULTS Higher approach reward sensitivity traits were associated with increased likelihood of cannabis use only (Odds Ratio (OR) = 1.15, p = .036) in female participants. Increased aerobic activity was associated with decreased likelihood of cannabis use only (OR = 0.91, p = .047) and cannabis and NTP co-use (OR = 0.88, p = .007) in female participants. Higher anxiety was associated with increased likelihood of cannabis NTP co-use (OR = 1.51, p = 0.025) in male participants. DISCUSSION Several health behaviors were linked with cannabis use and cannabis and NTP co-use in both females and male adolescents and young adults. Health markers differed by sex suggesting differing mechanisms of substance co-use. This study informs targetable health behaviors for prevention and intervention efforts.
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Affiliation(s)
- Alexander L Wallace
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA
| | - Kelly E Courtney
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA
| | - Natasha E Wade
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA
| | - Neal Doran
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA; Psychology Service, VA San Diego Healthcare System, San Diego, CA 92161, USA
| | - Everett L Delfel
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA; SDSU / UC San Diego Joint Doctoral Program in Clinical Psychology, USA
| | - Rachel Baca
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA
| | - Laura E Hatz
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA
| | - Courtney Thompson
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA
| | - Gianna Andrade
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA
| | - Joanna Jacobus
- University of California San Diego, Psychiatry Department, La Jolla, CA 92093, USA.
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Ricardo LIC, Smith AD, Hesketh KR, Chavez-Ugalde Y, Lee EY, van Sluijs EMF. Cross-sectional associations of gender identity and sexual orientation, with co-occurrence and clustering of health-related behaviours among British adolescents: Millennium cohort study. Prev Med 2024; 186:108084. [PMID: 39047953 DOI: 10.1016/j.ypmed.2024.108084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 07/18/2024] [Accepted: 07/21/2024] [Indexed: 07/27/2024]
Abstract
PURPOSE We examined whether gender identity and sexual orientation were associated with seven health-related behaviours, and with co-occurrence and clustering of these behaviours among British adolescents. METHODS Millennium Cohort Study (age 17 wave) provided data on the exposures, gender identity (male, female, genderqueer) and sexual orientation (heterosexual, bisexual, gay or lesbian, or other), and seven self-reported health-related behaviours (binge drinking, drug use, no consumption of breakfast, no consumption of fruits or vegetables, physical inactivity, poor sleep, and smoking or vaping). Poisson regressions examined associations between the exposures and single behaviours (reporting prevalence ratios (PRs)); and multinomial logistic regressions were used for behavioural cumulative co-occurrence score (reporting PRs). Cluster patterns were identified using Ward's agglomerative hierarchical cluster analysis while associations with cluster membership were performed using logistic regressions (reporting odds ratios (ORs)). RESULTS Our sample included 6022 adolescents (55.4% female, 1.5% genderqueer, 11.6% non-heterosexual). Adolescents who identified as genderqueer had the highest prevalence of not eating breakfast (PR: 60.5% [95%CI 48.4-71.4]) and poor sleep (68.7% [95%CI 55.6-79.3]). Those who identified as bisexual had a higher PR of co-occurring behaviours (2.46 [95%CI 1.39-4.27]). Among the three clusters identified (1: Multiple risk behaviours; 2: Physical inactivity and binge drinking; 3: Poor diet and physical inactivity), adolescents who identified as genderqueer or other sexual orientation showed the highest prevalence in cluster 3. CONCLUSION Gender and sexual minority British adolescents showed a higher prevalence of risky health-related behaviours, and higher risk of co-occurring behaviours. Physical inactivity and poor diet behaviours commonly clustered together for these groups.
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Affiliation(s)
| | - Andrea D Smith
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | | | | | - Eun-Young Lee
- School of Kinesiology & Health Studies, Queen's University, Ontario, Canada; Department of Gender Studies, Queen's University, Ontario, Canada
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Fakkel M, Peeters M, Branje S, Stevens GWJM. Parental SES and family support as predictors of educational level: Testing the buffering effect of effortful control and peer support. J Adolesc 2024. [PMID: 39154280 DOI: 10.1002/jad.12389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/19/2024] [Accepted: 07/29/2024] [Indexed: 08/19/2024]
Abstract
INTRODUCTION Exposure to family risk factors increases adolescents' chances of attaining a lower educational level. However, some adolescents attain a high educational level despite being exposed to family risk factors such as a lower parental socioeconomic status (SES) or receiving less family support. METHOD Using data from the Dutch TRAILS cohort study (NT1 = 2175; Mage = 11.1, SD = 0.55, 50.8% female), we investigated if higher levels of effortful control and peer support can buffer against the negative effects of a lower parental SES and less family support on educational level. Two multinomial logistic regressions were performed (from early to mid-adolescence and from mid-adolescence to young adulthood) with post hoc tests to contrast four ordinal educational levels: practical vocational, theoretical vocational, higher general, and (pre-)university. RESULTS Adolescents with a higher parental SES were consistently more likely to end up at a higher educational level, but family support was hardly associated with educational level. Neither effortful control nor peer support buffered the associations of parental SES and family support with educational level. Effortful control did have a positive direct (compensatory) effect on the educational level. CONCLUSION We conclude that other individual competencies or more structural changes may be more helpful buffers for reducing socioeconomic inequalities in educational attainment.
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Affiliation(s)
- Matthijs Fakkel
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
| | - Margot Peeters
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
| | - Susan Branje
- Department of Youth & Family, Utrecht University, Utrecht, The Netherlands
| | - Gonneke W J M Stevens
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
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Tunçgenç B, Greig EJ, Cohen E. Benefits of an online group dance program for adolescents' social bonding and wellbeing. J Adolesc 2024. [PMID: 39148201 DOI: 10.1002/jad.12391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 03/26/2024] [Accepted: 07/28/2024] [Indexed: 08/17/2024]
Abstract
INTRODUCTION The Covid-19 pandemic and its ensuing effects on mental health made it clearer than ever that social bonds are critical for survival, flourishing, and mental wellbeing. Experimental laboratory-based research with children and adults shows that activities involving movement alignment and joint action, such as dance, can facilitate social bonds. METHODS This study examined whether an online group dance intervention positively affects social bonding and wellbeing using a randomized control design. Participants were 58 UK adolescents aged 11-16 years (N = 52 girls, 75% White, 7% Asian/Asian British, 18% Mixed-Other), randomly assigned to an online intervention or waitlist control group. Participants in the intervention group completed an online 5-week hip-hop dance program during the Covid-19 pandemic in January to February 2021. Measures of social bonding, wellbeing, and future orientation were taken at the beginning and end of the program. RESULTS Linear mixed model analyses examining group × timepoint interaction showed greater increase in social bonding (p < .0001), and wellbeing (p < .0001) in the intervention vs control group. Moreover, increases in bonding significantly predicted increases in wellbeing (p < .0001), and increases in bonding (p = .03) and wellbeing (p = .0002) significantly predicted increases in the adolescents' hope for the future. CONCLUSIONS These data, collected at a time of mass social isolation, show that a 5-week-long online dance activity can help adolescents forge stronger social bonds, and improve their wellbeing and future orientation. Our findings suggest that the wellbeing and future orientation benefits of group dance may stem from having stronger social connectedness, opening up avenues for future research and interventions.
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Affiliation(s)
- Bahar Tunçgenç
- Psychology Department, Nottingham Trent University, Nottingham, UK
- Institute of Human Sciences, University of Oxford, Oxford, UK
| | | | - Emma Cohen
- Institute of Human Sciences, University of Oxford, Oxford, UK
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Russell MJ, Urichuk L, Parker N, Agyapong VIO, Rittenbach K, Dyson MP, Hilario C. Youth mental health care use during the COVID-19 pandemic in Alberta, Canada: an interrupted time series, population-based study. Child Adolesc Psychiatry Ment Health 2024; 18:101. [PMID: 39127668 DOI: 10.1186/s13034-024-00785-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 07/12/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND During the COVID-19 pandemic, youth had rising mental health needs and changes in service accessibility. Our study investigated changes in use of mental health care services for Canadian youth in Alberta before and during the COVID-19 pandemic. We also investigated how youth utilization patterns differed for subgroups based on social factors (i.e., age, gender, socioeconomic status, and geography) previously associated with health care access. METHODS We used cross-sectional population-based data from Alberta, Canada to understand youth (15-24 year) mental health care use from 2018/19 to 2021/22. We performed interrupted time series design, segmented regression modeling on type of mental health care use (i.e., general physician, psychiatrist, emergency room, and hospitalization) and diagnosis-related use. We also investigated the characteristics of youth who utilized mental health care services and stratified diagnosis-related use patterns by youth subgroups. RESULTS The proportion of youth using mental health care significantly increased from 15.6% in 2018/19 to 18.8% in 2021/22. Mental health care use showed an immediate drop in April 2020 when the COVID-19 pandemic was declared and public health protections were instituted, followed by a steady rise during the next 2 years. An increase was significant for general physician and psychiatrist visits. Most individual diagnoses included in this study showed significant increasing trends during the pandemic (i.e., anxiety, adjustment, ADHD, schizophrenia, and self-harm), with substance use showing an overall decrease. Mortality rates greatly increased for youth being seen for mental health reasons from 71 per 100,000 youth in 2018/19 to 163 per 100,000 in 2021/22. In addition, there were clear shifts over time in the characteristics of youth using mental health care services. Specifically, there was increased utilization for women/girls compared to men/boys and for youth from wealthier neighborhoods. Increases over time in the utilization of services for self-harm were limited to younger youth (15-16 year). CONCLUSIONS The study provides evidence of shifts in mental health care use during the COVID-19 pandemic. Findings can be used to plan for ongoing mental health needs of youth, future pandemic responses, and other public health emergencies.
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Affiliation(s)
| | - Liana Urichuk
- PolicyWise for Children & Families, 9925 109 St NW, Edmonton, AB, T5K 2J8, Canada
- Department of Psychiatry, University of Alberta, 4-142A Katz Group Centre for Research, 11315 - 87 Ave NW, Edmonton, AB, T6G 2H5, Canada
| | - Naomi Parker
- Faculty of Social Work, University of Calgary, 2500 University Dr NW MacKimmie Tower (MT) 301, Calgary, AB, T2N 1N4, Canada
| | - Vincent Israel Opoku Agyapong
- Department of Psychiatry, University of Alberta, 4-142A Katz Group Centre for Research, 11315 - 87 Ave NW, Edmonton, AB, T6G 2H5, Canada
- Faculty of Medicine, Dalhousie University, Abbie J Lane Building, 5909 Veterans Memorial Ln, Halifax, NS, B3H 2E2, Canada
| | - Katherine Rittenbach
- Department of Psychiatry, University of Alberta, 4-142A Katz Group Centre for Research, 11315 - 87 Ave NW, Edmonton, AB, T6G 2H5, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, 3330 Hospital Dr NW, Calgary, AB, T2N 4N1, Canada
| | - Michele P Dyson
- Department of Psychiatry, University of Alberta, 4-142A Katz Group Centre for Research, 11315 - 87 Ave NW, Edmonton, AB, T6G 2H5, Canada
- Provincial Addiction and Mental Health, Alberta Health Services, 10th Floor, South Tower, 10030-107 Street NW, Edmonton, AB, T5J 3E4, Canada
| | - Carla Hilario
- Department of Psychiatry, University of Alberta, 4-142A Katz Group Centre for Research, 11315 - 87 Ave NW, Edmonton, AB, T6G 2H5, Canada.
- School of Nursing, The University of British Columbia-Okanagan, ART360 (ARTS Building), 1147 Research Road, Kelowna, BC, V1V 1V7, Canada.
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Torres ME, Leguízamo A, Leibowitz G. An Exploration of Racial Differences Among Male Youth Adjudicated for Sexual Offenses. JOURNAL OF CHILD SEXUAL ABUSE 2024:1-20. [PMID: 39056342 DOI: 10.1080/10538712.2024.2381458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 04/22/2024] [Accepted: 06/20/2024] [Indexed: 07/28/2024]
Abstract
In 2019, the male adjudicated youth (AY) population in correctional facilities was 33% White and 67% minority. Yet, the distribution among male AY charged with sexual offenses (AYSOs) was 55% White and 45% minority, highlighting the lack of disproportionate minority contact within the AYSO population. Little research on AYSOs has focused explicitly on exploring racial differences within this population. Using secondary data from 720 AY 11-18 years of age, the goal of this exploratory study was to identify differences in length of detention, presence of clinical syndromes, attachment patterns, and childhood trauma experiences among a sample of AYSOs and AYs by race category. Although few racial differences were identified among AYSOs, study results overwhelmingly highlighted differences between AYSOs and AYs.
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Cook NE, Kissinger-Knox A, Iverson IA, Stephenson K, Norman MA, Hunter AA, Saadi A, Iverson GL. Social Determinants of Health and Health Equity in the Treatment and Rehabilitation of Sport-Related Concussion: A Content Analysis of Intervention Research and Call-To-Action. J Neurotrauma 2024. [PMID: 38753708 DOI: 10.1089/neu.2023.0550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024] Open
Abstract
This review was designed to (1) determine the extent to which the clinical science on sport-related concussion treatment and rehabilitation has considered social determinants of health (SDoH) or health equity and (2) offer recommendations to enhance the incorporation of SDoH and health equity in concussion treatment research and clinical care. The Concussion in Sport Group consensus statement (2023) was informed by two systematic reviews examining prescribed rest or exercise following concussion and targeted interventions to facilitate concussion recovery. We examined 31 studies, including 2,698 participants, from those two reviews. Race (k = 6; 19.4%) and ethnicity (k = 4; 12.9%) of the study samples were usually not reported. Four studies examined ethnicity (i.e., Hispanic), exclusively as a demographic category. Five studies (16.1%) examined race as a demographic category. Three studies (9.7%) examined socioeconomic status (SES; measured as household income) as a demographic category/sample descriptor and one study (3.2%) examined SES in-depth, by testing whether the treatment and control groups differed by SES. Five studies examined an SDoH domain in a descriptive manner and four studies in an inferential/intentional manner. No study mentioned SDoH, health equity, or disparities by name. Many studies (61.3%) excluded participants based on demographic, sociocultural, or health factors, primarily due to language proficiency. The new consensus statement includes recommendations for concussion treatment and rehabilitation that rely on an evidence base that has not included SDoH or studies addressing health equity. Researchers are encouraged to design treatment and rehabilitation studies that focus specifically on underrepresented groups to determine if they have specific and unique treatment and rehabilitation needs, whether certain practical modifications to treatment protocols might be necessary, and whether completion rates and treatment adherence and response are similar.
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Affiliation(s)
- Nathan E Cook
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
- Mass General for Children Sports Concussion Program, Waltham, MA, USA
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, USA
| | - Alicia Kissinger-Knox
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, USA
- Concussion Research Program, Spaulding Hospital Cambridge, Cambridge, MA, USA
| | - Ila A Iverson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Katie Stephenson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
- College of Osteopathic Medicine, University of New England, Biddeford, ME, USA
| | - Marc A Norman
- Department of Psychiatry, UC San Diego School of Medicine, San Diego, CA, USA
| | - Amy A Hunter
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT, USA
- Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT, USA
- Injury Prevention Center, Connecticut Children's Medical Center and Hartford Hospital, Hartford, CT, USA
| | - Altaf Saadi
- Department of Neurology, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Grant L Iverson
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
- Mass General for Children Sports Concussion Program, Waltham, MA, USA
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA, USA
- Concussion Research Program, Spaulding Hospital Cambridge, Cambridge, MA, USA
- Schoen Adams Research Institute at Spaulding Rehabilitation, Charlestown, MA, USA
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Kim SY, Park YS, Joo HJ, Park EC. Association between stress types and adolescent suicides: findings from the Korea Youth Risk Behavior Survey. Front Psychiatry 2024; 15:1321925. [PMID: 39041049 PMCID: PMC11260740 DOI: 10.3389/fpsyt.2024.1321925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 06/17/2024] [Indexed: 07/24/2024] Open
Abstract
Objective This study aims to explore the association between types of stress and suicidal behaviors-ideation and attempts-among Korean adolescents in two distinct years: 2015 and 2020. Methods Data were acquired from the Korea Youth Risk Behavior Web-based Survey conducted in 2015 and 2020. Participants' desire for suicide was evaluated by asking questions about suicidal ideation and attempts, during the past year. Types of stress were divided into five categories: none, home, school, academic achievement, and appearance. Multiple logistic regression was used to investigate the association between variables of interest and dependent variables. Results Among the 77,363 adolescents included in this study, 8.8% male and 13.2% female participants had seriously thought about committing suicide, and the rate of male and female participants who tried committing suicide was 1.6% and 2.5%, respectively. While every type of stress was highly associated with suicidal ideation, family and home types of stress had the highest odds ratio (OR), that was statistically significant for both sexes (Male: OR 3.81, 95% Confidence Interval [CI] 2.81 to 5.15; Female: OR 3.64, 95% CI 2.42 to 5.50). Moreover, the OR increased in order of: appearance; academic achievement; school and friends; and family and home, compared to the group that perceived no stress. Suicidal attempts were statistically significant and higher in likelihood, only amongst the female group that experienced stress from family and home (OR 2.48, 95% CI 1.08 to 5.67). In comparison to year 2015, suicidal ideation and attempts decreased in year 2020, but participants experiencing stress from family and home had a higher tendency of attempting suicide, though not statistically significant, regardless of their sex (Male: OR 1.03, 95% CI 0.74 to 1.44; Female: OR 1.06, 95% CI 0.81 to 1.4). Conclusion Adolescents who experience stress from family and home, or school and friends, are more likely to think about suicide, or carry it out, as compared to those having different causes of stress.
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Affiliation(s)
- Soo Young Kim
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Yu Shin Park
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Hye Jin Joo
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea
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Dobson KG, Gignac MAM, Tucker L, Jetha A. Double Trouble! Do Workplace Supports Mitigate Lost Productivity for Young Workers with Both Severe Rheumatic Diseases and Depressive Symptoms? JOURNAL OF OCCUPATIONAL REHABILITATION 2024:10.1007/s10926-024-10217-8. [PMID: 38960928 DOI: 10.1007/s10926-024-10217-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/09/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND The objectives of this longitudinal study were to understand how comorbid rheumatic disease and depression symptoms were associated with at-work productivity among young adults, and to examine whether workplace support modified this association. METHODS Seventy-six Canadian young adults who were employed and living with a rheumatic disease were surveyed three times over 27 months. Morbidity was defined by whether participants reported severe rheumatic disease symptoms and/or depressive symptoms. Participants were asked about presenteeism, absenteeism, and whether the workplace support needs (accommodation and benefit availability and use) were met. Generalized estimating equations were used to address study objectives. RESULTS Seventeen participants experienced neither severe rheumatic disease nor depressive symptoms (no morbidity), 42 participants experienced either severe rheumatic disease or depressive symptoms (single morbidity), and 17 participants reported comorbidity at baseline. Participants with comorbidity reported greater presenteeism scores and were most likely to report absenteeism, compared to the other two morbidity levels. Having workplace support needs met was associated with decreased presenteeism over the 27-month period among participants with no and a single morbidity. Conversely, unmet support need was associated with greater presenteeism for participants with comorbidity. Having workplace support needs met did not modify the association between morbidity and absenteeism. CONCLUSION Comorbid rheumatic disease and depression burden reduce productivity among young adults. A supportive work environment has the potential to address at-work productivity challenges. Additional research is needed to understand how workplace supports coupled with clinical interventions may tackle challenges at work for young adults living with rheumatic disease and depression.
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Affiliation(s)
- Kathleen G Dobson
- Institute for Work and Health, Suite 1800 400 University Avenue, Toronto, ON, M5G1S5, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Monique A M Gignac
- Institute for Work and Health, Suite 1800 400 University Avenue, Toronto, ON, M5G1S5, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Lori Tucker
- University of British Columbia, Vancouver, BC, Canada
- BC Children's Hospital, Vancouver, BC, Canada
| | - Arif Jetha
- Institute for Work and Health, Suite 1800 400 University Avenue, Toronto, ON, M5G1S5, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
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Brown H, Gao N, Song W. Regional trends in mental health inequalities in young people aged 16-25 in the UK and the role of cuts to local government expenditure: Repeated cross-sectional analysis using the British household panel Survey/UK household longitudinal survey. Soc Sci Med 2024; 353:117068. [PMID: 38954859 DOI: 10.1016/j.socscimed.2024.117068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 06/12/2024] [Accepted: 06/20/2024] [Indexed: 07/04/2024]
Abstract
Young people's mental health globally has been in decline. Because of their low perceived need, young people's services tend to be the first cut when budgets are reduced. There is a lack of evidence on how a reduction in services and opportunities for young people is associated with their mental health. Additionally, how this may be magnified by place and the assets and challenges of place. The aim of this study is to explore trends in young people's mental health measured by GHQ-12 over time in the twelve regions of the UK. We estimated an interrupted time series model using 2010 as a break point from which there was a shift in government policy to a prolonged period of large reductions in central government funding. Repeated cross-sectional data on young people aged 16-25 is used from the British Household Panel Survey and its successor survey UK Household Longitudinal Survey. Results showed a statistically significant reduction in mental health for young people living in the North East, Wales, and the East of England. The North East was the region with the largest reduction in funding and saw the greatest reduction in young people's mental health. Next, we look at how reductions in local government expenditure related to services for children and young people: children's social services, education, transportation, and culture; explain the observed decline in mental health. We employ a Blinder-Oaxaca Decomposition approach comparing young people's mental health between 2011 and 2017. Results show a marginally statistically significant decrease in young people's mental health over this time. Unobserved factors related to transport spending and children's social services explain some of this gap. Area level factors such as deprivation, infrastructure, and existing assets need to be considered when distributing funding for young people's services to avoid exacerbating regional inequalities in mental health.
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Affiliation(s)
- Heather Brown
- Lancaster University, Health Innovation One, Sir John Fisher Drive, Lancaster LA1 4AT, UK.
| | - Ni Gao
- Centre for Health Economics, York University, Heslington, York, YO10 5DD, UK
| | - Wei Song
- Centre for Health Economics, York University, Heslington, York, YO10 5DD, UK
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12
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Srinivasan SP, S S. A Comparative Review of UNCRC and Indian Legislation from the Child Mental Health Perspective. Indian J Psychol Med 2024; 46:289-297. [PMID: 39056031 PMCID: PMC11268273 DOI: 10.1177/02537176241226714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/28/2024] Open
Abstract
Background The United Nations Convention on the Rights of the Child (UNCRC) is the most comprehensive set of standards promoting and protecting children's interests. It can be utilized to create appropriate policies and legislation that enshrine the values identified in the UNCRC. In India, children have been considered only in the context of their family and were welfare recipients in the past, but more legislation has been enacted to protect and promote the child's rights. A comparative review will help identify how the new legislation enacted after India ratified the UNCRC directly or indirectly addressed children's mental health. Methodology Legislation enacted after 1992 with the search term "child" was identified in the Indian national portal for legislation. These were compared against specific articles of the UNCRC identified to have a direct or indirect bearing on children's mental health. Results The review revealed that only 11 of the 32 legislation enacted after 1992 address different aspects of children's mental health. Only three refer to the UNCRC in their preamble or content. Six of the 11 legislation addressed Article 24, while Article 32 and Article 34 were addressed in only one legislation each. Notably, most of the legislation is focused on child protection, while very few address the participation component of the guiding principles. Discussion The UNCRC is a valuable guide to creating a legal framework to support child rights. This review highlights the need to consider children's mental health as a fundamental right and incorporate the principles into future Indian legislation.
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Affiliation(s)
| | - Shruthi S
- Manipal Academy of Higher Education, Manipal, Karnataka, India
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13
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Thanachoksawang C, Arphorn S, Jarupat Maruo S, Punneng S, Ishimaru T, Bangkadanara G. Psychological Distress Among High School Students in Bangkok Thailand. Health Psychol Res 2024; 12:120045. [PMID: 38915787 PMCID: PMC11196123 DOI: 10.52965/001c.120045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 06/01/2024] [Indexed: 06/26/2024] Open
Abstract
Introduction This study investigated psychological distress among high school students in Thailand.A sample of 8,345 students from thirty-five Bangkok schools voluntarily participated, responding to a questionnaire and undergoing stress assessments. Socio-demographic factors including grade level, school scale, hometown, parental marital status, presence of siblings, gender, health conditions, online classes, and family monthly income were analyzed. Results Of the participants, 1,087 (13.02%) experienced psychological distress. Grade level, school scale, hometown, parental marital status, and siblings' presence showed no significant associations with distress. However, being female or transgender correlated with higher distress levels. Students with health issues and those in online classes also experienced elevated distress. Additionally, a family monthly income below 10,000 Thai Baht was associated with distress. Conclusion This study sheds light on factors contributing to psychological distress in high school students. It highlights the need for tailored support for vulnerable groups within the student population, emphasizing the role of educators, policymakers, and mental health professionals in addressing these challenges.
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Affiliation(s)
- Chatchai Thanachoksawang
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Sara Arphorn
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Suchinda Jarupat Maruo
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Suwatsa Punneng
- Health Science Programs, Faculty of Science and Technology, Sakon Nakhon Rajabhat University, Sakon Nakhon, Thailand
| | - Tomohiro Ishimaru
- Department of Medical Humanities, School of Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan
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14
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Gunasinghe C, Bergou N, MacCrimmon S, Rhead R, Woodhead C, Jones Nielsen JD, Hatch SL. Co-production of an online research and resource platform for improving the health of young people-The hype project. PLoS One 2024; 19:e0277734. [PMID: 38848378 PMCID: PMC11161015 DOI: 10.1371/journal.pone.0277734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/29/2024] [Indexed: 06/09/2024] Open
Abstract
Mental health conditions tend to go unrecognised and untreated in adolescence, and therefore it is crucial to improve the health and social outcomes for these individuals through age and culturally appropriate interventions. This paper aims firstly to describe the development and implementation of the HYPE project platform (a research and resource platform co-designed and co-produced with young people). The second aim is to describe the characteristics of participants who engaged with the platform and an embedded pilot online survey. Participatory action research approach was used to address objectives of the HYPE project. Data were analysed to: (1) help improve access to health and social services, (2) guide provision of information of online resources and (3) deliver complementary community-based events/activities to promote mental health and to ultimately prevent mental health issues. Pilot and main phases of the HYPE project demonstrated the capacity and feasibility for such a platform to reach local, national, and international populations. Analyses demonstrated that the platform was particularly relevant for young females with pre-existing health difficulties. Some of the barriers to involving young people in research and help-seeking are discussed.
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Affiliation(s)
- Cerisse Gunasinghe
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Department of Psychology, School of Health & Psychological Sciences, City, University of London, London, United Kingdom
| | - Nicol Bergou
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Shirlee MacCrimmon
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Rebecca Rhead
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Charlotte Woodhead
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Economic and Social Research Council (ESRC) Centre for Society and Mental Health, King’s College London, London, United Kingdom
| | - Jessica D. Jones Nielsen
- Department of Psychology, School of Health & Psychological Sciences, City, University of London, London, United Kingdom
| | - Stephani L. Hatch
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- Economic and Social Research Council (ESRC) Centre for Society and Mental Health, King’s College London, London, United Kingdom
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15
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Tinner L. Reflections on the benefits and challenges of using co-produced artistic workshops to engage with young people in community settings. RESEARCH INVOLVEMENT AND ENGAGEMENT 2024; 10:51. [PMID: 38831355 PMCID: PMC11149207 DOI: 10.1186/s40900-024-00575-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 04/18/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND Despite increased focus on adolescence, young people's voices are often undervalued and underrepresented in health inequalities research and policy. Through exploring young people's priorities for their health and their community, we may begin to understand how public health interventions and policies can be more effective and equitable. Engaging with youth using art enables empowerment and self-expression on these complex topics. METHODS Creative workshops, co-produced with a young artist, were delivered at three youth centres to participants aged 11-18 years (n = 30) in disadvantaged areas of Bristol, UK. Participants engaged in art and were guided by a semi-structured topic guide through focus group discussion. Thematic analysis, supported by the young artist, was used to distil key policy priorities for young people to be delivered to the local authority. RESULTS The young people identified a list of key priorities. These were: (1) mental health, (2) feeling 'forgotten' as an age group and having safe city spaces to socialise, (3) the need for greater support for their education and career aspirations. I provide a brief summary of these priorities, but the focus of this article is on the critical reflections on this innovative way of engaging with young people about local policy. I provide key learning points for researchers looking to do creative public health work in community settings and involve marginalised young people. CONCLUSIONS Art is a promising way of engaging with young people in community settings and elevating marginalised voices. Co-producing with a local young artist enriched the project and partially alleviated power imbalances. This approach has potential for involving different groups within local policymaking and priority setting around health inequalities.
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Affiliation(s)
- Laura Tinner
- Bristol Medical School, Population Health Sciences, Canygne Hall, Bristol, BS8 2BN, UK.
- Population Health Sciences. Bristol Medical School, University of Bristol, Bristol, BS8 2PN, UK.
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16
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Kondo MC, Locke D, Hazer M, Mendelson T, Fix RL, Joshi A, Latshaw M, Fry D, Mmari K. A greening theory of change: How neighborhood greening impacts adolescent health disparities. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2024; 73:541-553. [PMID: 38303603 DOI: 10.1002/ajcp.12735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/15/2023] [Accepted: 01/03/2024] [Indexed: 02/03/2024]
Abstract
Neighborhoods are one of the key determinants of health disparities among young people in the United States. While neighborhood deprivation can exacerbate health disparities, amenities such as quality parks and greenspace can support adolescent health. Existing conceptual frameworks of greening-health largely focus on greenspace exposures, rather than greening interventions. In this paper, we develop and propose a Greening Theory of Change that explains how greening initiatives might affect adolescent health in deprived neighborhoods. The theory situates greening activities and possible mechanisms of change in the context of their ability to modify distal social determinants of health factors, stemming from macrostructural and historical processes that lead to resource inequalities, affecting both the social and built environment in which adolescents live and develop. The framework illustrates both short- and long-term health, economic, and security effects of greening. We also describe how the theory informed the development of Project VITAL (Vacant lot Improvement to Transform Adolescent Lives) in Baltimore, MD, which aims to (1) build a citywide sharable database on vacant lot restoration activities, (2) evaluate the impact of greening initiatives on adolescent health outcomes, (3) conduct cost-effectiveness analyses, and (4) develop best practices for greening programs for improved adolescent health.
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Affiliation(s)
- Michelle C Kondo
- USDA Forest Service, Northern Research Station, Philadelphia, Pennsylvania, USA
| | - Dexter Locke
- USDA Forest Service, Northern Research Station, Baltimore, Maryland, USA
| | - Meghan Hazer
- Baltimore City Department of Public Works, Office of Research and Environmental Protection, Watershed Planning + Partnerships, Baltimore, Maryland, USA
| | - Tamar Mendelson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Rebecca L Fix
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ashley Joshi
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Megan Latshaw
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Dustin Fry
- USDA Forest Service, Northern Research Station, Philadelphia, Pennsylvania, USA
| | - Kristin Mmari
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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17
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Lirios A, Mullens AB, Daken K, Moran C, Gu Z, Assefa Y, Dean JA. Sexual and reproductive health literacy of culturally and linguistically diverse young people in Australia: a systematic review. CULTURE, HEALTH & SEXUALITY 2024; 26:790-807. [PMID: 37755697 DOI: 10.1080/13691058.2023.2256376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 09/04/2023] [Indexed: 09/28/2023]
Abstract
Young people from culturally and linguistically diverse backgrounds experience barriers accessing sexual and reproductive health (SRH) information and care. This systematic review, utilising a pre-determined protocol, performed according to PRISMA guidelines, explored SRH knowledge, attitudes and information sources for young (16-24 years) culturally and linguistically diverse background people living in Australia, to gain understanding of their sexual health literacy. CINAHL, Embase, MEDLINE, PubMed and Scopus were systematically searched with inclusion criteria applied to 216 articles. After title and abstract screening, backward/forward searching, and full-text review of 58 articles, 13 articles from eight studies were identified. Thematic analysis, guided by core constructs from cultural care theory, identified three themes: (1) SRH knowledge varied by topic but was generally low; (2) young people's attitudes and beliefs were influenced by family and culture; however, 'silence' was the main barrier to sexual health literacy; and (3) Access to SRH information was limited. To attain sexual health literacy and equitable access to culturally-congruent and responsive SRH information and care, there is a need for theory-informed strategies and policies that address the diverse social, cultural and structural factors affecting young culturally and linguistically diverse background people, especially the 'silence' or lack of open SRH communication they experience.
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Affiliation(s)
- Alison Lirios
- Faculty of Medicine, School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - Amy B Mullens
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Kirstie Daken
- School of Psychology and Wellbeing, Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Claire Moran
- True Relationships and Reproductive Health (True), Windsor, Queensland, Australia
| | - Zhihong Gu
- Ethnic Communities Council of Queensland (ECCQ), West End, Queensland, Australia
| | - Yibeltal Assefa
- Faculty of Medicine, School of Public Health, The University of Queensland, Herston, Queensland, Australia
| | - Judith A Dean
- Faculty of Medicine, School of Public Health, The University of Queensland, Herston, Queensland, Australia
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Blake JA, Thomas HJ, Pelecanos AM, Najman JM, Scott JG. The unique role of adolescent internalizing and externalizing problems, and maternal-adolescent communication in their association with attachment in early adulthood. Acta Psychol (Amst) 2024; 246:104273. [PMID: 38636402 DOI: 10.1016/j.actpsy.2024.104273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/20/2024] Open
Abstract
Attachment styles influence mental health and relationships through life. Few studies examine the adolescent factors associated with adult attachment styles. This paper examines the association between adolescent emotional and behavioral problems and maternal-adolescent communication with attachment style in early adulthood. Data from 3423 participants in a birth cohort study were examined. At 14-years, participants' mothers completed the Parent-Adolescent Communication Scale. Participants completed the Youth Self-Report at 14-years which measures internalizing and externalizing symptoms, and the Attachment Style Questionnaire (ASQ) at 21-years. The ASQ comprises five domains of internal working models of interpersonal relationships and attachment style: confidence (security), discomfort with closeness and relationships as secondary (avoidance), need for approval and preoccupation with relationships (anxiety). Associations were examined using general linear models. After adjustments, internalizing symptoms score was associated with all domains of attachment and externalizing symptoms score was associated with four domains of attachment insecurity, but not attachment security. Low openness in maternal-adolescent communication was most strongly associated with decreased confidence and high problem maternal-adolescent communication was associated with viewing relationships as secondary. Adolescents with emotional and behavioral problems and maternal-adolescent communication may benefit from attachment-based interventions to support the development of healthy relationships and attachments in young adulthood.
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Affiliation(s)
- Julie A Blake
- QIMR Berghofer Medical Research Institute of Herston, Queensland, Australia; Faculty of Medicine, University of Queensland, Queensland, Australia; Queensland Centre for Mental Health Research Queensland, Australia; Child and Youth Mental Health Service, Children's Health Queensland, South Brisbane, Queensland, Australia; Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia.
| | - Hannah J Thomas
- QIMR Berghofer Medical Research Institute of Herston, Queensland, Australia; Faculty of Medicine, University of Queensland, Queensland, Australia; Queensland Centre for Mental Health Research Queensland, Australia
| | - Anita M Pelecanos
- QIMR Berghofer Medical Research Institute of Herston, Queensland, Australia
| | - Jake M Najman
- Faculty of Medicine, University of Queensland, Queensland, Australia
| | - James G Scott
- QIMR Berghofer Medical Research Institute of Herston, Queensland, Australia; Faculty of Medicine, University of Queensland, Queensland, Australia; Queensland Centre for Mental Health Research Queensland, Australia; Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia
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Zhu X, Chu CKM, Wu X, Shek DTL. Validation of a Chinese Positive Youth Development Scale: Dimensionality and factorial invariance. PLoS One 2024; 19:e0303531. [PMID: 38820298 PMCID: PMC11142590 DOI: 10.1371/journal.pone.0303531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 04/26/2024] [Indexed: 06/02/2024] Open
Abstract
For a multi-dimensional measure of positive youth development (PYD), its factor structure should be invariant across groups and over time. This study examined the factorial validity of the 44-item short form of the "Chinese Positive Youth Development Scale" (CPYDS-SF) that assesses 15 dimensions of PYD attributes. Using two waves of longitudinal data with a one-year interval in between, this study examined the factor structure of the scale and whether the structure is invariant between gender groups and across time. The data were collected from 3,328 adolescents at Wave 1 and 3,638 adolescents at Wave 2, with a matched sample of 2,905 adolescents (mean age = 12.57 ± 0.72 at Wave 1; 49.54% girls). Confirmatory factor analysis revealed that the 15-factor structure fitted the data well. The findings of invariance tests further supported this structure's invariance across gender and time, indicating a stable factor structure of CPYDS-SF among Chinese adolescents. These findings suggest that CPYDS-SF can be used to examine gender differences and the longitudinal development of PYD qualities among Chinese adolescents.
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Affiliation(s)
- Xiaoqin Zhu
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, PR China
| | - Carman K M Chu
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, PR China
| | - Xue Wu
- Office of Undergraduate Studies, The Hong Kong Polytechnic University, Hong Kong, PR China
| | - Daniel T L Shek
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, PR China
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20
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Miao S, Xu L, Gao S, Bai C, Huang Y, Peng B. The association between anxiety and internet addiction among left-behind secondary school students: the moderating effect of social support and family types. BMC Psychiatry 2024; 24:406. [PMID: 38811914 PMCID: PMC11138066 DOI: 10.1186/s12888-024-05855-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 05/17/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND The left-behind children (LBC), children and adolescents aged 0-18 whose parents have migrated for economic purposes for extended periods exceeding three months, present a unique social concern. These children remain in their place of household registration, often under the guardianship of relatives, while receiving compulsory education. LBC with growing Internet addiction (IA) have made it urgent to take a close look at the mechanisms and effective interventions for them. Anxiety has been proven to be correlated with IA in adolescents; however, the mechanisms of addiction in this population are less well-fully grasped. Based on the current theories and empirical results, the study examined whether and how social support (SS) and family types moderated the associations between anxiety and IA among left-behind secondary students. METHODS Stratified cluster sampling survey. A questionnaire was administered to 5290 secondary school children (2553 classified as left-behind) to explore the relationships between anxiety, IA, left-behind types, family types, and social support. This cross-sectional study employed a stratified cluster sampling survey of students in the ethnic areas of southeast Chongqing. The study sought to appraise the relationships between anxiety and IA in different types of left-behind children and to assess the potential moderating effect of SS on the relationship among the population and its family types differences. RESULTS The relationship between anxiety and IA was moderated significantly by social support and family types. Notably, the impact of social support on the moderating effect between IA and anxiety varied among students from both family types. For students from families where both parents had migrated, social support weakened the association between IA and anxiety. Conversely, for students from single-parent families where the parent had migrated, social support seemed to strengthen the relationships between these two issues. CONCLUSIONS The moderating effects of SS on the relationship between anxiety and IA differs based on family type among various groups of left-behind secondary students. Gaining insights into the IA mechanisms can guide the development of targeted intervention strategies aimed at minimizing IA among diverse groups of left-behind students.
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Affiliation(s)
- Siwei Miao
- Centre for Medical Big Data and Artificial Intelligence, Southwest Hospital of Third Military Medical University, Chongqing, 400038, China
| | - Lu Xu
- School of Pharmacy, Chongqing Medical and Pharmaceutical College, Chongqing, 401331, China
| | - Sihong Gao
- Chongqing Fuling District Center for Disease Control and Prevention, Chongqing, 408000, China
| | - Cuiping Bai
- Xiushan Traditional Chinese Medicine Hospital, Chongqing, 409900, China
| | - Yan Huang
- Chongqing Traditional Chinese Medicine Hospital, Chongqing, 400021, China.
| | - Bin Peng
- Department of Health Statistics, School of Public Health, Chongqing Medical University, Chongqing, 400016, China.
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Guo S, Fu H, Guo K. Effects of physical activity on subjective well-being: the mediating role of social support and self-efficacy. Front Sports Act Living 2024; 6:1362816. [PMID: 38863568 PMCID: PMC11165021 DOI: 10.3389/fspor.2024.1362816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 05/14/2024] [Indexed: 06/13/2024] Open
Abstract
Objective Subjective well-being is an essential component of college students' mental health, and the purpose of this study was to investigate the relationship between physical activity and subjective well-being among college students and to examine the mediating role of social support and self-efficacy between the physical activity and subjective well-being. Methods This study utilized a cross-sectional design with a stratified whole group sample of 989 college students (Mage = 19.65 years, SD = 1.1) from three universities in Guangdong Province, China, and used the Physical Activity Scale, Subjective Well-Being Scale, Social Support Scale, and Self-Efficacy Scale for data collection. In this study, SPSS 26.0 was used for descriptive statistical analysis and correlation analysis of the collected data. Harman's one-way method was used to test for common method bias. Results (1) Physical activity, subjective well-being, social support and self-efficacy were significantly correlated with each other. Among them, physical activity was significantly and positively correlated with subjective well-being (r = 0.36), physical activity directly predicted subjective well-being (β = 0.125, t = 3.992, p < 0.01). (2) Physical activity positively predicted social support (β = 0.386, t = 12.505, p < 0.01) and self-efficacy (β = 0.358, t = 11.793, p < 0.01), social support significantly positively predicted subjective well-being (β = 0.332, t = 11.370, p < 0.01) and self-efficacy (β = 0.254, t = 8.744, p < 0.01), self-efficacy significantly and positively predicted subjective well-being (β = 0.255, t = 8.251, p < 0.01). (3) Not only did social support and self-efficacy play an independent mediating role between physical activity and subjective well-being, but social support and self-efficacy played a chain mediating role between physical activity and subjective well-being. Conclusion This study enriched the theoretical guidance for physical activity in promoting college students' subjective well-being. In the practical teaching of promoting college students' subjective well-being, in addition to paying attention to stimulating physical activity, special attention should be paid to the promotion of social support and self-efficacy.
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Affiliation(s)
- Siqiang Guo
- School of Physical Education and Health, Zhaoqing University, Zhaoqing, Guangdong, China
| | - Huaying Fu
- College of Economics and Management, Zhaoqing University, Zhaoqing, Guangdong, China
| | - Kelei Guo
- School of Physical Education and Health, Zhaoqing University, Zhaoqing, Guangdong, China
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de Mello GT, Thirunavukkarasu S, Jeemon P, Thankappan KR, Oldenburg B, Cao Y. Clustering of health behaviors and their associations with cardiometabolic risk factors among adults at high risk for type 2 diabetes in India: A latent class analysis. J Diabetes 2024; 16:e13550. [PMID: 38708436 PMCID: PMC11070839 DOI: 10.1111/1753-0407.13550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 02/06/2024] [Accepted: 02/16/2024] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND We aimed to identify clusters of health behaviors and study their associations with cardiometabolic risk factors in adults at high risk for type 2 diabetes in India. METHODS Baseline data from the Kerala Diabetes Prevention Program (n = 1000; age 30-60 years) were used for this study. Information on physical activity (PA), sedentary behavior, fruit and vegetable intake, sleep, and alcohol and tobacco use was collected using questionnaires. Blood pressure, waist circumference, 2-h plasma glucose, high-density lipoprotein and low-density lipoprotein cholesterol, and triglycerides were measured using standardized protocols. Latent class analysis was used to identify clusters of health behaviors, and multilevel mixed-effects linear regression was employed to examine their associations with cardiometabolic risk factors. RESULTS Two classes were identified, with 87.4% of participants in class 1 and 12.6% in class 2. Participants in both classes had a high probability of not engaging in leisure-time PA (0.80 for class 1; 0.73 for class 2) and consuming <5 servings of fruit and vegetables per day (0.70 for class 1; 0.63 for class 2). However, participants in class 1 had a lower probability of sitting for >=3 h per day (0.26 vs 0.42), tobacco use (0.10 vs 0.75), and alcohol use (0.08 vs 1.00) compared to those in class 2. Class 1 had a significantly lower mean systolic blood pressure (β = -3.70 mm Hg, 95% confidence interval [CI] -7.05, -0.36), diastolic blood pressure (β = -2.45 mm Hg, 95% CI -4.74, -0.16), and triglycerides (β = -0.81 mg/dL, 95% CI -0.75, -0.89). CONCLUSION Implementing intervention strategies, tailored to cluster-specific health behaviors, is required for the effective prevention of cardiometabolic disorders among high-risk adults for type 2 diabetes.
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Affiliation(s)
- Gabrielli T. de Mello
- Research Center for Physical Activity and HealthFederal University of Santa CatarinaFlorianópolisSanta CatarinaBrazil
| | - Sathish Thirunavukkarasu
- Department of Family and Preventive Medicine, School of MedicineEmory UniversityAtlantaGeorgiaUSA
- Emory Global Diabetes Research Center, Woodruff Health Sciences CenterEmory UniversityAtlantaGeorgiaUSA
| | - Panniyammakal Jeemon
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and TechnologyTrivandrumIndia
| | | | - Brian Oldenburg
- Baker Heart and Diabetes InstituteMelbourneVictoriaAustralia
- School of Psychology and Public HealthLa Trobe UniversityMelbourneVictoriaAustralia
| | - Yingting Cao
- Baker Heart and Diabetes InstituteMelbourneVictoriaAustralia
- Department of Sport, Exercise and Nutrition Sciences, School of Allied Health, Human Services and SportLa Trobe UniversityMelbourneVictoriaAustralia
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23
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Bardin S, Fotheringham AS. When everyone's doing it: The relative effects of geographical context and social determinants of health on teen birth rates. Health Place 2024; 87:103249. [PMID: 38685183 DOI: 10.1016/j.healthplace.2024.103249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 04/06/2024] [Accepted: 04/09/2024] [Indexed: 05/02/2024]
Abstract
Geographic disparities in teen birth rates in the U.S. persist, despite overall reductions over the last two decades. Research suggests these disparities might be driven by spatial variations in social determinants of health (SDOH). An alternative view is that "place" or "geographical context" affects teen birth rates so that they would remain uneven across the U.S. even if all SDOH were constant. We use multiscale geographically weighted regression (MGWR) to quantify the relative effects of geographical context, independent of SDOH, on county-level teen birth rates across the U.S. Findings indicate that even if all counties had identical compositions with respect to SDOH, strong geographic disparities in teen birth rates would still persist. Additionally, local parameter estimates show the relationships between several components of SDOH and teen birth rates vary over space in both direction and magnitude, confirming that global regression techniques commonly employed to examine these relationships likely obscure meaningful contextual differences in these relationships. Findings from this analysis suggest that reducing geographic disparities in teen birth rates will require not only ameliorating differences in SDOH across counties but also combating community norms that contribute to high rates of teen birth, particularly in the southern U.S. Further, the results suggest that if geographical context is not incorporated into models of SDOH, the effects of such determinants may be interpreted incorrectly.
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Affiliation(s)
- Sarah Bardin
- Spatial Analysis Research Center, School of Geographical Sciences and Urban Planning, Arizona State University, AZ, 85281, USA.
| | - A Stewart Fotheringham
- Spatial Analysis Research Center, School of Geographical Sciences and Urban Planning, Arizona State University, AZ, 85281, USA
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24
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Green R, Mardon AK, Beaumont T, Phillips K, Chalmers KJ. The accessibility of pelvic health physiotherapy for adolescents with persistent pelvic pain: a qualitative framework analysis. Physiother Theory Pract 2024; 40:973-982. [PMID: 36345863 DOI: 10.1080/09593985.2022.2143736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 10/27/2022] [Accepted: 10/27/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Physiotherapy, with a specific focus on pelvic health, is one service used in the multidisciplinary management of adolescent persistent pelvic pain (PPP). However, there has been little investigations into the accessibility of physiotherapy for adolescents with PPP. OBJECTIVE This qualitative study aimed to detail the experiences of adolescents with PPP accessing a tertiary hospital physiotherapy service. METHODS Two focus groups included six adolescent females diagnosed with PPP that had either a) been referred and attended the physiotherapy clinic (n = 5), or b) been referred to physiotherapy but yet to attend their appointment (n = 1 plus one support person). Focus group transcripts were deductively thematically analyzed according to four domains from the patient-centered healthcare accessibility framework. RESULTS The domain of 'Approachability and ability to perceive' was impacted by limited information and poor patient health literacy. 'Acceptability and ability to seek' was hindered by adolescent mental health struggles and failures of previous PPP management. 'Availability and accommodation, and ability to reach' was influenced by lengthy referral processes, and reliance on familial support for transport. 'Acceptability and ability to engage' was facilitated by engaging clinicians and group environments, however, adolescents became dependent on physiotherapy for pain management. CONCLUSION Physical, social, and environmental factors influence the accessibility of physiotherapy for adolescents with PPP. Healthcare services should consider the specific needs of adolescents with PPP for optimizing accessibility.
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Affiliation(s)
- Rose Green
- Women's Physiotherapy, Women's and Children's Hospital, Adelaide, Australia
| | - Amelia K Mardon
- IIMPACT in Health, University of South Australia, Adelaide, Australia
| | - Tara Beaumont
- Women's Physiotherapy, Women's and Children's Hospital, Adelaide, Australia
| | - Kate Phillips
- Women's Physiotherapy, Women's and Children's Hospital, Adelaide, Australia
| | - K Jane Chalmers
- IIMPACT in Health, University of South Australia, Adelaide, Australia
- School of Health Sciences, Western Sydney University, Campbelltown, Australia
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25
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Donohoe-Bales A, O’Dean S, Smout S, Boyle J, Barrett E, Teesson M, Bower M. What set some young adults apart during the COVID-19 pandemic? Mental health trajectories, risk and protective factors in an Australian longitudinal study. Aust N Z J Psychiatry 2024; 58:435-445. [PMID: 38205782 PMCID: PMC11055410 DOI: 10.1177/00048674231223690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
OBJECTIVE Evidence suggests that young adults (aged 18-34) were disproportionately impacted by the COVID-19 pandemic, but little is known about their longer-term mental health changes beyond the early pandemic period. This article investigates heterogeneous trajectories of mental health among Australian young adults across 2 years of the pandemic and identifies a broad range of associated risk and protective factors. METHOD Young adults (N = 653, Mage = 27.8 years) from the longitudinal Alone Together Study were surveyed biannually between July 2020 and June 2022. Measures assessed anxiety (7-item Generalised Anxiety Disorder scale) and depression (9-item Patient Health Questionnaire) symptoms at Waves 1-4, as well as demographic, psychological, adversity and COVID-19 factors at baseline. RESULTS Four and three distinct trajectories of anxiety and depressive symptoms, respectively, were identified through growth mixture modelling. The proportion of participants in each anxiety trajectory were Asymptomatic (45.9%), Mild Stable (17.9%), Moderate-Severe Stable (31.1%) and Initially Severe/Recovering (5.1%). For depression, Mild Stable (58.3%), Moderate-Severe Stable (30.5%) and Reactive/Recovering (11.2%). Baseline factors associated with severe symptom trajectories included a lifetime mental health disorder, pre-pandemic stressful events, identifying as LGBTQIA+ and/or female, and experiencing one or more infection-control measures. Higher household income was protective. CONCLUSION Most young adults demonstrated stable trajectories of low or high symptoms during the pandemic, with smaller groups showing initially severe or reactive symptoms followed by marked improvements over time. Vulnerable subgroups (gender- or sexuality-diverse, those with prior adversity or pre-existing mental ill-health) may face ongoing impacts and require targeted psychosocial supports to assist their mental health recovery post-COVID-19 and in the event of future crises.
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Affiliation(s)
- Amarina Donohoe-Bales
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Siobhan O’Dean
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Scarlett Smout
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Julia Boyle
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Emma Barrett
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Marlee Bower
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
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Wunsch K, Fiedler J, Hubenschmid S, Reiterer H, Renner B, Woll A. An mHealth Intervention Promoting Physical Activity and Healthy Eating in a Family Setting (SMARTFAMILY): Randomized Controlled Trial. JMIR Mhealth Uhealth 2024; 12:e51201. [PMID: 38669071 PMCID: PMC11087865 DOI: 10.2196/51201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/27/2023] [Accepted: 02/27/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Numerous smartphone apps are targeting physical activity (PA) and healthy eating (HE), but empirical evidence on their effectiveness for the initialization and maintenance of behavior change, especially in children and adolescents, is still limited. Social settings influence individual behavior; therefore, core settings such as the family need to be considered when designing mobile health (mHealth) apps. OBJECTIVE The purpose of this study was to evaluate the effectiveness of a theory- and evidence-based mHealth intervention (called SMARTFAMILY [SF]) targeting PA and HE in a collective family-based setting. METHODS A smartphone app based on behavior change theories and techniques was developed, implemented, and evaluated with a cluster randomized controlled trial in a collective family setting. Baseline (t0) and postintervention (t1) measurements included PA (self-reported and accelerometry) and HE measurements (self-reported fruit and vegetable intake) as primary outcomes. Secondary outcomes (self-reported) were intrinsic motivation, behavior-specific self-efficacy, and the family health climate. Between t0 and t1, families of the intervention group (IG) used the SF app individually and collaboratively for 3 consecutive weeks, whereas families in the control group (CG) received no treatment. Four weeks following t1, a follow-up assessment (t2) was completed by participants, consisting of all questionnaire items to assess the stability of the intervention effects. Multilevel analyses were implemented in R (R Foundation for Statistical Computing) to acknowledge the hierarchical structure of persons (level 1) clustered in families (level 2). RESULTS Overall, 48 families (CG: n=22, 46%, with 68 participants and IG: n=26, 54%, with 88 participants) were recruited for the study. Two families (CG: n=1, 2%, with 4 participants and IG: n=1, 2%, with 4 participants) chose to drop out of the study owing to personal reasons before t0. Overall, no evidence for meaningful and statistically significant increases in PA and HE levels of the intervention were observed in our physically active study participants (all P>.30). CONCLUSIONS Despite incorporating behavior change techniques rooted in family life and psychological theories, the SF intervention did not yield significant increases in PA and HE levels among the participants. The results of the study were mainly limited by the physically active participants and the large age range of children and adolescents. Enhancing intervention effectiveness may involve incorporating health literacy, just-in-time adaptive interventions, and more advanced features in future app development. Further research is needed to better understand intervention engagement and tailor mHealth interventions to individuals for enhanced effectiveness in primary prevention efforts. TRIAL REGISTRATION German Clinical Trials Register DRKS00010415; https://drks.de/search/en/trial/DRKS00010415. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/20534.
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Affiliation(s)
- Kathrin Wunsch
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Janis Fiedler
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Sebastian Hubenschmid
- Department of Computer and Information Science, University of Konstanz, Konstanz, Germany
| | - Harald Reiterer
- Department of Computer and Information Science, University of Konstanz, Konstanz, Germany
| | - Britta Renner
- Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Alexander Woll
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
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Alsharif A, Al Habbal O, Gabadian A, El Maamoun R, Al Faraj A, Kamr Aldin T, Haitham Aldammad O, Alkayakhi A, Al Habbal A. Behavioral difficulties and associated factors among the 'lost generation' of Syrian children and adolescents. Sci Rep 2024; 14:9286. [PMID: 38654099 DOI: 10.1038/s41598-024-59784-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 04/15/2024] [Indexed: 04/25/2024] Open
Abstract
Childhood and adolescence, vital in shaping adult life and society, are profoundly impacted during conflicts like Syria's devastating war. This study explores the prevalence of behavioral disorders in Syrian children and adolescents, examining the influence of war and family-related factors. This cross-sectional study was conducted on children aged 2-17 years at a children's outpatient clinic in Damascus, Syria. We assessed parents' quality of life, war and family-related factors, and behavioral difficulties through parental interviews using two questionnaires: the Arabic version of the Strengths & Difficulties Questionnaire (SDQ) and the brief Arabic version of the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF). 74.67% of children aged 2-4 years and 61.29% of children aged 5-17 years were experiencing behavioral difficulties, with emotional difficulties being the most prevalent ones. Children exposed to kidnapping, family losses, lack of school enrollment, and those with parents having lower education, lower socioeconomic status, and poorer quality of life exhibited higher Total SDQ scores. The high prevalence of behavioral difficulties among children and adolescents in Syria is a major concern, with both direct and indirect war-related factors contributing to this issue.
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Affiliation(s)
- Aya Alsharif
- Faculty of Medicine, Damascus University, Damascus, Syria
| | | | - Aram Gabadian
- Faculty of Medicine, Damascus University, Damascus, Syria
- Eye Surgical Hospital, Damascus, Syria
| | | | - Alaa Al Faraj
- Faculty of Medicine, Damascus University, Damascus, Syria
| | | | | | | | - Aya Al Habbal
- Faculty of Medicine, Damascus University, Damascus, Syria.
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28
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Mongan D, Perry BI, Healy C, Susai SR, Zammit S, Cannon M, Cotter DR. Longitudinal Trajectories of Plasma Polyunsaturated Fatty Acids and Associations With Psychosis Spectrum Outcomes in Early Adulthood. Biol Psychiatry 2024:S0006-3223(24)01229-0. [PMID: 38631425 DOI: 10.1016/j.biopsych.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/15/2024] [Accepted: 04/07/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Evidence supports associations between polyunsaturated fatty acids such as docosahexaenoic acid (DHA) and psychosis. However, polyunsaturated fatty acid trajectories in the general population have not been characterized, and associations with psychosis spectrum outcomes in early adulthood are unknown. METHODS Plasma omega-6 to omega-3 ratio and DHA (expressed as percentage of total fatty acids) were measured by nuclear magnetic spectroscopy at 7, 15, 17, and 24 years of age in participants of ALSPAC (Avon Longitudinal Study of Parents and Children). Curvilinear growth mixture modeling evaluated body mass index-adjusted trajectories of both measures. Outcomes were assessed at 24 years. Psychotic experiences (PEs), at-risk mental state status, psychotic disorder, and number of PEs were assessed using the Psychosis-Like Symptoms interview (n = 3635; 2247 [61.8%] female). Negative symptoms score was measured using the Community Assessment of Psychic Experiences (n = 3484; 2161 [62.0%] female). Associations were adjusted for sex, ethnicity, parental social class, and cumulative smoking and alcohol use. RESULTS Relative to stable average, the persistently high omega-6 to omega-3 ratio trajectory was associated with increased odds of PEs and psychotic disorder, but attenuated on adjustment for covariates (PEs adjusted odds ratio [aOR] = 1.63, 95% CI = 0.92-2.89; psychotic disorder aOR = 1.69, 95% CI = 0.71-4.07). This was also the case for persistently low DHA (PEs aOR = 1.42, 95% CI = 0.84-2.37; psychotic disorder aOR = 1.14, 95% CI = 0.49-2.67). Following adjustment, persistently high omega-6 to omega-3 ratio was associated with increased number of PEs (β = 0.41, 95% CI = 0.05-0.78) and negative symptoms score (β = 0.43, 95% CI = 0.14-0.72), as was persistently low DHA (number of PEs β = 0.45, 95% CI = 0.14-0.76; negative symptoms β = 0.35, 95% CI = 0.12-0.58). CONCLUSIONS Optimization of polyunsaturated fatty acid status during development warrants further investigation in relation to psychotic symptoms in early adulthood.
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Affiliation(s)
- David Mongan
- Centre for Public Health, Queen's University Belfast, Northern Ireland; Department of Psychiatry, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland.
| | - Benjamin I Perry
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom; Cambridgeshire and Peterborough National Health Service Foundation Trust, Cambridge, United Kingdom
| | - Colm Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
| | - Subash Raj Susai
- Department of Psychiatry, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
| | - Stan Zammit
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; Division of Psychological Medicine and Clinical Neurosciences, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, United Kingdom
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland; FutureNeuro Science Foundation Ireland Research Centre, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
| | - David R Cotter
- Department of Psychiatry, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland; FutureNeuro Science Foundation Ireland Research Centre, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
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29
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O'Donnell L, Green JJ, Hill EC, O'Donnell MJ. Biocultural and social determinants of ill health and early mortality in a New Mexican paediatric autopsy sample. J Biosoc Sci 2024:1-22. [PMID: 38618934 DOI: 10.1017/s0021932024000129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
RESULTS. Hispanic children have higher odds of growth stunting than non-Hispanic White children. Native American children die younger and have higher odds of respiratory diseases and porous lesions than Hispanic and non-Hispanic Whites. Rural/urban location does not significantly impact age at death, but housing type does. Individuals who lived in trailers/mobile homes had earlier ages at death. When intersections between housing type and housing location are considered, children who were poor and from impoverished areas lived longer than those who were poor from relatively well-off areas. CONCLUSIONS. Children's health is shaped by factors outside their control. The children included in this study embodied experiences of social and ELS and did not survive to adulthood. They provide the most sobering example of the harm that social factors (structural racism/discrimination, socioeconomic, and political structures) can inflict.
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Affiliation(s)
- Lexi O'Donnell
- College of Population Health, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
- Department of Anthropology, University of New Mexico, Albuquerque, NM, USA
| | - John J Green
- Southern Rural Development Center and Department of Agricultural Economics, Mississippi State University, Starkville, USA
| | - Ethan C Hill
- Division of Physical Therapy, Department of Orthopaedics and Rehabilitation, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Michael J O'Donnell
- Bureau of Business and Economic Research, University of New Mexico, Albuquerque, NM, USA
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30
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Arellano Spano M, Morris TT, Davies NM, Hughes A. Genetic associations of risk behaviours and educational achievement. Commun Biol 2024; 7:435. [PMID: 38600303 PMCID: PMC11006670 DOI: 10.1038/s42003-024-06091-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/22/2024] [Indexed: 04/12/2024] Open
Abstract
Risk behaviours are common in adolescent and persist into adulthood, people who engage in more risk behaviours are more likely to have lower educational attainment. We applied genetic causal inference methods to explore the causal relationship between adolescent risk behaviours and educational achievement. Risk behaviours were phenotypically associated with educational achievement at age 16 after adjusting for confounders (-0.11, 95%CI: -0.11, -0.09). Genomic-based restricted maximum likelihood (GREML) results indicated that both traits were heritable and have a shared genetic architecture (Riskh 2 = 0.18, 95% CI: -0.11,0.47; educationh 2 = 0.60, 95%CI: 0.50,0.70). Consistent with the phenotypic results, genetic variation associated with risk behaviour was negatively associated with education (r g = -0.51, 95%CI: -1.04,0.02). Lastly, the bidirectional MR results indicate that educational achievement or a closely related trait is likely to affect risk behaviours PGI (β=-1.04, 95% CI: -1.41, -0.67), but we found little evidence that the genetic variation associated with risk behaviours affected educational achievement (β=0.00, 95% CI: -0.24,0.24). The results suggest engagement in risk behaviour may be partly driven by educational achievement or a closely related trait.
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Affiliation(s)
- Michelle Arellano Spano
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, BS8 2BN, United Kingdom.
- Population Health Sciences, Bristol Medical School, University of Bristol, Barley House, Oakfield Grove, Bristol, BS8 2BN, United Kingdom.
| | - Tim T Morris
- Centre for Longitudinal Studies, Social Research Institute, University College London, London, United Kingdom
| | - Neil M Davies
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Rd, London, W1T 7NF, United Kingdom
- Department of Statistical Sciences, University College London, London, WC1E 6BT, United Kingdom
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology, 7491, Trondheim, Norway
| | - Amanda Hughes
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, BS8 2BN, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Barley House, Oakfield Grove, Bristol, BS8 2BN, United Kingdom
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31
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Nuss T, Chen YJM, Scully M, Hickey K, Martin J, Morley B. Australian adults' attitudes towards government actions to protect children from digital marketing of unhealthy food and drink products. Health Promot J Austr 2024; 35:332-339. [PMID: 37286359 DOI: 10.1002/hpja.755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 06/09/2023] Open
Abstract
ISSUE ADDRESSED This study assessed Australian adults' attitudes towards government actions to protect children from digital marketing of unhealthy food and drink products. METHODS An online survey was undertaken by Australian adults aged 18-64 recruited via two national panels in December 2019 (N = 2044). RESULTS Most respondents (69%) agreed the Government should protect children from unhealthy food and drink marketing and advertising broadly. Those who agreed most commonly indicated children should be protected up to age 16 (34%) or 18 (24%). There was widespread support for government actions to stop unhealthy food and drink marketing on digital platforms (e.g., internet sites) (68%-69%) and various digital marketing techniques (e.g., advertising by brands on social media) (56%-71%). A total ban on targeting unhealthy food and drink marketing to children online received the highest level of support (76%). Most respondents (81%) disagreed unhealthy food and drink companies should be able to collect children's personal information for marketing purposes. Support for examined actions was generally higher among older adults, more educated adults and more frequent internet users, lower among males, and similar between parents and non-parents. CONCLUSIONS There is public perception that the government is responsible for protecting children, well into adolescence, from unhealthy food and drink marketing broadly. Widespread public support extends to specific actions to reduce children's exposure to digital marketing of unhealthy food and drink products. SO WHAT?: Implementation of policies to protect children from digital marketing of unhealthy food and drink products would be well received by the Australian public.
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Affiliation(s)
- Tegan Nuss
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Victoria, Australia
| | - Yan Jun Michelle Chen
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Victoria, Australia
| | - Maree Scully
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Victoria, Australia
| | | | - Jane Martin
- Food For Health Alliance, Victoria, Australia
| | - Belinda Morley
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Victoria, Australia
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32
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Tillmann TFF, de Camargo MBJ, Cascaes AM, Barros AJD, Santos IS, Corrêa MB, Matijasevich A, D'Ávila OP, Silva AER. Perception of parents and caregivers about the need for dental appointments for adolescents from a Brazilian birth cohort. Community Dent Oral Epidemiol 2024; 52:217-223. [PMID: 37861237 DOI: 10.1111/cdoe.12915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 09/01/2023] [Accepted: 09/25/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVE To investigate the perception of parents or caregivers regarding the need for dental appointments for adolescents aged 12-13 years and associated factors. METHODS Data from the Pelotas 2004 Birth Cohort were used. The outcome variable was the need for dental appointments for young adolescents perceived by parents or caregivers. Demographic and economic exposure variables were obtained from the first (2004) and sixth general follow-up (2015), respectively. The exposure variables 'previous history of dental pain', 'self-rated oral health', clinical variables and the outcome variable were obtained from the second oral health follow-up (2017). Unadjusted and adjusted multivariate Poisson regression analyses provided prevalence ratios (PR) and respective 95% confidence intervals (CI). RESULTS At the first oral health follow-up (2009), 1303 five-year-old children were recruited, 996 of whom were reassessed and underwent oral health examinations at 12 and 13 years of age (response rate: 76.4%). The findings showed that 72.4% of parents/caregivers perceived that the adolescents needed dental appointments. No associations were found between the outcome and sociodemographic or economic variables. After adjustments, the outcome remained positively associated with previous history of toothache (PR 1.22; 95% CI 1.14-1.32), self-rated oral health as fair or poor (PR 1.26; 95% CI 1.15-1.39), the presence of dental caries (PR 1.27; 95% CI 1.20-1.38) and severe or disabling malocclusion (PR 1.14; 95% CI 1.05-1.25). CONCLUSIONS The perception of parents/caregivers regarding the need for dental appointments on the part of their adolescent sons and daughters was associated with oral health problems, and these findings can serve as the basis for creating and improving oral health programmes that seek a better understanding on the part of parents and caregivers regarding the importance of integral care for their adolescent children.
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Affiliation(s)
| | | | | | - Aluísio J D Barros
- Postgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Iná S Santos
- Postgraduate Programme in Epidemiology, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Marcos Britto Corrêa
- Postgraduate Programme in Dentistry, School of Dentistry, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Department of Preventive Medicine, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Otávio Pereira D'Ávila
- Postgraduate Programme in Dentistry, School of Dentistry, Universidade Federal de Pelotas, Pelotas, Brazil
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Hernandez MI, Miller EC, Biese KM, Columna L, Andreae S, McGuine TA, Snedden TR, Eberman LE, Bell DR. Secondary School Athletic Trainers' Perceptions of the Influence of Social Determinants of Health and Socioeconomic Status on Clinical Management Decisions. J Athl Train 2024; 59:388-393. [PMID: 37459372 PMCID: PMC11064109 DOI: 10.4085/1062-6050-0445.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
CONTEXT Evidence suggests that lower socioeconomic status (SES) and negative social determinants of health (SDOH) contribute to health care disparities. Due to their accessibility in the high school setting, secondary school athletic trainers (SSATs) may encounter patients who are historically underserved in health care, such as patients with low SES. However, a significant gap in knowledge exists regarding how SDOH and SES may influence SSATs' clinical management decisions. OBJECTIVES To describe SSATs' perceptions of how patient SDOH and SES influence clinical management decisions and to identify barriers to athletic health care. DESIGN Cross-sectional study. SETTING Online survey. PARTICIPANTS OR OTHER PARTICIPANTS National Athletic Trainers' Association SSATs (6.7% response rate). MAIN OUTCOME MEASURE(S) Secondary school athletic trainers were asked about their perceptions of patient SDOH and SES (content validity index = 0.83 for relevancy). The levels of relevance and agreement were answered on a 4-point Likert scale. Data were summarized using means and SDs, frequencies and proportions (%), and median scores. RESULTS A total of 380 SSATs participated (mean years of experience = 14.9 ± 11.7 years). When providing care, most (71.3%) SSATs believed their patients' health or health care access to be the most relevant of the 5 SDOH, whereas the other 4 SDOH were less than 60% relevant. Most SSATs agreed or strongly agreed that patient SES affected both referral (67.4%) and the reliance on conservative treatment before referral (71.2%). Secondary school athletic trainers identified patient or guardian compliance (70.2%) and type of health insurance (61.5%) as barriers to providing care to patients with low SES. CONCLUSIONS Secondary school athletic trainers perceived health or health care access as the most relevant social determinant when providing care to patients with low SES. When SSATs further considered the SES of patients, they identified all SDOH as barriers that they were ill equipped to navigate as they delivered care and engaged in patient referral.
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Affiliation(s)
| | | | - Kevin M Biese
- Kinesiology and Athletic Training, University of Wisconsin-Oshkosh
| | - Luis Columna
- Department of Kinesiology, University of Wisconsin-Madison
| | - Susan Andreae
- Department of Kinesiology, University of Wisconsin-Madison
| | - Timothy A McGuine
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison
| | | | - Lindsey E Eberman
- Neuromechanics, Interventions, and Continuing Education Research (NICER) Laboratory, Indiana State University, Terre Haute
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Cristi-Montero C, Johansen-Berg H, Salvan P. Multimodal neuroimaging correlates of physical-cognitive covariation in Chilean adolescents. The Cogni-Action Project. Dev Cogn Neurosci 2024; 66:101345. [PMID: 38277711 PMCID: PMC10832367 DOI: 10.1016/j.dcn.2024.101345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 10/19/2023] [Accepted: 01/13/2024] [Indexed: 01/28/2024] Open
Abstract
Health-related behaviours have been related to brain structural features. In developing settings, such as Latin America, high social inequality has been inversely associated with several health-related behaviours affecting brain development. Understanding the relationship between health behaviours and brain structure in such settings is particularly important during adolescence when critical habits are acquired and ingrained. In this cross-sectional study, we carry out a multimodal analysis identifying a brain region associated with health-related behaviours (i.e., adiposity, fitness, sleep problems and others) and cognitive/academic performance, independent of socioeconomic status in a large sample of Chilean adolescents. Our findings suggest that the relationship between health behaviours and cognitive/academic performance involves a particular brain phenotype that could play a mediator role. These findings fill a significant gap in the literature, which has largely focused on developed countries and raise the possibility of promoting healthy behaviours in adolescence as a means to influence brain structure and thereby cognitive/academic achievement, independently of socioeconomic factors. By highlighting the potential impact on brain structure and cognitive/academic achievement, policymakers could design interventions that are more effective in reducing health disparities in developing countries.
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Affiliation(s)
- Carlos Cristi-Montero
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom; IRyS Group, Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso 2340025, Chile.
| | - Heidi Johansen-Berg
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom
| | - Piergiorgio Salvan
- Wellcome Centre for Integrative Neuroimaging, FMRIB Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, United Kingdom
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Rivera MJ, Post EG, Eberman LE. The Social Determinants of Health and Athletic Trainer Availability in Indiana Secondary Schools. J Athl Train 2024; 59:381-387. [PMID: 37655802 PMCID: PMC11064117 DOI: 10.4085/1062-6050-0737.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
CONTEXT The social determinants of health (SDOH) are circumstances under which individuals are born, work, and live that influence health outcomes. Previous researchers have examined 1 determinant of economic stability and found disparities in socioeconomic status and athletic trainer (AT) availability. OBJECTIVE To examine the SDOH characteristics of Indiana secondary schools and AT availability. DESIGN Cross-sectional study. SETTING Database secondary analysis. PATIENTS OR OTHER PARTICIPANTS A total of 426 secondary schools. MAIN OUTCOME MEASURE(S) All data were collected from publicly available databases. The independent variable was AT availability, and schools were classified as having a full-time AT, a part-time AT only, or no AT. The SDOH variables were gathered for each school (at the school and county levels). Data were summarized using measures of central tendencies, 1-way analysis of variance, and Kruskal-Wallis tests. RESULTS School enrollment was larger in schools with greater AT availability (P< .001). The proportion of non-White students was greater in schools with more AT availability (P= .002). Greater AT availability was present in counties with higher graduation rates (P= .03). Post hoc comparisons revealed differences in graduation rates between schools with a part-time AT and those with no AT (P= .04). Schools with less AT availability were located in counties with a slightly higher percentage of the population uninsured (P= .02). Schools with greater AT availability were located in counties with a higher ratio of population to primary care physicians (P= .03). Schools with less AT availability were located in counties with a higher population experiencing severe housing problems (P= .02). No differences were found in AT availability based on the 3 social and community context variables (P> .05). CONCLUSIONS Differences were noted in AT availability and SDOH characteristics at the secondary school level. We observed less AT availability where high school graduation rates and the population of primary care providers were lower. Strategies should be implemented to improve access to athletic health care in underresourced communities.
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Schulz JA, Gimm G, West JC, Kock L, Villanti AC. Patterns of Alcohol, Marijuana, and Tobacco Use Among U.S. Adolescents and Young Adults by Disability Status: 2015-2019. J Adolesc Health 2024; 74:764-773. [PMID: 38043040 PMCID: PMC10960707 DOI: 10.1016/j.jadohealth.2023.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 07/28/2023] [Accepted: 09/12/2023] [Indexed: 12/04/2023]
Abstract
PURPOSE To estimate the national prevalence of tobacco, marijuana, and alcohol use among U.S. adolescents (age 12-17) and young adults (aged 18-25; adolescents and young adults [AYAs]) with a disability and examine associations between disability and substance use from 2015 to 2019. METHODS Data from the 2015-2019 National Survey on Drug Use and Health were used to estimate the prevalence of tobacco, marijuana, and alcohol use among AYAs with disabilities. Modified Poisson regression models evaluated linear time trends in past-month substance use and estimated adjusted prevalence ratios (aPRs) for past-month cigarette, any tobacco, alcohol, and marijuana use. RESULTS Adolescents with any disability had a higher prevalence of past-month cigarette (aPR = 1.87; 95% CI 1.67-2.09), alcohol (aPR = 1.21; 95% CI 1.11-1.31), and marijuana use (aPR = 1.47; 95% CI 1.36-1.60) compared to those without disabilities. Cigarette smoking among adolescents decreased over this time period; however, the decline among adolescents without a disability was greater than those with any disability. Young adults with any disability had a higher prevalence of past-month cigarette (aPR = 1.42; 95% CI 1.35-1.48) and marijuana use (aPR = 1.39; 95% CI 1.34-1.45), but a lower prevalence of past-month alcohol use (aPR = 0.93; 95% CI 0.90-0.95) than those without disabilities. Alcohol use remained constant among young adults with any disability but decreased for those without disabilities. DISCUSSION Population-level disparities in cigarette and marijuana use exist in AYAs with disabilities. Future studies should identify strategies tailored to AYAs with disabilities to encourage smoking cessation and prevent cannabis use disorder.
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Affiliation(s)
- Jonathan A Schulz
- Department of Psychiatry, Vermont Center on Behavior and Health, University of Vermont, Burlington, Vermont.
| | - Gilbert Gimm
- Department of Health Administration and Policy, George Mason University, Fairfax, Virginia
| | - Julia C West
- Department of Psychiatry, Vermont Center on Behavior and Health, University of Vermont, Burlington, Vermont; Department of Psychological Science, University of Vermont, Burlington, Vermont
| | - Loren Kock
- Department of Psychiatry, Vermont Center on Behavior and Health, University of Vermont, Burlington, Vermont
| | - Andrea C Villanti
- Rutgers Institute for Nicotine & Tobacco Studies, New Brunswick, New Jersey; Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, Piscataway, New Jersey
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Shramko M, Lucke C, Piescher K. Patterns of Social Determinants of Health and Publicly-Funded Service Access among Children Involved in Educational, Child Welfare, and Social Service Systems. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:521-531. [PMID: 38224389 DOI: 10.1007/s11121-023-01638-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2023] [Indexed: 01/16/2024]
Abstract
Social determinants of health (SDOH)-conditions in which children live, learn, and play-affect child health and well-being. Publicly funded services in education and child welfare systems are important resources to support child well-being, but cross-system coordination is rare. Leveraging integrated administrative data from 60,287 6th graders enrolled in public schools in Minnesota, we used latent class analysis (LCA) to examine patterns of cross-system SDOH, including educational services and involvement in child welfare. Five classes emerged. The largest class was characterized by a few multi-system SDOH and had low service needs. Two classes had differing patterns of school service use, one with a greater likelihood of special education service use alone and the other characterized by the use of multiple school services. Two classes were characterized by cross-system SDOH/service use (e.g., homelessness, child protection, placement in care, mental health, and special education services). We then assessed whether race/ethnicity predicted class membership and tested educational distal outcomes. American Indian, Black, and Latinx children had higher odds of exposure to both cross-system SDOH classes. Students facing any SDOH, particularly those with greater multi-system SDOH exposure, had worse attendance and academic achievement. Our study indicates that children are navigating complex experiences of SDOH and service needs, with a disproportional likelihood that Black children, Indigenous children, and other children of color (BIPOC) experience SDOH. Identifying patterns of SDOH provides an opportunity for policymakers and practitioners to intervene to promote health equity. By understanding facilitators and barriers to child well-being, the results inform how child-serving systems can strive toward health equity.
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Affiliation(s)
- Maura Shramko
- Center for Advanced Studies in Child Welfare, University of Minnesota, Minneapolis, MN, 55455, USA.
- American Institutes for Research, 10 S. Riverside Plaza, 6th Floor, Chicago, IL, 60606, USA.
| | - Cara Lucke
- Institute of Child Development, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Kristine Piescher
- Center for Advanced Studies in Child Welfare, University of Minnesota, Minneapolis, MN, 55455, USA
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Lovan P, Lozano A, Estrada Y, Lebron C, Lee TK, Messiah SE, Prado G. The Role of Intervention Fidelity, Culture, and Individual-Level Factors on Health-Related Outcomes Among Hispanic Adolescents with Unhealthy Weight: Findings from a Longitudinal Intervention Trial. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:85-95. [PMID: 37071322 PMCID: PMC11133134 DOI: 10.1007/s11121-023-01527-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2023] [Indexed: 04/19/2023]
Abstract
Previous studies have suggested the impact of intervention fidelity on the management and prevention of chronic diseases; however, little is known about the effect of the contributing determinants (at multiple levels of influence) that can impact health-related interventions intending to improve the health status of Hispanic adolescents with overweight or obesity. The current study aimed to assess whether fidelity (i.e., dosage and quality of the program delivery), acculturation (i.e., orientation to the American culture, retention of Hispanic cultural values), and individual-level socio-demographic characteristics (i.e., income, education) predict changes in family processes (e.g., parent control), which in turn may affect adolescent health-related outcomes including body mass index (BMI), physical activity, dietary intake, and adolescents' health-related quality of life. A pathway analysis model was utilized to explore the study variables among 140 Hispanic parent-adolescent dyads randomized to Familias Unidas Health and Wellness (FUHW) intervention. Results indicated that fidelity was significantly associated with changes in parent-adolescent communication, parent monitoring, limit-setting, and control. Parents' education was associated with changes in parent limit-setting, and parent Hispanicism was associated with changes in parent limit-setting and discipline. The examination between family processes and adolescent health outcomes revealed that parents' higher discipline and improved communication with their adolescents were significantly associated with improved adolescents' quality of life, and parent control was positively associated with physical activity and negatively associated with BMI in adolescents. Our findings demonstrated the significant contribution of intervention fidelity and participants' characteristics in parenting strategies leading to adolescents' health outcomes to prevent obesity-related chronic diseases. Future research is needed to investigate the effect of environmental and organizational factors on the delivery of the intervention materials.
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Affiliation(s)
- Padideh Lovan
- Department of Psychology, University of Miami, Miami, FL, USA.
- Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL, USA.
| | - Alyssa Lozano
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Yannine Estrada
- School of Nursing and Health Studies, University of Miami, Miami, FL, USA
| | - Cynthia Lebron
- School of Nursing and Health Studies, University of Miami, Miami, FL, USA
| | - Tae Kyoung Lee
- Department of Child Psychology and Education, Sungkyunkwan University, Seoul, South Korea
| | - Sarah E Messiah
- Department of Epidemiology, Human Genetics and Environmental Science, The University of Texas Health Science Center at Houston, School of Public Health, Dallas, TX, USA
- Center for Pediatric Population Health, University of Texas Health Science Center, School of Public Health, Dallas, TX, USA
- Department of Pediatrics, McGovern Medical School, Houston, TX, USA
| | - Guillermo Prado
- School of Nursing and Health Studies, University of Miami, Miami, FL, USA
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Jystad I, Haugan T, Bjerkeset O, Sund ER, Aune T, Nordahl HM, Vaag JR. School completion and progression to higher education in adolescents with social anxiety: a linkage between Young-HUNT3 and national educational data (2008-2019), Norway. BMC Public Health 2024; 24:833. [PMID: 38500113 PMCID: PMC10946117 DOI: 10.1186/s12889-024-18271-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/04/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Social anxiety disorder (SAD) most commonly develops in adolescence-a period of life that includes a transition to upper secondary school. The aim of this study is to investigate the extent to which social anxiety in adolescence is associated with the completion of upper secondary school and progression to higher education. METHODS This longitudinal study includes 8,192 adolescents aged 13-19 years who participated in the Norwegian Young-HUNT 3 population-based study. Social anxiety is measured employing (1) diagnostic interview screening questions (interview) and (2) a self-reported symptom index (questionnaire). Notably, we define the cohorts based on these two methods. Using national educational data (2008-2019), we follow educational attainment among the cohorts until they turn 25 years of age. RESULTS We found that adolescents who screened positive (SP) for SAD had a predicted probability of upper secondary school completion at 21 years of age that was 14% points lower than those who screened negative (SN). Further, differences remained when looking at completion rates at age 25 years. Moreover, predicted probabilities for completion were inversely associated with increasing levels of self-reported social anxiety symptoms. Similarly, the proportion of the completers of an academic program in the SP group that were enrolled in higher education by 25 years of age, were lower than for the SN group (87 vs. 92%). CONCLUSION Social anxiety in adolescence, both self-reported symptoms and diagnostic screening, has long-term negative impact on upper secondary school completion and to some extent enrollment to higher education.
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Affiliation(s)
- Ingunn Jystad
- Faculty of Nursing and Health Science, Nord University, 7601, Levanger, Postbox 93, Norway.
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Tommy Haugan
- Faculty of Nursing and Health Science, Nord University, 7601, Levanger, Postbox 93, Norway
| | - Ottar Bjerkeset
- Faculty of Nursing and Health Science, Nord University, 7601, Levanger, Postbox 93, Norway
| | - Erik R Sund
- Faculty of Nursing and Health Science, Nord University, 7601, Levanger, Postbox 93, Norway
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Levanger Hospital, Nord Trøndelag Hospital Trust, Levanger, Norway
| | - Tore Aune
- The Norwegian Directorate for Children, Youth, and Family Affairs, Bufetat, Norway
| | - Hans M Nordahl
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jonas R Vaag
- Department of Psychology, Inland Norway University of Applied Sciences, Lillehammer, Norway
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Hornberger SR, Zhang Y, Zhang N, Giambra BK. Association between parental education level & outcomes for children with long-term ventilator dependence: Communication behaviors as moderating variables. J Pediatr Nurs 2024; 75:205-212. [PMID: 38194763 DOI: 10.1016/j.pedn.2023.12.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 12/27/2023] [Accepted: 12/27/2023] [Indexed: 01/11/2024]
Abstract
PURPOSE The purpose of this study was to examine the correlation between parental education level and outcomes for children with long-term ventilator dependence (LTVD) and their families and whether parent communication behaviors with hospital nurses moderated the relationship. Advances in medical technology and policy changes allow children with LTVD to be cared for at home. The child's diagnosis and disease severity affect their health outcomes, as do their family's social determinants of health (SDoH) such as parent education. DESIGN AND METHODS This secondary data analysis used chi-square tests to evaluate the correlation between parental education level and outcomes. Generalized linear mixed effect models were used to examine the moderation effect of parent communication behaviors. RESULTS Lower parental education level was associated with more child respiratory infections and more parental uncertainty within one month following hospital discharge. Lower parent education level was also associated with fewer unplanned contacts with providers within one week post-discharge. Additionally, parent use of Verifying Understanding communication behaviors moderated the relationship between parental education level and number of respiratory infections and amount of parental uncertainty. Finally, parent use of Negotiating Roles moderated the association between education level and number of unplanned visits. CONCLUSIONS Contradicting previous research, lower parental education level does not consistently correspond to adverse outcomes and may be explained by parents' determination to ensure optimal outcomes for their children with LTVD. PRACTICE IMPLICATIONS Overall, healthcare providers should not be concerned that children with LTVD will have different outcomes based on their parents' education level.
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Affiliation(s)
- Sydney R Hornberger
- Indiana University School of Medicine: West Lafayette Campus, 715 Clinic Dr, West Lafayette, IN 47907, United States; Cincinnati Children's Hospital Medical Center: Division of Research in Patient Services, 3333 Burnet Ave, Cincinnati, OH 45229, United States.
| | - Yin Zhang
- Cincinnati Children's Hospital Medical Center: Division of Biostatistics and Epidemiology, 3333 Burnet Ave, Cincinnati, OH 45229, United States
| | - Nanhua Zhang
- Cincinnati Children's Hospital Medical Center: Division of Biostatistics and Epidemiology, 3333 Burnet Ave, Cincinnati, OH 45229, United States; University of Cincinnati College of Medicine: Department of Pediatrics, 3230 Eden Ave, Cincinnati, OH 45267, United States
| | - Barbara K Giambra
- Cincinnati Children's Hospital Medical Center: Division of Research in Patient Services, 3333 Burnet Ave, Cincinnati, OH 45229, United States; Cincinnati Children's Hospital Medical Center: Department of Pediatrics, 3333 Burnet Ave, Cincinnati, OH 45229, United States; University of Cincinnati College of Nursing, 3110 Vine St, Cincinnati, OH 45221, United States
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Bhardwaj G, Riadi Y, Afzal M, Bansal P, Kaur H, Deorari M, Tonk RK, Almalki WH, Kazmi I, Alzarea SI, Kukreti N, Thangavelu L, Saleem S. The hidden threat: Environmental toxins and their effects on gut microbiota. Pathol Res Pract 2024; 255:155173. [PMID: 38364649 DOI: 10.1016/j.prp.2024.155173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/18/2024]
Abstract
The human gut microbiota (GM), which consists of a complex and diverse ecosystem of bacteria, plays a vital role in overall wellness. However, the delicate balance of this intricate system is being compromised by the widespread presence of environmental toxins. The intricate connection between contaminants in the environment and human well-being has garnered significant attention in recent times. Although many environmental pollutants and their toxicity have been identified and studied in laboratory settings and animal models, there is insufficient data concerning their relevance to human physiology. Consequently, research on the toxicity of environmental toxins in GM has gained prominence in recent years. Various factors, such as air pollution, chemicals, heavy metals, and pesticides, have a detrimental impact on the composition and functioning of the GM. This comprehensive review aims to comprehend the toxic effects of numerous environmental pollutants, including antibiotics, endocrine-disrupting chemicals, heavy metals, and pesticides, on GM by examining recent research findings. The current analysis concludes that different types of environmental toxins can lead to GM dysbiosis and have various potential adverse effects on the well-being of animals. We investigate the alterations to the GM composition induced by contaminants and their impact on overall well-being, providing a fresh perspective on research related to pollutant exposure.
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Affiliation(s)
- Gautam Bhardwaj
- Department of Pharmaceutical Chemistry, School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences and Research University, Pushp Vihar sector-3, M-B Road, New Delhi 110017, India
| | - Yassine Riadi
- Department of Pharmaceutical Chemistry, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al Kharj 11942, Saudi Arabia
| | - Muhammad Afzal
- Department of Pharmaceutical Sciences, Pharmacy Program, Batterjee Medical College, P.O. Box 6231, Jeddah 21442, Saudi Arabia
| | - Pooja Bansal
- Department of Biotechnology and Genetics, Jain (Deemed-to-be) University, Bengaluru, Karnataka 560069, India; Department of Allied Healthcare and Sciences, Vivekananda Global University, Jaipur, Rajasthan 303012, India
| | - Harpreet Kaur
- School of Basic & Applied Sciences, Shobhit University, Gangoh, Uttar Pradesh 247341, India; Department of Health & Allied Sciences, Arka Jain University, Jamshedpur, Jharkhand 831001, India
| | - Mahamedha Deorari
- Uttaranchal Institute of Pharmaceutical Sciences, Uttaranchal University, Dehradun, India
| | - Rajiv Kumar Tonk
- Department of Pharmaceutical Chemistry, School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences and Research University, Pushp Vihar sector-3, M-B Road, New Delhi 110017, India.
| | - Waleed Hassan Almalki
- Department of Pharmacology, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Imran Kazmi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, 21589 Jeddah, Saudi Arabia
| | - Sami I Alzarea
- Department of Pharmacology, College of Pharmacy, Jouf University, 72341 Sakaka, Aljouf, Saudi Arabia
| | - Neelima Kukreti
- School of Pharmacy, Graphic Era Hill University, Dehradun 248007, India
| | - Lakshmi Thangavelu
- Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Shakir Saleem
- Department of Public Health. College of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia.
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Swendeman D, Rotheram-Borus MJ, Arnold EM, Fernández MI, Comulada WS, Lee SJ, Ocasio MA, Ishimoto K, Gertsch W, Duan N, Reback CJ, Murphy DA, Lewis KA. Optimal strategies to improve uptake of and adherence to HIV prevention among young people at risk for HIV acquisition in the USA (ATN 149): a randomised, controlled, factorial trial. Lancet Digit Health 2024; 6:e187-e200. [PMID: 38395539 DOI: 10.1016/s2589-7500(23)00252-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 09/22/2023] [Accepted: 12/05/2023] [Indexed: 02/25/2024]
Abstract
BACKGROUND Pre-exposure prophylaxis (PrEP), condom use, post-exposure prophylaxis (PEP), and sexual partner reduction help to prevent HIV acquisition but have low uptake among young people. We aimed to assess the efficacy of automated text messaging and monitoring, online peer support, and strengths-based telehealth coaching to improve uptake of and adherence to PrEP, condom use, and PEP among adolescents aged 12-24 years at risk of HIV acquisition in Los Angeles, CA, USA, and New Orleans, LA, USA. METHODS We conducted a four-arm randomised controlled factorial trial, assessing interventions designed to support uptake and adherence of HIV prevention options (ie, PrEP, PEP, condom use, and sexual partner reduction). We recruited young people aged 12-24 years who were at risk of HIV acquisition from 13 community-based organisations, adolescent medicine clinics, and organisations serving people who are unstably housed, people who were previously incarcerated, and other vulnerable young people, and through dating apps, peer referrals, and social venues and events in Los Angeles, CA, USA, and New Orleans, LA, USA. Young people who tested seronegative and reported being gay, bisexual, or other men who have sex with men, transgender men or women, or gender diverse (eg. non-binary or genderqueer) were eligible for inclusion. Participants were randomly assigned to one of four intervention groups in a factorial design: automated text messaging and monitoring (AMMI) only, AMMI plus peer support via private social media, AMMI plus strengths-based telehealth coaching by near-peer paraprofessionals, or AMMI plus peer support and coaching. Assignment was further stratified by race or ethnicity and sexual orientation within each interviewer's group of participants. Participants were masked to intervention assignment until after baseline interviews when offered their randomly assigned intervention, and interviewers were masked throughout the study. Interventions were available throughout the 24-month follow-up period, and participants completed baseline and follow-up assessments, including rapid diagnostic tests for sexually transmitted infections, HIV, and substance use, at 4-month intervals over 24 months. The primary outcomes were uptake and adherence to HIV prevention options over 24 months, measured by self-reported PrEP use and adherence, consistent condom use with all partners, PEP prescription and adherence, and number of sexual partners in participants with at least one follow-up. We used Bayesian generalised linear modelling to assess changes in outcomes over time comparing the four study groups. This study is registered with ClinicalTrials.gov (NCT03134833) and is completed. FINDINGS We screened 2314 adolescents beginning May 1, 2017, to enrol 1037 participants (45%) aged 16-24 years between May 6, 2017, and Aug 30, 2019, of whom 895 (86%) had follow-up assessments and were included in the analytical sample (313 assigned to AMMI only, 205 assigned to AMMI plus peer support, 196 assigned to AMMI plus coaching, and 181 assigned to AMMI plus peer support and coaching). Follow-up was completed on Nov 8, 2021. Participants were diverse in race and ethnicity (362 [40%] Black or African American, 257 [29%] Latinx or Hispanic, 184 [21%] White, and 53 [6%] Asian or Pacific Islander) and other sociodemographic factors. At baseline, 591 (66%) participants reported anal sex without a condom in the past 12 months. PrEP use matched that in young people nationally, with 101 (11%) participants reporting current PrEP use at baseline, increasing at 4 months to 132 (15%) and continuing to increase in the AMMI plus peer support and coaching group (odds ratio 2·31, 95% CI 1·28-4·14 vs AMMI control). There was no evidence for intervention effect on condom use, PEP use (ie, prescription or adherence), PrEP adherence, or sexual partner numbers. No unanticipated or study-related adverse events occurred. INTERPRETATION Results are consistent with hypothesised synergistic intervention effects of evidence-based functions of informational, motivational, and reminder messaging; peer support for HIV prevention; and strengths-based, goal-focused, and problem-solving telehealth coaching delivered by near-peer paraprofessionals. These core functions could be flexibly scaled via combinations of technology platforms and front-line or telehealth HIV prevention workers. FUNDING Adolescent Medicine Trials Network for HIV/AIDS Interventions, US National Institutes of Health.
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Affiliation(s)
- Dallas Swendeman
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA.
| | - Mary Jane Rotheram-Borus
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | | | | | - Walter Scott Comulada
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Sung-Jae Lee
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Manuel A Ocasio
- Department of Pediatrics, Tulane University School of Medicine, New Orleans, LA, USA
| | - Kelsey Ishimoto
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - William Gertsch
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Naihua Duan
- Division of Mental Health Data Science, Department of Psychiatry, Columbia University, New York, NY, USA
| | | | - Debra A Murphy
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Katherine A Lewis
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
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Veenman M, Janssen LHC, van Houtum LAEM, Wever MCM, Verkuil B, Epskamp S, Fried EI, Elzinga BM. A Network Study of Family Affect Systems in Daily Life. MULTIVARIATE BEHAVIORAL RESEARCH 2024; 59:371-405. [PMID: 38356299 DOI: 10.1080/00273171.2023.2283632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
Adolescence is a time period characterized by extremes in affect and increasing prevalence of mental health problems. Prior studies have illustrated how affect states of adolescents are related to interactions with parents. However, it remains unclear how affect states among family triads, that is adolescents and their parents, are related in daily life. This study investigated affect state dynamics (happy, sad, relaxed, and irritated) of 60 family triads, including 60 adolescents (Mage = 15.92, 63.3% females), fathers and mothers (Mage = 49.16). The families participated in the RE-PAIR study, where they reported their affect states in four ecological momentary assessments per day for 14 days. First, we used multilevel vector-autoregressive network models to estimate affect dynamics across all families, and for each family individually. Resulting models elucidated how family affect states were related at the same moment, and over time. We identified relations from parents to adolescents and vice versa, while considering family variation in these relations. Second, we evaluated the statistical performance of the network model via a simulation study, varying the percentage missing data, the number of families, and the number of time points. We conclude with substantive and statistical recommendations for future research on family affect dynamics.
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Affiliation(s)
- Myrthe Veenman
- Department of Clinical Psychology, Faculty of Social Sciences, Leiden University
| | - Loes H C Janssen
- Department of Clinical Psychology, Faculty of Social Sciences, Leiden University
| | | | - Mirjam C M Wever
- Department of Clinical Psychology, Faculty of Social Sciences, Leiden University
| | - Bart Verkuil
- Department of Clinical Psychology, Faculty of Social Sciences, Leiden University
| | - Sacha Epskamp
- Department of Psychology, National University of Singapore
| | - Eiko I Fried
- Department of Clinical Psychology, Faculty of Social Sciences, Leiden University
| | - Bernet M Elzinga
- Department of Clinical Psychology, Faculty of Social Sciences, Leiden University
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Bouraoui A, Newman P, Fisher C, Shah A, Burman R, Mavrommatis S, Sen D. Feasibility and acceptability of multidisciplinary team training in health coaching: Case study in adolescent rheumatology. Future Healthc J 2024; 11:100013. [PMID: 38646050 PMCID: PMC11025057 DOI: 10.1016/j.fhj.2024.100013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
The central importance of the biopsychosocial model of chronic disease is increasingly recognised in the management of long-term conditions (LTC), which are often associated with chronic pain, fatigue and disability. Despite the physical and mental health impact, 'struggle' to maintain self-efficacy, gap in effective transition to adult pathways and long term consequences of poor disease control and lifestyle choices in young people with LTCs, innovation in this age range is rarely reported in generic journals. This paper explores the feasibility and acceptability of health coaching with young service users to increase engagement and self-management, achieved through multidisciplinary team (MDT) training in Adolescent Rheumatology.
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Affiliation(s)
- Aicha Bouraoui
- Department of Adolescent and Young Adult Rheumatology, University College London hospital London, UK
| | | | - Corinne Fisher
- Department of Adolescent and Young Adult Rheumatology, University College London hospital London, UK
| | - Aisha Shah
- Department of Adolescent and Young Adult Rheumatology, University College London hospital London, UK
| | - Rhea Burman
- Department of Adolescent and Young Adult Rheumatology, University College London hospital London, UK
| | - Sophia Mavrommatis
- Department of Adolescent and Young Adult Rheumatology, University College London hospital London, UK
| | - Debajit Sen
- Department of Adolescent and Young Adult Rheumatology, University College London hospital London, UK
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Reuter M, Diehl K, Richter M, Sundmacher L, Hövener C, Spallek J, Dragano N. A longitudinal analysis of health inequalities from adolescence to young adulthood and their underlying causes. ADVANCES IN LIFE COURSE RESEARCH 2024; 59:100593. [PMID: 38340523 DOI: 10.1016/j.alcr.2024.100593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 12/04/2023] [Accepted: 01/08/2024] [Indexed: 02/12/2024]
Abstract
Research suggests that children of low-educated parents face greater health burdens during the passage from adolescence to young adulthood, as they are more likely to become low-educated themselves, establish behavioural and psychosocial disadvantages, or being exposed to unhealthy working conditions. However, studies examining the development and drivers of health inequalities during this particular life stage are limited in number and have produced varied results. This study investigates trajectories of self-rated health and overweight from 14 to 25 years of age, stratified by parental education, and explores the role of potential mediators (educational achievement, health behaviours, psychosocial factors, working conditions). We rely on prospective cohort data from the National Educational Panel Study (NEPS), a representative sample of 14,981 German ninth graders interviewed yearly from 2011 to 2021 (n = 90,096 person-years). First, we estimated random-effects growth curves for self-rated health and overweight over participants' age and calculated the average marginal effect of high versus low parental education. Second, a series of simulation-based mediation analyses were performed to test how much of health inequalities were explained by children's educational attainment (years of school education, years in university), health behaviours (smoking, alcohol, physical inactivity), psychosocial factors (number of grade repetitions, years in unemployment, chronic stress, self-esteem) and working conditions (physical and psychosocial job demands). We accounted for potential confounding by controlling for age, sex, migration background, residential area, household composition, and interview mode. Results show that higher parental education was related to higher self-rated health and lower probabilities of being overweight. Interaction between parental education and age indicated that, after some equalisation in late adolescence, health inequalities increased in young adulthood. Furthermore, educational attainment, health behaviours, psychosocial factors, and early-career working conditions played a significant role in mediating health inequalities. Of the variables examined, the level of school education and years spent in university were particular strong mediating factors. School education accounted for around one-third of the inequalities in self-rated health and one-fifth of the differences in overweight among individuals. Results support the idea that the transition to adulthood is a sensitive period in life and that early socio-economic adversity increases the likelihood to accumulate health disadvantages in multiple dimensions. In Germany, a country with comparatively low educational mobility, intergenerational continuities in class location seem to play a key role in the explanation of health inequalities in youth.
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Affiliation(s)
- Marvin Reuter
- Junior Professorship for Sociology, esp. Work and Health, Department of Sociology, University of Bamberg, Bamberg, Germany.
| | - Katharina Diehl
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias Richter
- Chair for Social Determinants of Health, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Leonie Sundmacher
- Chair of Health Economics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Claudia Hövener
- Department of Epidemiology and Health Monitoring, Robert Koch-Institute, Berlin, Germany
| | - Jacob Spallek
- Department of Public Health, Brandenburg University of Technology Cottbus-Senftenberg, Senftenberg, Germany
| | - Nico Dragano
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany
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Choudhary P, Ronkainen J, Carson J, Karhunen V, Lin A, Melton PE, Jarvelin MR, Miettunen J, Huang RC, Sebert S. Developmental origins of psycho-cardiometabolic multimorbidity in adolescence and their underlying pathways through methylation markers: a two-cohort study. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02390-1. [PMID: 38366065 DOI: 10.1007/s00787-024-02390-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 01/26/2024] [Indexed: 02/18/2024]
Abstract
Understanding the biological mechanisms behind multimorbidity patterns in adolescence is important as they may act as intermediary risk factor for long-term health. We aimed to explore relationship between prenatal exposures and adolescent's psycho-cardiometabolic intermediary traits mediated through epigenetic biomarkers, using structural equation modeling (SEM). We used data from mother-child dyads from pregnancy and adolescents at 16-17 years from two prospective cohorts: Northern Finland Birth Cohort 1986 (NFBC1986) and Raine Study from Australia. Factor analysis was applied to generate two different latent factor structures: (a) prenatal exposures and (b) adolescence psycho-cardiometabolic intermediary traits. Furthermore, three types of epigenetic biomarkers were included: (1) DNA methylation score for maternal smoking during pregnancy (DNAmMSS), (2) DNAm age estimate PhenoAge and (3) DNAm estimate for telomere length (DNAmTL). Similar factor structure was observed between both cohorts yielding three prenatal factors, namely BMI (Body Mass Index), SOP (Socio-Obstetric-Profile), and Lifestyle, and four adolescent factors: Anthropometric, Insulin-Triglycerides, Blood Pressure, and Mental health. In the SEM pathways, stronger direct effects of F1prenatal-BMI (NFBC1986 = β: 0.27; Raine = β: 0.39) and F2prenatal-SOP (β: -0.11) factors were observed on adolescent psycho-cardiometabolic multimorbidity. We observed an indirect effect of prenatal latent factors through epigenetic markers on a psycho-cardiometabolic multimorbidity factor in Raine study (P < 0.05). The present study exemplifies an evidence-based approach in two different birth cohorts to demonstrate similar composite structure of prenatal exposures and psycho-cardiometabolic traits (despite cultural, social, and genetic differences) and a common plausible pathway between them through underlying epigenetic markers.
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Affiliation(s)
- Priyanka Choudhary
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | - Justiina Ronkainen
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Jennie Carson
- Telethon Kids Institute, Perth, Australia
- School of Population and Global Health, University of Western Australia, Perth, Australia
| | - Ville Karhunen
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
- Research Unit of Mathematical Sciences, Faculty of Science, University of Oulu, Oulu, Finland
| | - Ashleigh Lin
- Telethon Kids Institute, Perth, Australia
- UWA Centre for Child Health Research, University of Western Australia, Perth, Australia
| | - Phillip E Melton
- School of Population and Global Health, University of Western Australia, Perth, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Marjo-Riitta Jarvelin
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College, London, UK
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Kingston Lane, Uxbridge, Middlesex, UK
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Jouko Miettunen
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Rae-Chi Huang
- Telethon Kids Institute, Perth, Australia
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
- Nutrition and Health Innovation Research Institute (NHIRI), School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Sylvain Sebert
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
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Cosma A, Martin G, Walsh SD, Chzhen Y, Currie C. Editorial: Contemporary perspectives in adolescent mental health. Front Psychol 2024; 15:1376940. [PMID: 38410403 PMCID: PMC10894967 DOI: 10.3389/fpsyg.2024.1376940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 01/30/2024] [Indexed: 02/28/2024] Open
Affiliation(s)
- Alina Cosma
- Department of Sociology, Trinity College Dublin, Dublin, Ireland
- School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Gina Martin
- Faculty of Health Disciplines, Athabasca University, Athabasca, AB, Canada
- Department of Geography and Environment, Western University, London, ON, Canada
| | - Sophie D. Walsh
- Department of Criminology, Bar Ilan University, Ramat Gan, Israel
| | | | - Candace Currie
- Glasgow Caledonian University London, London, United Kingdom
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Parsonage-Harrison J, Eklund M, Dawes H. A Delphi method investigation to prioritize activity-related determinants thought to affect mental health in adolescent populations. Early Interv Psychiatry 2024. [PMID: 38327246 DOI: 10.1111/eip.13512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 12/21/2023] [Accepted: 01/24/2024] [Indexed: 02/09/2024]
Abstract
INTRODUCTION Emergent mental illness during adolescence affects daily functioning, causing disruption to daily activities, routines, and patterns. Multiple inter-related personal, social and environmental determinants influence the onset, nature and subsequent course of those difficulties. Research suggests a bi-directional relationship exists between mental health and activity choices. Activity-focused interventions such as occupational therapy may improve adolescent mental health related outcomes. In this study, we identify and select which activity-related determinants should be prioritized in the development of an occupation therapy-based intervention for adolescents with emerging mental health difficulties using expert consensus. METHOD A modified two-round Delphi survey method was conducted with occupational therapists and researchers to ascertain a consensus opinion on the prioritization of specific activity-related determinants that influence 16- to 17-year-olds'. RESULTS Eighty-nine determinants were identified and prioritized. Fourteen of these were personal activity-related determinants including 'types of activity' in which young people engage, the 'balance of activities' in which they engage, their 'over and under consumptions of activities', and their 'underdeveloped occupation-based coping skills'. The expert panel prioritized 'personal self-confidence', 'values', and 'perception of confidence' in relation to the activities adolescents do. CONCLUSIONS This study generated a detailed picture of the activity-related determinants that are important in adolescence, and aligns with the adolescent model of occupational choice. Our findings have potential to inform activity-related intervention development and policy. Further research is needed, particularly to understand young people's perspectives on these determinants and to investigate the determinants that would benefit from further empirical research.
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Affiliation(s)
| | | | - Helen Dawes
- Oxford Brookes University, Oxford, UK
- Now Exeter University, Exeter, UK
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Danielsen E, Ingebrigtsen T, Gulati S, Salvesen Ø, Johansen TO, Nygaard ØP, Solberg TK. Patient Characteristics Associated With Worsening of Neck Pain-Related Disability After Surgery for Degenerative Cervical Myelopathy: A Nationwide Study of 1508 Patients. Neurosurgery 2024:00006123-990000000-01043. [PMID: 38323820 DOI: 10.1227/neu.0000000000002852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 12/17/2023] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Functional status, pain, and quality of life usually improve after surgery for degenerative cervical myelopathy (DCM), but a subset of patients report worsening. The objective was to define cutoff values for worsening on the Neck Disability Index (NDI) and identify prognostic factors associated with worsening of pain-related disability 12 months after DCM surgery. METHODS In this prognostic study based on prospectively collected data from the Norwegian Registry for Spine Surgery, the NDI was the primary outcome. Receiver operating characteristics curve analyses were used to obtain cutoff values, using the global perceived effect scale as an external anchor. Univariable and multivariable analyses were performed using mixed logistic regression to evaluate the relationship between potential prognostic factors and the NDI. RESULTS Among the 1508 patients undergoing surgery for myelopathy, 1248 (82.7%) were followed for either 3 or 12 months. Of these, 317 (25.4%) were classified to belong to the worsening group according to the mean NDI percentage change cutoff of 3.3. Multivariable analyses showed that smoking (odds ratio [OR] 3.4: 95% CI 1.2-9.5: P < .001), low educational level (OR 2.5: 95% CI 1.0-6.5: P < .001), and American Society of Anesthesiologists grade >II (OR 2.2: 95% CI 0.7-5.6: P = .004) were associated with worsening. Patients with more severe neck pain (OR 0.8: 95% CI 0.7-1.0: P = .003) and arm pain (OR 0.8: 95% CI 0.7-1.0; P = .007) at baseline were less likely to report worsening. CONCLUSION We defined a cutoff value of 3.3 for worsening after DCM surgery using the mean NDI percentage change. The independent prognostic factors associated with worsening of pain-related disability were smoking, low educational level, and American Society of Anesthesiologists grade >II. Patients with more severe neck and arm pain at baseline were less likely to report worsening at 12 months.
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Affiliation(s)
- Elisabet Danielsen
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tor Ingebrigtsen
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Neurosurgery and the Norwegian Registry for Spine Surgery (NORspine), University Hospital of North Norway, Tromsø, Norway
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Sasha Gulati
- Department of Neurosurgery, St. Olavs Hospital, Trondheim, Norway
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
- National Advisory Unit on Spinal Surgery, St. Olavs Hospital, Trondheim, Norway
| | - Øyvind Salvesen
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Tonje O Johansen
- Department of Neurosurgery, St. Olavs Hospital, Trondheim, Norway
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Øystein P Nygaard
- Department of Neurosurgery, St. Olavs Hospital, Trondheim, Norway
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
- National Advisory Unit on Spinal Surgery, St. Olavs Hospital, Trondheim, Norway
| | - Tore K Solberg
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Neurosurgery and the Norwegian Registry for Spine Surgery (NORspine), University Hospital of North Norway, Tromsø, Norway
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50
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Gervais C, Jose PE. Relationships Between Family Connectedness and Stress-Triggering Problems Among Adolescents: Potential Mediating Role of Coping Strategies. Res Child Adolesc Psychopathol 2024; 52:237-251. [PMID: 37725201 DOI: 10.1007/s10802-023-01122-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2023] [Indexed: 09/21/2023]
Abstract
The aim of this study was to provide a better understanding of the mechanisms underlying the relationships between family connectedness, coping strategies, and stress-triggering problems in adolescents. To this end, it longitudinally examined the relationships between these three phenomena in a sample of New Zealand adolescents. Data were the three waves of the Youth Connectedness Project, in which 1,774 adolescents aged 10-17 completed a self-report survey three times at one-year intervals. Using random intercept longitudinal mediation path models, we tested whether and to what extent different coping strategies at T2 functioned as mediators between family connectedness at T1 and stress-triggering problems at T3. As predicted, statistical analyses indicated that family connectedness negatively predicted stress-triggering problems over time, and we found that maladaptive coping, but not adaptive coping, significantly mediated this relationship. This result suggests that family connectedness predicted a reduction in maladaptive coping one year later, and this lower level of maladaptation predicted a reduction in stress-triggering problems a subsequent year later. These and other related findings are important as they highlight several mechanisms shaping unfolding problematic situations experienced by adolescents. Contributions of the results to the existing body of knowledge about adolescents' stress and coping strategies are discussed, as well as their clinical implications for the prevention or reduction of stress experienced by adolescents.
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Affiliation(s)
- Christine Gervais
- Nursing Department, University of Quebec in Outaouais, 5 St-Joseph Street, St-Jerome Campus, Qc, J7Z 0B7, Canada.
| | - Paul E Jose
- School of Psychology, Victoria University of Wellington, P.O. Box 600, 6012, Wellington, New Zealand
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