Adolescent Health Medicine and Therapeutics最新文献

Background: The condition of being overweight is the abnormal excessive accumulation of fat in the body. Globally, it is a serious public health issue in both developing and developed countries.

Objective: This study aims to identify determinants of overweight among primary school children in Arba Minch town, Southern Ethiopia, 2021.

Methods: A school-based unmatched case control study was conducted from June 20 to 30, 2021. The total sample size was 285 (95 cases and 190 controls). Multistage sampling technique was used. Data were entered using Epi data 3.1 version and analyzed using SPSS version 24 software. Frequency, tables and figures were used. Bivariable analysis was done and variables with p <0.025 were entered to multivariable logistic regression analysis. Statistical significance was declared at p <0.05 with 95% confidence interval (CI).

Results: The odds of overweight increased 19.8 times more in children whose fathers work in private business [AOR: 19.82, 95% CI: 6.21, 63.25], increased 4.8 times more in children who consume meat on more than 2 days per week [AOR: 4.75, 95% CI: 1.61, 14.03], increased 5 times more in children who consume milk on more than 2 days per week [AOR: 5.02, 95% CI: 1.80, 13.98], increased 11.9 times more in children who spend more than 6 hours sitting per day [AOR: 11.89, 95% CI: 4.13, 34.28]. And also, odds decreased by 84% in children who consume fruit on more than 2 days per week [AOR: 0.07, 95% CI: 0.03, 0.19], decreased 93% in children who consume vegetables on more than 2 days per week [AOR: 0.16, 95% CI: 0.06, 0.42], decreased 67% in children who consume cereals on more than 2 days per week [AOR: 0.33, 95% CI: 0.13, 0.84].

Conclusion: Fathers working in private business, consuming fruit, vegetables, cereals, meat and milk on more than 2 days per week and sitting for more than 6 hours per day were determinants for overweight in this study. Therefore, it is better to include fruit, vegetables and cereals in dietary habits, decrease consumption of meat and milk and minimize sitting to less than 6 hours per day including school learning time.

Purpose: Rape is one of the sexual violence acts against women globally. Adolescent girls are vulnerable to this event and experience more severe and long-standing adverse effects. Thus, this study aimed to examine major depressive symptoms and associated factors and the level of sexually transmitted infection among female adolescents evaluated for rape cases at Jimma Medical Center.

Patients and methods: Institutional-based cross-sectional study was conducted among adolescent girls assessed for rape cases in Jimma Medical Center. Data were collected using structured questionnaire and entered into Epi Data version 3.1 then exported to SPSS version 21.0 for analysis. Descriptive statistics and regression analyses were carried out.

Results: A total of 174 raped adolescent females took part in the study. Of the total participants, 155 (89.1%) of these individuals had major depressive symptoms (95 CI %, 84.5-93.7%), while 85 (48.9%) of them had an STI (95% CI, 41.1-56.9%). From logistic regression, place of residence (AOR 14.65, 95%, (p=0.002)), attending school currently (AOR 9.01, 95%, p=0.004), raped by hitting (AOR 17.67, 95%, p<0.001) and unwanted pregnancy (AOR 14.68, 95%, p=0.001) were the variables associated with major depression.

Conclusion: This study indicates that adolescents were suffering from several encumbrances like major depressive symptoms, sexually transmitted diseases and unwanted pregnancy. It also indicated that place of residence, school attending, and unwanted pregnancy had an association with major depressive symptoms. Therefore, the need for a comprehensive approach while treating this vulnerable group is highly recommended.

Background: The PedsQL^TM 4.0 generic core scales (GCS) assess the generic health by integrating with disease-specific PedsQL^TM 3.0 diabetes module (DM). The PedsQL^TM 3.0 DM measures the health-related quality of life (HrQoL) specific to diabetes. Even though there is no translation to Ethiopian Amharic, the instruments had translated to different languages and validated. The study is aimed to assess the validity and reliability of the Amharic version of the PedsQL^TM 4.0 GCS and the PedsQL^TM 3.0 DM in children and adolescents with diabetes.

Methods: PedsQL^TM 4.0 GCS and the PedsQL^TM 3.0 DM were administered on 193 children and adolescents with diabetes and their parents. The validity was examined by the exploratory factor analysis, multitrait/multi-item scaling analysis, and multitrait-multimethod and monotrait-multimethod analysis. Cronbach's alpha coefficient checked the reliability.

Results: Cronbach's alpha coefficient for the total PedsQL^TM 4.0 GCS (α child self-report= 0.96; α parent proxy report= 0.95) and for total PedsQL^TM 3.0 DM (α child self-report= 0.96; α parent proxy report=0.93) were acceptable at individual patient-level analysis. The monotrait-multimethod correlations were higher than multitrait-multimethod correlations. In multitrait/multi-item scale analysis, both total PedsQL^TM 4.0 GCS and PedsQL^TM 3.0 DM had an excellent item convergent and discriminatory validity success rate.

Conclusion: The Amharic versions of the PedsQL^TM 4.0 GCS and the PedsQL^TM 3.0 DM were valid and reliable instruments to measure the HrQoL of children and adolescents with diabetes.

Introduction: Major depressive disorder (MDD) is a common condition with heterogeneous presentations that often include predominant anhedonia. Previous studies have revealed that childhood trauma is a potent risk factor for the development of MDD; however, the clinical implications of this finding are not fully understood.

Methods: Participants were adolescents (age 13-21 years) with a diagnosis of moderate-to-severe major depressive disorder and healthy controls. We used generalized linear models to assess the relationship between anhedonia severity and trauma severity in a cross-sectional dataset.

Results: This cross-sectional analysis of an adolescent sample that underwent clinical evaluations and a trauma assessment, suggested that anhedonia was associated with historical trauma severity. The association between anhedonia and sexual abuse was greater in female participants compared to male participants.

Discussion: Our results were partially in line with the reported literature in adult samples. Future studies aiming to characterize the trauma-anhedonia relationship in adolescents should utilize scales designed specifically to measure these constructs in young populations, and scales that assess specific subtypes of anhedonia.

Neurofibromatosis type 1 (NF1) is an incurable genetic condition that frequently includes the development of plexiform neurofibromas (PNs) in patients. A systematic literature review was conducted to identify data on the natural history, disease burden, and treatment patterns among patients diagnosed with NF1 and PN, as well as to identify evidence gaps in these areas. MEDLINE and MEDLINE In-Process, Embase, and Cochrane Library Searches were searched using predefined terms. Potential references underwent two phases of screening by two independent researchers. A total of 39 references focusing on populations of patients with both NF1 and PN were included in this review. The wide range of PN-related complications creates a substantial quality-of-life (QOL) burden for patients, including pain, social functioning, physical function impact, stigma, and emotional distress. The severe burden of NF1 with PN on the QOL of patients demonstrates the high unmet need for an effective treatment option that can reduce tumor burden and improve QOL. The heterogeneity of measurement tools used to evaluate QOL and the gap in data evaluating the health economic burden of PN should be the focus of future research.

The prevalence of Hepatitis C virus infection (HCV), a leading cause of chronic liver disease worldwide, is rising in the United States (US) and other high-income countries, especially among youth and young adults. This surge in cases is closely associated with the opioid crisis and intravenous drug use (IVDU). However, its prevalence and impact on the adolescent population have not been thoroughly studied and therefore is poorly understood. The pediatric population tends to have milder liver disease and progression when compared to adults; however, there is a risk of developing liver cirrhosis, in addition to facing decreased quality of life and stigmatization from the disease. The recent approval of direct-acting antiviral (DAA) regimens for all HCV genotypes and age greater than 3 years has revolutionized its management. Therapy has shifted from the prolonged interferon-based regimens, to shorter duration, once daily oral pills that are highly effective, curative and with fewer side effects. Therapy is now indicated for all adolescents with hepatitis C virus infection, regardless of stage of liver disease, recent IVDU, or coinfection with HIV, therefore eliminating a lifetime risk of chronic liver disease, cirrhosis and hepatocarcinoma. Nonetheless, adolescents are rarely tested or treated for hepatitis C infection, and very few adolescents complete therapy. Implementation of point of care (POC) testing of high-risk youth at drug treatment centers or other juvenile facilities may be a good strategy to increase testing, diagnosis and therapy. This review article aims to educate pediatricians and other primary care providers to help decrease the existing knowledge gap on the subject.

Purpose: Evaluate the experience of virtual consultations for young people and their families and assess whether young people are being offered a confidential space as part of these virtual encounters.

Patients and methods: An anonymous online survey was sent to young people age 10-18 y.o. who had experienced at least one virtual consultation with an adolescent medicine tertiary service in the United Kingdom between March 13th and June 13th 2020 mostly associated with, but not exclusively, management of chronic fatigue syndrome or medically unexplained symptoms. Responses from the survey were analysed by two authors who independently coded the common themes reported by the participants.

Results: Fifty young people and their families participated in the survey. Eighty-eight percent reported feeling prepared for virtual appointments, 90% found them helpful, 88% felt that they were private and 86% reported they would find further virtual appointments helpful. Positive impacts reported were no need to travel (38%) and the continuity of care (36%). Many of our participants reported no negative impact (39%) and felt that nothing needed to be improved (56%). The most frequent improvement reported was the provision of a quality video call (34%). Only 36% of young people had the opportunity to speak in confidence to the health care provider without their parents' presence.

Conclusion: Virtual appointments are perceived as safe and helpful by the young people and their families. Professionals should offer a confidential remote space for young people to speak without their parents.

Purpose: Since the introduction of the HPV vaccine in Chile in 2014, there have been few studies exploring community perspectives on the vaccine, specifically of parents of adolescents. This study sought to identify maternal factors and family dynamics that affect HPV vaccination behavior.

Participants and methods: Participants were recruited at an OB/GYN clinic in Linares, Chile. Participation was voluntary, and eligibility required 1) having an adolescent daughter between 9 and19 years-old and 2) demonstrating a willingness to discuss HPV-related topics. Thirty semi-structured interviews were conducted to generate qualitative data analyzed using Grounded Theory methodology.

Results: Three thematic constructs emerged from the interviews. Mothers' motivations to vaccinate centered on disease prevention and trust in the medical system but were influenced by notions of sexual liberalism and promiscuity. Second, participants desired, but often had trouble finding, adequate information about vaccine safety and turned to the internet. Third, joint decision making in the family about vaccination led to open family discussions about sex and sexuality.

Conclusion: Chile's school-based opt-out HPV vaccination program engenders a unique landscape of maternal decision-making, risk-benefit analysis, information-seeking, and at-home discussion. More studies are needed around the variable role of fathers in the decision-making process.

Background: Sexual assault cases are increasingly reported in Ethiopia and worldwide. However, in Ethiopia, sexual assaults' profile was not investigated well, regardless of its social, physical, and psychological impacts on survivors. Hence, this study assessed the survivors' characteristics, circumstances of the victims, and treatment offered with the view of describing the management process, and service responsiveness.

Methods: A descriptive study with 3 years retrospective chart review was conducted in Jimma University Medical Center (JUMC). Samples of 187 charts/medical records were selected using a systematic random sampling technique from the medical unit. The selected survivors' records were reviewed using a structured checklist. Data were analyzed using SPSS Version 21.0.

Results: Out of the 187 cases of sexual assaults during the study period, 67.4% were rape cases. Among these, 58.8% were below 14 years, and 85.6% knew their assailants. Above 30% of the victims were assaulted during the daytime, and 51.9% developed perennial laceration. Threat and physical force were mostly used to coerce victims during the violence. All of the survivors were not investigated for vaginal/anal swab (for sperm analysis), and 96.8% of the victims were not tested for HIV screening. Only 8% of the victims received emergency contraception.

Conclusion and recommendation: Children and adolescents remain the most sexually assaulted group of the population, requiring protection and appropriate medical services to ensure their well-being and reduce their suffering. Appropriate and timely intervention is needed to care for such survivors. The findings have highlighted the need for closer monitoring and better follow-up of the care and support provided in the Medical Center to sexual assault victims.

Background: Obesity is characterized by the disproportionate expansion of the fat mass and is most commonly diagnosed using the Body Mass Index (BMI) z-score or percentile in children. However, these measures associate poorly with the fat mass. This is important, as adiposity is a more robust predictor of cardiometabolic risk than BMI-based measures, but there are limited clinical measures of adiposity in children. A new measure, the Tri-ponderal Mass Index (TMI, kg/m³) has recently demonstrated robust prediction of adiposity in children. The aim of this study is to explore the association of leptin, a validated biomarker of the fat mass, with TMI.

Methods: One hundred and eight children and adolescents were included in this cross-sectional study. Height and weight were used to calculate TMI. Plasma leptin was measured using ELISA. Multivariable regression analysis was applied to determine the predictors of TMI.

Results: The age range of participants included in this study was 8.00-16.90 years (female n=48, 44%). Leptin correlated with BMI percentile (r=0.64, p-value <0.0001) and TMI (r=0.71, p-value <0.0001). The multivariable regression analysis revealed that BMI percentile (Estimated Beta-coefficient 0.002, 95% CI 0.002-0.003, p-value <0.0001) and Leptin (Estimated Beta-coefficient 0.05, 95% CI 0.02-0.07, p-value 0.013) were associated with TMI.

Conclusion: Leptin is associated with TMI in healthy children. The TMI is a feasible clinical measure of adiposity that may be used to stratify children and adolescents for further assessments and interventions to manage and attempt to prevent cardiometabolic comorbidities.