Development and psychometric assessment of the Sociocultural Influences on Exercise Behaviours in Adolescents Questionnaire.

OBJECTIVES: This research aimed to construct and psychometrically test a measure of multiple sociocultural dimensions (i.e. family, peers, media) theoretically associated with exercise behaviours/attitudes in adolescents; the Sociocultural Influences on Exercise Behaviours in Adolescents Questionnaire (SIEBAQ). METHODS AND MEASUREMENT: Part 1 of this study focused on measure construction and psychometric testing, involving item generation and exploratory factor analysis (EFA) to refine the item pool, with 905 adolescents (Mage 13.66 years (SD = 0.94); girls = 442). Part 2 sought to explore the convergent validity of the SIEBAQ (n = 846; n = 414 girls). RESULTS: EFA resulted in a 47-item measure with a nine-factor structure (including social media modelling, parent exercise expectations, peer co-participation; α = 0.72-0.92). Correlations revealed weak-moderate significant relationships between the SIEBAQ and related constructs (e.g. compulsive exercise, sociocultural attitudes towards appearance). Regression analyses with the SIEBAQ identified social media modelling of exercise as a significant predictor of compulsive exercise in boys and girls. Proving exercise ability to significant others also significantly predicted compulsive exercise outcomes. CONCLUSION: This newly developed measure holds promise. Further psychometric testing and validation of the SIEBAQ is the recommended next step to confirm the measure's nine-factor structure identified through EFA.

Food-Related Online Media (Mukbang and Cookbang) Exposure and Dietary Risk Behaviors in Korean Adolescents.

BACKGROUND: Studies have shown that prolonged smartphone use is associated with dietary risk behaviors among adolescents. However, little is known about whether the exposure to food-related online media contents, such as mukbang (eating broadcast) and cookbang (cooking broadcast), is associated with unhealthy dietary behaviors, independent of overall duration of smartphone use. OBJECTIVES: This study investigated the associations between the frequency of mukbang/cookbang watching and dietary risk behaviors among Korean adolescents, using nationally representative survey data. METHODS: In this cross-sectional study, we examined the data from 50,044 middle and high school students in the Korea Youth Risk Behavior Web-based Survey 2022. Participants reported their frequency of mukbang/cookbang watching, mean duration of smartphone use, frequency of breakfast eating, frequency of nighttime eating, and intakes of fast foods, sugar-sweetened beverages (SSBs), and high-caffeine drinks. We performed multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between mukbang/cookbang watching and dietary risk behaviors, accounting for complex survey sampling and adjusting for potential confounders. RESULTS: Frequent mukbang/cookbang watching (≥5 times/wk compared with never) was positively associated with dietary risk behaviors, including frequent breakfast skipping (OR: 1.20; 95% CI: 1.13, 1.28), frequent nighttime eating (OR: 1.43; 95% CI: 1.33, 1.54), and frequent intakes of fast foods (OR: 1.69; 95% CI: 1.58, 1.80), SSBs (OR: 1.47; 95% CI: 1.30, 1.66), and high-caffeine drinks (OR: 1.41; 95% CI: 1.33, 1.50), adjusting for duration of smartphone use. All mukbang/cookbang viewers, including those who perceived that mukbang/cookbang videos had "no influence" on their dietary behavior, had higher prevalence of dietary risk behaviors than nonviewers (perceived "no influence" compared with nonviewers-OR: 1.18; 95% CI: 1.10, 1.26, breakfast skipping; OR: 1.15; 95% CI: 1.06, 1.24, nighttime eating; OR: 1.40; 95% CI: 1.30, 1.50, fast foods; OR: 1.22; 95% CI: 1.07, 1.38, SSBs; OR: 1.28; 95% CI: 1.20, 1.37, high-caffeine drinks). CONCLUSIONS: Our findings suggest that frequent mukbang/cookbang watching may be associated with unhealthy dietary behaviors among Korean adolescents.

Factors Associated With Surveillance Testing in Individuals With COVID-19 Symptoms During the Last Leg of the Pandemic: Multivariable Regression Analysis.

Background: Rural underserved areas facing health disparities have unequal access to health resources. By the third and fourth waves of SARS-CoV-2 infections in the United States, COVID-19 testing had reduced, with more reliance on home testing, and those seeking testing were mostly symptomatic. Objective: This study identifies factors associated with COVID-19 testing among individuals who were symptomatic versus asymptomatic seen at a Rapid Acceleration of Diagnostics for Underserved Populations phase 2 (RADx-UP2) testing site in West Virginia. Methods: Demographic, clinical, and behavioral factors were collected via survey from tested individuals. Logistic regression was used to identify factors associated with the presence of individuals who were symptomatic seen at testing sites. Global tests for spatial autocorrelation were conducted to examine clustering in the proportion of symptomatic to total individuals tested by zip code. Bivariate maps were created to display geographic distributions between higher proportions of tested individuals who were symptomatic and social determinants of health. Results: Among predictors, the presence of a physical (adjusted odds ratio [aOR] 1.85, 95% CI 1.3-2.65) or mental (aOR 1.53, 95% CI 0.96-2.48) comorbid condition, challenges related to a place to stay/live (aOR 307.13, 95% CI 1.46-10,6372), no community socioeconomic distress (aOR 0.99, 95% CI 0.98-1.00), no challenges in getting needed medicine (aOR 0.01, 95% CI 0.00-0.82) or transportation (aOR 0.23, 95% CI 0.05-0.64), an interaction between community socioeconomic distress and not getting needed medicine (aOR 1.06, 95% CI 1.00-1.13), and having no community socioeconomic distress while not facing challenges related to a place to stay/live (aOR 0.93, 95% CI 0.87-0.99) were statistically associated with an individual being symptomatic at the first test visit. Conclusions: This study addresses critical limitations to the current COVID-19 testing literature, which almost exclusively uses population-level disease screening data to inform public health responses.

Mind the gap: why we need to consider teenage and young adult cancers across the research pipeline.

Historically, teenage and young adult (TYA) cancers have been understudied, with research largely focussing on paediatric or older adult (OA) indications. With increasing TYA cancer incidence rates internationally, now is the time to focus on teenager and young adults across the research pipeline to improve not only outcomes but also the quality of life for this underserved group.

Cyber social proof and hazard: Investigating the impact of social media on pediatric burn incidents - Analysis and comprehensive literature review.

Investigating the growing concern of pediatric burn injuries caused by social media challenges. Adolescents, seeking fame or succumbing to peer pressure, engage in risky behaviors, recording and sharing them online. The study presents two case reports detailing severe burn injuries resulting from such challenges, highlighting the physical and psychological toll on affected children and their families. In Case report 1, a 14-year-old suffered severe burns attempting a TikTok challenge involving igniting a soaked t-shirt. The patient's critical condition necessitated intensive care, surgical procedures, and skin grafts, accompanied by complications like anemia and sepsis. Case report 2 features a 9-year-old who sustained extensive burns while attempting another social media challenge. Treatment included escharolysis, skin grafts, and surgeries, with complications managed during the recovery process. A literature review explores social media-generated burn injuries, revealing their physical and psychological impact. The influence of social proof and peer pressure on adolescents' behavior in the digital age is discussed. The pandemic's effect on mental health is considered, emphasizing the vulnerability of adolescents to such challenges. In conclusion, the paper highlights the rising incidence of teen burn injuries linked to social media challenges. Urgent measures are needed to restrict the promotion of risky behaviors on social platforms. Alongside state-of-the-art burn treatments, comprehensive psychological care is essential for young patients and their families to cope with trauma. Increased content monitoring and the dissemination of prevention materials are recommended to mitigate the occurrence of such incidents.

Lung Adenocarcinoma Manifested as Ground Glass Nodules in Teenagers: Characteristics, Surgical Outcomes, and Management Strategies.

OBJECTIVES: Ground glass nodules featured lung cancer have been identified in some teenagers in recent years. This study aims to investigate the characteristics and surgical outcomes of these patients and explore proper management strategy. METHODS: Patients aged ≤20 with incidentally diagnosed lung cancer were retrospectively reviewed from February 2016 to March 2023. Based on lymph node evaluation status, these patients were divided into non-lymph node evaluation and lymph node evaluation groups. The clinical and pathological characteristics were analyzed. RESULTS: A total of 139 teenage patients were included, with an obviously increased cases observed from 2019, corresponding to the COVID-19 pandemic. The median age of the 139 patients was 18 years (range 12-20). 85 patients had pure ground glass nodules while others had mixed ground glass nodules. The mean diameter of nodules was 8.87 ± 2.20 mm. Most of the patients underwent wedge resection (64%) or segmentectomy (31.7%). 52 patients underwent lymph node sampling or dissection. None of these patients had lymph node metastasis. The majority of lesions were adenocarcinoma in situ (63 cases) and minimally invasive adenocarcinoma (72 cases), while 4 lesions were invasive adenocarcinoma. The median follow-up time was 2.46 years, and none of these patients experienced recurrence or death during follow-up. The lymph node evaluation group had longer hospital stays (p < 0.001), longer surgery time (p < 0.001), and greater blood loss (p = 0.047) than the non-lymph node evaluation group. CONCLUSIONS: The COVID-19 pandemic significantly increased the number of teenage patients incidentally diagnosed with lung cancer, presenting as ground glass nodules on CT scans. These patients have favorable surgical outcomes. We propose a management strategy for teenage patients, and suggest that sublobar resection without lymph node dissection may be an acceptable surgical procedure for these patients.

Investigating the Use of Serious Games for Cancer Control Among Children and Adolescents: Scoping Review.

BACKGROUND: Effective health care services that meet the diverse needs of children and adolescents with cancer are required to alleviate their physical, psychological, and social challenges and improve their quality of life. Previous studies showed that serious games help promote people's health. However, the potential for serious games to be used for successful cancer control for children and adolescents has received less attention. OBJECTIVE: This scoping review aimed to map the use of serious games in cancer prevention and cancer care for children and adolescents, and provide future directions for serious games' development and implementation within the context of cancer control for children and adolescents. METHODS: This study followed a combination of the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) and the JBI (Joanna Briggs Institute) framework for the conduct of scoping reviews. PubMed, CINAHL Plus Full Text, Scopus, Web of Science Core Collection, and American Psychological Association (APA) PsycINFO databases were used for the search. RESULTS: From the initial 2750 search results, 63 papers were included in the review, with 28 quantitative, 14 qualitative, and 21 mixed method studies. Most of the studies were cancer care serious game papers (55/63, 87%) and a small number of studies were cancer prevention serious game papers (8/63, 13%). The majority of the included studies were published between 2019 and 2023 (cancer prevention: 5/8, 63%; cancer care: 35/55, 64%). The majority of the studies were conducted in Europe (cancer prevention: 3/8, 38%; cancer care: 24/55, 44%) and North America (cancer prevention: 4/8, 50%; cancer care: 17/55, 31%). Adolescents were the most represented age group in the studies' participants (cancer prevention: 8/8, 100%; cancer care: 46/55, 84%). All (8/8, 100%) cancer prevention serious game papers included healthy people as participants, and 45 out of 55 (82%) cancer care serious game papers included patients with cancer. The majority of cancer prevention serious game papers addressed game preference as a target outcome (4/8, 50%). The majority of cancer care serious game papers addressed symptom management as a target outcome (28/55, 51%). Of the cancer care studies examining serious games for symptom management, the majority of the studies were conducted to treat psychological (13/55, 24%) and physical symptoms (10/55, 18%). CONCLUSIONS: This review shows both the growth of interest in the use of serious games for cancer control among children and adolescents and the potential for bias in the relevant literature. The diverse characteristics of the included papers suggest that serious games can be used in various ways for cancer control among children and adolescents while highlighting the need to develop and implement serious games in underrepresented areas.

Examining the association of family environment and children emotional/behavioral difficulties in the relationship between parental anxiety and internet addiction in youth.

Introduction: Associations between parental anxiety and adolescent internet addiction have been documented in the literature; however, few studies have analyzed the role of the family environment in this relationship. This study aims to explore the relationship between parental anxiety and adolescent internet addiction while also investigating the indirect relationships involving multiple dimensions of the family environment and child emotional behavior issues. Methods: Surveys were conducted among 6,296 parent-child pairs. We administered SDQ, CIAS-R, and FES-CV to assess adolescents' issues and internet addiction, and evaluate family environment. Additionally, parents completed GAD-7 to assess parental anxiety levels.Results: Correlation analysis revealed that the family environment and adolescent emotional behavior issues played an indirect relationship in the link between parental anxiety and internet addiction. Discussion: The findings emphasize the importance of addressing parental anxiety and fostering a positive family environment as effective measures to alleviate adolescent emotional behavior problems and reduce the risk of internet addiction.

Telemedicine With Wearable Technologies in Patients Undergoing Hematopoietic Cell Transplantation and Chimeric Antigen Receptor T-Cell Therapy (TEL-HEMATO Study): Prospective Noninterventional Single-Center Study.

BACKGROUND: Patients with hematological malignancies receiving hematopoietic cell transplantation (HCT) or chimeric antigen receptor (CAR) T-cell therapy are at risk of developing serious clinical complications after discharge. OBJECTIVE: The aim of the TEL-HEMATO study was to improve our telehealth platform for the follow-up of patients undergoing HCT or CAR T-cell therapy during the first 3 months after discharge with the addition of wearable devices. METHODS: Eleven patients who received autologous (n=2) or allogeneic (n=5) HCT or CAR T-cell therapy (n=4) for hematological malignancies were screened from November 2022 to July 2023. Two patients discontinued the study after enrollment. The telehealth platform consisted of the daily collection of vital signs, physical symptoms, and quality of life assessment up to 3 months after hospital discharge. Each patient received a clinically validated smartwatch (ScanWatch) and a digital thermometer, and a dedicated smartphone app was used to collect these data. Daily revision of the data was performed through a web-based platform by a hematologist or a nurse specialized in HCT and CAR T-cell therapy. RESULTS: Vital signs measured through ScanWatch were successfully collected with medium/high adherence: heart rate was recorded in 8/9 (89%) patients, oxygen saturation and daily steps were recorded in 9/9 (100%) patients, and sleeping hours were recorded in 7/9 (78%) patients. However, temperature recorded manually by the patients was associated with lower compliance, which was recorded in 5/9 (55%) patients. Overall, 5/9 (55%) patients reported clinical symptoms in the app. Quality of life assessment was completed by 8/9 (89%) patients at study enrollment, which decreased to 3/9 (33%) at the end of the third month. Usability was considered acceptable through ratings provided on the System Usability Scale. However, technological issues were reported by the patients. CONCLUSIONS: While the addition of wearable devices to a telehealth clinical platform could have potentially synergic benefits for HCT and CAR T-cell therapy patient monitoring, noncomplete automation of the platform and the absence of a dedicated telemedicine team still represent major limitations to be overcome. This is especially true in our real-life setting where the target population generally comprises patients of older age with a low digital education level.

Digital Gaming and Exercise Among Youth With Type 1 Diabetes: Cross-Sectional Analysis of Data From the Type 1 Diabetes Exercise Initiative Pediatric Study.

Background: Regular physical activity and exercise are fundamental components of a healthy lifestyle for youth living with type 1 diabetes (T1D). Yet, few youth living with T1D achieve the daily minimum recommended levels of physical activity. For all youth, regardless of their disease status, minutes of physical activity compete with other daily activities, including digital gaming. There is an emerging area of research exploring whether digital games could be displacing other physical activities and exercise among youth, though, to date, no studies have examined this question in the context of youth living with T1D. Objective: We examined characteristics of digital gaming versus nondigital gaming (other exercise) sessions and whether youth with T1D who play digital games (gamers) engaged in less other exercise than youth who do not (nongamers), using data from the Type 1 Diabetes Exercise Initiative Pediatric study. Methods: During a 10-day observation period, youth self-reported exercise sessions, digital gaming sessions, and insulin use. We also collected data from activity wearables, continuous glucose monitors, and insulin pumps (if available). Results: The sample included 251 youths with T1D (age: mean 14, SD 2 y; self-reported glycated hemoglobin A1c level: mean 7.1%, SD 1.3%), of whom 105 (41.8%) were female. Youth logged 123 digital gaming sessions and 3658 other exercise (nondigital gaming) sessions during the 10-day observation period. Digital gaming sessions lasted longer, and youth had less changes in glucose and lower mean heart rates during these sessions than during other exercise sessions. Youth described a greater percentage of digital gaming sessions as low intensity (82/123, 66.7%) when compared to other exercise sessions (1104/3658, 30.2%). We had 31 youths with T1D who reported at least 1 digital gaming session (gamers) and 220 youths who reported no digital gaming (nongamers). Notably, gamers engaged in a mean of 86 (SD 43) minutes of other exercise per day, which was similar to the minutes of other exercise per day reported by nongamers (mean 80, SD 47 min). Conclusions: Digital gaming sessions were longer in duration, and youth had less changes in glucose and lower mean heart rates during these sessions when compared to other exercise sessions. Nevertheless, gamers reported similar levels of other exercise per day as nongamers, suggesting that digital gaming may not fully displace other exercise among youth with T1D.

Predicting the Population Risk of Suicide Using Routinely Collected Health Administrative Data in Quebec, Canada: Model-Based Synthetic Estimation Study.

BACKGROUND: Suicide is a significant public health issue. Many risk prediction tools have been developed to estimate an individual's risk of suicide. Risk prediction models can go beyond individual risk assessment; one important application of risk prediction models is population health planning. Suicide is a result of the interaction among the risk and protective factors at the individual, health care system, and community levels. Thus, policy and decision makers can play an important role in suicide prevention. However, few prediction models for the population risk of suicide have been developed. OBJECTIVE: This study aims to develop and validate prediction models for the population risk of suicide using health administrative data, considering individual-, health system-, and community-level predictors. METHODS: We used a case-control study design to develop sex-specific risk prediction models for suicide, using the health administrative data in Quebec, Canada. The training data included all suicide cases (n=8899) that occurred from January 1, 2002, to December 31, 2010. The control group was a 1% random sample of living individuals in each year between January 1, 2002, and December 31, 2010 (n=645,590). Logistic regression was used to develop the prediction models based on individual-, health care system-, and community-level predictors. The developed model was converted into synthetic estimation models, which concerted the individual-level predictors into community-level predictors. The synthetic estimation models were directly applied to the validation data from January 1, 2011, to December 31, 2019. We assessed the performance of the synthetic estimation models with four indicators: the agreement between predicted and observed proportions of suicide, mean average error, root mean square error, and the proportion of correctly identified high-risk regions. RESULTS: The sex-specific models based on individual data had good discrimination (male model: C=0.79; female model: C=0.85) and calibration (Brier score for male model 0.01; Brier score for female model 0.005). With the regression-based synthetic models applied in the validation data, the absolute differences between the synthetic risk estimates and observed suicide risk ranged from 0% to 0.001%. The root mean square errors were under 0.2. The synthetic estimation model for males correctly predicted 4 of 5 high-risk regions in 8 years, and the model for females correctly predicted 4 of 5 high-risk regions in 5 years. CONCLUSIONS: Using linked health administrative databases, this study demonstrated the feasibility and the validity of developing prediction models for the population risk of suicide, incorporating individual-, health system-, and community-level variables. Synthetic estimation models built on routinely collected health administrative data can accurately predict the population risk of suicide. This effort can be enhanced by timely access to other critical information at the population level.

Factors contributing to rise in teenage pregnancy in Sekhukhune district, Limpopo province.

BACKGROUND:  The Department of Health in South Africa has reported an alarming total of 90 037 teenage girls between the ages of 10 years and 19 years who gave birth from March 2021 to April 2022, across all provinces and districts. The rise in teenage pregnancy is of serious concern as adolescents girls are more likely to experience difficult pregnancies and deliveries which could lead to detrimental effects on their health. OBJECTIVES:  The study aimed to explore and describe factors contributing to the increase in teenage pregnancy in the Sekhukhune district of Limpopo. METHOD:  The study was conducted in the healthcare facilities of Sekhukhune area. A qualitative, exploratory design was followed. Participants were purposively selected, and data were gathered through face-to-face individual interviews. Data analysis employed Tesch's inductive, descriptive coding method. RESULTS:  Negligence, peer pressure, ambiguity, choice, lack of contraceptive use, and lack of family attachment were identified as exacerbating factors in the district's surge in teenage pregnancy. CONCLUSION:  To reduce teen pregnancy, it is crucial to promote contraception, enhance cooperation between schools and the government, involve families in sexual and reproductive health discussions, prioritise a supportive home environment, advocate for child support grants, revitalise school health services, and empower teenagers to make informed choices and resist peer pressure.Contribution: The study will provide guidance to policy makers and other stakeholders in developing appropriate programmes to address the problem and improve the health and socioeconomic status of adolescents in rural areas. This will reduce healthcare costs associated with complications and premature birth.

An Introduction to the OutSMART Cancer Serious Game: Current and Future Directions.

Given that cancer is a challenging disease that plagues millions of individuals of all age groups and socioeconomic statuses globally, developmentally appropriate education is often lacking for young people, particularly adolescents. Increasing cancer awareness and prevention education among adolescents using innovative strategies, such as game-based learning, is critical in reducing the burden of this disease. Adolescents are understudied in the field of cancer prevention and control, yet vulnerable as they tackle creating life-long health behavior patterns. Targeting cancer prevention education for adolescents has the potential to support long-term healthy behavior and reduce their risk of cancer. This paper provides an overview of the Collaborative Research on MEdication use and family health (CRoME) Lab's novel game-based cancer prevention education tool. OutSMART Cancer is an innovative, novel educational intervention in the form of a serious game. Serious games are educational tools that seek to impart knowledge and improve behaviors in their players. This game covers information related to breast cancer, colon cancer, and lung cancer. This viewpoint is a summary of the developmental process for the OutSMART Cancer game. We describe in detail the work preceding initial game development, the current version of the game, future directions for the game, and its educational potential. The long-term goal of OutSMART Cancer is to improve cancer awareness and knowledge regarding prevention behaviors in adolescents and support a lifetime of health and wellness.

Social Media Use and Serious Psychological Distress Among Adolescents.

Unlabelled: This Research Letter describes the increasing trend of almost-constant social media use among California adolescents and the association with serious psychological distress, focusing on the influence of familial and experiential factors.

Clinical characteristics and hearing loss etiology of cochlear implantees undergoing surgery in their teens, 20s, and 30s.

PURPOSE: This study aimed to investigate the etiology of hearing loss, including genetic variants, in individuals who underwent cochlear implantation (CI) in their teens to thirties. It also sought to analyze post-CI speech performance and identify prognostic factors affecting CI outcomes in this age group. METHODS: We conducted a retrospective review of 421 cochlear implant patients at Seoul National University Bundang Hospital, focusing on 63 subjects aged 10-39 years who underwent their first CI by a single surgeon between July 2018 and June 2022. The study included audiologic evaluation, molecular genetic testing, and analysis of speech performance post-CI. Statistical analyses were performed using SPSS 25 and GraphPad Prism 7. RESULTS: Among 63 participants (M:F, 24:39), nine underwent CI in their teens, 24 in their 20 s, and 30 in their 30 s. Most of them (40, 63.5%) had postlingual deafness. The study found that 65.2% (40/63) of subjects received a genetic diagnosis, with DFNB4 being the most common etiology (37.5%, 15/40). Post-CI speech evaluation showed an average sentence score of 80% across all subjects. Factors such as the onset of hearing loss, duration of deafness (DoD), and preoperative Speech Intelligibility Rating (SIR) significantly influenced CI outcomes. Notably, longer DoD was associated with poorer CI outcomes, but this did not affect individuals with postlingual hearing loss as much. CONCLUSION: The study concludes that in individuals aged 10-39 undergoing CI, the onset of hearing loss and preoperative SIR are critical predictors of postoperative outcomes. CI is recommended for those with postlingual hearing loss in this age group, irrespective of the DoD. The study highlights the importance of genetic factors especially DFNB4 in hearing loss etiology and underscores the value of the relatively easy-to-evaluate factor, preoperative SIR in predicting CI outcomes.

Understanding Adolescent Gynecological Issues: A Cross-Sectional Study at a Tertiary Care Center.

BACKGROUND AND OBJECTIVES: Adolescence is a crucial phase in a woman's life, as it signifies the beginning of her reproductive journey. During this time, there are notable variations in sexual development and a sense of caution that can present challenges for healthcare providers. The rationale for studying adolescent gynecological problems lies in the need to understand and address the unique reproductive health challenges faced by young girls. By investigating these issues, researchers and healthcare professionals can develop effective strategies for prevention, early detection, and treatment of gynecological conditions in adolescents. This knowledge is crucial for promoting the overall well-being and reproductive health of young girls, ensuring they receive appropriate care and support during this critical stage of development. This study focuses on identifying the most common gynecological issues in teenagers, exploring the root causes, examining the available treatment options, and understanding how they are managed at a tertiary care facility.  Methods: This cross-sectional observational study took place at a tertiary care center and focused on gynecological issues in adolescent females who sought care at the gynecology department from January 2016 to December 2022. The study participants were categorized into three groups: early adolescence (10-13 years), middle adolescence (14-16 years), and late adolescence (17-19 years) for analysis. Ethical approval was obtained for this hospital-based research, which involved examining, investigating, and treating the study participants. RESULTS: Out of the 49,700 new female patients, 2000 (4.02%) fell within the specified age range. The average age of the participants was 16.87±2.16, and the majority of them sought help for menstrual issues (63.45%), followed by abdominal discomfort (15.6%) and vaginal discharge (7.2%). Menstrual disorders were the most common concern, with dysmenorrhea and puberty menorrhagia being prevalent issues. Abdominal pain was caused by various factors, such as urinary tract infections, ovarian tumors, pelvic inflammatory disease, endometriosis, and endometrial tuberculosis. The majority of cases were treated conservatively, with only a small percentage requiring surgical intervention. CONCLUSION: The significance of early detection and intervention in addressing gynecological issues among adolescents is highlighted in the findings of this research, underscoring the necessity for specialized healthcare services that cater to the specific needs of this demographic. Adolescent gynecology plays a crucial role in safeguarding the reproductive health and overall well-being of young women, emphasizing the importance of seeking assistance proactively.

Patterns and trajectories of inequality in physical activity from childhood to adolescence in Kazakhstan.

Objective: Sociodemographic differences in physical activity (PA) levels during the transition from childhood to adolescence, particularly in Central Asian countries, is lacking. In this study, we examine individual, family and environmental sociodemographic variables associated with PA among children and young adolescents in Kazakhstan. Study design: Secondary data analyses of two nationally representative cross-sectional studies administered by parents of children (aged 7-9 y) and by self-report surveys (adolescents aged, 11-15 y) . Methods: The 2020 Childhood Obesity Surveillance Initiative (COSI) and 2018 Health Behaviour in School-aged Children (HSBC) studies were used. Predictors of daily PA by individual (gender, grade, weight status), family (family composition, family employment, family wealth), and environment (school location) factors were analysed through binary logistic regressions after adjusting for screen time. Results: Among both children and adolescents, males were more physically active than females. Daily PA among children was positively associated with high family employment (OR = 1.23, CI = 1.03-1.48) or living in an urban location (OR = 0.58, CI = 0.49-0.70). Daily PA was associated with low family wealth, two-parent families (OR = 1.25 CI = 1.08-1.44) or living in a rural location (OR = 1.18 CI = 1.04-1.34) among adolescents. Conclusion: In Kazakhstan, the trajectory of children's and adolescent's PA levels, differed according to individual, family and environmental characteristics , suggesting a need for age-specific, targeted interventions to promote PA, appropriate policies that promote programs in schools, communities, and development of infrastructure for physically active lifestyles.

Digital Food Frequency Questionnaire Assessing Adherence to the Norwegian Food-Based Dietary Guidelines and Other National Lifestyle Recommendations: Instrument Validation Study.

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