Discussion, implications, and recommendations of several alternative interventions to intervene suicidal ideation in youth with autism spectrum disorder.

The purpose of this article is to provide an additional point of view containing discussion, implications, and recommendations for intervention to autistic persons who have suicidal ideation and behavior. Therefore, the author hopes that this article can complement reports on several previous studies that have had an extraordinary impact.

Association of body composition with ambulatory blood pressure among Chinese youths.

BACKGROUND: For youths, abnormalities in ambulatory blood pressure (ABP) patterns are known to be associated with increased cardiovascular disease risk and potential target organ damage. Body composition, including indicators such as lean mass index (LMI), fat mass index (FMI), and visceral fat level (VFL), plays a significant role in blood pressure (BP) regulation. However, little is known about the association between these body composition indicators and ABP. Therefore, the present study examined the association between these body composition indicators and BP among Chinese youths. METHODS: A total of 477 college students aged 17 to 28 years old (mean ± Standard deviation = 18.96 ± 1.21) from a university in Changsha, Hunan Province, China, were included in this study. Body composition indicators were measured with a bioelectrical impedance body composition analyzer, and 24-hour ambulatory blood pressure monitoring (ABPM) was conducted. Multivariable logistic regression was performed to assess the relationship between body composition indicators and abnormal ABP. RESULTS: The prevalence of abnormal BP, including 24-hour BP, daytime BP, nighttime BP, and clinic BP, were 4.8%, 4.2%, 8.6%, and 10.9%, respectively. After adjusting for potential covariates, LMI [abnormal 24-hour BP (OR = 1.85, 95%CI:1.31, 2.62), abnormal daytime BP (OR = 1.76, 95%CI:1.21, 2.58), abnormal nighttime BP (OR = 1.64, 95%CI:1.25, 2.14), abnormal clinic BP (OR = 1.84, 95%CI:1.38, 2.45)], FMI [abnormal 24-hour BP (OR = 1.20, 95%CI:1.02, 1.41), abnormal daytime BP (OR = 1.30, 95%CI:1.07, 1.57), abnormal nighttime BP (OR = 1.24, 95%CI:1.10, 1.39), abnormal clinic BP (OR = 1.42, 95%CI:1.22, 1.65)], and VFL [abnormal 24-hour BP (OR = 1.22, 95%CI:1.06, 1.39), abnormal daytime BP (OR = 1.29, 95%CI:1.10, 1.51), abnormal nighttime BP (OR = 1.24, 95%CI:1.12, 1.39), abnormal clinic BP (OR = 1.38, 95%CI:1.21, 1.57)] are positively linked to abnormal BP. Additionally, there were significant sex differences in the association between body composition and abnormal BP. CONCLUSIONS: Our findings suggested maintaining an individual's appropriate muscle mass and fat mass and focusing on the different relations of males' and females' body composition is crucial for the achievement of appropriate BP profiles.

Awareness and utilization of Swedish youth clinics among migrants enrolled in Swedish language programmes: a cross-sectional study.

BACKGROUND: Previous research has highlighted inequalities in access to Swedish youth clinics (YCs). These inequalities exist not only between non-migrant and young migrant populations but also within various migrant groups. OBJECTIVES: To assess awareness and utilization of Swedish YCs among migrants enrolled in Swedish language programmes and explore associated factors. METHODS: This cross-sectional study involved 1,112 migrants aged 15-65. The analytical sample included 642 (57%) participants who answered the main outcome question about awareness of YCs. Descriptive statistics, bivariate, and multivariate log-binomial regression analyses using a Bayesian approach were applied to summarize the data and identify factors associated with awareness and utilization of YCs among migrants. RESULTS: The results revealed that 30% of all participants and 40% of the participants aged 15-25 years had heard of YCs. Additionally, 23% of the target group (15-25 years) had ever visited one. During descriptive and bivariate analyses, socio-demographic variations were evident in YCs' awareness and utilization. However, in multivariate analyses, only the associations between awareness and year of arrival, and YCs' utilization and year of arrival and type of residence permit, remained statistically significant. CONCLUSION: This study highlights the level of awareness of YCs among migrants attending Swedish language programmes and their utilization by those aged 15-25 years, potentially impacting their access to crucial services and resources. Targeted interventions and sustainable strategies beyond one-time interventions are essential to address the specific needs of different socio-demographic groups and ensure equitable access to YCs' information and services.

Main findings: This study highlights the level of awareness and utilization of youth clinics among migrants attending Swedish language programmes, revealing socio-demographic disparities across different groups.Added knowledge: Migrant men and unaccompanied minors are more likely to be aware of and use youth clinics than migrant women and those with legal guardians, while recent migrants and those with temporary residence permits are at an increased risk of being unaware of or not utilizing these services.Global health impact for policy and action: Targeted interventions and sustainable strategies, beyond one-time efforts, are essential to address the specific needs of different migrant subgroups and ensure equitable and universal access to crucial information and services related to sexual and reproductive health and rights.

Evaluating a Mobile App Supporting Evidence-Based Parenting Skills: Thematic Analysis of Parent Experience.

Background: Disruptive behavior disorders are among the most common disorders of childhood, and evidence-based parenting programs are the first-line treatment. Digital microinterventions have been proposed as one possible means of supporting parenting style change by giving parents in-the-moment advice about how to respond to challenging behavior. Until now, no digital microintervention supporting evidence-based parenting skills programs has been evaluated. Objective: The aim of this study is to evaluate the subjective experience of parents using a digital microintervention to support evidence-based parenting skills, with particular attention to acceptability, usability, family relationships, and parents' values. Methods: We conducted serial interviews with 11 parents of 33 children before and after spending 3 weeks using an app including 3 digital microinterventions. Parents were recruited via local authorities in the Midlands region of the United Kingdom. Previous participation in a parenting program was an inclusion criterion. Interviews explored family composition; child behavior problems; and experience of using the mobile app, including barriers to use. Thematic analysis was conducted from a user-centered design perspective, and illustrative case vignettes were produced. Results: Many parents used the app in ways that helped them rather than strictly following the instructions they were given. Parents described a range of barriers to using the app including practical problems and failure to change child behavior. Parents and children responded in a variety of ways to the use of the phone, with many wholeheartedly embracing the convenience of technology. Case vignettes illustrate the uniqueness of each family's experience. Conclusions: Parents' use of a mobile app supporting evidence-based parenting skills is difficult to predict due to the unique challenges each family encounters. Many parents found it an acceptable and helpful addition to family life, but increased personalization is likely to be key to supporting parents. Future digital microintervention developers should keep in mind that parents are likely to use the app pragmatically rather than following instructions, may struggle to use a complex app under pressure, and are likely to hold complex feelings about parenting with an app.

Inclusion Goals: What Sex Education for LGBTQIA+ Adolescents?

According to the World Health Organization and the World Association for Sexual Health (WAS) Declaration of Sexual Rights, sex education aims to provide children and adolescents with comprehensive knowledge, skills, attitudes, and values, promoting equality and nondiscrimination while upholding freedom of thought and expression. However, current school curricula often focus on dichotomous sexual identity and hetero-cis-normative prevention strategies, neglecting the needs of gender minority (GM) and sexual minority (SM) youths. In family settings, discussions typically revolve around sexual risk reduction and basic contraception, omitting relational aspects and components of sexual identity such as orientations and gender expressions. This discrepancy highlights a gap between the official goals of sex education and its practical implementation, reflecting a cultural deficit in familial sex education. This study reviews the scientific literature on sexual health promotion interventions from 2015 to 2024 to identify inclusive approaches that enhance the participation of all youths, not just hetero-cis-normative individuals. The hypothesis is that most interventions primarily serve heterosexual and cisgender youths, indicating a need for more inclusive strategies to achieve better sexual health and educational outcomes. The study also suggests expanding curricula to align with recognized guidelines and the diverse needs of youth.

Development of a multidomain gender norm attitude scale for youth in Bangladesh.

Objective: Gender norms shape individuals' perceptions and behaviours, particularly concerning health outcomes. However, the lack of comprehensive gender norm attitude measures in low- and middle-income countries, including Bangladesh, impedes gender-transformative efforts. This study introduces the Multidomain Gender Norm Attitude Scale (M-GNAS) to evaluate gender norm attitudes among Bangladeshi youths. Method: Three sequential studies were conducted in Bangladesh in 2022 to develop the M-GNAS. Study 1 engaged 124 participants in focus group discussions, generating a 40-item pool reflecting prevalent gender norms. Study 2 involved 1374 youths (mean age 26.82, SD 5.50) to finalise the M-GNAS items and explore its latent structure through exploratory factor analysis (EFA). Study 3, with 1416 participants of similar age, used confirmatory factor analysis (CFA) to assess structural validity and structural equation modelling to evaluate measurement invariance (MI) across genders. Results: EFA identified a four-domain solution with 13 items: gender-appropriate behaviour, family financial decisions, family responsibility, and career choice. CFA supported this four-domain solution (CFI=0.96, TLI=0.95; RMSEA=0.07; SRMR=0.04). MI across gender was well established (CFI & TLI>0.95, RMSEA≤0.06, SRMR<0.6). Higher education was associated with more egalitarian attitudes (F (5, 1408) = 7.25, p < 0.001), supporting the scale's construct validity. Conclusion: The M-GNAS is a psychometrically robust tool for assessing youths' attitudes toward prevalent gender norm domains in Bangladesh. It holds the potential for contributing to gender-transformative programmes and could be applied in similar initiatives across developing nations, contingent upon appropriate validation.

Meal Duration and Obesity-Related Indicators among Adolescents: Insights from the EHDLA Study.

PURPOSE: This paper aims to examine the association between meal duration and obesity indicators among Spanish adolescents. METHODS: We conducted a cross-sectional analysis using data from the Eating Healthy and Daily Life Activities (EHDLA) project involving 755 adolescents aged 12 to 17 years (54.8% girls) from three secondary schools in the Valle de Ricote Region of Murcia, Spain. To evaluate overall meal duration, participants were asked how long (on average) breakfast, morning snacks, lunch, afternoon snacks, and dinner typically last. Subsequently, global meal duration was measured, and the participants were categorized into tertiles. Obesity-related indicators, including body mass index (BMI) z score, waist circumference (WC), and skinfold thickness, were assessed. The analyses were adjusted for potential confounders such as sex, age, socioeconomic status, physical activity, sedentary behavior, diet quality, and energy intake. RESULTS: Concerning meal duration status, adolescents with long meal durations had the lowest estimated marginal means of BMI z score, WC, and body fat percentage (using the sum of triceps and calf skinfolds). However, significant differences between adolescents with a long meal duration and those with a short meal duration were observed only for BMI z score (p = 0.008), and WC (p = 0.020). Furthermore, significant differences in BMI z score (p = 0.017) between adolescents with a long meal duration and those with a moderate meal duration were identified. CONCLUSIONS: These findings underscore the importance of promoting slower eating habits as part of obesity prevention strategies. Future studies should explore the causality of this association and its potential for behavioral interventions.

Strength versus aerobic program: effects on body composition and health-related physical fitness levels of youths with Down syndrome.

Aims: To determine the effect of a 16-week fitness program (strength vs. aerobic) on different indicators of body composition and components of health-related physical fitness in youths with Down syndrome. Methods and procedures outcomes: Fifty adolescents (19 girls and 31 boys; average age, 18.33 ± 1.42 years) with Down syndrome were recruited and randomized to two groups (strength group vs. aerobic group). Adolescents allocated in the aerobic group carried out a physical activity program three times a week for 16 weeks meanwhile adolescents allocated in the strength group performed a fitness program three times a week for 16 weeks. Results: The exercise group had significant improvements in all health-related physical fitness variables (p < .05) but not on body composition. Conclusions and implications: A sixteen week fitness program consisting of three sessions of 60 min is able to increase levels of health-related physical fitness but not on body composition in youths with Down syndrome. The aerobic program does not seem to show significant differences.

Exploring perceptions of sexuality among youth with physical disabilities in Gweru, Zimbabwe.

Background: Disability and sexuality are topical issues although they are not given much-deserved attention in most societies, and Zimbabwe is not an exception. The socio-cultural stigma associated with disability adversely impacts sexuality and seeps into the social existence of youth with disability. Youths with disability are assumed to be hypersexual or asexual. Objectives: This article explores the sexuality views and experiences of youth with disability in the context of the negative stigma associated with disability and sexuality in Gweru, Zimbabwe. Method: Semi-structured interviews and focus group discussions were conducted among 20 Gweru youth (18-35 years old) with physical disabilities and five key informants. Perceptions of youth with disability and socio-cultural assumptions regarding their sexuality were analysed. Results: The study established that most youths with disability faced social closure in terms of sexuality, with sparse offerings of sexuality education in their families. One sexual education theme that emerged from this study is sexual abstinence. Some suggestions of more open forms of communication on sexuality and disability also emerged although as a minority view. Conclusion: It was concluded from the study that, most youth feel that they are denied information on sexuality in their families and communities, as they are wrongfully assumed to have no need for it. However, youths with disability do not passively accept the negative perceptions about their sexuality, and they demonstrate their agency in resisting such negative perceptions. Contribution: The study contributes to knowledge on sexuality and disability among youths with disability in contexts where strong traditional beliefs, myths, and misconceptions exist.

What Is the Relationship between Chronotype and Disordered Eating in Adolescents? The EHDLA Study.

BACKGROUND: Evidence assessing the relationship between chronotype and disordered eating in adolescents is scarce. The current study tried to evaluate the association between chronotype and disordered eating in a sample of Spanish adolescents. METHODS: This secondary cross-sectional study analyzed data from the Eating Healthy and Daily Life Activities (EHDLA) study. The sample consisted of 703 adolescents (56.3% girls) aged between 12 and 17 years from the Valle de Ricote (Region of Murcia, Spain). Chronotype was assessed using the Morningness/Eveningness Scale in Children (MESC). Disordered eating was evaluated by two psychologists using the Sick, Control, One, Fat, and Food (SCOFF) questionnaire. RESULTS: Adolescents with an eveningness chronotype showed a higher SCOFF score (estimated marginal mean [M] = 1.1; 95% confidence interval [CI] 0.7 to 1.5) in comparison with adolescents with a morningness chronotype (M = 0.7; 95% CI 0.5 to 0.8) (p = 0.010), as well as with those with an intermediate chronotype (M = 0.6; 95% CI 0.5 to 0.8) (p = 0.032). A higher predictive probability of having disordered eating was identified in adolescents with an eveningness chronotype (39.5%; 95% CI 22.8% to 59.1%), compared to adolescents with an intermediate chronotype (14.9%; 95% CI 10.8% to 20.1%) (p = 0.008) and with their counterparts with a morningness chronotype (16.9%; 95% CI 11.6% to 24.0%) (p = 0.021). CONCLUSIONS: This study reveals that adolescents with an eveningness chronotype are more likely to exhibit disordered eating behaviors compared to those with morningness or intermediate chronotypes. These findings highlight the importance of considering chronotype in adolescent health, particularly in developing targeted interventions to prevent eating disorders.

Characterization of Psychopathology in Latin American Adolescents Using a Web-Based Screening Tool: Cross-Sectional Study.

BACKGROUND: Mental health problems and suicide ideation are common in adolescents. Early detection of these issues could prevent the escalation of mental health-related symptoms in the long term. Moreover, characterizing different profiles of prevalent symptoms in conjunction with emotional regulation strategies could guide the design of specific interventions. The use of web-based screening (WBS) tools has been regarded as a suitable strategy to timely detect symptomatology while improving the appeal, cost, timeliness, and reach of detection in young populations. However, the evidence regarding the accuracy of these approaches is not fully conclusive. OBJECTIVE: The study aims (1) to examine the capability of a WBS to identify adolescents with psychiatric symptoms and suicidality and (2) to characterize the mental health profiles of a large sample of adolescents using WBS. METHODS: A total of 1599 Latin American Spanish-speaking adolescents (mean age 15.56, SD 1.34 years), consisting of 47.3% (n=753) female, 98.5% Chilean (n=1570), and 1.5% Venezuelan (n=24) participants, responded to a mental health WBS. A randomized subsample of participants also responded to the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID). McNemar χ2 and receiver-operating characteristic curves tested the detection accuracy of WBS contrasted with the MINI-KID. Latent profile analyses explored the symptomatic and emotional regulation profiles of participants. RESULTS: Both measures showed an adequate level of agreement (area under the curve per symptom domain ranging from 0.70 to 0.89); however, WBS yielded a higher prevalence than MINI-KID for all psychiatric symptoms, except suicide ideation and depression. Latent profile analyses yielded 4 profiles-one of them presented elevated psychopathological symptoms, constituting 11% of the sample (n=175). Rumination (odds ratio [OR] 130.15, 95% CI 51.75-439.89; P<.001), entrapment (OR 96.35, 95% CI 29.21-317.79; P<.001), and defeat (OR 156.79, 95% CI 50.45-487.23; P<.001) contributed significantly to the prediction of latent profile memberships, while cognitive reappraisal did not contribute to the prediction of any latent profile memberships, and expressive suppression was only associated to profile-2 membership. CONCLUSIONS: WBS is acceptable for the timely detection of adolescents at risk of mental health conditions. Findings from the symptomatic and emotional regulation profiles highlight the need for comprehensive assessments and differential interventions.

Nicotine prevalence among youth of rural Jaipur, Rajasthan.

Background: Children are more sensitive to tobacco advertisements than adults. The World Health Organization (WHO) reported that tobacco use has doubled in the past four decades particularly among the youth. Smoking among teenagers is an issue that affects countries worldwide. Objective: This study identified the prevalence of tobacco consumption among youth of rural Jaipur. We also studied, their age of initiation of tobacco and their correlation with the income and occupation of parents. Method: Community based cross-sectional type of study was conducted on youth of 15-24 years of age in 30 clusters in the Vatika, Jaipur. Cluster sampling technique was adopted. A semi-structured pretested and predesigned questionnaire was used for data collection. The inter-personal communication technique was used maintaining full confidentiality. All the results were transferred onto Microsoft excel sheet and evaluated statistically. Results: Out of 420 youths, 79.0% youths consumes nicotine in any form. More male subjects (90.9%) consume nicotine than females (62.8%) highly significantly. 33.1% youths started nicotine consumption <12 years. Youths from more income family(63.6%), illiterate father (76.2%), illiterate mother (74.4%), father having farming as occupation (67.2%), consumes more nicotine. more (88.6%) of youths consume nicotine with their friends. 58.1% parents oppose their children. Conclusion: The prevalence of nicotine intake was higher in boys than girls and majority of them consumes nicotine in any form gutka or beedi-cigarette. The reasons for such high dependence of nicotine according to the youth were lack of knowledge of the ill effects of nicotine intake and peer pressure. However, majority of the youth did not want to quit nicotine consumption.

Mobile App Intervention to Reduce Substance Use, Gambling, and Digital Media Use in Vocational School Students: Exploratory Analysis of the Intervention Arm of a Randomized Controlled Trial.

BACKGROUND: During adolescence, substance use and digital media exposure usually peak and can become major health risks. Prevention activities are mainly implemented in the regular school setting, and youth outside this system are not reached. A mobile app ("Meine Zeit ohne") has been developed specifically for vocational students and encourages participants to voluntarily reduce or abstain from a self-chosen addictive behavior including the use of a substance, gambling, or a media-related habit such as gaming or social media use for 2 weeks. Results from a randomized study indicate a significant impact on health-promoting behavior change after using the app. This exploratory study focuses on the intervention arm of this study, focusing on acceptance and differential effectiveness. OBJECTIVE: The aims of this study were (1) to examine the characteristics of participants who used the app, (2) to explore the effectiveness of the mobile intervention depending on how the app was used and depending on participants' characteristics, and (3) to study how variations in app use were related to participants' baseline characteristics. METHODS: Log data from study participants in the intervention group were analyzed including the frequency of app use (in days), selection of a specific challenge, and personal relevance (ie, the user was above a predefined risk score for a certain addictive behavior) of challenge selection ("congruent use": eg, a smoker selected a challenge related to reducing or quitting smoking). Dichotomous outcomes (change vs no change) referred to past-month substance use, gambling, and media-related behaviors. The relationship between these variables was analyzed using binary, multilevel, mixed-effects logistic regression models. RESULTS: The intervention group consisted of 2367 vocational students, and 1458 (61.6%; mean age 19.0, SD 3.5 years; 830/1458, 56.9% male) of them provided full data. Of these 1458 students, 894 (61.3%) started a challenge and could be included in the analysis (mean 18.7, SD 3.5 years; 363/894, 40.6% female). Of these 894 students, 466 (52.1%) were considered frequent app users with more than 4 days of active use over the 2-week period. The challenge area most often chosen in the analyzed sample was related to social media use (332/894, 37.1%). A total of 407 (45.5%) of the 894 students selected a challenge in a behavioral domain of personal relevance. The effects of app use on outcomes were higher when the area of individual challenge choice was equal to the area of behavior change, challenge choice was related to a behavior of personal relevance, and the individual risk of engaging in different addictive behaviors was high. CONCLUSIONS: The domain-specific effectiveness of the program was confirmed with no spillover between behavioral domains. Effectiveness appeared to be dependent on app use and users' characteristics. TRIAL REGISTRATION: German Clinical Trials Register DRKS00023788; https://tinyurl.com/4pzpjkmj. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s13063-022-06231-x.

Trajectories of mental health in children and adolescents during the COVID-19 pandemic: findings from the longitudinal COPSY study.

BACKGROUND: Mental health and health-related quality of life (HRQoL) in children and adolescents deteriorated during the COVID-19 pandemic. The aim of this population-based longitudinal study was to explore whether distinct mental health trajectories in youths can be identified over the course of the pandemic. METHODS: Mental health problems (MHP), psychosomatic symptoms and HRQoL were assessed at five time points between May 2020 and October 2022 in 744 children and adolescents aged 7 to 20 years using established instruments. We used generalized mixture modeling to identify distinct mental health trajectories and fixed-effects regressions to analyse covariates of the identified profiles of change. RESULTS: We found five distinct linear latent trajectory classes each for externalising MHP and psychosomatic symptoms and four trajectory classes for internalising MHP. For HRQoL, a single-class solution that indicates a common development process proved to be optimal. The largest groups remained almost stable at a low internalising and externalising symptom level (64 to 74%) and consistently showed moderate psychosomatic symptoms (79%), while 2 to 18% showed improvements across the pandemic. About 10% of the youths had consistently high internalising problems, while externalising problems deteriorated in 18% of youths. Class membership was significantly associated with initial HRQoL, parental and child burden, personal resources, family climate and social support. CONCLUSIONS: The mental health of most children and adolescents remained resilient throughout the pandemic. However, a sizeable number of youths had consistently poor or deteriorating mental health. Those children and adolescents need special attention in schools and mental health care.

Strength of relationship between body mass index and gross motor capacity in youth with intellectual disabilities.

BACKGROUND: Adequate skill levels of gross motor capacity affect activities of daily living, participation in recreational activities and general physical activity levels of youths (7-21 years). Most studies of typically developing youths have reported significant negative relationships between gross motor capacity and body mass index. The latter findings are especially of concern for youths with intellectual disabilities in that it has been estimated that 61% of children and 66% of adolescents were classified as overweight/obese. Therefore, the purpose of this study was to determine the strength of the relationship between body mass index and gross motor capacity among youths with mild to moderate intellectual disability (ID). METHODS: Components of the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2) were used for designated aspects of gross motor capacity: six items for upper limb coordination (ULC); seven items for balance (BAL); six items for bilateral coordination (BLC); and one item for agility (A-2). Participants consisted of 654 youths (438 men), ages 8-21 years with ID. Participants were divided into pre-puberty and post-puberty men (post ≥12 years) and women (post ≥10 years of age). Body mass index (BMI, kg/m2) was determined by height and weight measurements on the day of testing. A Kendall's tau correlation coefficient (τ) was used to determine the strength of the relationship between body mass index and gross motor capacity (BOT-2 test scores). RESULTS: The τ values for both pre-puberty and post-puberty for all BAL, BLC, A-2 tests and for three of the six ULC tests were negligible to very weak (τ = 0 to ±0.19). Higher τ values were seen for pre-puberty youths in three of the ULC tests, but they fell within the weak range (τ < 0.24). When combining all pre-puberty and post-puberty participants, τ values were in the negligible to very weak range for all tests. CONCLUSION: The strength of relationship between body mass index and gross motor capacity as measured by the BOT-2 subtest item scores used in this study is very weak and suggests that they are not clinically relevant.

Advanced HIV disease and associated factors among young people aged 15-24 years at a tertiary hospital in Sierra Leone: a cross-sectional study.

BACKGROUND: Advanced HIV disease (AHD) in young people living with HIV (PLHIV) is an increasingly pressing public health issue in sub-Saharan Africa. Despite global progress in early HIV testing and reducing HIV-related deaths, many youths experience increased rates of HIV disease progression in sub-Saharan Africa. This study describes the burden, clinical manifestations, and factors for disease progression among young PLHIV aged 15 - 24 years seeking medical services at a major public hospital in Sierra Leone. METHODS: We performed a cross-sectional analysis of routinely collected data for PLHIV patients aged 15 to 24 seen at Connaught Hospital in Sierra Leone between September 2022 and March 2023. We estimated the proportion of AHD in young PLHIV and performed logistic regression modelling to explore predictors of AHD. The statistical significance level was set at 0.05 for all statistical tests. RESULTS: Of the 581 PLHIV that were reported, 238 (40.9%) were between the ages of 15 and 24 years, with a median age of 22 (20-24), and 151 (63.5%) were females. On review, 178 (74.8%) has initiated antiretroviral therapy regimen (ART); 117 (65.7%) were actively on ART for ≤ 6 months, while 114 (64%) had interruptions with their ART treatment. The overall prevalence of AHD was 41.6% (99/238); 46.7% (35/68) of young PLHIV at the HIV clinic, and 39.3% (64/163) of admission. Sex-Female (OR, 0.51; 95% CI, 0.28-0.94; p = 0.030), and Tertiary Education level (OR, 0.27; 95% CI, 0.10 - 0.78; p = 0.015) have significantly lower odds of AHD in the entire study population. While for inpatients, Age (young Adults) of PLHIV (OR, 1.23; 95% CI, 1.00-1.52; p = 0.047) had 1.23 times the odds of AHD compared to adolescents, and being female (OR, 0.27; 95% CI, 0.08-0.84; p = 0.024), Overweight-Body mass index (OR, 0.10; 95% CI, 0.01-0.77; p = 0.028), Tertiary Education level (OR, 0.08; 95% CI, 0.01-0.52; p = 0.008) have significantly lower odds of AHD. Common conditions reported for the AHD group in the medical wards are tuberculosis (13.58%), hepatitis B (6.13%), Kaposi sarcoma (3.07%), and oesophagal candidiasis (2.45%). CONCLUSION: We reported a high prevalence of advanced HIV among young patients in a tertiary Hospital in Sierra Leone. One in two young PLHIV aged 15 to 24 years reported AHD, emphasizing the need to strengthen public health measures that address access to and retention of HIV services.

Association of a Healthy Lifestyle With Ambulatory 24-Hour Blood Pressure Among Chinese Youths: A Cross-Sectional Study.

BACKGROUND: This study aims to explore the association between a healthy lifestyle and abnormal ambulatory blood pressure (ABP) in Chinese youths. METHODS: A school-based sample of 1,296 college students was investigated. A lifestyle score was calculated by synthesizing 5 lifestyle factors, including smoking, alcohol consumption, diet, physical activity, and sleeping. The total score ranged from 0 to 5, with a higher score indicating a healthier lifestyle. This score was then divided into 3 categories representing low adherence to a healthy lifestyle (0-2), medium adherence (3), and high adherence (4-5). Abnormal 24-hour blood pressure (BP) was defined as systolic BP (SBP) ≥ 130 mm Hg and/or diastolic BP (DBP) ≥ 80 mm Hg. Abnormal daytime BP was determined as daytime SBP ≥ 135 mm Hg and/or DBP ≥ 85 mm Hg, while abnormal nighttime BP was characterized as nighttime SBP ≥ 120 mm Hg and/or DBP ≥ 70 mm Hg. We assessed the associations using the binomial regression model. RESULTS: Mean age was 18.81 years, and 74.5% were women. The prevalence of abnormal 24-hour BP, daytime BP, and nighttime BP are 4.2%, 3.7%, and 9.0%, respectively. We found that participants with a high level of adherence to a healthy lifestyle had a significantly lower prevalence of abnormal 24-hour BP [prevalence ratios (PR) = 0.15, 95% CI: 0.05, 0.48] and abnormal daytime BP (PR = 0.16, 95%CI: 0.05, 0.52), when compared to those with a low level of adherence and after adjusting for the potential covariates. CONCLUSIONS: A healthier lifestyle is associated with a better ambulatory BP profile among youths.

Is higher adherence to the mediterranean diet associated with greater academic performance in children and adolescents? A systematic review and meta-analysis.

OBJECTIVE: The aim of the present study was to synthesize the available evidence from the relationship between adherence to the Mediterranean diet (MedDiet) and academic performance in children and adolescents. METHODS: A systematic review and meta-analysis was conducted, which adhered to the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Four electronic databases (PubMed, Scopus, Web of Science, and the Cochrane Library) were examined from inception to April 8th, 2024. RESULTS: Eighteen studies were included in the current systematic review and sixteen in the meta-analysis. The relationship between adherence to the MedDiet and academic performance among children and adolescents was statistically significant (Pearson's correlation coefficient [r] = 0.17, 95% confidence interval [CI]: 0.14 to 0.21, p < 0.001; inconsistency index [I2] = 56.7%). The influence analysis revealed that removing individual studies one at a time did not result in any changes to the overall results (p < 0.05 in all cases). CONCLUSIONS: A higher adherence to the MedDiet could play a relevant role in academic performance among children and adolescents.

Proportion of early treatment seeking for sexually transmitted infections and associated factors among patients attending youth friendly service in Bahir Dar City health centers, Northwest, Ethiopia.

BACKGROUND: Sexually transmitted infection is a common public health issue of youths and is characteristically transmitted through sexual intercourse. Even though early treatment for sexually transmitted infection is very important to reduce further complications and economic burden, studies to identify the proportion and the possible factor of early treatment seeking is rare in Ethiopia. OBJECTIVE: To assess the proportion of early treatment seeking for sexually transmitted infections and associated factors among patients attending youth friendly service in Bahir Dar city health centers, northwest, Ethiopia 2023. METHOD: Institutional based Cross-sectional study was used among 407 participants from April 25 to May 24 /2023. A systematic random sampling technique was used to select the participants. An interview-administered questionnaire was used for data collection, whereas Epi-data version 4.6.0.2 and the statistical package for statistical science version 23 were used for data entry and analysis respectively. A frequency table and bar chart were used for descriptive analysis. Multiple binary logistic regression was employed to identify the factors at p-value of <0.05. The necessary assumption of the model was also checked by the Hosmer and Lemishow test. RESULTS: The response rate of this study was 391 (96.1%) and the proportion of early treatment for sexually transmitted infection was 108 (27.6%, 95%CI; 23-32). Good knowledge about sexually transmitted infection (AOR=1.98, 95CI%; 1.13-3.47) know about their HIV status (AOR=1.95, 95%CI; 1.13-3.36), perceive severity of sexually transmitted infection (AOR=11.23, 95%CI; 6.15-20.45), and not fear the stigma about being infected with sexually transmitted infection (AOR=2.29, 95%CI; 1.32-3.96) were the significantly associated factors for early treatment of sexually transmitted infection. CONCLUSION AND RECOMMENDATION: The proportion of early treatment for sexually transmitted infection in Bahir Dar city was low. Knowledge about STIs, testing/ knowing HIV status, perception of the severity about sexually transmitted infection, and fear of stigma about sexually transmitted infection were the statistically significant factors for early treatment of sexually transmitted infection. So the government better give attention to health education and other health promotion activities to increase the knowledge of youths about sexually transmitted infection and to change their perception of sexually transmitted infection.

Resilience in children of parents with mental illness, alcohol or substance misuse-An integrative review.

AIM: The aim of this integrative review was to investigate how resilience has been researched and explore experiences of resilience, in children of parents with mental illness or alcohol or substance misuse. DESIGN: An integrative review. METHOD: The search included three major electronic databases, PubMed, Scopus and PsycINFO with the aim of identifying peer-reviewed studies where the concept of resilience was explored as resilience, coping, adaptation or protective factors. RESULTS: Out of 4016 studies, 14 were included after meeting predetermined criteria and methodological quality evaluation. The findings are presented in five categories: characteristics of the studies, operationalization and interpretation of resilience, individual resources, family resources and resources outside the family. PATIENT OR PUBLIC CONTRIBUTION: Resilience in children of parents with mental illness or substance misuse refers to coping strategies, protective factors and absence of symptoms or risk behaviour despite being exposed to risk. We suggest a three-level approach for mapping of resilience resources in the target group: the individual level, family level and outside of the family that includes both non-professionals and professionals. The use of disengagement or avoidance strategies implies poor resilience but may be necessary in absence of support, as acts of self-preservation during chaotic periods or harmful situations.