Associations between participation in family activities and adolescent school problems.

INTRODUCTION: Adolescent risk outcomes related to school issues are widespread, with about 20% parents reporting poor school engagement amongst their youth. Previous literature suggests that adolescents who report strong bonds with their parents are often identified as being less likely to engage in risky behaviours, such as substance use. The current study sought to examine the association between the frequencies of selected family activities and school problems amongst adolescents after adjustments for family connectedness and other characteristics. METHODS: Data were drawn from the National Longitudinal Survey of Youth, 1997. Of the 8984 youth interviewed, 3855 also had a sibling interviewed who met the selection criteria. School problem outcomes measured were suspension occurrence, poor grades and highest grade completed low for age. Independent variables of interest were self-reported frequency of family dinner, fun and religious activities in a typical week. Multivariable logistic models were estimated for each outcome, and multivariable linear probability models were estimated adjusting for family fixed effects. RESULTS: Adjusting for family connectedness, there were significant associations between certain family activities and adolescent school problem measures. However, these results did not remain significant in models with family fixed effects, suggesting that associations could be driven by family-level confounders. DISCUSSION: This study did not find strong evidence of a protective relationship between family activities and school problems. Therefore, it suggested that programme and policymakers be cautious in overstating the importance of family activities in preventing adolescent risk outcomes until true causal relationships can be determined.

Wellness among US adolescents ages 12-17 years.

BACKGROUND: Wellness is a multidimensional construct related to an individual's physical, emotional, intellectual and social well-being. We present estimates of wellness among US adolescents aged 12-17 years and explore how demographic characteristics are associated with wellness. METHODS: All respondents aged 12 to 17 years (n = 34,601) from the 2011-2012 National Survey of Children's Health were included in the sample. Survey items were coded to operationalize an overall wellness score, comprised of four subdimensions (physical, intellectual, emotional and social). RESULTS: The mean adjusted overall wellness score was 30.2 (out of 40). Mean raw subdimensions scores were: social = 3.14 (out of 4), emotional = 4.79 (out of 6), intellectual = 4.80 (out of 8) and physical = 6.57 (out of 8). Older adolescents, those with special health needs, those in lower income families and those whose mother or father report fair-poor mental health status had lower wellness scores. CONCLUSIONS: US adolescents have wellness scores towards the upper or higher end of our scale. Several adolescent and family characteristics were associated with either lower overall wellness and/or lower wellness on multiple subdimensions. Assessing wellness during critical developmental periods of adolescence is a first step towards promoting behaviours that support increased wellness into adulthood.

Correlates of wellness among youth with functional disabilities.

BACKGROUND: The literature is more informative on the impediments to wellness among youth with functional limitations and less instructive on the state of wellness for this population. OBJECTIVE: To explore overall wellness, and each sub-dimension of wellness, in a national sample of youth with functional limitations and to determine how demographic characteristics are associated with wellness. METHODS: Using a previously validated screening instrument, we identify youth with functional limitations aged 12 to 17 represented in the 2011/12 National Survey of Children's Health. Survey items were coded to operationalize an overall wellness score comprised of four sub-dimensions of wellness (i.e., physical, intellectual, emotional, and social). RESULTS: The mean overall wellness score was 26.7 (out of 40) and had an approximate normal distribution. Mean raw scores for each sub-dimension were as follows: social = 2.79 (out of 4; 69.7%); emotional = 4.09 (out of 6; 68.2%); intellectual = 3.79 (out of 8; 47.4%); and physical = 6.30 (out of 8; 78.7%). Lower wellness scores were associated with older age among youth, increasing number of chronic health conditions, lower income, single mother homes, and youth whose mother reported fair or poor mental health status (all p < 0.05). Higher wellness scores were positively associated with mother's education (p < 0.001). CONCLUSIONS: Program planners should consider interventions that target youth with functional limitations shown to be at particular risk for lower overall wellness and promote family involvement and comprehensive supports, including maternal educational attainment, mental health screening, and referral.

Erythropoietic protoporphyria: hepatic cirrhosis.

Observations on liver pathology and function were made on 12 patients with erythropoietic protoporphyria (EPP). Needle liver biopsies in 3 of 11 patients showed mild portal or periportal fibrosis without evidence of abnormal liver function. One patient (Case 12), died from hepatic cirrhosis and failure at the age of 11 years, the youngest yet reported. He was not suspected of pending liver disease until 3 months before death. The quantity of protoporphyrin present in his liver was approximately 5.75% of total liver weight. Fatal liver disease in EPP has occurred in 13 patients, 7 male and 6 female, in which the mean age of death was 38 years. The pathology of the liver in EPP is characteristic and is described.

Erythropoietic protoporphyria: juvenile protoporphyrin hepatopathy cirrhosis and death.

Severe hepatic cirrhosis and failure in erythropoietic protoporphyria is rare. An 11-year-old boy is described who developed protoporphyrin hepatopathy (protoporphyrin 5.75 mg/gm liver wet weight), cirrhosis, and liver failure and died.