Biotics and Children's and Adolescents' Health: A Narrative Review.

Recently, there has been an increasing interest in the association of gut microbiota with health conditions and the potentially beneficial role of several types of biotics in several population groups, including children and adolescents. Children and adolescents comprise a unique population group due their rapid growth rates, high nutritional requirements, the immaturity of their immune system in early life, and their susceptibility to infectious diseases. The aim of the present study is to investigate the role and limitations of the administration of biotics in specific conditions affecting children and adolescents. A narrative review of related articles published on PubMed up to October 2023 was conducted. The administration of biotics has been evaluated in several health conditions among children and adolescents, such as the treatment and prevention of infectious diarrhea, the prevention of diarrhea after the use of antibiotics, the prevention of necrotizing enterocolitis, the treatment of functional gastrointestinal diseases, such as infant colic, functional abdominal pain, and irritable bowel syndrome, the eradication of H. pylori, the treatment of ulcerative colitis and pouchitis, and the prevention of atopic dermatitis, and the findings indicate improved symptoms and various beneficial health outcomes. However, some limitations have been identified regarding probiotics' use. In conclusion, biotics may have a beneficial impact in several health conditions among children and adolescents. There is a need for additional randomized, controlled clinical studies on the effects of the administration of biotics in children and particularly in adolescents and young adults.

Social Egg Freezing-A Trend or Modern Reality?

INTRODUCTION: Egg freezing for social reasons is a process in which women who want to preserve their ability to fertilize their own oocytes at an older age freeze their eggs. With the help of in vitro fertilization, the cryopreservation of oocytes for future use is achieved. The aim of this article is to study the reasons, the risks and the effectiveness of the method from a worldwide aspect. METHODS: A literature search was conducted to evaluate pertinent studies, using data from the search engines PubMed, Google and UptoDate as well as the medical literature. RESULTS: The reasons for delayed procreation are non-medical, with the lack of an appropriate partner for a family being first on the list. The success rate of this method differs with the age of the woman, the number of fertilized eggs and other factors. Like every medical procedure, this method carries risks that relate to the mother (being of advanced age), the embryo and the procedure of in vitro fertilization. The policies that apply in each country differ depending on respective social, economic, religious and cultural factors. Due to the high cost of the method, its selection remains a choice for only a few, reinforcing social inequality. The question of the medicalization of reproduction remains unanswered in the industry of assisted reproduction. CONCLUSIONS: In conclusion, egg freezing for social reasons is gradually becoming more widely known, with the United States of America and Israel being at the top the list. Unfortunately, there is no official data registry, and consequently, no statistical results are yet available for Greece, even though it is a method that more and more women are considering. Nevertheless, there is an imperative need for a universal legal framework for all countries with respect for the needs of every woman and different social conditions. More research and data from the literature are needed in relation to the effectiveness of the method from moral and social perspectives.

Serum concentrations of BDNF in adolescents with metabolic syndrome: a case-control study between normal - BMI adolescents and adolescents with obesity.

Brain-Derived Neurotrophic Factor (BDNF) has been linked to various conditions of the cardiovascular and nervous systems. Scarce data exist about the concentrations of BDNF in children and adolescents in relation with obesity and metabolic syndrome (MetS). The aim of this study was to examine the serum BDNF concentrations in adolescents with metabolic syndrome and according to their body mass index (BMI) status. This was a case-control study, assessing BDNF concentrations between adolescents with MetS (with obesity vs. normal-BMI), in relation to sex, anthropometric, metabolic and endocrine parameters. Participants included male and female adolescents, whose anthropometric and metabolic panel, as well as serum BDNF concentrations were measured. A total of 59 adolescents (obesity: 29; normal-BMI: 30) were included in the study. Increased serum BDNF concentrations were observed in MetS adolescents with obesity when compared with normal-BMI adolescents (p < 0.001). Males exhibited higher concentrations of BDNF than females (p = 0.045). The sample was further divided into four categories by sex and BMI status, with normal-BMI females exhibiting significantly lower BDNF concentrations than females and males with obesity(p = 0.005). In the entire study sample, serum BDNF concentrations correlated positively with BMI z-scores, however, this statistical significance was preserved only in the females of the sample. No statistical difference was observed between males of different BMI z-scores categories.  Conclusion: Obesity appeared as a major factor for increased serum BDNF concentrations in adolescents with MetS (vs. normal-BMI), with a higher impact on BDNF concentrations in females than males. What is Known: • The brain-derived neurotrophic factor (BDNF) is involved in metabolic syndrome in adults but data in adolescents are scarce. What is New: • Obesity (vs. normal BMI) was a major factor for increased serum BDNF in adolescents with metabolic syndrome. • Obesity had a higher impact on BDNF concentrations in females than males with metabolic syndrome.

The role of various influence sources on sexual behavior in adolescents with type 1 diabetes in comparison to healthy peers: a cross-sectional study from Greece.

PURPOSE: Patients with type 1 diabetes mellitus (T1D) are at increased risk of sexually risky behaviors, such as unintended pregnancies. Adolescents with T1D use different sources of information on sexual education such as parents, friends, teachers, and the media. The study aim was to investigate the effect of different sources of information in development of sexual risk behaviors in T1D adolescents in comparison to healthy peers. METHODS: The study included 174 adolescents (58 adolescents with T1D and 116 healthy controls). Anonymous questionnaires were used to evaluate sexually risky behaviors. RESULTS: T1D adolescents were more frequently asking advice from friends on sexual matters concerning the opposite sex (p = 0.026) and from school teachers (p = 0.059) when compared to controls. The proportion of sexually active T1D adolescents who had ever consumed alcohol before any sexual intercourse was higher when informed by friends of the opposite sex (p = 0.039) and not informed by a physician (p = 0.025) and lower when informed by parents (p = 0.015). When comparing among sexually active adolescents those who felt that they were adequately informed to those not well informed, no significant difference in high risk behaviors was found. CONCLUSIONS: The majority of T1D adolescents felt that they were adequately informed on sexual matters compared to healthy peers. They mostly used friends of the opposite sex and teachers as information sources. Nevertheless, T1D adolescents were more likely to adopt a risky sexual behavior if they were not informed by their parents and medical professionals, or preferred friends of the opposite sex.

Comparative study of pandemics and their impact on children and adolescents: COVID-19 and Spanish Flu.

Overview: Pandemics are characterized by an abrupt and sudden outburst and absence of preparation for its management. The focus during pandemics is on the medical aspect of the disease and not on its impact on the citizens' or vulnerable groups' psychosocial wellbeing. Aim: The purpose of this study was to highlight the impact of the pandemics of the Spanish Flu and COVID-19 on children and adolescents as well as to recognize their short and long-terms effects on children's and adolescents' physical and mental health. Materials and Methods: The material of this review constituted of publications regarding the impact of the Spanish Flu and COVID-19 on children and adolescents via relative search through valid databases and websites of trustworthy organizations. Results: The main finding of the present review was that pandemics negatively affect children and adolescents undermining their mental and physical health. The factors that negatively impact on this population's normal development include parental death, financial hardships, restrictive measures, disruption of daily routine and absence of social contact. The short-term effects include anxiety, depression, aggressive behavior as well as fear and grief. Mental disorders, disability, poor academic performance and low socioeconomic level are among the long-term effects of the two under study pandemics. Conclusions: Children and adolescents constitute a vulnerable group amidst pandemics and there is a need for coordinated worldwide and national actions to prevent and timely manage a pandemic's impact.

Domestic Violence During the COVID-19 Pandemic: A Systematic Review.

BACKGROUND: COVID-19 outbreak and the followed confinement measures have raised concerns to specialists worldwide regarding the imminent increase in domestic violence cases. The present systematic review aims to identify the international trends in domestic violence during the COVID-19 epidemic and to examine the possible differences among all population groups and different geographic areas worldwide. METHOD: The following databases were accessed: DOAJ, ERIC, Google Scholar, ProQuest, Pubmed, PsycNet, and SCOPUS, up to July 22, 2020. RESULTS: A total of 32 studies were considered eligible. Data from North America, Europe, Asia-Pacific Area, Africa, and worldwide researches were retrieved. COVID-19 has caused an increase in domestic violence cases, especially during the first week of the COVID-19 lockdown in each country. In children, however, although the specialists' estimations suggested an increase in child maltreatment and abuse cases, the rate of police and social services' reports has declined during the COVID-19 pandemic. School closures that isolated students at home seemed to have contributed to this decrease. CONCLUSIONS: Domestic violence has been a considerable issue imposed by the COVID-19 epidemic to a worldwide context. The home confinement led to constant contact between perpetrators and victims, resulting in increased violence and decreased reports. In order to minimize such issues, prevention measures and supporting programs are necessary.

Vaccination Coverage during Childhood and Adolescence among Undergraduate Health Science Students in Greece.

High rates of vaccination coverage in childhood represent one of the most important cost-effective tools of primary prevention and have substantially reduced the incidence of and mortality from vaccine-preventable diseases globally. Vaccination coverage of young people has not been well estimated in Greece. Anonymous self-completed questionnaires and the participants' Child Health Booklet were used to estimate complete vaccination coverage of mandatory vaccinations against vaccine-preventable diseases of undergraduate students at the University of West Attica during the academic year 2020−2021. Student's t-tests were used to estimate mean values. Overall, 79% (95% CI: 78−81%) of study participants were fully vaccinated. This coverage was lower in males especially for vaccines that should be done during childhood (p = 0.045). High vaccination percentage (>90%) was observed for the meningococcus group A, C, W135, Y, measles-mumps-rubella, hepatitis B and meningitis C vaccine. Nevertheless, suboptimal coverage was assessed for the booster dose of tetanus, diphtheria, pertussis, for the human papillomavirus vaccine among girls, for the tuberculosis, for the meningococcus group B, for the pneumococcal, and for the seasonal influenza vaccines. In conclusion, the promotion of routine vaccination programs for young adults needs to be strengthened. An identification system for under-vaccinated students, an efficient reminder system and university campus vaccine program practices should be established, particularly among males.

Postpartum depression and ADHD in the offspring: Systematic review and meta-analysis.

BACKGROUND: Postpartum depression (PPD) is a disorder that has a severe impact on a woman's mental state and mood after birth. Research has shown that postnatal levels of family adversity and maternal psychopathology are associated with Attention Deficit Hyperactivity Disorder (ADHD). This paper is intended to examine the association among maternal PPD and the risk of ADHD in the offspring. METHODS: Keyword search was conducted for PsycINFO, PubMed, Google Scholar, and Embase up to Feb 28, 2021; studies in English were deemed eligible. Random-effects meta-analysis and meta-regression analysis took place. Subgroup analyses by study design, geographical region, level of adjustment and study setting were performed. RESULTS: Nine cohort studies and two case-control studies published from 2003 to 2019 were included in the qualitative synthesis; among them, eight studies were synthesized in the meta-analysis. Overall, maternal PPD was associated with an increased risk of ADHD in the offspring (pooled relative risk, RR = 1.69, 95%CI: 1.27-2.26). Significant associations were noted in the subsets of cohort studies, studies implementing multivariate analyses and registry-based surveys. LIMITATIONS: Overall, a larger number of studies of the field are needed. Data collection relied on self-report and attrition bias limited the validity of eligible studies. Studies from developing countries were underrepresented. There was significant publication bias (p = 0.035, Egger's test). CONCLUSIONS: The relationship between PPD and ADHD in children was found to be significant in this systematic review and meta-analysis and reveals the need for further investigation in various geographical regions.

Giftedness and Neurodevelopmental Disorders in Children and Adolescents: A Systematic Review.

OBJECTIVE: Throughout the years, several myths have arisen suggesting that children diagnosed with neurodevelopmental disorders possess unusually high abilities in specific domains, depending on the disorder. On the other hand, special skills and talents in children with neurodevelopmental disorders are most commonly overshadowed by their difficulties and overlooked. The purpose of this systematic review is to examine the association between giftedness and neurodevelopmental disorders. METHODS: The related articles published in PubMed, Google Scholar, PsycINFO, and Embase up to December 31, 2020, as well as their reference lists, were reviewed systematically. RESULTS: A total of 6069 studies were scanned, and 32 of them (9904 subjects) were deemed eligible for this systematic review. Studies have supported associations between autism spectrum disorders and music ability. Contradictory results have been published regarding associations between giftedness, attention-deficit/hyperactivity disorder, and specific learning disorders. Diagnostic methods seemed to modify associations between giftedness and neurodevelopmental disorders. CONCLUSION: The dearth of the available evidence is prominent. More research is needed to investigate the field of dual exceptionality. Longitudinal studies are needed, addressing methodological challenges pertaining to variability in the definition of giftedness.

Psycho-emotional consequences in pregnant women during the COVID-19 pandemic.

Fear of COVID-19, especially in vulnerable groups such as pregnant women, created excessive concern leading to unexpected psycho-emotional consequences and a need to summarize the most recent knowledge about this topic. Therefore, we conducted a narrative review of the relevant literature, synthesizing data from available databases.

Sexual abuse and post-traumatic stress disorder in childhood, adolescence and young adulthood: a systematic review and meta-analysis.

Child sexual abuse (CSA) has been associated with mental health disorders throughout life during childhood, adolescence and adulthood; one of the most prevalent mental health conditions after CSA is post-traumatic stress disorder (PTSD). The present systematic review and meta-analysis aims to examine the association between CSA and PTSD in children and adolescents, evaluating also the role of potential effect modifiers, such as gender and geographic region. Participants were sexually abused (vs. CSA-free) children, adolescents and young adults, up to 21 years of age, with or without a PTSD diagnosis. Settings of eligible studies spanned school, college, university, community, hospital and non-hospital mental health facilities. Eligible studies were sought in PUBMED, ΕΜΒΑSE, PSYCINFO and GOOGLE SCHOLAR databases; end-of-search was set at August 31, 2020. Random-effects (DerSimonian-Laird) models were used for the pooling of studies. Results were reported as pooled odds ratios (OR) and 95% confidence intervals (95% CIs). Twenty-eight studies were identified, including a total cohort of 28,693 subjects. CSA was strongly associated with PTSD, at a similar extent in boys (pooled OR = 2.86, 95% CI 2.09-3.91) and girls (pooled OR = 2.38, 95% CI 1.76-3.23); meta-regression with gender confirmed the non-significant effect of gender. The association was present in all examined geographic regions. CSA is strongly associated with PTSD in childhood, adolescence and young adulthood, irrespectively of gender. Future studies should opt for thorough assessment of confounders and examine regions with paucity of studies, such as East Asia and Latin America.

Adolescent Idiopathic Scoliosis and Mental Health Disorders: A Narrative Review of the Literature.

Adolescent idiopathic scoliosis (AIS) is the most common type of scoliosis. The condition begins in puberty, affects 1-4% of adolescents, and disproportionately affects young women. Our aim was to comprehensively examine the association between AIS and risk for depression, anxiety, eating disorders, psychotic disorders, and personality dysfunctional mechanisms. METHODS: Literature review of related articles published in PubMed, Google Scholar, and Scopus up to 15 July 2021. RESULTS: A total of 30 studies were deemed eligible, examining the effects of AIS upon mental health, and using appropriate psychometric inventories. Studies highlighted the association of brace treatment with elevated anxiety. In addition, mental health conditions and traits (e.g., anxiety and depressive symptoms, neuroticism) were detected more frequently amongst AIS patients compared to healthy controls. CONCLUSIONS: AIS represents a risk factor for mental health disorders. More longitudinal studies, utilizing accurate psychometric instruments, are warranted, to reveal the current impact of AIS on the mental health of youngsters, along with the tailoring of well-targeted interventions to reduce the burden of mental health issues in adulthood.

Orthorexia and Eating Disorders in Adolescents and Young Adults: A Systematic Review.

BACKGROUND: In recent years a new term in the field of eating behaviors has emerged, namely "orthorexia". This behavior is associated with significant dietary restrictions and omission of food groups. The aim of the present study is to estimate the possible correlations between orthorexia and eating disorders in young adults and adolescents. METHODS: A systematic review of related articles in PubMed, Google Scholar, and PsycInfo was conducted up to 30 June 2021. RESULTS: A total of 37 studies (16,402 subjects) were considered eligible for this systematic review. Significant correlations were observed in most of the studies between orthorexia and eating disorders. However, the majority of studies adopted a cross-sectional design. CONCLUSIONS: An association between and eating disorders emerged. Prospective studies seem necessary to investigate associations and succession of orthorexia and eating disorders over time.

Gut microbiome and attention deficit/hyperactivity disorder: a systematic review.

BACKROUND: This systematic review aims to examine the associations between features of gut microbiome and Attention Deficit/Hyperactivity Disorder (ADHD) risk or severity in children, adolescents and young adults. METHODS: Eligible studies were identified in PubMed and Google Scholar databases until December 31, 2020. RESULTS: The search identified a total of 1197 items, of which 11 were included in this systematic review. The findings regarding alpha, beta diversity, bacterial phyla, orders and families were inconclusive. At the genus level an increased abundance of Odoribacter (two studies) and Eggerthella (two studies) was found in ADHD; on the contrary, decreased abundance of Faecalibacterium (three studies) was noted, whereas one study suggested its inverse association with ADHD severity and hyperactivity. One study indicated that Bacteroides species also correlated with levels of hyperactivity and impulsivity. At the species level, a lower abundance of Faecalibacterium prausnitzii, but higher of Odoribacter splanchnicus and Bacteroides uniformis was reported. CONCLUSIONS: This systematic review highlights associations between gut microbiome features and ADHD. Potential mechanisms differ by microorganism and include effects on neurotransmitter production, dopamine metabolism, modulation of inflammation and neurodevelopment through the release of cytokines. IMPACT: The existence of correlations between features of gut microbiome and ADHD manifestation or its severity in children, adolescents and young adults. Associations between gut microbiome features and ADHD are highlighted. Potential mechanisms seem to differ by microorganism and include effects on neurotransmitter production, dopamine metabolism, modulation of inflammation and neurodevelopment through the release of cytokines. As correlations between gut microbiome features and ADHD seem to exist, additional studies are needed for further investigation.

Cross-National Comparisons of Internalizing Problems in a Cohort of 8952 Adolescents from Five European Countries: The EU NET ADB Survey.

Various factors such as family relationships, socioeconomic indicators, socio-cultural aspects, mental health problems and demographic variables, have been associated with internalizing problems in adolescence. The purpose of this study was to examine the prevalence of internalizing problems in adolescents from five European countries in comparison with risk factors. Using data from the European Network for Adolescent Behavior (EU NET ADB) survey, a cross-sectional school-based study of adolescents (from 14 to 17.9 years) was conducted. Data were retrieved from self-report questionnaires derived from Greece, Spain, the Netherlands, Iceland and Romania. Multiple logistic regression analysis overall and by country was held through estimation of odds ratios (OR) and 95% confidence intervals (95% CI). A total of 8952 adolescents participated in the study. According to the results, Greece (7.6%) and Romania (2.4%) presented with the lowest rates of internalizing problems, while Iceland presented the highest (11.1%). Internalizing problems were associated with lower school grades (adjusted OR = 1.21, 95% CI: 1.08-1.36), while the higher education level of parents was associated with lower odds of internalizing problems (adjusted OR = 0.75, 95% CI: 0.62-0.92). In country-specific analyses, factors that affected the likelihood of internalizing problems were gender, age, maternal and paternal unemployment. Variations detected in adolescents' internalizing problems were determined by the socio-cultural context of each country. Cultural differences should be addressed thoroughly in further research, in order to better understand and intervene in aspects of internalizing problems in adolescence.

Food Difficulties in Infancy and ASD: A Literature Review.

PURPOSE: The aim of this literature review is to investigate the potential association between specific food difficulties and autism spectrum disorder (ASD) during the first two years of life. MATERIALS: The search was conducted in PubMed, Google Scholar, Embase and PsycInfo databases. RESULTS: Twenty-one studies were synthesized (3763 infants and children). Difficulties during breastfeeding, breast milk refusal and avoidance of taking solids have been linked to ASD. Infants with ASD have been referred to as picky eaters. Problematic mealtime behaviour during infancy has also been associated with ASD. CONCLUSIONS: The present review highlights the association between food difficulties, including problematic mealtime behaviours, food selectivity, breastfeeding difficulties and food refusal during infancy and ASD early during life, including the first months.

Adolescent Perspectives About Online Hate Speech: Qualitative Analysis in the SELMA Project.

OBJECTIVE: This paper aims to study the views, perceptions and representations of online hate speech among adolescents in the Greek cohort of the SELMA Project. METHODS: Qualitative research was conducted in focus groups of 36 Greek adolescents and the data were processed through thematic analysis method. RESULTS: The majority was unfamiliar with the term "hate speech" and confused it with cyberbullying. The target characteristics of hate, ethnicity, race, gender, religion, physical weakness, disability, sexual orientation, and appearance emerged. Regarding people involved in hate speech, perpetrators in both hate speech and bullying were described to share common characteristics. The emphasis was placed on the victims' resilience, as well as their socialization, as protective behaviors. Participants stressed the value of the right to freedom of speech, although there was no agreement on its limits. Additionally, it was highlighted that awareness of what is right and wrong is mostly taught by parents, while the role of education was also important. An important finding was that the majority of teenagers were optimistic, supporting the belief that it is possible to find a realistic solution. CONCLUSION: The findings support the need for prevention strategies in the school environment, so that adolescents will be able to recognize and potentially combat hate speech in the online and offline worlds.

School Performance among Children and Adolescents during COVID-19 Pandemic: A Systematic Review.

As a result of COVID-19 restrictions, conventional ways of schooling were not possible, and in order to continue the educational process new digital resources, such as online learning platforms, were imposed. Although virtual courses provided high-quality educational material, the efficiency in children's and adolescents' academic performance in general is yet to be known. The purpose of this systematic review is to examine whether the academic performance of school-aged students was impacted or not through online learning and modified educational methods during the ongoing COVID-19 pandemic. According to the studies, either students suffered from learning losses comparing to pre-pandemic years or, in some cases, they benefited from online learning, especially in mathematics. Younger students and students with neurodevelopmental disorders or special education needs seemed to suffer more. Parents/caregivers reported that their children's performance deteriorated, while others thought that online learning was beneficial. Teachers also reported that students presented academic gaps and difficulties in mathematics and reading compared to typical years. Consequently, the new ways of schooling imposed by the restrictions have not been fully tested and the impact cannot be described thoroughly. The investment in technological equipment in schools for the majority of students, along with the training of teachers in digital competence, should be a priority.

Validation of the Greek version of the Adolescent Sleep Hygiene Scale (ASHS).

Transition from childhood to adolescence is known to bring about many changes in the lifestyle and psycho-emotional state of adolescents. One of the major lifestyle factors that affect adolescents' physical and mental health is sleep. The aim of this study was to validate the Adolescent Sleep Hygiene Scale (ASHS), a tool that measures sleep hygiene, in an adolescent sample living in Greece. The study's sample consisted of 146 Greek adolescents aged 12-18 years. The Adolescent Stress Questionnaire was used for convergent validity and correlation with adolescents' stress. The pilot and the main study demonstrated sufficient internal consistency. Exploratory Factor Analysis showed an adequate adaptation of the original ASHS questionnaire to the Greek adolescents. The findings of this study support the use of ASHS as a reliable and valid tool for evaluating sleep-facilitating and sleep-inhibiting practices of Greek adolescents.

Adolescents' Online Pornography Exposure and Its Relationship to Sociodemographic and Psychopathological Correlates: A Cross-Sectional Study in Six European Countries.

The aim of the study was to assess the prevalence of online exposure to pornography in European adolescents and its relationship to sociodemographic and psychopathological correlates. A cross-sectional school-based survey of 10,930 adolescents (5211 males/5719 females), aged 14-17 years old (mean age 15.8 ± 0.7) was carried out in six European countries (Greece, Spain, Poland, Romania, the Netherlands, and Iceland). Anonymous self-completed questionnaires covered exposure to pornography, internet use and dysfunctional internet behavior, and psychopathological syndromes (measured by Achenbach's Youth Self-Report). The prevalence of any online exposure to pornography was 59% overall and 24% for exposure at least once a week. The likelihood of online exposure to pornography was greater in male adolescents, heavier internet users, and those who displayed dysfunctional internet behavior. Country-specific analyses confirmed that the gender effect existed in every country, although its strength varied, from an odds ratio of 1.88 in Poland to 14.9 in Greece. Online exposure to pornography was shown to be associated with externalizing problem scale scores, especially rule-breaking and aggressive behavior, but also associated with higher scores in competences, namely activities and social competence. Exposure to pornography is ubiquitous, more relevant to boys, and is associated with both positive qualities/competences and externalizing behavioral problems.