Prevalence and Correlates of Double and Triple Burden of Malnutrition Among Children and Adolescents in India: Comprehensive National Nutrition Survey.

BACKGROUND: Limited information on the co-prevalence of undernutrition, micronutrient deficiencies, overnutrition, and abnormal levels of noncommunicable disease biomarkers at the same time in children and adolescents in India hinders efforts to comprehensively address their health. This study aims to examine the prevalence and correlates of double and triple burden of malnutrition (DBM, TBM) among children and adolescents (5-19 y) to inform policies and programs. METHODS: A total of 17,599 children (5-9 y) and 16,184 adolescents (10-19 y) with available biomarker data from the Comprehensive National Nutrition Survey were included. Malnutrition was defined based on either undernutrition based on anthropometry, overnutrition/abnormal metabolic markers, and anemia/micronutrient deficiency. DBM was defined as the coexistence of any two forms of malnutrition. DBM+ was defined as the coexistence of undernutrition and/or micronutrient deficiency along with overnutrition. TBM was defined as having the coexistence of all three forms of malnutrition. The prevalence of DBM, DBM+ and TBM was estimated accounting for probabilistic selection. We used mixed effects binomial regression to determine correlates of DBM/TBM in children and adolescents separately. RESULTS: The prevalence of DBM, DBM+ and TBM was 50.8%, 37.2%, and 14.4%, respectively, in children, and 53.4%, 36.1%, and 12.7%, respectively, in adolescents. The prevalence of DBM+ was significantly higher in children girls compared to boys. In children, being in a disadvantaged caste group, having a lower wealth index, having inadequate diet diversity, having no maternal schooling and having a recent history of acute illness were associated with DBM. In adolescents, being in a disadvantaged caste group, maternal occupation, and lower paternal age were correlated with DBM. A similar set of variables was associated with TBM in both age groups. CONCLUSION: The prevalence of DBM and TBM is substantial in children and adolescents in India and varies across states. Socioeconomic factors and acute illness were the main correlates for DBM and TBM.

[Relationship between dietary risk factors and sedentary recreational screen time among school-age children in grades 4-6 in Baise City from 2018 to 2019].

OBJECTIVE: To explore the relationship between dietary risk factors and sedentary recreational screen time of adolescents. METHODS: A total of 6363 pupils of Grades 4-6 from 6 primary schools in Baise were recruited with cluster-sampling method from Sep.2018 to Nov.2019. Participants were asked to report the average duration of watching television, digital devices use, intakes of sugar-sweetened beverage(SSB), snacks, fast-food, soymilk/milk product, skipping breakfast, and frequency of fruit/vegetable. We performed multivariable logistic regression to estimate OR and 95%CI for the relations between duration of sedentary recreational screen time and dietary risk factors, accounting for complex survey sampling and adjusting for potential confounders. RESULTS: (1)Both prolonged watching television and leisure-time digital devices use were associated with high intakes of SSBs, snacks, and low intakes of fruits and vegetables. And compared with <2 h/d, two kinds of screen-time(>4 h/d) was associated with significantly higher odds for intakes of fast food(watching television: OR=2.551;leisure-time digital devices use: OR=3.024), and frequent breakfast skipping(watching television: OR=1.646;leisure-time digital devices use: OR=1.674). (2)Compared with the reference groups(<2 h/d), participants spending more time per day on sedentary recreational screen time were more likely to drink sugar-sweetened beverages(OR=1.717-3.272), consume snacks(OR=1.626-3.154)and less likely to consume fruit/vegetable(OR=1.526-2.251). Compared to ≤2 h/d, estimated ORs of high intakes of fast food were 2.118 for>3 h/d of screen time, and 2.357 for >4 h/d. CONCLUSION: Increased television viewing and digital devices use in adolescence of Grades 4-6 is associated with higher odds of consumption of sweetened beverages, snacks and lower odds of fruit consumption in Baise.

Characteristics of astigmatism in school-age children aged 5 to 13 years in northeast Sichuan: a cross-sectional school-based study.

Background: Astigmatism is closely associated with myopia progression, vision loss, eye fatigue and amblyopia, which seriously endangers children's eye health. This study aims to investigate the prevalence and characteristic distribution of astigmatism in children in Langzhong City, providing valuable insights for allocating resources and develop prevention and control strategies. Methods: A cross-sectional study and random sampling survey were conducted. Between January and November 2021, 21,415 students aged 5 to 13 years from 14 primary schools in Langzhong City underwent non-cycloplegic refractive testing using autorefraction. The data on myopia were analyzed using SPSS (Statistical Package for the Social Sciences) version 23.0. Results: The inclusion criterion was set at an absolute astigmatism value of ≥0.50D. Among the 21,415 children studied, 61.70% were found to have astigmatism. The prevalence of astigmatism varied significantly across different grades (χ2=501.414, P<0.001). The predominant types of astigmatism were mild astigmatism (0.50-1.00D) and with-the-rule astigmatism. Mixed astigmatism was primarily observed in children in grades 1 and 2, while compound myopic astigmatism was more common in children in grades 3 to 6. These differences were statistically significant. As the degree of astigmatism increased, the proportions of against-the-rule astigmatism, oblique astigmatism, compound myopic astigmatism, and simple hyperopic astigmatism decreased, whereas the proportions of with-the-rule astigmatism, mixed astigmatism, and compound hyperopic astigmatism increased. Conclusions: The prevalence of astigmatism among school-age children aged 5 to 13 years in northeast Sichuan is notably high, with compound myopic astigmatism and with-the-rule astigmatism being the most common types. Regular refractive examinations are crucial for the early detection and management of astigmatism.

Impact of wheat sensitization on wheeze and T2 phenotypes in general population of children.

Background: The association between sensitization to specific aeroallergens and outcomes in patients with asthma is well researched; however, the association between childhood-onset wheeze/asthma and sensitization to various aeroallergens and food allergens in the general pediatric population remains poorly understood. Objective: We sought to investigate the association between sensitization to common aeroallergens and food allergens with wheeze and type 2 (T2) inflammation in the general pediatric population. Methods: Specific IgEs against 9 aeroallergens and 4 food allergens were measured in the prospective Hokkaido birth cohort of 428 school-age children (age ∼10 years). Wheeze and other allergic symptoms were assessed using the International Study of Asthma and Allergies in Childhood questionnaire. Blood eosinophil count and fractional exhaled nitric oxide level were assessed as T2 biomarkers. The Isle of Wight birth cohort in the United Kingdom was used for replication analysis (n = 1032). Results: The prevalence of sensitization to at least 1 aeroallergen and food allergen was 70.5% and 22.3%, respectively. A significant association between wheeze and sensitization to aeroallergens such as ragweed, Japanese cedar, mugwort, and pet dander was found. However, the association between wheeze and wheat sensitization was highly significant (Hokkaido birth cohort: odds ratio, 4.67; 95% CI, 1.98-11.01; Isle of Wight birth cohort, odds ratio, 4.01; 95% CI, 1.78-9.07). Sensitization to most aeroallergens, though not any food allergen, was associated with the T2-high phenotype. Conclusions: Sensitization to wheat may be an important risk factor for wheeze/asthma development, especially the pathogenesis of T2-non/low asthma, independent of aeroallergens, in the general pediatric population.

Understanding autistic youths' menstrual product preferences and caregivers' product choices.

LAY ABSTRACT: There is little research exploring the menstrual product preferences of autistic youth, especially those who recently started their period. Study authors surveyed caregivers' choice of menstrual products for their autistic children. They provided popular menstrual materials to autistic youth to try, then asked them which product(s) they preferred, did not try, and why they did not try it. Caregivers selected sensory impact as the most important feature they consider when choosing a menstrual product for their child, and youth participants preferred to use period underwear. Therefore, autistic youth may benefit from purchasing and using period underwear, and caregivers, clinicians, and companies should consider the impact of menstrual product features, like sensory sensitivities, on young autistic menstruators and how best to support them.

The lived experience of mothers caring for school-age children with Pompe disease: A qualitative study.

PURPOSE: To explore the lived experiences of mothers caring for school-age children with Pompe disease. DESIGN AND METHODS: A qualitative study using a descriptive phenomenology approach. Semi-structured interviews were conducted from October to December 2022 with 10 mothers of school-age children diagnosed with Pompe disease, which were identified through the Taiwan Pompe Disease Association. Colaizzi's phenomenological method was employed for data analysis. RESULTS: The study identified five themes in the caregiving experiences of mothers: 1. unwavering parenting beliefs; 2. child-centric approach; 3. focus on peer relationships and coping strategies; 4. integration of learning, treatment, and rehabilitation; and 5. embracing and navigating life's challenges. Mothers balanced education, treatment, and rehabilitation for their children with Pompe disease, offering perspectives into the caregiving experience. CONCLUSIONS: This study highlights the complex experiences of mothers caring for children with Pompe disease, emphasizing the importance of comprehensive support. PRACTICE IMPLICATIONS: Insights into the perspectives of mothers can aid health-care professionals in understanding the challenges faced by families with children diagnosed with Pompe disease and can enable the development of strategies for providing comprehensive psychological support to improve mental health outcomes for these children and their families. Increased awareness among health-care professionals and in the society leads to an informed and empathetic approach to addressing the unique challenges faced by children with Pompe disease and their families.

Developmental changes in numerosity and area perception in school-age children.

Humans can quickly estimate the quantity of objects in their environment through the Approximate Number System (ANS). However, the developmental trajectories of numerical and spatial perception in school-aged children are not well understood. This study aimed to address this issue by examining the performance of 7-year-olds, 9-year-olds, and 11-year-olds in the dot-number and dot-area tasks. In each trial, participants were presented with pairs of dots array simultaneously and were asked to indicate which array had a greater quantity of dots in the dot-number task, and which array had a larger overall area of dots in the dot-area task. We manipulated number cues and area cues of the dots array in these two tasks, creating three different relationships between dot-number and dot-area: congruent, neutral, and incongruent. Our results showed school-aged children's ability to estimate numerosity improved significantly after the age of 7, with no apparent improvement observed between the ages of 9 and 11. This indicates a marked growth in acuity in the perception of numerical quantities. Conversely, the capacity to estimate area showed consistent stability across the various age groups examined. Additionally, our results demonstrated a pronounced difficulty among participants in ignoring numerical cues when assessing dot quantity or dot area, as opposed to non-numerical cues. This highlights a preferential sensitivity to numerical information in cognitive processing. These findings provide valuable insights into the cognitive development underlying quantity perception and may offer practical guidance for educational practices.

The influence of parents on children's consciousness of gender equality: a multi-group structural equation modeling approach.

Objective: This study aimed to understand the consciousness of gender equality among school-aged children in China and its influencing factors using structural equation modeling to explore the pathways, intensity and group differences among these factors. Methods: A cross-sectional survey was conducted using stratified random whole-group sampling of primary school students in grades 1-6 and their parents who met the inclusion and exclusion criteria. In this study, 1,312 valid questionnaires were collected from a total of 1,500 school-aged children in Hunan Province, China (effective response rate of 87.5%). Statistical analysis was conducted using SPSS 26.0 and AMOS 24.0 software. Statistical inference consisted of t-tests, analysis of variance, the LSD test, Pearson correlation analysis, multiple stepwise linear regression analysis and structural equation modeling. Results: School-aged children had the lowest consciousness of gender equality in the area of occupation and relatively higher consciousness in the areas of family and school. Children's age, gender, gender role, parent-child relationship, teacher-student relationship and parents' gender equality consciousness had predictive effects on children's consciousness of gender equality. The structural equation model constructed in this study is applicable to school-aged children of different genders. There was a significant difference in the structural equation modeling for children in different study period groups. Conclusion: In the education process, parents and teachers should attempt to improve their own consciousness of gender equality, integrate the concept of androgynous education, enhance close relationships with children, and adopt appropriate education methods according to the characteristics of different groups of children.

Educating Japanese elementary students on proper smartphone use and social media risks: Reflecting on post-COVID-19 crime trends.

Smartphone ownership and social media use are increasing worldwide, and children are not exempt from these trends. Past studies on this issue have mainly focused on educational campaigns to prevent the prolonged use of smartphones, social media, and video games. Recently, harm to children from engagement with bad actors through social media has become a major problem in Japan, and preventive measures need to be based on close analysis of the facts. The present study was performed descriptive epidemiology and comparison between two groups. This study investigated the number of children in Japan who fell victim to criminal offense through their use of social media, categorized by level of schooling, type of offense, and means of accessing social media over the 8-year period from 2016 to 2023. The 8-year period was divided into 2016-2019 (4 years prior to the COVID-19 pandemic) and 2020-2023 (4 years during the pandemic). Statistical analysis was conducted to compare these periods. The number of elementary school students victimized by criminal offense through social media in Japan increased significantly in 4 years during the pandemic. Furthermore, in 4 years during the pandemic, there was also a notable rise in felony-related incidents, and an increase in the number of victims accessing social media via smartphones. Schools, parents/guardians, and personnel and organizations in relevant fields need to collaborate in addressing and educating students about the proper use of smartphones and the risks of social media starting at the elementary school age.

Comorbidity rates of autism spectrum disorder and functional neurological disorders: A systematic review, meta-analysis of proportions and qualitative synthesis.

LAY ABSTRACT: Autism spectrum disorder (ASD) and functional neurological disorders (FND) are relatively common conditions, and there has been recent interest in the overlap between them. Both conditions share core features of alexithymia, impaired interoception and deficits in attentional focus. To date, relatively little is known about the comorbidity rates between ASD and FND. This is the first meta-analysis and qualitative synthesis on the subject. We found that around 10% of children presenting with functional seizures have a comorbid ASD diagnosis. People with ASD are more likely than the neurotypical population to have functional somatic disorders, and there is also evidence that ASD rates are higher for other FNDs such as functional motor disorders. Since FND comes with risks of unnecessary medical procedures and investigations, it is important to recognize the potential for people with ASD to have an FND comorbidity.

Different time courses of maturation for learning and generalization following auditory training in children.

OBJECTIVE: We recently demonstrated that learning abilities among school-age children vary following frequency discrimination (FD) training, with some exhibiting mature adult-like learning while others performing poorly (non-adult-like learners). This study tested the hypothesis that children's post-training generalisation is related to their learning maturity. Additionally, it investigated how training duration influences children's generalisation, considering the observed decrease with increased training in adults. DESIGN: Generalisation to the untrained ear and untrained 2000 Hz frequency was assessed following single-session or nine-session 1000 Hz FD training, using an adaptive forced-choice procedure. Two additional groups served as controls for the untrained frequency. STUDY SAMPLE: Fifty-four children aged 7-9 years and 59 adults aged 18-30 years. RESULTS: (1) Only adult-like learners generalised their learning gains across frequency or ear, albeit less efficiently than adults; (2) As training duration increased children experienced reduced generalisation, similar to adults; (3) Children's performance in the untrained tasks correlated strongly with their trained task performance after the first training session. CONCLUSIONS: Auditory skill learning and its generalisation do not necessarily mature contemporaneously, although mature learning is a prerequisite for mature generalisation. Furthermore, in children, as in adults, more practice makes rather specific experts. These findings should be considered when designing training programs.

Recognition of Dynamic Emotional Expressions in Children and Adults and Its Associations with Empathy.

This present study investigates emotion recognition in children and adults and its association with EQ and motor empathy. Overall, 58 children (33 5-6-year-olds, 25 7-9-year-olds) and 61 adults (24 young adults, 37 parents) participated in this study. Each participant received an EQ questionnaire and completed the dynamic emotion expression recognition task, where participants were asked to identify four basic emotions (happy, sad, fearful, and angry) from neutral to fully expressed states, and the motor empathy task, where participants' facial muscle activity was recorded. The results showed that "happy" was the easiest expression for all ages; 5- to 6-year-old children performed equally well as adults. The accuracies for "fearful," "angry," and "sad" expressions were significantly lower in children than in adults. For motor empathy, 7- to 9-year-old children exhibited the highest level of facial muscle activity, while the young adults showed the lowest engagement. Importantly, individual EQ scores positively correlated with the motor empathy index in adults but not in children. In sum, our study echoes the previous literature, showing that the identification of negative emotions is still difficult for children aged 5-9 but that this improves in late childhood. Our results also suggest that stronger facial mimicry responses are positively related to a higher level of empathy in adults.

Evaluation and application of a Chinese version symptom questionnaire for visual dysfunctions (CSQVD) in school-age children.

Objective: To develop and evaluate a Chinese version of the Symptom Questionnaire for Visual Dysfunctions (CSQVD) to quantify visual dysfunction symptoms in school-age children with various eye diseases, and to explore the relationship between ophthalmological disorders and visual dysfunction symptoms. Methods: Following standard scale adaptation procedures, the Symptom Questionnaire for Visual Dysfunctions (SQVD) was translated into Chinese (CSQVD). We employed random sampling to survey 198 outpatients aged 7-18 to assess the psychometric properties of the CSQVD. Using the reliable and validated questionnaire, we evaluated the determinants of visual dysfunction symptoms among 406 school-age patients at an eye center. The CSQVD scores were correlated with demographic and clinical variables, including gender, age, eye position, refractive power, and best-corrected visual acuity. Univariate analysis identified potential risk factors, followed by binary logistic regression and multiple linear regression analysis on factors with a P-value <0.05. Results: The CSQVD scale's critical ratio (CR) values ranged from 6.028 to 10.604. The Cronbach's Alpha coefficient was 0.779, and Spearman-Brown split-half reliability was also 0.779. The I-CVI varied from 0.83 to 1.000, the S-CVI/Ave was 0.857, and the KMO value was 0.821. Multifactorial regression analysis indicated that high myopia (OR â€‹= â€‹5.744, 95% CI [1.632, 20.218], P â€‹= â€‹0.006) and amblyopia (OR â€‹= â€‹9.302, 95% CI [1.878, 46.058], P â€‹= â€‹0.006) were significant predictors of CSQVD symptoms. Multiple linear regression analysis showed that BCVA of amblyopic eyes (B â€‹= â€‹-5.052, 95% CI [-7.779, 2.325], P â€‹= â€‹0.000) and SE power (B â€‹= â€‹-0.234, 95% CI [-0.375, 0.205], P â€‹= â€‹0.001) significantly affected the CSQVD scale scores. Conclusions: The Chinese version of the SQVD scale (CSQVD) demonstrates good feasibility, discriminatory power, validity, and reliability in assessing Chinese school-aged children. Furthermore, those who have severe myopia and amblyopia reported more visual dysfunction symptoms.

Experiences of patients, parents, and healthcare professionals in the process of transitioning from hospital to community after inpatient pediatric rehabilitation among children with special health care needs.

PURPOSE: Children with Special Health Care Needs (CSHCN) may experience disruptions in education due to extended hospitalizations. The purpose of this study was to describe how CSHCN experience educational supports during inpatient rehabilitation and identify the ongoing challenges when planning to return to school. MATERIALS AND METHODS: Semi-structured focus groups were conducted with parents (n = 12), former patients (n = 20), and rehabilitation professionals (n = 8). RESULTS: Through qualitative thematic analysis based on descriptive phenomenology, we developed three themes: 1) Inpatient educational support such as instruction and schoolwork helped reduce the learning loss during hospitalization. However, these supports were sometimes complicated by lags in school approvals and challenges in coordination between systems. 2) Transition planning involved establishing necessary services to support CSHCN's educational and healthcare needs at school re-entry. However, families reported limited information and guidance as key barriers. 3) Dynamic courses of school re-entry required continued support after discharge. The participants recommended that reassessment and adjustment of transition plans were often necessary to account for evolving developmental and educational needs but were not always received. CONCLUSIONS: There is an ongoing need to improve communication between clinicians and educators, information for families, and long-term follow-up on the changing educational needs for CSHCN after rehabilitation.

School re-entry after extended hospitalization is challenging for children with special health care needs (CSHCN) due to school disruption, social disconnection, and change in functional abilities.The hospital-to-school transition processes include inpatient educational programs during hospitalization, pre-discharge transition planning, and the subsequent implementation and adjustment of transition plans to facilitate individualized school re-entry.Key areas in need of improving school re-entry include coordination between the hospital and school about rehabilitation and educational goals and information provided to families about transition processes, particularly for newly acquired health conditions.A common need expressed by parents and CSHCN is to simplify and accelerate the process to establish services that support children's educational and healthcare needs.

Prevalence of attention deficit hyperactivity disorder in school-going children in rural Konkan region of Maharashtra.

Background: Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder of childhood characterised by attention deficit, hyperactivity and impulsiveness. The present study was designed to compute the prevalence of ADHD and assess the association of the predetermined demographic variables and ADHD in school-going children aged 6-12 years in rural areas of Konkan. Material and Methods: The present study was a descriptive, cross-sectional study. Using the first edition of Vanderbilt's scale - D4 (Teacher's informant) by National Institute for Children's Health Quality (NICHQ) for identifying symptoms of ADHD in children, a questionnaire was filled out for each child with input from their class teacher. These data were then compiled and analysed. Results: Out of the 133 participants in the study aged 6-12 years, the gender distribution was 69 boys and 64 girls. The mean age was 9.2 ± 2.3 years. Of which, one student (0.75%) was found to have a predominantly inattentive subtype of ADHD (ADHD-IA). The prevalence was found to be 1.5% (2/133). In addition, one student (0.75%) was found to have a combined ADHD-IA and hyperactive (ADHD-H/I) subtype of ADHD (ADHD-C). The latter was also positive for the anxiety/depression screening scale administered as part of the same questionnaire. The total symptom score for questions 1-18 was 8.44 ± 7.29. Conclusion: One of the most common neurodivergent conditions among school-age children is ADHD. Using an easy-to-use questionnaire, teachers and parents can report those experiencing symptoms of ADHD. Early diagnosis and treatment are recommended to avoid complications and aid in the improvement of quality of life.

A lower gender equality consciousness in rural and left-behind children: a latent class analysis.

Objective: School age is a critical period for the development of individual gender equality consciousness. The purpose of this study was to explore the potential classes of school-age children's gender equality consciousness, influencing factors and their differences in gender role, thus providing targeted guidance for the formulation and implementation of gender equality education strategies. Methods: A cross-sectional survey was conducted among 1846 school-age children using the demographic information questionnaire, gender equality consciousness questionnaire and Bem Sex Role Inventory. A latent class analysis was performed to explore gender equality consciousness latent classes. Multinomial logistic regression analysis was conducted to examine the predictors of class membership, and chi-square test was used to compare the gender role of each latent class. Results: The average age of the included 1846 participants was 10.10 ± 1.82 years old. The proportion of boy, grade 6 and living in urban area, respectively, were 50.8, 25.3, and 60.2%. The only children was 16.3% and left-behind children was 22.5%. 60.5% of all children thought their parents had a good relationship. The core family structure in all participants was 54.1%. Mothers were the caregivers of most children (63.6%). The same-sex friends more than 3 was 73.5%, while opposite-sex friends ranged from 0 to 1 was 41.7%. Three latent classes were identified and labeled "high gender equality consciousness" class (20.6%), "moderate gender equality consciousness" class (42.3%) and "low high gender equality consciousness" class (37.1%). Factors affecting the different types of school-age children's gender equality consciousness include gender, grade, caregiver, place of residence, whether they are left-behind children and parental relationship. Rural and left-behind children are more likely to enter the "low gender equality consciousness" group. Children in the "low gender equality consciousness" group had a lower proportion of androgynous gender role. Conclusion: Rural children and left-behind children are the priority groups for gender equality education. Gender role is the important predictors and intervention targets of children's gender equality consciousness. Educators or policy makers can formulate targeted intervention measures according to the influencing factors of potential classes.

Assessing sociodemographic disparities in HPV vaccine uptake among grade 6 and 9 students in the Vancouver Coastal Health region.

PURPOSE: To identify sociodemographic factors associated with HPV vaccine uptake in a universal, in-school HPV vaccination program, among grade 6 and 9 students in the regional health authority of Vancouver Coastal Health (VCH), British Columbia (BC), Canada during the 2021/22 school year. VCH operates within the southwest corner of the province of BC serving a mix of urban and rural regions. HPV vaccine is offered in school to all grade 6 students using a two-dose series, with catch up immunizations offered to students in grade 9. METHODS: We conducted a cross-sectional study of grade 6 and 9 students enrolled in VCH schools for the 2021/22 school year, who also resided within the VCH region. We modelled the associations between sociodemographic explanatory variables (individual-level and group-level) and fully vaccinated outcome using a cross-classified (non-nested) multilevel model. RESULTS: Among the 17,939 students eligible, 74 % were fully vaccinated for HPV. Immunization coverage was associated with grade, geographic area of residence, school category, social and material deprivation. We demonstrated that grade modified the association between material deprivation and being fully vaccinated. Grade 9 students, including those residing in more materially deprived neighbourhoods, had substantially higher odds (OR 2.01 [95 % CI 1.08, 3.75]) of being fully vaccinated relative to grade 6 students in the least materially deprived neighbourhoods. CONCLUSIONS: Though publicly funded HPV vaccine is offered to all students in grade 6 and 9, in a space that maximizes programmatic access, sociodemographic factors associated with under-immunized populations were identified. This information can be leveraged for strategic targeting of resources to underimmunized schools or students to mitigate impacts. The repeat offering of HPV vaccine in an older grade (grade 9 in BC) is a key programmatic strategy to reach under-immunized populations and should be complemented by other creative approaches.

Emotion Regulation Training as an Add-on in the Treatment of Obesity in Young Adolescents: A Randomized Controlled Superiority Trial.

In an inpatient treatment center for pediatric obesity, the effectiveness of an emotion regulation (ER) training on top of the multidisciplinary obesity treatment (MOT) was tested by means of an RCT. The ER training was evaluated on primary outcomes: ER and emotional eating, and secondary outcomes: well-being and weight loss, taking into account pre, post, and follow-up measurements. Of the 115 10- to-14-year old adolescents with obesity (52.2% girls), 65 were allocated to the ER training. Physicians measured their height and weight objectively (4 times). Participants also filled out questionnaires on ER competencies (ER abilities and ER strategies), emotional eating and well-being (3 times). Significant pre-post interactions were found for "emotional awareness," "problem solving," and "evoking a positive mood." Moreover, the positive effects of the ER training on emotion regulation strategies were maintained at follow-up. Concerning well-being, no significant pre-post interaction effects were found but a significant interaction effect was found when comparing pre with follow-up. Analyses show a significant main effect of time on weight loss, but this was not qualified by a Time × Condition interaction effect. The current RCT study shows limited but promising effects of adding an ER training to the MOT. Further research should investigate whether the positive short-term effects will be maintained.

Optimism, pessimism, and physical health among youth: a scoping review.

OBJECTIVE: High levels of optimism (and low levels of pessimism) are associated with improved physical health in adults. However, relatively less is known about these relations in youth. The present study aimed to review the literature investigating optimism, pessimism, and physical health in children and adolescents from populations with and without health conditions. METHODS: We conducted a scoping review up until February 2024. Studies were included if they sampled youth (average age ≤18 years) and treated optimism or pessimism as predictors of health behaviors or outcomes. Data on study and sample characteristics, health outcome, optimism construct, and findings were extracted from eligible papers and results were synthesized. RESULTS: Sixty studies were retained. Most studies were conducted in North America, with adolescents, and used cross-sectional designs and self-reported measures of health. Measures of optimism and pessimism differed across studies. Roughly one-third of studies sampled medical populations. Health categories included substance use, diet and physical activity, sexual health practices, medical adherence, other health behaviors, cardiometabolic health, subjective health/health-related quality of life, pain, sleep, and oral health. Generally, we observed adaptive associations between optimism and health. Higher optimism and lower pessimism were most consistently associated with lower rates of substance use and lower cardiometabolic risk. CONCLUSIONS: The presence of optimism or the absence of pessimism appears to be associated with various adaptive health outcomes among youth with and without health conditions. Developmental, methodological, and clinical considerations for future research are discussed, such as conducting longitudinal studies with objective measures of health and psychometrically validated instruments.

Perceived acceptability and appropriateness of a web-based program targeting risk for anxiety in young children and their parents.

OBJECTIVE: This mixed-methods study examined perceived acceptability and appropriateness of a novel digital mental health program targeting anxiety risk (i.e., perfectionism or error sensitivity) in 5-to-7-year-old children and their parents. METHODS: Parent-child dyads participated in a modular, web-based cognitive-behavioral program targeting negative overreactions to making mistakes. The program, "Making Mistakes", consisted of a 6-month series of short video clips, journaling activities, and weekly reminders, and modules were delivered to caregivers and children separately. 86 dyads completed self-report measures, 18 of whom participated in semi-structured interviews, following completion of the primary program module. A standard thematic analysis was used to elucidate themes from the parent and child interview content. RESULTS: Our quantitative and qualitative results were generally aligned. Children and parents viewed the novel digital mental health program as acceptable and appropriate, favoring the cognitive behavioral strategies such as modeling positive reactions to mistakes, responding positively to child mistakes, and emphasizing effort over outcome. Participants also provided helpful feedback related to program content, delivery, and engagement, as well as suggestions to enhance the program. CONCLUSIONS: Findings have implications for design and content features of parent-based and dyad-based programs, as well as digital mental health programs focused on reducing anxiety risk.