Research

10 pages, 673 KiB

Open AccessArticle

Lessons Learned from the Impact of HIV Status Disclosure to Children after First-Line Antiretroviral Treatment Failure in Kinshasa, DR Congo

by Faustin Nd. Kitetele, Gilbert M. Lelo, Cathy E. Akele, Patricia V. M. Lelo, Loukia Aketi, Eric M. Mafuta, Thorkild Tylleskär and Espérance Kashala-Abotnes

Children 2022, 9(12), 1955; https://doi.org/10.3390/children9121955 - 13 Dec 2022

Cited by 1 | Viewed by 1358

Abstract

HIV status disclosure to children remains a challenge in sub-Saharan Africa. For sociocultural reasons, parents often delay disclosure with subsequent risks to treatment compliance and the child’s psychological well-being. This article assesses the effects of HIV disclosure on second-line ART compliance after first-line [...] Read more.

HIV status disclosure to children remains a challenge in sub-Saharan Africa. For sociocultural reasons, parents often delay disclosure with subsequent risks to treatment compliance and the child’s psychological well-being. This article assesses the effects of HIV disclosure on second-line ART compliance after first-line failure. We conducted a retrospective study of 52 HIV-positive children at Kalembelembe Pediatric Hospital in Kinshasa who were unaware of their HIV status and had failed to respond to the first-line ART. Before starting second-line ART, some parents agreed to disclosure. All children were followed before and during the second-line ART. Conventional usual descriptive statistics were used. For analysis, the children were divided into two groups: disclosed to (n = 39) and not disclosed to (n = 13). Before starting the second-line ART, there was no difference in CD4 count between the two groups (p = 0.28). At the end of the first year of second-line ART, the difference was statistically significant between the two groups with regard to CD4% (p < 0.001) and deaths (p = 0.001). The children disclosed to also reported fewer depressive symptoms post-disclosure and had three times fewer clinic visits. HIV status disclosure to children is an important determinant of ART compliance and a child’s psychological well-being. Full article

(This article belongs to the Special Issue New Frontiers in Adolescent Health and Development)

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10 pages, 456 KiB

Open AccessArticle

Increased Risk of Generalized Anxiety Disorder According to Frequent Sedentary Times Based on the 16th Korea Youth Risk Behavior Web-Based Survey

by Hongsun Song and Kihyuk Lee

Children 2022, 9(10), 1548; https://doi.org/10.3390/children9101548 - 12 Oct 2022

Cited by 3 | Viewed by 1291

Abstract

This study aimed to identify the association between sedentary behavior and anxiety disorders in 53,510 Korean adolescents. It analyzed data from the 16th (2020) Korea Youth Risk Behavior Web-based Survey (KYRBS). The dependent variable was the generalized anxiety disorder-7 (GAD-7). The GAD-7 scores [...] Read more.

This study aimed to identify the association between sedentary behavior and anxiety disorders in 53,510 Korean adolescents. It analyzed data from the 16th (2020) Korea Youth Risk Behavior Web-based Survey (KYRBS). The dependent variable was the generalized anxiety disorder-7 (GAD-7). The GAD-7 scores were divided into normal, mild, moderate, and severe levels. The independent variables were sedentary time for learning, other sedentary times, total sedentary time, and regular physical activity. The confounding variables were sex, grade, stress, depression, substance abuse, suicidal thoughts, violent victimization, drinking, smoking, sleep satisfaction, and smartphone addiction. A chi-squared test, one-way analysis of variance, and logistic regression analysis were used for analysis. After adjusting for all confounding variables, the risk of severe level in GAD-7 increased by 1.045 times each time the sedentary time for learning based on increased by one hour. In other sedentary time and total sedentary time, the risk of severe level in GAD-7 increased by 1.025 times and 1.045 times per hour, respectively. However, in regular physical activity, after adjusting for the confounding variables, there was no significant association with the GAD-7 levels. Therefore, to prevent generalized anxiety disorders in Korean adolescents, it is necessary to reduce the overall sedentary times including sedentary time for learning. Full article

(This article belongs to the Special Issue New Frontiers in Adolescent Health and Development)

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14 pages, 663 KiB

Open AccessArticle

Social and Emotional Learning and Internalizing Problems among Adolescents: The Mediating Role of Resilience

by Aurora Adina Colomeischi, Andreea Ursu, Ionela Bogdan, Alina Ionescu-Corbu, Romina Bondor and Elisabetta Conte

Children 2022, 9(9), 1326; https://doi.org/10.3390/children9091326 - 31 Aug 2022

Cited by 3 | Viewed by 2456

Abstract

(1) Background: The high rates of mental disorders in adolescence presented in the literature often exclude internalizing problems. Although there is extensive data on the effectiveness of SEL skills in improving resilience, few studies included evidence in their reports on the relationship between [...] Read more.

(1) Background: The high rates of mental disorders in adolescence presented in the literature often exclude internalizing problems. Although there is extensive data on the effectiveness of SEL skills in improving resilience, few studies included evidence in their reports on the relationship between SEL skills and internalizing problems. The present study aims to deepen the understanding of the relationship between SEL, resilience, and internalizing problems, by investigating the mediating effect of resilience between SEL components and internalizing problems. (2) Methods: Adolescents (N = 968 adolescents, aged between 11 and 18 years old; M = 13.30; SD = 1.92) from 30 schools from the NE region of Romania were invited to fill out questionnaires on social and emotional learning, internalizing problems, and resilience. (3) Results: The results show that resilience mediates the link between self-awareness and internalizing problems, between self-management and internalizing problems, between relationship skills and internalizing problems, and between responsible decision-making and internalizing problems. (4) Conclusions: These findings revealed the need for social and emotional learning interventions that include resilience-oriented approaches in order to decrease internalizing problems in adolescents. Moreover, we suggest that more culturally appropriate interventions are required to better investigate the interaction between SEL components, resilience, and internalizing problems. Full article

(This article belongs to the Special Issue New Frontiers in Adolescent Health and Development)

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9 pages, 464 KiB

Open AccessArticle

The Discrepancy between Actual Performance and Self-Awareness among Adolescents with Executive Function Deficits

by Yael Fogel

Children 2022, 9(5), 684; https://doi.org/10.3390/children9050684 - 08 May 2022

Cited by 5 | Viewed by 1884

Abstract

Adolescents with executive function deficits (EFD) struggle to perform complex daily activities and have difficulty being self-aware of their performance. This study aimed to compare actual performance with self-awareness of performance among adolescents with EFD before and after a metacognitive intervention. The participants [...] Read more.

Adolescents with executive function deficits (EFD) struggle to perform complex daily activities and have difficulty being self-aware of their performance. This study aimed to compare actual performance with self-awareness of performance among adolescents with EFD before and after a metacognitive intervention. The participants consisted of 41 adolescents aged 10 to 14 years, previously diagnosed with EFD. All performed the Children’s Cooking Task (CCT), and completed the Behavioral Rating Inventory Executive Function—Self-Report (BRIEF-SR) and the Self-Awareness of Performance Questionnaire. Significant positive differences were found in the time duration and the total number of errors from the CCT and three BRIEF-SR subscale scores before and after the intervention. No significant differences were found in self-awareness of performance. After a cognitive intervention, adolescents with EFD improved their performance of a learned skill, but their self-awareness of their performance remained unchanged. These results may imply that EFD inhibits self-awareness development, and that self-awareness may not depend on task performance, but, rather, is influenced by other external factors. The article reports the secondary analysis from the results of the Functional Individualized Therapy for Teenagers with Executive Deficits (FITTED) intervention on human participants. Full article

(This article belongs to the Special Issue New Frontiers in Adolescent Health and Development)

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15 pages, 4620 KiB

Open AccessArticle

The Analysis of the Correlations between BMI and Body Composition among Children with and without Intellectual Disability

by Bogdan Constantin Ungurean, Adrian Cojocariu, Beatrice Aurelia Abalașei, Lucian Popescu, Alexandru Rares Puni, Marius Stoica and Carmen Pârvu

Children 2022, 9(5), 582; https://doi.org/10.3390/children9050582 - 20 Apr 2022

Cited by 7 | Viewed by 2520

Abstract

Background: Compared to the great volume of studies focusing on children and adolescents without intellectual disability, research regarding body mass index among young populations (13–17 years old) with intellectual disability is scarce, mostly when we refer to the comparisons between various degrees of [...] Read more.

Background: Compared to the great volume of studies focusing on children and adolescents without intellectual disability, research regarding body mass index among young populations (13–17 years old) with intellectual disability is scarce, mostly when we refer to the comparisons between various degrees of intellectual disability and gender. Methods: The purpose of this study was to assess a series of morphofunctional parameters among children with and without intellectual disability to characterise the morphofunctional normality and its perturbations. Within the study, we included 101 subjects from several educational institutions, distributed on five groups, by their gender and degree of intellectual disability. Results: The average values of body mass index exceed the values recommended by the WHO among all the five groups (boys and girls with and without intellectual disabilities) prone to obesity. Upon analysing the values of BMI by gender and type of intellectual disability, we note that the prevalence of obesity among boys is 28.07% (BMI > 24), while 19.29% are overweight (BMI ranging between 21.5 and 24). Conclusions: The prevalence of excess weight and obesity among persons with intellectual disabilities was similar among the male and female subjects. It shows an increasing trend by age. Full article

(This article belongs to the Special Issue New Frontiers in Adolescent Health and Development)

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15 pages, 1918 KiB

Open AccessArticle

Hypertension Predisposition and Thermoregulation Delays in Adolescents with Polycystic Ovary Syndrome: A Pilot Study

by Styliani Geronikolou, Flora Bacopoulou, Stavros Chryssanthopoulos, Dennis V. Cokkinos and George P. Chrousos

Children 2022, 9(3), 316; https://doi.org/10.3390/children9030316 - 25 Feb 2022

Cited by 1 | Viewed by 2244

Abstract

Background: Polycystic ovary syndrome (PCOS) is a heterogeneous disorder in which clinical, sonographic, and endophenotypic features have been underinvestigated or inconclusive, especially in the early stages of the disease (adolescence/young adulthood). Objective: This prospective pilot study focused on the differences of multiple physiological [...] Read more.

Background: Polycystic ovary syndrome (PCOS) is a heterogeneous disorder in which clinical, sonographic, and endophenotypic features have been underinvestigated or inconclusive, especially in the early stages of the disease (adolescence/young adulthood). Objective: This prospective pilot study focused on the differences of multiple physiological functions between Greek adolescent/young adult females suffering from PCOS and age- and body mass index (BMI)- matched healthy controls. Study design: Nineteen PCOS patients and eighteen healthy controls (aged 13 to 23 years) were studied for: (i) biochemical and hormonal dysfunction by measuring circulating glucose, insulin, and androgen levels; (ii) arterial stiffness with pulse wave analysis (PWA) by Sphygmocord; (iii) intima-media thickness (IMT) by ultrasound; (iv) heart rate variability (HRV) by Task Force Monitor; and (v) QT, QRS, QT, P, QRSD by electrocardiogram (ECG). Statistical analysis included Hedge’s g correction for small samples bias, and the results are shown using the Hedge’s g effect size and 95% CI, in line with precision medicine prerequisites. Results: Significant differences in pulse wave velocity (PWV) (g = 0.964 [0.296, 1.632]), subendocardial viability ratio (SEVR) carotid (g = −0.679 [−1.329, −0.030]), pulse pressure (PP) carotid (g = 0.942 [0.275, 1.608]), systolic pressure (SP) carotid (g = 0.785 [0.129, 1.440]), free-testosterone (g = 0.677 [0.042, 0.312]), and Delta4-androstenedione (g = 0.735 [0.097, 0.373]) were observed between PCOS patients and controls. No differences were detected in the remaining endocrine and PWA or ECG biomarkers. Conclusions: Our multidisciplinary approach showed early onset of vascular dysfunction, predisposition to hypertension, thermoregulation delays, and metabolic syndrome changes in adolescent/young adult PCOS. Full article

(This article belongs to the Special Issue New Frontiers in Adolescent Health and Development)

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18 pages, 1349 KiB

Open AccessFeature PaperEditor’s ChoiceArticle

Finding the True Number of Females with Autistic Spectrum Disorder by Estimating the Biases in Initial Recognition and Clinical Diagnosis

by Robert McCrossin

Children 2022, 9(2), 272; https://doi.org/10.3390/children9020272 - 17 Feb 2022

Cited by 14 | Viewed by 26637

Abstract

The proportion of females whose ASD diagnosis is missed is unknown. The ratio of males to females with ASD is generally quoted as 4:1, though it is believed that there are biases preventing females from being diagnosed and that the true ratio is [...] Read more.

The proportion of females whose ASD diagnosis is missed is unknown. The ratio of males to females with ASD is generally quoted as 4:1, though it is believed that there are biases preventing females from being diagnosed and that the true ratio is lower. These biases have not been clearly identified or quantified. Starting with a clinical dataset of 1711 children <18 years old, four different methods were employed in an inductive study to identify and quantify the biases and calculate the proportion of females missed. A mathematical model was constructed to compare the findings with current published data. The true male-to-female ratio appears to be 3:4. Eighty percent of females remain undiagnosed at age 18, which has serious consequences for the mental health of young women. Full article

(This article belongs to the Special Issue New Frontiers in Adolescent Health and Development)

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12 pages, 472 KiB

Open AccessArticle

Depressive Symptoms, Alcohol Beliefs and Heavy Episodic Drinking in Adolescents

by Robert J. Wellman, Catherine M. Sabiston and Matthis Morgenstern

Children 2022, 9(1), 103; https://doi.org/10.3390/children9010103 - 13 Jan 2022

Cited by 3 | Viewed by 1765

Abstract

Adolescents who engage in heavy episodic drinking (HED—i.e., 5+ drinks on a single occasion) increase risks for psychopathology, alcohol dependence, and similar negative consequences in adulthood. We explored associations among depressive symptoms, positive alcohol beliefs, and progression of heavy episodic drinking (HED) in [...] Read more.

Adolescents who engage in heavy episodic drinking (HED—i.e., 5+ drinks on a single occasion) increase risks for psychopathology, alcohol dependence, and similar negative consequences in adulthood. We explored associations among depressive symptoms, positive alcohol beliefs, and progression of heavy episodic drinking (HED) in 3021 German adolescents (M(SD) age at baseline = 12.4 (1.0)) followed for 30 months in 4 waves, using a conditional parallel process linear growth model, with full information maximum likelihood estimation. By wave 4, 40.3% of participants had engaged in HED more than once; 16.4% had done so ≥5 times. Depressive symptoms were indirectly related to baseline values of HED (through positive beliefs and wave 1 drinking frequency and quantity) and to the rate of growth in HED (through positive beliefs and wave 1 quantity). Adolescents with higher levels of depressive symptoms and positive alcohol beliefs drink more frequently and at greater quantities, which is associated with initiating HED at a higher level and escalating HED more rapidly than peers with similar depressive symptoms who lack those beliefs. This suggests that, to the extent that positive alcohol beliefs can be tempered through public health campaigns, education and/or counseling, HED among depressed adolescents might be reduced. Full article

(This article belongs to the Special Issue New Frontiers in Adolescent Health and Development)

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11 pages, 989 KiB

Open AccessArticle

A 10-Week Program of Combined Hippotherapy and Scroth’s Exercises Improves Balance and Postural Asymmetries in Adolescence Idiopathic Scoliosis: A Randomized Controlled Study

by Amr A. Abdel-aziem, Osama R. Abdelraouf, Shahesta A. Ghally, Haytham A. Dahlawi and Rafik E. Radwan

Children 2022, 9(1), 23; https://doi.org/10.3390/children9010023 - 30 Dec 2021

Cited by 9 | Viewed by 3692

Abstract

Introduction: The most frequent type of spine abnormality throughout adolescence was adolescent idiopathic scoliosis (AIS). Hippotherapy improved posture, balance and gait of different musculoskeletal conditions. Therefore, this study aims to see how hippotherapy combined with Schroth exercises affected postural asymmetry and dynamic balance [...] Read more.

Introduction: The most frequent type of spine abnormality throughout adolescence was adolescent idiopathic scoliosis (AIS). Hippotherapy improved posture, balance and gait of different musculoskeletal conditions. Therefore, this study aims to see how hippotherapy combined with Schroth exercises affected postural asymmetry and dynamic balance in AIS compared to traditional physiotherapy (Schroth exercises) alone. Materials and methods: In this randomized controlled trial, fifty-two patients with AIS (10–18 years, 37 girls and 15 boys) participated. They were arbitrarily allocated into two groups: experimental (19 female/8 male; aged 14.74 ± 1.79 years; Cobb angle 18.59 ± 2.66 degrees) and control (18 female/7 male; aged 15.04 ± 1.81 years; Cobb angle 19.32 ± 2.69 degrees) groups. Both groups received Schroth exercises for 10 weeks, three days/week. The experimental group additionally received hippotherapy training. Pre-treatment and post-treatment assessment for the scoliotic, kyphotic angle, pelvic obliquity, pelvic torsion and vertical spinal rotation and the anteroposterior, mediolateral and overall stability indices were assessed using the formetric system 4D and Biodex Balance System, respectively. Results: After intervention, both groups illustrated significant improvements in all examined variables (p < 0.05). The experimental group illustrated significant improvements in scoliotic angle, kyphotic angle, pelvic obliquity, pelvic torsion and vertical spinal rotation and the stability indices compared to the control group (p < 0.05). Conclusion: In adolescence idiopathic scoliosis, hippotherapy training combined with Schroth exercises improves posture asymmetry and balancing ability more effectively than Schroth exercises alone. Full article

(This article belongs to the Special Issue New Frontiers in Adolescent Health and Development)

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11 pages, 251 KiB

Open AccessArticle

Sexual Risk Behaviors of Adolescents with Type 1 Diabetes in Comparison with Their Peers

by Betina Kandyla, Artemis Tsitsika, Alexandra Soldatou, Chara Tzavara, Spyridon Karanasios and Kyriaki Karavanaki

Children 2022, 9(1), 20; https://doi.org/10.3390/children9010020 - 29 Dec 2021

Cited by 1 | Viewed by 1369

Abstract

Background: Adolescents with type 1 diabetes mellitus (T1D) may differ from peers regarding sexual risk behaviors. Objectives: To explore sexual risk behaviors of adolescents with T1D in comparison with peers. Materials and methods: The subjects were 174 adolescents, 58 adolescents with T1D (mean [...] Read more.

Background: Adolescents with type 1 diabetes mellitus (T1D) may differ from peers regarding sexual risk behaviors. Objectives: To explore sexual risk behaviors of adolescents with T1D in comparison with peers. Materials and methods: The subjects were 174 adolescents, 58 adolescents with T1D (mean ± SD age 16.3 ± 2.0 yrs, disease duration 6.7 ± 3.5 yrs and HbA1c:8.0 ± 1.3%) and 116 without (matched 1:2). Anonymous, self-reported questionnaires were used to evaluate sexual education and behaviors. Results: Fewer adolescents with T1D than those without had a sexual experience (74.1% vs. 87.4%, p = 0.033), with similar age of sexual debut. Among adolescents with T1D, ≥2 risky behaviors were observed less frequently than adolescents without T1D (8.62% vs. 23.27%, p = NS respectively) and in fewer girls than boys in both adolescents with T1D (0% vs. 18.5%, p = NS) and adolescents without T1D (11% vs. 44%, p = 0.022). Adolescents with T1D with ≥2 risky behaviors were older (p = 0.031), younger at first sexual intercourse (p = 0.031), with higher maternal education (p = 0.039). Early sexual debut was associated with higher maternal education (p = 0.014) and HbA1c (p = 0.049). Most adolescents without T1D with ≥2 risky behaviors were boys and older than peers. Conclusions: Adolescents with T1D and females were more cautious than adolescents without T1D regarding sex. The associations of increased risky behaviors with male gender, older age, younger age at sexual debut and higher maternal education in adolescents with T1D merit further investigation. Full article

(This article belongs to the Special Issue New Frontiers in Adolescent Health and Development)

13 pages, 267 KiB

Open AccessArticle

Cardiovascular Risk Factors and Subclinical Atherosclerosis in Greek Adolescents with Polycystic Ovary Syndrome: Its Relationship with Body Mass Index

by Anastasia Garoufi, Athanasia Pagoni, Maria Papadaki, Antonios Marmarinos, Georgios Karapostolakis, Lina Michala and Alexandra Soldatou

Children 2022, 9(1), 4; https://doi.org/10.3390/children9010004 - 22 Dec 2021

Cited by 7 | Viewed by 2486

Abstract

Polycystic ovary syndrome (PCOS) is the most common endocrine condition affecting 6–18% of adolescents and is strongly associated with obesity and cardiovascular risk factors, enhancing the risk of atherosclerosis. Thirty-two adolescents with newly diagnosed PCOS were evaluated for lipid profile disorders, insulin resistance, [...] Read more.

Polycystic ovary syndrome (PCOS) is the most common endocrine condition affecting 6–18% of adolescents and is strongly associated with obesity and cardiovascular risk factors, enhancing the risk of atherosclerosis. Thirty-two adolescents with newly diagnosed PCOS were evaluated for lipid profile disorders, insulin resistance, inflammation, non-alcoholic fatty liver disease (NAFLD), and subclinical atherosclerosis through measurements of carotid intima–media thickness (cIMT). The relationships of the above markers with increased body mass index and abdominal obesity were investigated. Twenty-three adolescents (72%) were overweight (OW) or obese (OB). The OW/OB group had significantly higher insulin, HOMA-IR, high-sensitive C-reactive protein (hsCRP), visceral adiposity index (VAI), and lipid accumulation product (LAP) levels; and lower glucose-per-insulin ratios and HDL-C levels compared to the healthy weight group. The cIMT and small dense low-density lipoprotein cholesterol (sdLDL-C) levels did not differ between the two groups. Similarly, cIMT and sdLDL-C levels did not differ between PCOS-adolescents and healthy controls. CIMT was positively correlated with systolic blood pressure and waist circumference per height ratio. In conclusion, OW/OB PCOS-adolescents have a cluster of adverse factors predisposing them to atherosclerotic cardiovascular disease. Therefore, early cardiovascular risk assessment, as well as timely and targeted interventions, are necessary for prevention. Full article

(This article belongs to the Special Issue New Frontiers in Adolescent Health and Development)

16 pages, 313 KiB

Open AccessArticle

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

by Elisabeth K. Andrie, Irene Ikbale Sakou, Eleni C. Tzavela, Clive Richardson and Artemis K. Tsitsika

Children 2021, 8(10), 925; https://doi.org/10.3390/children8100925 - 16 Oct 2021

Cited by 18 | Viewed by 6965

Abstract

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 [...] Read more.

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. Full article

(This article belongs to the Special Issue New Frontiers in Adolescent Health and Development)

9 pages, 254 KiB

Open AccessArticle

Acanthosis Nigricans in Children and Adolescents with Type 1 Diabetes or Obesity: The Potential Interplay Role between Insulin Resistance and Excess Weight

by Valeria Calcaterra, Annalisa De Silvestri, Laura Schneider, Miriam Acunzo, Viola Vittoni, Giulia Meraviglia, Francesco Bergamaschi, Gianvincenzo Zuccotti and Chiara Mameli

Children 2021, 8(8), 710; https://doi.org/10.3390/children8080710 - 18 Aug 2021

Cited by 8 | Viewed by 2680

Abstract

Acanthosis nigricans (AN) is associated with obesity and type 2 diabetes, where insulin resistance (IR) is considered a predisposing factor. IR can also affect patients with type 1 diabetes (T1D). We evaluated the prevalence of AN in patients with T1D compared to subjects [...] Read more.

Acanthosis nigricans (AN) is associated with obesity and type 2 diabetes, where insulin resistance (IR) is considered a predisposing factor. IR can also affect patients with type 1 diabetes (T1D). We evaluated the prevalence of AN in patients with T1D compared to subjects with obesity in order to define the interplay between IR and excess weight. We considered 138 pediatric patients who presented with T1D and 162 with obesity. As controls, 100 healthy normal-weight subjects were included. A physical examination with the detection of AN and biochemical assessments was performed. IR was calculated by using the homeostasis model assessment for IR in patients with obesity and the estimated glucose disposal rate in T1D. The AN prevalence was higher in T1D and obese subjects compared with controls in whom AN was not detected (p = 0.02 and p < 0.001, respectively). A greater number of AN cases were observed in subjects with obesity compared with T1D (p < 0.001). Patients with AN were older than subjects without AN (p = 0.005), and they had higher body mass index (BMI) values, waist circumference (WC), fasting triglycerides and blood pressure (all p < 0.001). Thirty-five patients with AN exhibited IR with an association between AN presence and IR in patients with obesity (p < 0.001). In T1D, there was an association between AN and being overweight/obese (p = 0.02), independently of IR. AN is a dermatological condition associated with obesity. In T1D, the presence of AN was significantly associated with overweight status or obesity but not IR. The presence of AN in the absence of IR supports the interplay role between impaired insulin signaling, IR and excess weight in the pathogenic mechanism. Full article

(This article belongs to the Special Issue New Frontiers in Adolescent Health and Development)

Review

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13 pages, 304 KiB

Open AccessFeature PaperReview

Atypical Anorexia in Youth: Cautiously Bridging the Treatment Gap

by Melissa Freizinger, Michelle Recto, Grace Jhe and Jessica Lin

Children 2022, 9(6), 837; https://doi.org/10.3390/children9060837 - 05 Jun 2022

Cited by 6 | Viewed by 3714

Abstract

Atypical anorexia nervosa (AAN) is a restrictive eating disorder (ED) that describes individuals who may be normal weighted or overweight; many have a premorbid history of obesity. Pediatric care providers are trained to identify and provide best practices for youth with pediatric obesity; [...] Read more.

Atypical anorexia nervosa (AAN) is a restrictive eating disorder (ED) that describes individuals who may be normal weighted or overweight; many have a premorbid history of obesity. Pediatric care providers are trained to identify and provide best practices for youth with pediatric obesity; however, most pediatric care providers are not trained to assess and treat restrictive EDs which typically present in youth aged 10 and 14 years. Although individuals with AAN may appear to be within a ‘healthy weight’, many experience malnutrition, psychological symptoms, and severe physiological complications after weight loss. These individuals are presenting to pediatric services at an increasing rate and exhibit acute medical instability along with severe ED psychopathology. One complicating factor is youth with AAN may take longer to be identified by pediatric providers and may be reluctant to engage in treatment. Delayed treatment for AAN, along with all EDs often results in poorer treatment outcomes. A greater understanding of this complex illness is essential to inform medical decisions, such as labs, vitals, hospital admissions, and psychological therapy. Currently, there are no standardized guidelines for treating AAN in youths. This review is designed to present evidence-based treatment to inform and guide best treatment practices. Full article

(This article belongs to the Special Issue New Frontiers in Adolescent Health and Development)

8 pages, 253 KiB

Open AccessReview

Trauma in Rapes and Assaults

by Jean-Michel Darves-Bornoz

Children 2021, 8(12), 1143; https://doi.org/10.3390/children8121143 - 06 Dec 2021

Cited by 2 | Viewed by 2826

Abstract

Psychological trauma primarily affects children and adolescents; it mostly results from physical and sexual maltreatment. In the Medico-Judicial Unit Center for Sexual Violence Victims in Tours, France, which I joined in 1992 for research and to give treatment, underage patients represented about three-quarters [...] Read more.

Psychological trauma primarily affects children and adolescents; it mostly results from physical and sexual maltreatment. In the Medico-Judicial Unit Center for Sexual Violence Victims in Tours, France, which I joined in 1992 for research and to give treatment, underage patients represented about three-quarters of patients. At the same time, a national survey was conducted in collaboration with Marie Choquet’s “Adolescent Health” group (INSERM), which targeted several thousand adolescents representing the general population. It revealed that almost one out of five adolescents had experienced physical or sexual assault, and that although the number of sexual assaults probably does not exceed that of physical assaults, most of the time their psychological consequences do considerably exceed those of physical assaults. Several symptoms appear after experiencing rapes or assaults. They have a distinct semiology and independent evolutions. We isolated three of them: dissociative and phobic traumatic syndrome, re-experiencing traumatic syndrome, and borderline-like traumatic syndrome. They are generally triggered all at the same time or in close succession. Re-experiencing traumatic syndrome is profound, but the other two are often more worrying, particularly in relation to children and adolescents, because they generate disorders in their psychological development. Full article

(This article belongs to the Special Issue New Frontiers in Adolescent Health and Development)

Other

Jump to: Research, Review

17 pages, 557 KiB

Open AccessSystematic Review

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

by Panagiota Skella, Maria Eleni Chelmi, Eleni Panagouli, Anastasia Garoufi, Theodora Psaltopoulou, George Mastorakos, Theodoros N. Sergentanis and Artemis Tsitsika

Children 2022, 9(4), 514; https://doi.org/10.3390/children9040514 - 06 Apr 2022

Cited by 4 | Viewed by 3124

Abstract

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 [...] Read more.

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. Full article

(This article belongs to the Special Issue New Frontiers in Adolescent Health and Development)

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16 pages, 1703 KiB

Open AccessCase Report

Intensive Family Intervention as Support for Professional Treatment: Evolution of Symptoms in a Diagnosed Case of Autism Spectrum Disorder

by José María Salgado-Cacho, María del Pilar Moreno-Jiménez and María Luisa Ríos-Rodríguez

Children 2022, 9(3), 400; https://doi.org/10.3390/children9030400 - 11 Mar 2022

Cited by 2 | Viewed by 2028

Abstract

This article shows the progress achieved in a child who has received professional treatment combined with a family intervention at home. It discusses a 22-month-old patient identified as showing warning signs of autism spectrum disorder (ASD), a diagnosis that was subsequently confirmed through [...] Read more.

This article shows the progress achieved in a child who has received professional treatment combined with a family intervention at home. It discusses a 22-month-old patient identified as showing warning signs of autism spectrum disorder (ASD), a diagnosis that was subsequently confirmed through a standardized ADOS-2 test at 31 months of age. To establish the initial working objectives, a functional diagnosis was carried out at 23 months of age using the Battelle Developmental Inventory; a maturational delay was detected, situating the child at an age equivalent to 16 months. A professional intervention was designed in an early childhood care center, complemented by family intervention, so that the hours in which the child participated in learning experiences were increased. Notable advances were made in the areas of cognitive and motor skills, with more standard scores than when initially evaluated. Progress was also observed (though to a lesser extent) in other developmental areas such as language total, adaptive behavior, and self-help, while slight delays in the areas of socio-emotional development and reasoning and academic skills were found. Full article

(This article belongs to the Special Issue New Frontiers in Adolescent Health and Development)

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Open AccessSystematic Review

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

by Eleni Panagouli, Androniki Stavridou, Christina Savvidi, Anastasia Kourti, Theodora Psaltopoulou, Theodoros N. Sergentanis and Artemis Tsitsika

Children 2021, 8(12), 1134; https://doi.org/10.3390/children8121134 - 04 Dec 2021

Cited by 46 | Viewed by 16302

Abstract

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 [...] Read more.

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. Full article

(This article belongs to the Special Issue New Frontiers in Adolescent Health and Development)

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