Search Results (523)

Background: Cervical cancer poses a threat to the health of women globally. Adolescent girls are the primary target population for HPV vaccination, and guardians’ attitude towards the HPV vaccine plays a significant role in determining the vaccination status among adolescent girls. Objectives: This study aimed to explore the factors influencing guardians’ HPV vaccine acceptance for their girls and provide clues for the development of health intervention strategies. Methods: Combining the health belief model as a theoretical framework, a questionnaire-based survey was conducted. A total of 2157 adolescent girls and their guardians were recruited. The multivariable logistic model was applied to explore associated factors. Results: The guardians had a high HPV vaccine acceptance rate (86.7%) for their girls, and they demonstrated a relatively good level of awareness regarding HPV and HPV vaccines. Factors influencing guardians’ HPV vaccine acceptance for girls included guardians’ education background (OR = 0.57, 95%CI = 0.37–0.87), family income (OR = 1.94, 95%CI = 1.14–3.32), risk of HPV infection (OR = 3.15, 95%CI = 1.40–7.10) or importance of the HPV vaccine for their girls (OR = 6.70, 95%CI = 1.61–27.83), vaccination status surrounding them (OR = 2.03, 95%CI = 1.41–2.92), awareness of negative information about HPV vaccines (OR = 0.59, 95%CI = 0.43–0.82), and recommendations from medical staff (OR = 2.32, 95%CI = 1.65–3.25). Also, guardians preferred to get digital information on vaccines via government or CDC platforms, WeChat platforms, and medical knowledge platforms. Conclusions: Though HPV vaccine willingness was high among Chinese guardians, they preferred to vaccinate their daughters at the age of 17–18 years, later than WHO’s recommended optimal age period (9–14 years old), coupled with safety concerns. Future work should be conducted based on these findings to explore digital intervention effects on girls’ vaccination compliance. Full article

Road traffic accidents are a leading cause of injury and death among adolescents, making road safety education crucial. This study assesses the performance of and users’ opinions on the Route 2 School (R2S) traffic safety education program, designed for secondary school students (13–17 years) in Belgium. The program incorporates gamified e-learning modules containing, among others, podcasts, interactive 360° visuals, and virtual reality (VR), to enhance traffic knowledge, situation awareness, risk detection, and risk management. This study was conducted across several cities and municipalities within Belgium. More than 600 students from school years 3 to 6 completed the platform and of these more than 200 students filled in a comprehensive questionnaire providing detailed feedback on platform usability, preferences, and behavioral risk assessments. The results revealed shortcomings in traffic knowledge and skills, particularly among older students. Gender-based analysis indicated no significant performance differences overall, though females performed better in risk management and males in risk detection. Furthermore, students from cities outperformed those from municipalities. Feedback on the R2S platform indicated high usability and engagement, with VR-based simulations receiving the most positive reception. In addition, it was highlighted that secondary school students are high-risk groups for distraction and red-light violations as cyclists and pedestrians. This study demonstrates the importance of gamified, technology-enhanced road safety education while underscoring the need for module-specific improvements and regional customization. The findings support the broader application of e-learning methodologies for sustainable, behavior-oriented traffic safety education targeting adolescents. Full article

Background: Emotional abuse is both prevalent and underrecognized particularly in culturally complex settings like India. Adolescents, being in a critical developmental phase, are especially vulnerable to the long-lasting psychological effects of emotional abuse. This qualitative literature review aims to synthesize findings from primary studies that explore the lived experiences of emotional abuse among Indian adolescents and identify emerging patterns across sociocultural contexts. Method: Electronic databases, including DOAJ, Google Scholar, ProQuest, JSTOR, Pubmed, PsycNet, and SCOPUS, were searched for peer-reviewed articles published in English up to March 2025. Inclusion criteria comprised qualitative or mixed-methods research focusing on emotional abuse among adolescents aged 12–20 in Indian contexts. The Critical Appraisal Skills Programme (CASP) was used for quality assessment. Results: Five major thematic domains were identified across the included studies: (1) Family as a primary site of emotional abuse; (2) Gendered experiences of abuse; (3) Cultural normalization and silence; (4) Psychological and emotional consequences; and (5) Coping and resilience among adolescents. These themes reflect shared experiences of emotional abuse shaped by cultural, familial, and gender-based expectations. Conclusions: This review highlights the urgent need for increased awareness and culturally sensitive interventions addressing emotional abuse in Indian adolescents. The findings suggest that parents, educators, and policymakers must recognize emotionally harmful behaviors and implement prevention-oriented strategies, particularly through non-violent communication and adolescent mental health support frameworks. Full article

Background/Objectives: Migraine affects approximately 3–10% of school-aged children and up to 28% of adolescents, with prevalence increasing during adolescence. For pediatric specialty providers, increased awareness of this condition may influence patient care. This study examined pediatric dentists’ education, clinical exposure, and perceived knowledge gaps related to pediatric migraine, with the goal of identifying barriers to recognition and referral, as well as informing future training to support accurate diagnosis and interdisciplinary care. Methods: A 28-item electronic questionnaire was distributed to all members of the American Academy of Pediatric Dentistry, including pediatric dentists and postgraduate pediatric dental residents, assessing knowledge, beliefs, clinical experience, and interest in further training regarding pediatric headache/migraine management. Respondents with and without previous training were compared in terms of general understanding using t-tests; a linear regression model analyzed predictors of provider awareness regarding links between oral conditions and headache/migraine. Results: Among 315 respondents, the mean self-perceived awareness score was 2.7 ± 1.3 (on a 0–5 scale). The most frequently identified contributing factors were clenching (73.7%), bruxism (72.4%), and temporomandibular disorders (65.7%). Nearly all respondents (95.2%) reported no formal education on headache/migraine prevention, yet 78.1% agreed on the importance of understanding the relationship between oral health and headache/migraine. Respondents with prior training were significantly more aware (p < 0.001) than those without prior training. Educating families (p < 0.001), frequency of patient encounters with headache (p = 0.032), coordination with healthcare providers (p = 0.002), and access to appropriate management resources (p < 0.001) were significant predictors of providers’ awareness. Conclusions: Pediatric dental providers expressed strong interest in enhancing their knowledge of headache/migraine management, highlighting the value of integrating headache/migraine-related education into training programs and promoting greater interdisciplinary collaboration. Full article

This study examined how two metacognitive constructs, cognitive self-consciousness and beliefs about emotion regulation, mediate the link among early adolescents between emotion regulation and engagement in coping with worry, and whether these relationships change with age during this period. A total of 338 Chinese pupils completed a series of measures assessing the metacognitive constructs plus emotional awareness and regulation; scenario-based questions examined coping strategies. Participants were divided into two age groups, 11 to 12 (M_age = 11.9 years) and 13 to 15 (M_age = 13.2 years). Path models showed that younger participants adopted emotion-focused coping whereas older participants adopted more problem-focused coping, and these response patterns were mediated as hypothesized by cognitive self-consciousness and controllability beliefs towards worry. These findings highlight the need for more adaptive coping to be specifically targeted during early adolescence by raising awareness of controllability beliefs. Full article

The thyroid gland plays a crucial role in regulating metabolism and supporting development through the production of the hormones T4 and T3. These hormones are essential during childhood for nervous system myelination, physical growth, puberty, skeletal and dental maturation, and overall metabolic balance. In early infancy, when the hypothalamic–pituitary–thyroid axis is still immature, thyroid dysfunction can result in a range of long-term complications. The metabolism and action of thyroid hormones depend not only on iodine but also on other vital micronutrients, particularly selenium (Se). This narrative review aims to comprehensively examine the role of selenium in maintaining thyroid health from fetal life through adolescence. Selenium is a key micronutrient involved in thyroid development, hormone synthesis, antioxidant defense, and immune regulation, especially during pregnancy and childhood. Inadequate selenium levels may contribute to the onset, progression, and clinical management of various thyroid disorders, particularly hypothyroidism and autoimmune thyroid diseases. Although scientific evidence supports selenium’s critical functions in hormone metabolism and antioxidant protection, public awareness and monitoring of selenium intake remain insufficient. Beyond the need for further research, there is an urgent call for integrated public health strategies, ranging from sustainable, food-based approaches to targeted clinical screening and educational programs. Promoting awareness of selenium’s importance and incorporating selenium status into maternal and pediatric care protocols could play a significant role in preventing deficiencies and supporting long-term endocrine and neurodevelopmental health. Full article

Although smart device use among children is increasing, most interventions overlook their cognitive and emotional development or rely too heavily on external control. Such approaches often overlook the developmental needs of children for emotional regulation and autonomy. Therefore, this study aims to propose a child-centred user experience (UX) framework to support digital self-regulation in preschool-aged children. The proposed system integrates multiple psychological theories—including Piaget’s concept of animistic thinking, executive function theory, Self-Determination Theory, and Acceptance and Commitment Therapy—to support cognitive and emotional regulation during screen use. Key features include persistent visual cues to enhance time awareness and behavioural anticipation, narrative-based character interactions to foster empathy and agency, and ritualised closure routines supported by multimodal and tangible interaction elements. Developed as a mobile prototype, the system was iteratively refined through two-stage consultations with child and adolescent psychiatrists and a developmental psychologist, including formative design feedback and follow-up expert review. Their feedback provided preliminary validation of the system’s developmental validity and emotional coherence. These findings suggest that affectively attuned UX design is a viable alternative to conventional control-based screen-time interventions in early childhood. Full article

Background/Objectives: Sexual health research involving young adolescents remains scarce despite rising rates of early sexual debut, pregnancies, and sexually transmitted infections (STIs) in this population. We explored community stakeholders’ perspectives on engaging young adolescents in sexual health research in Western New York to inform strategies for engaging young adolescents in sexual health research. Methods: This qualitative descriptive study was conducted from April 2022 to June 2023. Seventeen community stakeholders, including health education teachers, youth counselors, and adolescent health providers, participated in semi-structured in-depth interviews. Data were analyzed using conventional content analysis, managed by MAXQDA 2020. The rigor and trustworthiness of the data were ensured through triangulation with observations, peer debriefing, team analysis, and respondent validation. Results: Participants were predominantly female (94.1%), 52.9% Black/African American, 41.2% White, and 5.9% Caucasian–Indian American, and aged 23–59 years. Four themes emerged: perspectives on conducting sexual health research with young adolescents, recruitment strategies, sexual health questions appropriate for young adolescents, and building readiness for participation in sexual health research. Participants reported the need for sexual health research with young adolescents and recommended building a trusting relationship and involving schools, parents, and trusted community organizations in the research process. Suggested research questions included those related to awareness of sex, STIs, available resources, experiences with sexual education, and desired support. The findings also revealed the need to initiate sexual health conversations early when children start asking questions, as a foundation for meaningful participation in sexual health research. Conclusions: The findings suggest that sexual health research with young adolescents is feasible and necessary, with implications for the design of developmentally appropriate sexual health research and interventions grounded in trust and community collaboration. Future research should explore the perspectives of caregivers and young adolescents to inform studies and programs that are attuned to young adolescents’ developmental needs. Full article

Background: High-voltage electrical injuries (HVEIs) represent a complex and life-threatening entity, frequently involving multi-organ damage. While traditionally linked to occupational hazards, train surfing—riding on moving trains—and train climbing—scaling stationary carriages—have emerged as increasingly common causes among adolescents. Popularized via social media, these behaviors expose individuals to the invisible danger of electric arcs from 15,000-volt railway lines, often resulting in extensive burns, cardiac complications, and severe trauma. This study presents a 30-year retrospective analysis comparing cardiac biomarkers and clinical outcomes in train-surfing injuries versus work-related HVEIs. Methods: All patients with confirmed high-voltage injury (≥1000 volts) admitted to a Level 1 burn center between 1994 and 2024 were retrospectively analyzed. Exclusion criteria comprised low-voltage trauma, suicide, incomplete records, and external treatment. Clinical and laboratory parameters—including total body surface area (TBSA), Abbreviated Burn Severity Index (ABSI), electrocardiogram (ECG) findings, intensive care unit (ICU) and hospital stay, mortality, and cardiac biomarkers (creatine kinase [CK], CK-MB, lactate dehydrogenase [LDH], aspartate transaminase [AST], troponin, and myoglobin)—were compared between the two cohorts. Results: Of 81 patients, 24 sustained train-surfing injuries and 57 were injured in occupational settings. Train surfers were significantly younger (mean 16.7 vs. 35.2 years, p = 0.008), presented with greater TBSA (49.9% vs. 17.9%, p = 0.008), higher ABSI scores (7.3 vs. 5.1, p = 0.008), longer ICU stays (53 vs. 17 days, p = 0.008), and higher mortality (20.8% vs. 3.5%). ECG abnormalities were observed in 51% of all cases, without significant group differences. However, all cardiac biomarkers were significantly elevated in train-surfing injuries at both 72 h and 10 days post-injury (p < 0.05), suggesting more pronounced cardiac and muscular damage. Conclusions: Train-surfing-related high-voltage injuries are associated with markedly more severe systemic and cardiac complications than occupational HVEIs. The significant biomarker elevation and critical care demands highlight the urgent need for targeted prevention, public awareness, and early cardiac monitoring in this high-risk adolescent population. Full article

This article focuses on an advocacy campaign for a complete ban on vaping in Kazakhstan led by the Smokefree Kazakhstan Coalition. Initiated in 2021, the campaign aimed to address the growing public health concerns about vaping among adolescents, which was reflected in a sharp increase in vape use among young people—from 1.6% in 2014 to 5.8% in 2022. Despite facing strong opposition from the vaping industry and political lobbyists, the Coalition gained support from key political figures, public health leaders, and NGOs. Over 32 months, the campaign achieved several key milestones, including the inclusion of criminal liabilities for those involved in the vaping industry, and, in 2024, it eventually joined a number of countries such as Thailand, Qatar, Japan, Singapore, and India in approving a vaping ban. The advocacy efforts relied on public engagement, social media, and coordinated civil society mobilization—including petitions, public meetings, awareness campaigns, and coalition-building among NGOs and health advocacy groups—to overcome industry resistance toward official vaping market ban approvals. This article uses the case study approach with the Power Prism framework to describe and evaluate the advocacy campaign’s strategic plan, its political challenges, and the significant impact of public health advocacy in shaping national health policy. The significance of the article lies in the success of the vaping ban in the Kazakhstani context, which may serve as a model for other countries facing similar public health issues, political instability, and industry resistance. Full article

Tetanus is a life-threatening, vaccine-preventable disease caused by tetanospasmin and tetanolysin, which are potent neurotoxins produced by Clostridium tetani, an anaerobic, spore-forming bacterium. Due to the widespread presence of spores in the environment, the disease cannot be eradicated. However, global tetanus prevention initiatives have contributed to a significant decline in tetanus incidence worldwide. Aiming to present the tetanus trends in Romania, we conducted a retrospective analysis of the tetanus surveillance data. During the study period (2010–2023), 97 cases of tetanus were reported in Romania (median: 6.5; IQR: 5–7) with an average incidence rate of 0.03 per 100,000 inhabitants (95% CI: 0.02–0.04; range: 0.01–0.09). The highest incidence rates were recorded among people aged 1 to 14 years old (0.09 per 100,000 inhabitants, 95% CI: 0.06–0.13; range: 0.00–0.20), male (0.05 per 100,000 inhabitants; 95% CI: 0.03–0.06; range: 0.03–0.12), and from rural areas (0.05 per 100,000 inhabitants; 95% CI: 0.03–0.08; range: 0.01–0.17). A decline in the number of tetanus cases of 7% by year was observed, which is supported by the statistical analysis showing a p-value of 0.005 (IRR: 0.93; 95% CI: 0.88–0.98). However, the same decline in tetanus incidence was not supported by the statistical analysis (IRR: 0.93; 95% CI: 0.44–1.98; p = 0.9). Forty-seven tetanus deaths were recorded, with an average case fatality ratio of 42% (95% CI: 25.62–57.92; range: 0–100), showing a decreasing trend of 9% by year (IRR: 0.91; 95% CI: 0.89–0.93). Although the annual number of tetanus cases in Romania has shown a slight downwards trend, its situation has remained relatively stable, as shown by the tetanus incidence. Moreover, the case fatality rate continues to be high. Therefore, our study emphasizes the importance of achieving high vaccination uptake among children and adolescents, raising awareness of the importance of booster doses in adults, and improving the management of tetanus-prone wounds. Full article

Objectives/Background: With increasing awareness of the association between physical activity and mental health, promoting youth health has gained prominence. For this, education and support are needed. As psychological school-based factors could be key to affecting this behavior, this study investigates middle school students’ trust in their physical education teachers and their grit, analyzing their effects on health-promoting behaviors that could follow these adolescents through adulthood. Methods: Middle school students, aged 12–14, were recruited from three schools in Sejong City, Korea, in May 2025; 420 survey questionnaires were distributed and 390 were returned (response rate: 92.86%). After eliminating those with insincere responses, 369 valid questionnaires (boys = 186, girls = 183) were analyzed. The analysis covered the descriptive statistics, Pearson’s correlation, and structural equation modeling, with grit, trust in physical education teachers, and health-promoting behaviors as variables. Results: The correlation analysis verified multicollinearity between trust in physical education teachers (closeness, fairness, teaching method, and physical ability), grit (effort, perseverance, and interest consistency), and health-promoting behaviors (self-actualization, health management, and stress management). A positive significant correlation was found between all subfactors (p < 0.05). The research model’s fit was confirmed through several fit indices; specifically, normed χ² = 4.138, goodness-of-fit-index = 0.942, root mean square residual = 0.033, root mean square error of approximation = 0.092, incremental fit index = 0.965, Tucker–Lewis index = 0.947, and comparative fit index = 0.965, and all values were judged acceptable. The standardized coefficients of each latent variable explaining the measurement variables were 0.707 or higher. Therefore, the explanatory power of the measurement variables was also satisfactory; thus, the research model was appropriate and could be used for analysis. The model findings revealed that trust in physical education teachers had a positive effect on student grit (β = 0.505, p < 0.001) and that grit had a positive effect on health-promoting behaviors (β = 0.743, p < 0.001); however, trust in physical education teachers did not have a direct effect on health-promoting behaviors (statistically insignificant [β = 0.103, p > 0.05]). Thus, grit had a mediating effect between trust in physical education teachers and health-promoting behaviors (β = 0.375, p < 0.01). Conclusions: This study highlights the educational implications for physical education teachers of building trust and strengthening student grit as key factors in achieving sustainable health-promoting behaviors among adolescents. Full article

Although professionals who work with children and adolescents are well aware of psychological symptom presentations once children and adolescents are in school, such symptom presentations in very young children are less understood. Diagnoses like selective mutism may promote further complications for professionals, as the symptom presentation of anxiety and failure to speak in this diagnosis may overlap with the acquisition of speech and language milestones and problems in very young children. Thus, providing professionals who work with very young children a way to adapt their thinking about selective mutism symptom presentations and interventions is of utmost importance. As a result, this clinically oriented paper will compare DSM-5-TR criteria to DC:0-5 criteria, consider the occurrence of selective mutism symptoms in the context of young children’s speech and language milestones and problems, and reflect upon how intervention adaptations meant to incorporate parents into treatment and account for the capacities of very young children can be helpful in facilitating successful outcomes. It is hoped that having this constellation of clinical information in one place will help providers gain clarity regarding selective mutism symptom presentation and relevant intervention considerations for very young children. Full article

Objective: Eating habits established during adolescence play a crucial role in shaping both current and future health status. However, adolescents today appear to be increasingly adopting poorer dietary and lifestyle habits. This study aims to investigate eating behaviors and supplement use among adolescent students who participated in the EduALI nutrition education project. Methods: The project included first-year students from six sports-oriented scientific high schools in Florence. The students participated in six nutrition sessions, completing the International Physical Activity Questionnaire to assess physical activity performance, a questionnaire on dietary supplement use, and, to assess eating habits a Food Frequency Questionnaire (FFQ), as well as the Medi-Lite questionnaire to specifically assess adherence to the Mediterranean diet (MD). The data from the FFQ were compared with national dietary guidelines. Results: The study sample consisted of 83 students (69.9% male; average age: 13.8 ± 0.4 y). The results showed that 61.4% of participants had used supplements in the past year, most commonly mineral salts (56.6%) and vitamins (54.2%), followed by botanical products (22%), sports drinks (16%), proteins/amino acids (8%), and creatine (2%). Alarmingly, 27.7% used supplements without medical supervision. Students involved in individual sports had higher supplement consumption than those in team sports, especially creatine use. Eating habits revealed poor adherence to both the MD and Italian dietary guidelines, with deficiencies in fruits, vegetables, olive oil, fish, and legumes, and excessive intake of cheese, meat, especially red and processed meats. Conclusions: A high prevalence of supplement use among adolescents was observed, along with poor adherence to dietary guidelines and MD. These findings underscore the need for targeted, school- and sport-based interventions to enhance adolescents’ nutritional awareness and responsible supplement use. Full article

Background/Objectives: Aggression in adolescents with autism, particularly those with high-functioning autism (HFA), presents a unique clinical profile. The aim of this study was to assess and compare anger expression and regulation in adolescents with HFA, those diagnosed with conduct disorder (CD), and a control group with no psychiatric diagnoses. Methods: A total of 120 adolescents aged 14–17 were divided into three equal groups: 40 with HFA, 40 with CD, and 40 controls. Participants were assessed using the State-Trait Anger Expression Inventory (STAXI-2), which measures emotional intensity, trait predisposition, and modes of anger expression and control. Non-parametric statistical analyses were conducted to examine group differences. Results: Statistically significant differences were found across most STAXI-2 scales. Adolescents with CD exhibited the highest scores on anger intensity and expression, followed—at a lower level—by those with HFA. The autism group showed significantly elevated levels of verbal anger expression and frustration reactivity compared to controls, but lower tendencies for physical aggression. Trait anger was also higher in the HFA group, particularly in response to frustration or criticism. No significant differences were found between the HFA and control groups on anger control scales individually; however, the overall Anger Expression Index was significantly elevated in HFA, reflecting a global imbalance between anger expression and regulation. Conclusions: Adolescents with high-functioning autism exhibit a distinct profile of emotional dysregulation, characterized by increased verbal anger and frustration sensitivity, despite lower levels of overt aggression. This comparative pilot study contributes to a better understanding of emotional dysregulation and anger expression in adolescents with HFA. These findings highlight the need for tailored emotion regulation interventions. School-based programs focused on emotional awareness and verbal anger management could offer meaningful benefits for this population. Future research should expand sample diversity, explore gender differences, include common comorbidities like ADHD, and investigate longitudinal and neurobiological patterns of anger regulation in ASD. Full article