Search Results (3,391)

Background: Kawasaki disease (KD) is an acute childhood vasculitis with well-recognized coronary involvement, but subtle long-term myocardial dysfunction may persist despite preserved conventional systolic indices. Two-dimensional speckle-tracking echocardiography enables sensitive assessment of left ventricular global longitudinal strain (GLS). Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA 2020. PubMed, Scopus, Web of Science, and Google Scholar were searched for studies evaluating post-acute GLS in children or adolescents with prior KD compared with healthy controls. The outcome measure was the mean difference (MD) in GLS (KD minus control). Random-effects models were used for the primary analysis. Results: Four case–control studies involving 192 patients with prior KD and 138 healthy controls were included in the quantitative synthesis. Compared with controls, patients with prior KD had significantly less negative GLS values, indicating worse longitudinal deformation (pooled MD, 0.77%; 95% CI, 0.18 to 1.36; Z = 2.34; p = 0.019). Between-study heterogeneity was low (Q = 3.17, I² = 5.3%, tau² = 0.030). Leave-one-out analysis showed that the overall direction of effect remained positive, although confidence intervals widened when individual studies were omitted. Interpretation of the funnel plot was limited by the small number of studies. Conclusions: Children and adolescents with a history of KD demonstrate a modest but significant reduction in LV GLS during follow-up, consistent with persistent subclinical myocardial dysfunction. Speckle-tracking echocardiography may provide incremental value in the long-term cardiac assessment of selected patients with prior KD. Full article

This study aimed to evaluate the effectiveness of counseling and educational interventions delivered during pregnancy and early motherhood in promoting maternal health knowledge, self-care behaviors, and related health outcomes among adolescent and young women. A systematic review of randomized controlled trials and quasi-experimental studies published in English or Spanish was conducted using Medline, Web of Science, Scopus, Cinahl, and the Cochrane Library. Methodological quality was assessed using Joanna Briggs Institute critical appraisal tools, and risk of bias was evaluated using the Risk-of-Bias 2 and ROBINS-I tools. Data were synthesized narratively and in tables. When comparable outcomes were reported, preliminary meta-analyses were performed using standardized mean differences with random-effects models. The certainty of evidence was assessed using the GRADE approach. Seven studies (n = 7) involving 776 participants were included. Interventions consisted of counseling or educational programs delivered through face-to-face sessions, group activities, or digital resources. Overall, the interventions were associated with improvements in pregnancy-related knowledge, self-care behaviors, psychological outcomes, and maternal health practices and attitudes; however, the certainty of evidence was low to very low and a high risk of bias was identified across studies. Meta-analysis suggested a possible beneficial effect favoring the intervention for pregnancy-related health knowledge (SMD = 1.90; 95% CI: −0.02 to 3.83) and self-care behaviors (SMD = 2.39; 95% CI: 0.29 to 4.49), although substantial heterogeneity was observed. Counseling and educational interventions during pregnancy may contribute to improvements in pregnancy-related health knowledge and self-care among pregnant adolescents and young women; however, the current evidence is limited and of low certainty. Further well-designed studies conducted in diverse settings are needed to confirm these findings and strengthen the evidence base. Full article

Currently, identity formation is undertaken in hyper-individualized virtual microsystems, such as TikTok. Here, content creators set the boundaries of adolescents’ identity exploration and construction. However, few studies have engaged with the content adolescents actively choose to follow to understand the behaviors and messages that are circulated and modeled by TikTok creators. To bridge this gap, 127 TikTok videos from accounts that a sample of 328 Romanian adolescents (M_age = 16.99, SD_age = 0.78; 60.4% male) reported following were thematically analyzed. This resulted in a novel codebook that went beyond surface-level content typologies to reveal exposure to positive content, such as awareness raising, family values, and motivational videos, as well as negative content, such as age-inappropriate behaviors, materialistic values, and gender stereotypes. Results suggest that master and alternative narratives are portrayed by TikTok creators, generating tensions between conforming to norms that might be potentially harmful and following less common identity scripts. Full article

Background/Objectives: Celiac disease is a chronic autoimmune disorder triggered by gluten ingestion in genetically predisposed individuals. In children and adolescents, it presents heterogeneously and may negatively affect physical, psychological, and social well-being. Although a strict gluten-free diet is the only effective treatment, it may also impose important dietary, social, and economic burdens. This systematic review aimed to evaluate the impact of celiac disease on the quality of life of affected children and adolescents and their families. Methods: This systematic review was conducted according to PRISMA, AMSTAR 2, and Cochrane Handbook recommendations. Searches were performed in PubMed, Scopus, CINAHL, Web of Science, and PsycINFO for studies published between 2019 and 2026 in English or Spanish. Quantitative, qualitative, and mixed-methods studies on pediatric celiac disease and quality of life were included. Two reviewers independently conducted study selection, data extraction, and risk-of-bias assessment. Due to study heterogeneity, a narrative synthesis was performed. Results: Thirteen studies were included. Children and adolescents with celiac disease generally reported lower quality of life, particularly in emotional, social, and school-related domains. Adherence to a gluten-free diet was an important factor associated with quality of life. Although it improved symptoms, it was also linked to social restrictions, nutritional imbalances, and financial burden. Families also reported stress, lifestyle changes, and reduced well-being. Findings should be interpreted cautiously due to heterogeneity and variability in methodological quality across studies. Conclusions: Current evidence suggests that celiac disease may have a multidimensional impact on the quality of life of pediatric patients and their families. These findings support the need for a comprehensive multidisciplinary approach addressing dietary, psychosocial, and family-related factors. Full article

COVID-19 has had profound global impacts, and Long COVID may continue to affect quality of life and well-being in some individuals. Young adults may be particularly vulnerable to these impacts due to ongoing physiological, behavioral, and psychological development. This study aimed to examine the associations between Long COVID, mental health-related outcomes, and quality of life among university students. A total of 365 Thai undergraduate students participated in this cross-sectional study screening for Long COVID. Long COVID symptoms, mental health, sleep quality, and quality of life were assessed using validated Thai versions of the Long COVID Screening Questionnaire, DASS-21, PSQI, and EQ-5D-5L. Regression and group comparison analyses were conducted between participants with Long COVID and those without Long COVID. Fatigue and cough were the most reported symptoms, while sleep disturbances were also prevalent. Long COVID was associated with significantly lower quality of life scores (p = 0.035). However, no significant differences were observed in DASS-21 or PSQI scores between groups. Vaccination doses and prior COVID-19 infections differed significantly between groups (p < 0.001 and p = 0.017). These findings highlight the multisystem impacts of Long COVID and emphasize the importance of identification and supportive interventions to enhance student health and well-being. Full article

In modern society, adolescents experiencing mental health problems are increasing. This study aims to identify barriers to mental health care at the individual, family, school, and staff levels among at-risk adolescents, employing a mixed-methods approach. Given the ethical and practical constraints of engaging at-risk adolescents directly, the study quantitatively analyzed responses to the AMPQ-III-I survey from 47 runaway adolescents, while conducting interviews with eight school nurses serving as proxy informants. The at-risk adolescents were found to be in a state of mental health crisis characterized by somatization, self-harm, excessive digital media use, and peer imitation. Within the family environment, they experienced communication gaps with adults, concerns about mental health stigma, and the risk of disengagement from home and school. Despite experiencing physical and emotional difficulties that hindered their ability to focus on academic work, schools tended to deprioritize mental health, and these adolescents reported notably low utilization of professional counseling. School nurses, although well-positioned to identify at-risk adolescents, expressed barriers such as excessive workload and a lack of communication among teachers. These findings suggest that, to support the growing and intensifying population of at-risk adolescents, an urgent shift in awareness and the alleviation of barriers within the family–school–staff ecosystem is required. Full article

Background: Gender differences in adolescent mental health are well documented; however, the extent to which modifiable behavioral and psychosocial factors account for the excess of mental health problems in females remains insufficiently quantified. Methods: Data from the 2025 Corona and Psyche South Tyrol (COP-S) survey comprised a base sample of 2428 adolescents aged 11–19 years (51.4% males) with valid self-reported data. Multivariable regression analyses were conducted on 1448–1603 adolescents (depending on the outcome) who provided complete responses to the relevant predictor and outcome measures. Gender differences in depressive symptom scores (PHQ-2), generalized anxiety symptom scores (SCARED-GAD), and emotional/behavioral difficulties (SDQ) were examined using Mann–Whitney U and chi-square tests. Multivariable linear regression models were used to assess the associations between mental health outcomes and the ten predictors. Gender effects were quantified by comparing standardized regression coefficients from unadjusted and adjusted models. Results: Female adolescents reported higher generalized anxiety symptoms (median 6 vs. 4; rank-biserial r = 0.24), depressive symptoms (r = 0.13), and emotional/behavioral (r = 0.08) scores than male adolescents. School stress, problematic Internet use, and sleep-onset difficulties were the factors most strongly associated with all three outcomes (all p < 0.001). After multivariable adjustment, gender remained significantly associated with generalized anxiety symptoms (β = 0.18) and depressive scores (β = 0.09) but no longer reached significance for emotional/behavioral scores (β = 0.04, p = 0.078). The attenuation of the gender effect ranged from 25.3% for generalized anxiety symptoms to 37.1% for depressive symptoms and 58.5% for emotional/behavioral difficulties. Conclusions: Gender differences in adolescent mental health were substantially attenuated after adjustment for modifiable behavioral and psychosocial factors, with the gender difference in emotional/behavioral scores no longer statistically significant after adjustment. Persistent gender disparities in generalized anxiety symptoms suggest that mechanisms beyond the measured behavioral correlates may contribute to this gender difference and warrant further investigation. Full article

Background: Atopic dermatitis (AD) is a chronic, relapsing inflammatory dermatosis that is characterized by pruritus, xerosis, and age-dependent clinical heterogeneity. Accurately diagnosing AD remains challenging due to the absence of specific biomarkers and the broad spectrum of conditions that may mimic its presentation. A wide range of inflammatory, infectious, and genetic disorders resemble AD, including seborrheic dermatitis, psoriasis, contact dermatitis, scabies, dermatophytosis, and nummular eczema, as well as rare immunodeficiency and metabolic conditions. This review summarizes the evolution of the clinical features of pediatric AD across infancy, childhood, and adolescence, with a focus on key differential diagnoses. Recognizing age-specific patterns and potential mimickers is essential for improving diagnostic accuracy and guiding appropriate management in pediatric AD. Methods: This study was designed as a narrative review. A structured literature search was conducted of PubMed/MEDLINE for studies published between January 2001 and March 2026 using predefined keywords related to AD, childhood, diagnosis, and differential. Clinical trials, randomized controlled trials, systematic reviews, meta-analyses, and guidelines or consensus documents were included. Studies focusing exclusively on adults or lacking clinical relevance were excluded. A qualitative synthesis was performed due to the heterogeneity in study designs and outcomes. Results: This review demonstrates that pediatric atopic dermatitis exhibits marked age-dependent clinical heterogeneity, with distinct morphological features and lesion distribution patterns across infancy, childhood, and adolescence. Furthermore, the substantial clinical overlap with a broad spectrum of inflammatory, infectious, and genetic disorders—combined with the absence of specific diagnostic biomarkers—significantly complicates accurate differential diagnosis and increases the risk of misclassification. Conclusions: The recognition of age-specific patterns and potential mimickers is essential for improving diagnostic accuracy and guiding appropriate management in pediatric AD. Full article

Background: Vaping has become one of the most prevalent risk behaviors among adolescents and young adults worldwide. Although electronic cigarettes (ECs) are often perceived as safer than conventional tobacco, concerns regarding their impact on oral health are increasing. This systematic review aimed to critically evaluate and synthesize the available evidence regarding the association between e-cigarette use and oral health outcomes in adolescents and young adults. Methods: A systematic search of PubMed/MEDLINE, EMBASE, Scopus, and EBSCOhost databases was conducted for observational studies published within the last ten years. Studies evaluating oral health outcomes among adolescents and young adults were included. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Tool for Analytical Cross-Sectional Studies, and certainty of evidence was graded using the GRADE approach. Results: Eight observational studies met the inclusion criteria and were included in the qualitative synthesis. E-cigarette use was associated with increased caries risk, higher prevalence of gingival inflammation, alterations in salivary flow and pH, changes in oral microbiota—including increased levels of Porphyromonas gingivalis—and elevated frequencies of micronuclei in oral mucosal cells. Four studies were rated as having low risk of bias and four as moderate risk. The overall certainty of evidence was low for all outcomes due to methodological limitations, heterogeneity in outcome assessment, and inadequate control of confounding factors, including dual use of combustible tobacco products. Conclusions: Current evidence may suggest a possible association between e-cigarette use and adverse oral health alterations in adolescents and young adults. However, given the low certainty of evidence, residual confounding, and the predominance of cross-sectional designs, causal relationships cannot be established. Well-designed longitudinal studies that clearly differentiate exclusive e-cigarette users from dual users and adequately adjust for behavioral confounders are required to clarify the independent impact of vaping on oral health in this vulnerable population. Full article

Sexual objectification is the treatment of a person as a body or a collection of body parts that are valued primarily for their sexual appeal. The main purpose of this study was to determine the relevance of sexual objectification to women’s health and well-being across the life cycle, from middle adolescence to old age. Additionally, the relevance of age and education to sexual objectification and its association with traditional gender role attitudes was examined. This study was cross-sectional and the sample consisted of 6112 Spanish women between the ages of 16 and 85, who were assessed using seven questionnaires and scales. The results show that lower age and lower number of children were associated with greater importance of sexual and physical attractiveness and with a more sexualized image, although there were no differences between adolescent and emerging adult women. Greater importance placed on sexual and physical attractiveness, as well as total sexual objectification, was associated with greater mental distress, lower psychological well-being, lower life satisfaction, and lower self-esteem at every life stage. Greater importance placed on sexual and physical attractiveness was associated with more traditional gender role attitudes among all age groups, except for older women. We conclude that sexual objectification is a threat to women’s mental health and well-being. Full article

Background: The aim of this study was to examine the pattern of child-to-parent violence (CPV) across a broad age range, from early adolescence to late emerging adulthood. Specifically, the objectives were to analyze the linear and quadratic relationships between CPV types (psychological, physical, financial, and control/domain behaviors) and age, as well as to examine the interaction of sex within this relationship. Methods: A total of 1959 adolescents (13–17 years) and 1046 young adults (18–25 years) completed, respectively, the adolescent and young adult versions of the Child-to-Parent Violence Questionnaire (CPV-Q). Results: Age was curvilinearly associated with psychological CPV (increasing until approximately age 19 and then decreasing), positively linearly associated with financial CPV (increasing with age), and negatively linearly associated with control/domain behaviors (decreasing with age). No significant association was found between age and physical CPV. Furthermore, boys and girls showed different age-related patterns in some CPV types. Conclusions: These findings suggest that CPV does not disappear after adolescence, and that the pattern is not uniform throughout development nor the same for boys and girls. The results (1) underscore the importance of studying CPV considering developmental stage, sex, and the specific CPV types, and (2) may contribute to facilitate the early detection of CPV, anticipating changes in violence patterns, and guiding prevention strategies tailored to each developmental stage. Full article

Background: Youth with type 1 diabetes (T1D) often show low physical activity levels and a long time spent in sedentary and poor sleep, which may worsen their health. This study aimed to describe baseline movement and sleep patterns in children and adolescents with T1D and compare them with behaviors recorded during a structured summer camp. Methods: Twenty-three participants (13.33 ± 2.13 years) completed physical fitness tests, self-report questionnaires, and 7–8 days of wearable monitoring before camp. During a 10-day diabetes summer camp, participants continued wearing the devices to track physical activity, sedentary time, and sleep. Comparisons between pre- and during-camp periods were performed using paired statistics, and linear regressions examined associations between activity and sleep awakenings. Results: At baseline, device-based monitoring showed low physical activity levels, long sedentary time and poor sleep. Self-reported data confirmed low activity levels and long time spent in sedentary activities, especially screen time. During camp, daily steps increased significantly (p < 0.001), as well as all the physical activity intensities (p < 0.01). Sedentary time decreased significantly (p < 0.001), and sleep duration declined (p < 0.001), but awakenings were shorter (p = 0.005). Baseline sedentary time predicted longer nocturnal awakenings, while greater increases in steps during camp correlated with longer awakenings. Conclusions: Children and adolescents with T1D showed low baseline activity, high sedentary time, and poor sleep. Participation in the structured summer camp appears to be associated with changes in physical activity, sedentary behavior, and sleep patterns. Full article

Objective: To systematically review the effects of family-based physical activity interventions on the mental health of children and adolescents and identify potential moderators. Methods: Following PRISMA guidelines, we searched PubMed, PsycARTICLES, PsycINFO, Elsevier, Web of Science, Cochrane, and three major Chinese databases for randomized controlled trials and non-randomized controlled trials on family-based physical activity interventions targeting mental health in children and adolescents aged 5–19 years. Searches were conducted through 10 February 2026. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Meta-analyses were performed using CMA 3.3. Results: Eleven studies involving 1160 participants were included. The random-effects model indicated that the overall pooled effect size for family physical activity interventions included in this study was (g = 0.443, 95% CI: 0.272–0.614), suggesting that family physical activity interventions, regardless of their specific components, are generally associated with improved mental health in children and adolescents. Further analysis revealed that this overall effect reached statistical significance in the positive mental health dimensions (e.g., self-esteem, emotional well-being) (g = 0.467, 95% CI: 0.271–0.663), whereas it did not reach statistical significance in the negative psychological symptoms dimensions (e.g., depression) (g = 0.358, p > 0.05). Subgroup analyses indicated that intervention location (home-based group g = 0.26 vs. non-home-based group g = 0.55), intervention duration (≤3 months, g = 0.54 vs. >3 months, g = 0.36), and program type (non-multicomponent programs, g = 0.26 vs. multicomponent programs, g = 0.55) showed no statistically significant differences in their effects across groups (p > 0.05). No significant effects were observed in the overall meta-regression model. Conclusions: Current evidence suggests that family involvement may provide a more conducive setting for physical activity interventions targeting children and adolescents; overall, such interventions are associated with improvements in positive mental health. However, this finding should be interpreted as a composite estimate of intervention programs across various heterogeneous factors, such as different modes of family involvement and program components, and their effects on reducing negative psychological symptoms remain unclear. Future research should further refine the composition of these interventions and conduct high-quality, long-term studies to clarify their key components and long-term effects. Full article

Background: This study was conducted to examine the relationships between distress and eustress levels and lifestyles and self-perception in adolescents presenting to a pediatric emergency department with psychosocial complaints. Methods: This descriptive cross-sectional study was conducted in a single training and research hospital with 142 adolescents aged 12–17 years who presented to a pediatric emergency department with psychosocial complaints. Data were collected using an introductory information form, the Adolescent Distress–Eustress Scale, the Adolescent Lifestyle Scale, and the Self-Perception Scale for Adolescents. Pearson correlation analyses were performed to examine bivariate relationships among variables. Multiple linear regression analyses were conducted to identify variables independently associated with lifestyle and self-perception scores after controlling for relevant sociodemographic variables. Variables were entered simultaneously into the regression model. Results: Distress level was significantly negatively correlated with self-perception and lifestyle scores, whereas eustress level was positively correlated with both variables (p < 0.001). In multiple linear regression analyses, eustress, distress, and economic status were significantly and independently associated with self-perception and lifestyle scores. The models explained 45.9% and 44.8% of the variance in self-perception and lifestyle, respectively. Adolescents reporting better sleep patterns, higher academic achievement, greater self-confidence, and perceived social acceptance had higher self-perception and lifestyle scores (p < 0.05). Conclusions: These findings highlight the importance of stress perception and socioeconomic factors in understanding psychosocial well-being among adolescents presenting to pediatric emergency departments. Full article

Objective: Youth mental health has become a global public health priority, with psychological distress, anxiety, and depressive symptoms increasing sharply over the last decade. Numerous interventions, ranging from mindfulness-based and cognitive behavioral programs to digital applications and peer-support initiatives, have been evaluated through meta-analytic reviews. However, the cumulative evidence remains heterogeneous and dispersed across intervention modalities. The present umbrella meta-analysis synthesized existing meta-analyses on psychological and digital interventions for adolescents and young adults, adopting a Bayesian random-effects framework to quantify the overall effectiveness and heterogeneity of outcomes. Method: Systematic searches were conducted in PubMed, PsycINFO, and Web of Science up to September 2025, using the following syntax: (“meta-analysis” OR “systematic review”) AND (adolescent* OR “youth” OR “young people”) AND (“mental health” OR “well-being” OR “psychological intervention”). Eligible reviews reported standardized mean differences (Hedges’ g) or convertible statistics and targeted mental health or well-being outcomes. Effect sizes were standardized using Hedges’ g and synthesized under a random-effects framework. They were then pooled using Bayesian random-effects modeling with a Normal (0, 0.5²) prior on the grand mean μ and a half-Cauchy (0, 0.5) prior on the heterogeneity variance τ. Results: Nine eligible meta-analyses (k = 9 aggregated effects, ≈1150 primary studies) met the inclusion criteria. The posterior mean standardized effect was μ = 0.229 (95% CrI [0.157, 0.301]), indicating a small but credible positive impact of interventions on youth mental health and well-being indicators (μ = 0.19 for symptom reduction; μ = 0.28 for positive well-being). Between-study heterogeneity was non-negligible (τ² = 0.003; posterior mean I² = 23%, 95% CrI [0.04%, 74%]), reflecting uncertainty about the true degree of variability across modalities and settings. The posterior probability that μ > 0 was >0.999, providing strong Bayesian evidence for credible but heterogeneous effects. Conclusions: The findings suggest potentially credible but heterogeneous effects of psychological and digital interventions on youth mental health and well-being outcomes, although the magnitude and consistency of these effects remain constrained by substantial heterogeneity and the breadth of aggregated outcome constructs. Results should be interpreted with appropriate caution. Full article