Objective: The aim of this research was to study the mediation of body dissatisfaction, physical self-concept, and body mass index (BMI) on the relationship between physical activity and self-concept in adolescents. Materials and Methods: A sample of 652 Spanish students between 12 and 17 years participated in a cross-sectional study. Physical self-concept and general self-concept were assessed with the Physical Self-Concept Questionnaire (CAF), body dissatisfaction with the Body Shape Questionnaire (BSQ), and physical activity was estimated with the International Physical (...) Activity Questionnaire (IPAQ-SF). BMI was utilized as a measurement of body composition. Structural equation modeling was used to assess the results. Results: The resulting models showed good fit indexes. Physical activity had a positive and indirect effect on self-concept (β = 0.29, p < 0.01) and direct effects on dissatisfaction (β = -0.26, p < 0.01) and physical self-concept (β = 0.20, p < 0.01). BMI had a direct effect on dissatisfaction (β = 0.31, p < 0.01) and on physical self-concept (β = -0.10, p < 0.01) and an indirect effect on general self-concept (β = -0.24, p < 0.01). However, it was only associated with physical activity in males, playing a mediating role between physical activity and body dissatisfaction. Conclusion: Physical activity can help individuals to achieve a positive self-concept and promote psychological well-being in adolescents through the improvement of physical perceptions and body satisfaction. The importance of BMI, body dissatisfaction, and physical self-concept on the configuration of the self-concept are also emphasized. Educational policymakers and Physical Education teachers should implement strategies to promote physical activity in the schools and provide a Quality Physical Education programs to increase physical activity during adolescence. (shrink)

Background: Visual technologies are central to youth culture and are often the preferred communication means of adolescents. Although these tools can be beneficial in fostering relations, adolescents’ use of visual technologies and social media also raises ethical concerns. Aims: We explored how school public health nurses identify and resolve the ethical challenges involved in the use of visual technologies in health dialogues with adolescents. Research design: This is a qualitative study utilizing data from focus group discussions. Participants (...) and research context: We conducted focus group discussions using two semi-structured discussion guides with seven groups of public health nurses working in Norwegian school health services. The data were collected during January and October 2016. Discussions were audio recorded, transcribed, and coded into themes and subthemes using systematic text condensation. Ethical considerations: The leader of the public health nursing service who agreed to provide access for the study and the Norwegian Center for Research Data that reviewed and approved the study. All participants gave informed consent. Findings: In adolescents’ use of visual materials with public health nurses, ethical concerns were raised regarding suicide ideations, socially unacceptable content, violation of privacy, and presentations of possible child neglect. The nurses utilized their professional knowledge and experience when identifying and navigating these ethical dilemmas; they resolved ethical uncertainties through peer discussion and collaboration with fellow nurses and other professionals. Discussion: We discussed the findings in light of Annemarie Mol’s interpretation of the ethics of care. Mol expands the notion of ethical care to include the action of technologies. Conclusion: Although the increasing use of visual technologies offered benefits, school nurses faced ethical challenges in health dialogues with adolescents. To address and navigate these ethical issues, they relied on their experience and caring practices based on their professional ethics. Uncertainties were resolved through peer dialogue and guidance. (shrink)

ABSTRACTEmotion differentiation refers to the precision with which people can identify and distinguish their emotions and has been associated with well-being in adults. This study investigated ED and its relation with emotional well-being in adolescents. We used an experience sampling method with 72 participants to assess adolescents’ positive and negative emotions at different time points over the course of two weekends and a baseline questionnaire to assess emotional well-being. Differentiating negative emotions was related to less negativity intensity and (...) propensity, and to the belief that emotions are malleable. Differentiating positive emotions was not related to any of the assessed well-being variables. Together, these results suggest that a detailed awareness of one’s negative emotional states is an important dimension of well-being, also in adolescence. (shrink)

SummaryThis study examined the secular changes in height, body weight, body mass index and pubertal development in male children and adolescents in Krakow over the past 80 years, with an emphasis on the last decade. The survey of the population of Krakow is a continuation of observations conducted in that area for many years. The analysis aims to determine whether in the last decade Krakow still witnessed the secular trend, and what form the trend took. The body height and (...) weight, and body mass index, of 1862 boys aged 3.5–18.5 years were analysed, against the background of a survey series from the years 1938, 1971, 1983 and 2000. The mean body height, in almost all age categories, was greater than in the past; however the final height over the last decade remained the same. The mean values of body weight and BMI increased, especially in the last decade. Also, an acceleration of puberty in boys was observed. The last 10 years saw an over 3-month decrease in the age of initial appearance of pubic hair in boys. In conclusion, the last decade saw cessation of the growing taller trend: maximum body height stabilized at approximately 179 cm, but weight and BMI increased. Also, a distinct acceleration of puberty was noticed. Lack of height increase, at the same time as weight gain and puberty acceleration, indicate a progressing developmental disharmony. (shrink)

PurposeAdolescents develop their decision-making ability as they transition from childhood to adulthood. Participation in their medical care should be encouraged through obtaining assent, as recommended by the American Academy of Pediatrics (AAP). In this research, we aim to define the current knowledge of AAP recommendations and surgeon practices regarding assent for elective reconstructive procedures.MethodsAn anonymous electronic survey was distributed to North American paediatric surgeons and fellows through the American Pediatric Surgical Association (n=1353).ResultsIn total, 220 surgeons and trainees responded (16.3%). Fifty (...) per cent of the surgeons who are familiar with the concept of assent had received formal training; 12% of the respondents had not heard of assent before the survey. Forty-seven per cent were aware of the 2016 AAP policy statement regarding assent in paediatric patients. Eighty-nine per cent always include adolescents as part of the consent discussion. Seventy-seven per cent solicit an expression of willingness to accept the proposed care from the patient. The majority (74%) of the surgeons perceived patient cooperation/understanding as the biggest barrier to obtaining assent. Over half of the respondents would consider proceeding with elective surgery despite the adolescent patient’s refusal. Reasons cited for proceeding with elective surgery include surgeons’ perception of medical necessity, perceptions of disease urgency, and lack of patient maturity.ConclusionPaediatric surgeons largely acknowledge the importance of assent, but variably practice the principles of obtaining assent from adolescent patients undergoing elective reconstructive procedures. Fewer surgeons are explicitly aware of formal policy statements or received formal training. Additional surgeon education and institutional policies are warranted to maximise inclusion of adolescents in their medical care. (shrink)

Gender affirming hormone treatment is an important part of the care of trans adolescents which enables them to develop the secondary sexual characteristics congruent with their identified genders. There is an increasing amount of empirical evidence showing the benefits of gender affirming hormone treatment for psychological health and social well-being in this population. However, in several countries, access to gender affirming hormone treatment for trans adolescents has recently been severely restricted. While much of the opposition to gender affirming (...) hormone treatment for trans adolescents has in part been ideologically motivated, it also reflects a debate about whether there are harms that outweigh the benefits of the treatment. Accordingly, a systematic and comprehensive philosophical analysis of the ethics of gender affirming hormone treatment for trans adolescents is needed. Herein, I offer such an analysis that draws on the four principles of biomedical ethics by Tom Beauchamp and James Childress. Based on the considerations of beneficence, nonmaleficence, autonomy, and justice, I argue that the provision of access to gender affirming hormone treatment for consenting trans adolescents is ethically required and that the current restrictions to such treatment are ethically wrong. (shrink)

The tendency to get involved in helping one’s family, friends, school, and community has many potential benefits such as greater compassion, concern for others, and social responsibility. Research interest in the benefits of contribution in adolescents has increased recently, but there are not many studies examining the effect of contribution on adolescents’ mental health. The present study focused on whether the contribution is associated with fewer self-rated depression symptoms in adolescents. We further tested whether self-regulation and academic (...) performance can have a mediating role in this association. A total of 423 secondary school students (233 female) from eastern Croatia participated in the study. Mean age was 16.78 (SD= 1.21). Students completed measures of self-regulation, depression symptoms, and contribution (helping one’s family, friends, or neighbors, mentoring peers, volunteering in one’s community, and participating in school organizations or boards), and gave information about age, gender, and academic performance. A hierarchical regression analysis revealed that contribution, self-regulation, and academic performance were related with lower levels of self-rated depression symptoms. Furthermore, mediation analysis indicated a significant indirect effect through two mediators, self-regulation and academic performance, which was stronger than a path containing only self-regulation. Academic performance alone was not a significant mediator. Our findings suggest that contribution could protect against depression by promoting self-regulation, leading to higher academic performance, and consequently fewer depression symptoms. (shrink)

IntroductionDespite a growing interest in the field, scarce narrative studies have delved into adolescents’ psychological experiences related to global emergencies caused by infective diseases. The present study aims to investigate adolescents’ narratives on positive and negative experiences related to COVID-19.MethodsItalian adolescents, 2,758, completed two narrative tasks on their most negative and positive experiences during the COVID-19 emergency. Data were analyzed by modeling an analysis of emergent themes.Results“Staying home as a limitation of autonomy,” “School as an educational, not (...) relational environment,” the impact of a “new life routine,” and experiencing “anguish and loss” are the four emergent themes for negative experiences. As for positive experiences, the four themes were “Being part of an extraordinary experience,” “Discovering oneself,” “Re-discovering family,” and “Sharing life at a distance.”ConclusionAuthors discuss the impact of COVID-19 on adolescents’ developmental tasks, such as identity processes and autonomy acquisition. (shrink)

Objectives: Young people who are concerned that consultations may not remain confidential are reluctant to consult their doctors, especially about sensitive issues. This study sought to identify issues and concerns of adolescents, and their parents, in relation to confidentiality and teenagers’ personal health information.Setting: Recruitment was conducted in paediatric dermatology and general surgery outpatient clinics, and on general surgery paediatric wards. Interviews were conducted in subjects’ own homes.Methods: Semistructured interviews were used for this exploratory qualitative study. Interviews were carried (...) out with 11 young women and nine young men aged 14–17. Parents of 18 of the young people were interviewed separately. Transcripts of tape recorded interviews provided the basis for a framework analysis.Results: Young women were more concerned than young men, and older teenagers more concerned than younger teenagers, about people other than their general practitioner having access to their health information. Young people with little experience of the healthcare system were less happy than those with greater knowledge of the National Health Service for non-medical staff to access their health information. As they grow older, adolescents become increasingly concerned that their health information should remain confidential.Conclusion: Young people’s willingness to be open in consultations could be enhanced by doctors taking time to explain to them that their discussion is completely confidential. Alternatively, if for any reason confidentiality cannot be assured, doctors should explain why. (shrink)

Background: Physical exercises can affect executive function both acutely and chronically, with different mechanisms for each moment. Currently, only a few reviews have elaborated on the premise that different types of exercises have different mechanisms for improving executive function. Therefore, the primary purpose of our systematic review was to analyze the effects of acute and chronic exercises on executive function in children and adolescents.Objective: We identified acute and chronic exercise studies and randomized controlled trials of executive function in children (...) and adolescents that reported overall effect, heterogeneity, and publication bias of acute and chronic exercises on executive function.Methods: We searched for RCTs of exercise interventions in children and adolescents from databases including PubMed, Web of Science, Scopus, The Cochrane Library, CNKI, and Wanfang, from January 1 2009 to December 31 2019. We performed methodological quality evaluations on the included literature using the Physiotherapy Evidence Database Scale and graded evidence with a meta-analysis using Stata 12.0 software.Results: In total, 36 RCTs were included ; the overall results of the meta-analysis indicated that acute exercises significantly improved working memory = −0.72; 95% confidence interval −0.89 to −0.56; p < 0.001), inhibitory control, and cognitive flexibility, whereas chronic exercises significantly improved working memory, inhibitory control, and cognitive flexibility.Conclusion: Acute and chronic exercises can effectively improve the executive function of children and adolescents. The effects on inhibitory control and cognitive flexibility are considered as small effect sizes, while the effects on working memory are considered as moderate effect size. Limited by the quantity and quality of the included studies, the above conclusions need to be verified with more high-quality studies. (shrink)

BackgroundCarefully planned research is critical to developing policies and interventions that counter physical, psychological and social challenges faced by young people living with HIV/aids, without increasing burdens. Such studies, however, must navigate a ‘vulnerability paradox’, since including potentially vulnerable groups also risks unintentionally worsening their situation. Through embedded social science research, linked to a cohort study involving Adolescents Living with HIV/aids (ALH) in Kenya, we develop an account of researchers’ responsibilities towards young people, incorporating concepts of vulnerability, resilience, and (...) agency as ‘interacting layers’.MethodsUsing a qualitative, iterative approach across three linked data collection phases including interviews, group discussions, observations and a participatory workshop, we explored stakeholders’ perspectives on vulnerability and resilience of young people living with HIV/aids, in relation to home and community, school, health care and health research participation. A total of 62 policy, provider, research, and community-based stakeholders were involved, including 27 ALH participating in a longitudinal cohort study. Data analysis drew on a Framework Analysis approach; ethical analysis adapts Luna’s layered account of vulnerability.ResultsALH experienced forms of vulnerability and resilience in their daily lives in which socioeconomic context, institutional policies, organisational systems and interpersonal relations were key, interrelated influences. Anticipated and experienced forms of stigma and discrimination in schools, health clinics and communities were linked to actions undermining ART adherence, worsening physical and mental health, and poor educational outcomes, indicating cascading forms of vulnerability, resulting in worsened vulnerabilities. Positive inputs within and across sectors could build resilience, improve outcomes, and support positive research experiences.ConclusionsThe most serious forms of vulnerability faced by ALH in the cohort study were related to structural, inter-sectoral influences, unrelated to study participation and underscored by constraints to their agency. Vulnerabilities, including cascading forms, were potentially responsive to policy-based and interpersonal actions. Stakeholder engagement supported cohort design and implementation, building privacy, stakeholder understanding, interpersonal relations and ancillary care policies. Structural forms of vulnerability underscore researchers’ responsibilities to work within multi-sectoral partnerships to plan and implement studies involving ALH, share findings in a timely way and contribute to policies addressing known causes of vulnerabilities. (shrink)

International research guidance has shifted towards an increasingly proactive inclusion of children and adolescents in health research in recognition of the need for more evidence-based treatment. Strong calls have been made for the active involvement of children and adolescents in developing research proposals and policies, including in decision-making about research participation. Much evidence and debate on this topic has focused on high-income settings, while the greatest health burdens and research gaps occur in low-middle income countries, highlighting the need (...) to take account of voices from more diverse contexts. Between January and March 2014, 56 community representatives and secondary school students were involved in eight group discussions to explore views on the acceptability of involving children and adolescents in research, and how these groups should be involved in decision-making about their own participation. Discussions were voice-recorded and transcriptions analyzed using Framework Analysis, combining deductive and inductive approaches. Across these discussions, the idea of involving children and adolescents in decision-making about research participation was strongly supported given similar levels of responsibility carried in everyday life; existing capacity that should be recognized; the opportunity for learning involved; varying levels of parental control; and generational shifts towards greater understanding of science for adolescents than their parents. Joint decision-making processes were supported for older children and adolescents, with parental control influenced by perceptions of the risks involved in participation. Moves towards more active involvement of children and adolescents in planning studies and in making decisions about their participation are supported by these findings from Kenya. Important emerging considerations include the need to take account of the nature of proposed studies and prevailing attitudes and understanding of research in identifying children’s and adolescents’ roles. More research is needed to expand diversity and develop approaches to joint assent and consent processes that would fairly represent children’s and adolescents’ wishes and interests, towards their long term benefit. (shrink)

The current study examined the effects of cardiorespiratory fitness, identified with a continuous graded cycle ergometry, and aerobic exercise on cognitive functioning and entropy of the electroencephalogram (EEG) in 30 adolescents between the ages of 13 and 14 years. Higher and lower fit participants performed an executive function task after a bout of acute exercise and after rest while watching a film. EEG entropy, using the sample entropy measure, was repeatedly measured during the 1500ms post-stimulus interval to evaluate changes (...) in entropy over time. Analysis of the behavioural data for lower and higher fit groups revealed an interaction between fitness levels and acute physical exercise. Notably, lower fit, but not higher fit, participants had higher error rates for NoGo relative to Go trials in the rest condition, whereas in the acute exercise condition there were no differences in error rates between groups; higher fit participants also had significantly faster reaction times in the exercise condition in comparison with the rest condition. Analysis of EEG data revealed that higher fit participants demonstrated lower entropy post-stimulus than lower fit participants in the left frontal hemisphere, possibly indicating increased efficiency of early stage stimulus processing and more efficient allocation of cognitive resources to the task demands. The results suggest that EEG entropy is sensitive to stimulus processing demands and varies as a function of physical fitness levels, but not acute exercise. Physical fitness, in turn, may enhance cognition in adolescence by facilitating higher functionality of the attentional system in the context of lower levels of frontal EEG entropy. (shrink)

As one of the foundations of existential positive psychology, self-transcendence can bring positive intrapersonal and interpersonal outcomes, especially in the COVID-19 era in which people are suffering huge mental stress. Based on Schwartz's theory of human basic values, the current study combines variable-centered and person-centered approaches to examine the relationships between adolescents' values and mental health across two regions in China. The results generally showed that both self-enhancement and conservation values were positively correlated with depression and loneliness, while both (...) self-transcendence and openness to change values negatively correlated with depression and loneliness. The results also showed that there were four value clusters, and, compared to adolescents in the self-focus and undifferentiated values cluster, all adolescents in the anxiety-free values cluster reported lower depression and loneliness, while all adolescents in the other-focus values cluster reported higher depression and loneliness. The differences between the two regional groups only emerged in depression. Specifically, adolescents in Shanghai have higher levels of depression than adolescents in Qingdao. This study provides some evidence for the new science of self-transcendence among adolescents and also sheds light on how we may improve the level of mental health during the COVID-19 era. (shrink)

A sample of 711 16 year old adolescents completed an Anglicised form of the Dommert revision of the Rokeach Dogmatism Scale, together with the Junior Eysenck Personality Inventory and Raven's Standard Progressive Matrices. They also provided information about church attendance, personal prayer and paternal occupation. The data demonstrate that higher dogmatism scores are associated with lower IQ scores, lower social class backgrounds, higher neuroticism scores, higher lie scale scores and being male. No correlation was found between dogmatism scores and (...) personal prayer, church attendance or extroversion scores. These findings are discussed against the wider background of the personal and social correlates of dogmatism. (shrink)

The disease brought about by the SARS-CoV-2, COVID-19 coronavirus has had an unprecedented global impact. Confinement to control the outbreak may have mental health consequences for the most vulnerable in the population, including adolescents. This study aims to describe and analyze the relationships between the stress variables, Emotional Intelligence and the intention to use cannabis in healthy adolescents, before and after the end of the COVID-19 pandemic containment stage. A comparative correlational study was carried out with validated self-completed (...) questionnaires through an online platform. The sample is made up of adolescents aged 13–17 from two different schools in Ponferrada. The analysis of correlation and differences between the groups indicate that confinement has had effects on the mental health of the adolescents, specifically on the emotional manifestations of stress. Furthermore, significant gender differences were found for stress values and Emotional Intelligence. However, no differences have been found for cannabis use intention. (shrink)

Background: By providing healthcare to adolescents, a major opportunity is created to help them cope with the challenges in their lives, develop healthy behaviour and become responsible healthcare consumers. Confidentiality is a major issue in adolescent healthcare, and its perceived absence may be the main barrier to an adolescent seeking medical care. Little is known, however, about confidentiality for adolescents in primary care practices in Spain.Objective: To ascertain the attitudes of Spanish family doctors towards the right of (...) class='Hi'>adolescents to confidentiality in different healthcare situations and in the prescription of treatment.Method: A descriptive postal questionnaire was self-administered by family doctors.Results: Parents of patients under 18 years are always informed by 18.5% of family doctors, whereas parents of those under 16 years are informed by 38.8% of doctors. The patients are warned of this likelihood by 79.3% of doctors. The proportion of doctors supporting confidentiality for adolescents increases with the age and maturity of the patients, whereas workload and previous training has a negative effect.Conclusions: Spanish laws on adolescent healthcare are not reflected by the paternalistic attitude that Spanish primary care doctors have towards their adolescent patients. Doctors need to be provided with up-to-date and clinically relevant explanations on contemporary legal positions. In primary care, more attention should be paid to adolescents’ rights to information, privacy and confidentiality. Doctors should be more aware of the need to encourage communication between teenagers and their parents, while also safeguarding their patients’ rights to confidential care. (shrink)

Physical activity, body composition and sedentary behavior may affect the health of children. Therefore, this study examined the effect of an educational hybrid physical education program on physical fitness, body composition and sedentary and PA times in adolescents. A 9-month group-randomized controlled trial was conducted in 150 participants allocated into the control group and experimental group. Cardiorespiratory fitness, speed, strength, agility, flexibility and body mass index were assessed through previously validated field tests. Sedentary time, PA at school and afterschool (...) were evaluated with the Youth Activity Profile-Spain questionnaire. Significant differences were observed concerning to the CG in APA-weekend, speed-agility and agility. Regarding the intervention, cardiorespiratory fitness, speed-agility, strength, flexibility, agility, PA in school, APA-weekday, APA-weekend, APA-week, and sedentary time increased significantly in the EG. The use of a hybrid program based on teaching personal and social responsibility and gamification strategies produced enhancements in cardiorespiratory fitness, agility, speed, APA-weekdays and APA-weekends, reducing the sedentary time. (shrink)