Medicine and Health Sciences Commons^™

Association Of Manganese Biomarker Concentrations With Blood Pressure And Kidney Parameters Among Healthy Adolescents: Nhanes 2013–2018, Maria D. Politis, Jacob C. Freedman, Erin N. Haynes, Alison P. Sanders

Epidemiology and Environmental Health Faculty Publications

Deficiency or excess exposure to manganese (Mn), an essential mineral, may have potentially adverse health effects. The kidneys are a major organ of Mn site-specific toxicity because of their unique role in filtration, metabolism, and excretion of xenobiotics. We hypothesized that Mn concentrations were associated with poorer blood pressure (BP) and kidney parameters such as estimated glomerular filtration rate (eGFR), blood urea nitrogen (BUN), and albumin creatinine ratio (ACR). We conducted a cross-sectional analysis of 1931 healthy U.S. adolescents aged 12–19 years participating in National Health and Nutrition Examination Survey cycles 2013–2014, 2015–2016, and 2017–2018. Blood and urine Mn concentrations …

Temporal Trends In Suicidal Ideation And Attempts Among Us Adolescents By Sex And Race/Ethnicity, 1991-2019, Yunyu Xiao, Julie Cerel, J. John Mann

Social Work Faculty Publications

Importance: Disparities by sex and racial/ethnic group in suicide death rates are present in US adolescents. Whether disparities in suicide death extend to groups targeted for suicide prevention efforts, namely, those with suicidal ideation or nonfatal suicide attempts, is unknown.

Objective: To examine differences in temporal trends between suicidal ideation and suicide attempts in US adolescents from 1991 through 2019 by sex and race/ethnicity subgroups.

Design, Setting, and Participants: A cross-sectional analysis of the national Youth Risk Behavior Survey, weighted to represent US adolescents from 1991 to 2019, included 183 563 US high-school students in grades 9 to 12. Data …

Age At First Alcohol Use And Weapon Carrying Among Adolescents: Findings From The 2019 Youth Risk Behavior Survey, Philip Baiden, Nusrat Jahan, Henry K. Onyeaka, Shawndaya Thrasher, Savarra Tadeo, Erin Findley

Social Work Graduate Research

Background
Although studies have investigated the association between alcohol use and violent behaviors such as weapon carrying, few studies have examined the association between age at first alcohol use and weapon-carrying among adolescents. The objective of this study was to investigate the association between age at first alcohol use and weapon carrying among adolescents.

Methods
Data for this study came from the 2019 Youth Risk Behavior Survey. An analytic sample of 13,442 adolescents aged 14–18 years old (51% female) was analyzed using binary logistic regression. The outcome variable investigated in this study was weapon carrying during the past 30 days, …

Examining Criteria For Defining Persistent Post-Concussion Symptoms In Children And Adolescents, Grant L. Iverson, Justin E. Karr, Bruce Maxwell, Ross Zafonte, Paul D. Berkner, Nathan E. Cook

Psychology Faculty Publications

Researchers operationalize persistent post-concussion symptoms in children and adolescents using varied definitions. Many pre-existing conditions, personal characteristics, and current health issues can affect symptom endorsement rates in the absence of, or in combination with, a recent concussion, and the use of varied definitions can lead to differences in conclusions about persistent symptoms and recovery across studies. This study examined how endorsement rates varied by 14 different operational definitions of persistent post-concussion symptoms for uninjured boys and girls with and without pre-existing or current health problems. This cross-sectional study included a large sample (age range: 11–18) of girls (n = …

An Emergency Department Medical Record Review For Adolescent Intentional Self-Harm Injuries, Anna Hansen, Dessi Slavova, Gena Cooper, Jaryd Zummer, Julia Costich

Emergency Medicine Faculty Publications

BACKGROUND: Non-suicidal self-injury and suicide attempts are increasing problems among American adolescents. This study developed a definition for identifying intentional self-harm (ISH) injuries in emergency department (ED) records coded with International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes. The definition is based on the injury-reporting framework proposed by the Centers for Disease Control and Prevention. The study sought to estimate the definition's positive predictive value (PPV), and the proportion of ISH injuries with intent to die (i.e., suicide attempt).

METHODS: The study definition, based on first-valid external cause-of-injury ICD-10-CM codes X71-X83, T14.91, T36-T65, or T71, captured 207 discharge …

Risky Substance Use Behaviors Among Adolescents Residing In Non-Metropolitan And Metropolitan Counties In The United States, 2017-2018, Tyrone F. Borders, Michael D. Singleton, Katherine Youngen

Rural & Underserved Health Research Center Publications

Overview of Key Findings

Tobacco Use. The prevalence of any past year tobacco use was significantly higher among non-metropolitan than metropolitan adolescents (13.9% vs. 8.3%). Daily cigarette use in the past 30 days was more than 3 times more prevalent among non-metropolitan than metropolitan adolescents (1.0% vs. 0.3%) and the difference was also statistically significant.

Alcohol Use. Alcohol was the most commonly used substance among both non-metropolitan and metropolitan adolescents, although the differences in prevalence rates for past year and past 30-day alcohol use were not statistically significant. In the past year, 21.8% of non-metropolitan and 21.7% of …

Sex Differences In Problem Alcohol Use In High School As A Function Of Recent Sexual Violence Victimization Or Perpetration, Christal L. Badour, Samuel C. Bell, Emily R. Clear, Ann L. Coker

Psychology Faculty Publications

To investigate sex differences in associations between sexual violence victimization (SVV), sexual violence perpetration (SVP), and binge drinking and/or alcohol problems among high school students. While SVV has been linked to problem alcohol use among young women, little research has addressed the unique associations of SVV and SVP on alcohol use/problems within both sexes. A cross-sectional analysis of 16,992 high school students’ self-reports of past-year SVP and SVV was used where SVV/SVP was defined by three tactics (sexual coercion, drug/alcohol-facilitated or incapacitated sex, and physically forced sex). Alcohol measures included past-month binge drinking and past-year alcohol problems. Rates of SVV …

What Contributes To High Adolescent Pregnancy Rates In Ecuador? A Secondary Analysis Of A Qualitative Study, Isabel D. Gollmar, Hartley C. Feld

Posters-at-the-Capitol Presentations

Introduction: Ecuador has the second highest rates of adolescent pregnancy in South America. Adolescent pregnancy is associated with negative health implications, including miscarriage, neonatal and maternal demise, cephalopelvic disproportion, and illness throughout infancy. Additionally, adolescent pregnancy perpetuates the cycle of poverty and is associated with lower educational attainment and increased reliance on social services.

Purpose: The purpose of this study was to describe experiences that contributed to unintended adolescent pregnancy of Ecuadorian women living in a low-resource community. Specifically, this work aimed to identify barriers to seeking or utilizing birth control in sexually active adolescents. The long-term goal of this …

Measurement Of Bystander Actions In Violence Intervention Evaluation: Opportunities And Challenges, Heather M. Bush, Samuel C. Bell, Ann L. Coker

Biostatistics Faculty Publications

Purpose of Review

This review discusses design and methodological challenges specific to measuring bystander actions in the evaluation of bystander-based violence prevention programming. “Bystanders” are defined as people who are present immediately before, during and/or after a violent event, but are not a perpetrator nor the intended victim. Bystander-based violence prevention programs seek to prevent or mitigate violent events by empowering bystanders to intervene on acts of violence and social norms that promulgate violence.

Recent Findings

Effective bystander-based violence prevention programs demonstrate increased bystander intentions, actions, and attitudes [Bringing in the Bystander: Banyard et al. J Community Psychol. 2007;35:463-481; iSCREAM: …

Association Between School Performance And Body Mass Index, Megan Rajagopal, Alissa Briggs, Hatim A. Omar

Pediatrics Faculty Publications

The purpose of this paper is to determine the relationship between grade point average and other factors, including: body mass index, exercise habits, and weight perception. Data from School-Based Health Promotion Centers (SBHC) were used for this study. Students in sixth, seventh, and eighth grades were screened at the SBHC for a variety of behaviors and lifestyle characteristics using the Perkins Adolescent Risk Screen (PARS). Data from a total 579 students (281 males and 298 females; 278 sixth graders, 151 seventh graders, and 150 eight graders) were obtained. Of these students, 145 were underweight, with a BMI less than 18.5; …

Improving Human Papillomavirus Immunization Rates In Kentucky, Nneka S. Udechukwu, Paul Duffin, Alissa Briggs, Hatim A. Omar

Pediatrics Faculty Publications

No abstract provided.

Early Detection Of Idiopathic Scoliosis In Adolescents, M. Timothry Hresko, Vishwas Talwalkar, Richard Schwend

Orthopaedic Surgery and Sports Medicine Faculty Publications

The early detection of idiopathic scoliosis has been advocated since the 1950s and ’60s, concurrent with the development in the modern era of ambulatory spinal orthoses to treat scoliosis in adolescents. This led to the development of screening programs for specific populations, as evidenced by school screening programs in the United States and public health systems in Europe and Asia. Over time, the value of population screening in terms of optimal health care and economics has been debated in the popular press, by the U.S. Preventive Services Task Force, and by professional societies. Recent studies on the effectiveness of bracing …

National Trends In Off-Label Use Of Atypical Antipsychotics In Children And Adolescents In The United States, Minji Sohn, Daniela C. Moga, Karen Blumenschein, Jeffery C. Talbert

Pharmacy Practice and Science Faculty Publications

The objectives of the study were as follows: to examine the national trend of pediatric atypical antipsychotic (AAP) use in the United States; to identify primary mental disorders associated with AAPs; to estimate the strength of independent associations between patient/provider characteristics and AAP use. Data are from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. First, average AAP prescription rates among 4 and 18-year-old patients between 1993 and 2010 were estimated. Second, data from 2007 to 2010 were combined and analyzed to identify primary mental disorders related to AAP prescription. Third, a multivariate logistic …

Effect Of Vitamins C And E On Endothelial Function In Type 1 Diabetes Mellitus, Rachel-Marie Cazeau, Hong Huang, John A. Bauer, Robert P. Hoffman

Pediatrics Faculty Publications

Background/Objectives. Endothelial dysfunction due to hyperglycemia-induced oxidative damage is an important predictor of future cardiovascular risk in patients with type 1 diabetes mellitus (T1DM) and is present in adolescent T1DM. We hypothesized that combined treatment with the antioxidant vitamins C and E might improve endothelial function (EF) and other biochemical risk factors in adolescents with T1DM. Subjects/Methods. Open-label antioxidant supplementation was given for six weeks with endpoint measurements collected at baseline and study completion. Endpoints measured included EF and plasma measurements of biochemical endothelial risk. Results. Two males and 7 females were studied. Mean age was 12.9 ± 0.9 yrs; …

Challenges Of Internet And Social Media Use In Adolescents, Mandakini Sadhir, Stephanie J. Stockburger, Hatim A. Omar

Pediatrics Faculty Publications

There has been tremendous growth in use of technology in recent decades. The majority of teens now have access to a desktop/laptop computer as well as a gaming console and smartphone. With growing internet and social media use teens now face challenges including cyberbullying, sexting and problematic internet use that result in various health implications. Health care providers are in unique position to educate adolescents and families about current challenges and provide age appropriate guidance to promote healthy internet behaviors.

Sexual Minority (Lgbtq) Youth And Role Of Health Care Provider, Mandakini Sadhir, Stephanie J. Stockburger, Hatim A. Omar

Pediatrics Faculty Publications

Adolescence is a time period of physical, psychological and cognitive changes. It is an important phase for an individual to discover who they really are (self-identity), how they are perceived (social identity) and how they fit into the environment they live in.¹ One of the major tasks of adolescence is sexual maturation and sexual and /or gender identity development.² Adolescents who are developing as gay, lesbian, bisexual or transgender face a tremendous challenge of establishing their identity which is often complex.³ They cope with the feelings of being different and are in constant dilemmas about revealing their …

Paper I: Stress In Adolescents, Stephanie Stockburger, Hatim A. Omar

Pediatrics Faculty Publications

It is well known that adolescents experience stress. In this article, sources of adolescent stress will be discussed as well as the physiological effects of stress on the body. Stress disorders will also be briefly reviewed. Mainly, research on stress management strategies that have been evaluated in adolescents will be presented. Many studies have a small number of participants and lack control groups. Therefore, there is a need for ongoing research in this important area.

The Importance Of Comprehensive Sexuality Education In Adolescents, Sarah Lebrun, Hatim A. Omar

Pediatrics Faculty Publications

No abstract provided.

Part Ii - Stress And Stress Management Strategies In Adolescents, Stephanie Stockburger, Hatim A. Omar

Pediatrics Faculty Publications

It is well known that adolescents experience stress. In this article, sources of adolescent stress will be discussed as well as the physiological effects of stress on the body. Stress disorders will also be briefly reviewed. Mainly, research on stress management strategies that have been evaluated in adolescents will be presented. Many studies have a small number of participants and lack control groups. Therefore, there is a need for ongoing research in this important area.

Self-Cutting And Suicide In Adolescents, Donald E. Greydanus, Hatim A. Omar

Pediatrics Faculty Publications

Deliberate self-harm (DSH) is a common and typically secret phenomenon in adolescents, especially females that involves two main features—self-derogation and negative emotionality. Causes of non-suicidal self-injury include attempts to get help from professionals, express disgust or self-anger, resist suicidal thoughts, and correct episodes of dissociation. DSH is associated with eating disorders and alcohol abuse, as well as other illict drug abuse. Fortunately, most self-cutters are not at high risk for eventual suicide; however, all those with DSH histories should be carefully assessed for suicide as well as offered comprehensive management. Programs for prevention of suicide should be implemented for adolescents …

Disability And Suicide, Divya Nagraj, Hatim A. Omar

Pediatrics Faculty Publications

We provide a systematic review of suicide among adolescents with physical disabilities, intellectual disability and learning disability. A search was performed of English articles published prior to December 2014 in the PubMed database for studies examining suicide, suicidal behavior and suicidal ideation among adolescents with and without varied disabilities. Nine studies were retrieved, of which two studies examined adolescent populations with physical disabilities, three looked at suicide in adolescents with intellectual disability and four studies examined adolescents with learning disabilities. There were consistent results to prove that these adolescents with special needs had an increased tendency to commit suicide and …

An Examination Of Exposure And Avoidance Behavior Related To Second-Hand Cigarette Smoke Among Adolescent Girls In Canada, Jennifer Schwartz, Raquel B. Graham, Chris G. Richardson, Chizimuzo T.C. Okoli, Laura L. Struik, Joan L. Bottorff

Nursing Faculty Publications

BACKGROUND: Although rates of tobacco use and exposure to second-hand smoke (SHS) are declining in Canada, SHS exposure among non-smoking adolescents remains high. This study aimed to describe frequency, locations, and avoidance behavior related to SHS exposure among adolescent girls in British Columbia, Canada.

METHODS: Data were analyzed from 841 adolescent girls aged 13 to 15 years old who completed an internet-delivered survey as part of a cohort study examining SHS exposure and substance use. Measures assessed demographics, smoking behavior and intentions, frequency and locations of SHS exposure, and avoidance behavior related to SHS.

RESULTS: Excluding their own smoking, 27% …

Do Not Play With Fire, Joav Merrick, Hatim A. Omar

Pediatrics Faculty Publications

Fire is the rapid oxidation of a material in the exothermic chemical process of combustion, releasing heat, light and various reaction products. Fire is intriguing and therefore something that will attract a curious child from an early age. In 2010, the United States fire department responded to 44,900 fires started by someone, usually a child, playing with fire. These fires caused 90 civilian deaths, 890 civilian injuries and $210 million in direct property damage. Preschoolers and kindergartners are most likely to start these fires, while playing with matches or lighters and most likely to die in these fires. Most fire-play …

United States: Sexual Behavior In Association With Human Papilloma Virus Vaccination In Young Girls, Wafa R.R. Al Romaih, Said Shahtahmasebi, Hatim A. Omar

Pediatrics Faculty Publications

The first human Papilloma virus (HPV) vaccine was approved in the United States in 2006 with the potential to reduce cervical cancer and genital warts. Since then, its efficacy in preventing HPV-related cancers in both males and females has been promising. Despite CDC recommendations, opponents of the vaccine assert that vaccinating preadolescents and adolescents will increase their sexual activity, as well as overtly condone risky sexual behavior. We analyzed clinic data of 499 adolescents with a mean age of 16 years to explore whether vaccination led to change in sexual behavior after one year. Our results showed no statistically significant …

Adolescence And Sexuality, Joav Merrick, Ariel Tenenbaum, Hatim A. Omar

Pediatrics Faculty Publications

No abstract provided.

Gender Identity, Ethnic Identity, And Smoking Among First Nations Adolescents, Lorraine Greaves, Joy Johnson, Annie Qu, Chizimuzo T.C. Okoli, Natalie Hemsing, Lucy Barney

Nursing Faculty Publications

Smoking rates among Aboriginal adolescents are the highest of any population group in British Columbia, Canada. Recent studies suggest that substance use is affected by gender and ethnic identity among youth. The purpose of our study was to explore the association of gender and ethnic identity with smoking behaviour among First Nations adolescents. This study is based on a convenience sample (i.e., an on-hand, readily available sample) of 124 youth (123 First Nations and 1 Métis) recruited at youth drop-in centres, health fairs, and cultural activities. We obtained information on demographics, smoking history, Bem Sex Role Inventory (BSRI), composite measure …

Contraception In Adolescents, Donald E. Greydanus, Carolyn M. Lentzsch-Parcells, Hatim A. Omar

Pediatrics Faculty Publications

The age of adolescence is the time when most adolescents in the world begin to be sexually active with resultant millions of pregnancies and sexually transmitted diseases (STDs). This chapter considers methods of contraception for these adolescents, including oral contraceptives, transdermal contraception, minipills, intra-vaginal ring, injectable contraception, intrauterine devices (IUDs), barrier contraceptives, implants, and others. It is important for clinicians caring for sexually active youth to provide information regarding contraception and appropriate contraceptive prescriptions.

Sexually Transmitted Diseases (Stds), Donald E. Greydanus, Jane Seyler, Hatim A. Omar

Pediatrics Faculty Publications

High rates of unprotected sexual behavior in adolescents result in millions of cases of STDs in the world. This chapter reviews factors inducing high STD rates, specific STDs, and their management based on 2010 U.S. Centers for Disease Control and Prevention (CDC) STD guidelines. Clinicians should screen all their sexually active adolescent patients for STDs and provide preventive education as well as treatment measures.

Menstrual Bleeding Patterns In Adolescents Using Etonogestrel (Eng) Implant, Amit M. Deokar, Wendy Jackson, Hatim A. Omar

Pediatrics Faculty Publications

Background: Etonogestrel (ENG) implant is an effective method of contraception. The implant is designed to provide contraceptive efficacy for 3 years with a relatively quick return of fertility upon its removal. Menstrual irregularities are not uncommon on long-acting progestins and can often be the factor for discontinuation or removal. A retrospective chart analysis was done on 58 patients who chose to be on the ENG implant. Age ranged from 12 to 24 years. The cycle ranged from 1 to 17 months. The mean length of use of the implant was 10.9 months. Over the 20-month period, 13 ENG implants were …

No Significant Change In Sexual Behavior In Association With Human Papilloma Virus Vaccination In Young Girls, Wafa R.R. Al Romaih, Archana Srinivas, Said Shahtahmasebi, Hatim A. Omar

Pediatrics Faculty Publications

The first human Papilloma virus (HPV) vaccine was approved in the United States in 2006 with the potential to reduce cervical cancer and genital warts. Since then, its efficacy in preventing HPV-related cancers in both males and females has been promising. Despite CDC recommendations, opponents of the vaccine assert that vaccinating pre-adolescents and adolescents will increase their sexual activity, as well as overtly condone risky sexual behavior. We analyzed clinic data of 499 adolescents with a mean age of 16 years to explore whether vaccination led to change in sexual behavior after one year. Our results showed no statistically significant …