Band 37, Heft 3

Following prospective registration (PROSPERO CRD42024564275), three databases (PubMed, SCOPUS, Web of Science) were searched for trials reporting the effects of anti-obesity drugs (AODs) (with placebo as control) on cardiometabolic risk factors in the pediatric population with obesity. Data was synthesized using RStudio within a Random effect model. Risk of Bias was assessed through the Cochrane Risk of Bias 2 tool. Five clinical trials fulfilled the eligibility criteria. Pooled estimates showed significant reductions in triglycerides [−13.84 mg/dl (CI: −26.46 to −1.21; p 0.03) (I 2 93 %, p<0.01), Systolic blood pressure [−1.49 mmHg (CI: −2.77 to −0.21; p 0.02) (I 2 0 %, p 0.61)], and Waist circumference [−6.55 cm (CI: −10.56 to −2.55; p<0.01) (I 2 93 %, p<0.01)]. Fasting glucose, Insulin, Insulin resistance, Glycated hemoglobin, Diastolic blood pressure, Total cholesterol, Low density lipoproteins, High density lipoproteins, Very low density lipoproteins, and C-Reactive Protein showed insignificant reductions. No significant publication bias was detected in any outcome except Waist circumference (p 0.03).

Objectives Non-communicable diseases (NCDs), including cardiovascular conditions such as hypertension, are increasingly affecting young adults. Elevated blood pressure (BP) in this age group is often overlooked despite its potential to cause long-term health consequences. This study aimed to assess the prevalence and determinants of elevated blood pressure among urban college-going young adults in Meghalaya. Methods An analytical cross-sectional study was conducted among college students aged 18–25 years in a selected college in Shillong, representing the urban population of Meghalaya. A total of 274 participants were included. Data were collected using a semi-structured WHO STEPs-based questionnaire, followed by anthropometric and blood pressure measurements. BP was classified using JNC-8 criteria. Descriptive statistics and logistic regression analyses were performed using SPSS v25. Results The mean age of participants was 19.9 (±1.2) years; 55.8 % were female, and 38.0 % belonged to below poverty line (BPL) households. The prevalence of elevated BP was 17.9 % (95 % CI: 13.6–23.0 %). In multivariable analysis, non-BPL status (AOR: 5.4; 95 % CI: 2.1–14.1), obesity (AOR: 3.9; 95 % CI: 1.5–9.8), and smoking (AOR: 2.1; 95 % CI: 1.1–4.0) were significantly associated with elevated BP. Conclusions Elevated blood pressure was prevalent among nearly one-fifth of urban young adults, with socioeconomic status, obesity, and smoking emerging as significant determinants. These findings highlight the need for early screening and targeted interventions to mitigate cardiovascular risk among youth in urban India.

Objectives Adolescence is a critical period for psychosocial development, often marked by elevated stress levels. The present study examines the role of psychosocial factors as predictors of adolescent stress, with a focus on personality traits, social support, and family health. Methods A cross-sectional sample of 1,104 school-going adolescents from Telangana, India were analysed. Using the Adolescence Stress Scale and various psychosocial scales, hierarchical multiple regression and path analysis were employed to assess direct and indirect effects of psychosocial variables on stress levels. Results Key predictors of stress included ill-health experiences, conscientiousness, emotional instability, and psychosocial support. Together, these factors explained 6 % of the variance in stress. Serial mediation analysis revealed significant indirect effects, where family health and emotional efficacy acted as mediators between psychosocial factors and stress. Emotional instability and frustrative non-reward responsiveness were the strongest predictors of stress. Conclusions Psychosocial factors play a significant but modest role in adolescent stress, highlighting the need for further research into additional contributors. Interventions targeting family health and emotional regulation may alleviate stress among adolescents.

Objectives With over 54,000 people affected, cystic fibrosis is one of the most common rare diseases in Europe. As life expectancy of this disease has steadily increased in recent years, the transition from pediatric to adult care has become a principal issue. This study aimed to identify facilitating and hindering factors in the transitional care of cystic fibrosis patients in order to derive indications for improving care. Methods A qualitative systematized review was conducted in May 2024 with a systematic search carried out in MEDLINE, CINAHL and Livivo, including European studies from 2009 to 2024. The studies’ quality was assessed using the Critical Appraisal Skills Programme checklist for qualitative studies. Thematic analysis was applied for analyzing the data to identify categories. Results Nine studies met the inclusion criteria. Their quality can be rated as medium to high. Parental support, commitment and social support were identified as beneficial factors. Preparation for the transition, appropriate communication and continuous follow-ups at the adult center also contributed to a continuous transition. However, the parents’ changing roles, fears and the usual treatment in pediatrics were obstacles. The adjustment to the adult center and structural problems presented further barriers to transition. Conclusions Various factors were identified to influence the transition process in cystic fibrosis, with consistency across the studies. In practice, comprehensive care is required, focused on the patients’ needs, with more information provided and enhanced collaboration among stakeholders. Further research regarding the long-term effects of transition and the utilization of structured transition programs is needed.

Context Globally self-medication is an important public health problem, with prevalence ranging from 11.7 to 92 % worldwide and around 52 % in India. It is nevertheless common, particularly in developing nations like India, despite the possible hazards, including adverse drug reactions and the risk of drug resistance. Objectives This study estimates the prevalence of self-medication, examines associated factors and explores attitudes toward self-medication among young adults in Bengaluru. Methods Community-based cross-sectional study, conducted from August 1 to September 30, 2023, involved 453 young adults aged 18–22 in four Bengaluru colleges. Participants were selected using a multistage random sampling technique. Data were collected through a pre-tested, self-administered questionnaire covering socio-demographic details, self-medication practices, and attitudes. Data were analyzed using EpiData 3.1 analysis software. Chi-square, Fisher exact tests, and Binary logistic regression were used to identify significant predictors of self-medication. Results The prevalence of self-medication among young adults is found to be 93 % and it was influenced by factors such as age, gender, and education. Common reasons included time-saving (40 %) and possession of old prescriptions (35 %). The most frequently self-medicated conditions were headaches (61 %) and fever (55 %). Significant predictors of self-medication included age (20–22 years) with an adjusted odds ratio of 0.4 (95 % CI 0.1–0.8). Conclusions Self-medication practices were highly prevalent among young adults in urban Bengaluru, driven by factors such as convenience and cost-saving. There is a need for targeted health education and stricter enforcement of drug sale regulations to mitigate these risks.

Objectives Adolescents with life-limiting conditions are distinct from children or older adults in their palliative needs and developmental stage, yet, there is limited literature addressing this population. Our aim was to describe the characteristics of the adolescent population, aged 13–18, who have received specialist palliative care in the Republic of Ireland, from 2019 to 2022 inclusive. Methods This study examined medical records from the national paediatric palliative care centre and a radiation oncology network. These two centres hold medical records for all adolescents linked to paediatric specialist palliative care nationally . Results Of the 145 patients identified 58 (40.0 %) had cancer and 87 (60.0 %) a non-cancer diagnosis. Those with a non-cancer diagnosis were subdivided into those with severe neurological impairment (n=56, 38.6 %) and those without (n=31, 21.4 %). All groups had a high prevalence of physical symptoms. Just under half of those with cancer had psychological symptoms (n=26, 44.8 %). The majority of those with severe neurological impairment required medical devices/technology in the home, with 48 (85.7 %) requiring feeding devices and 33 (58.9 %) requiring respiratory support devices. Nearly a half of the adolescents had died at the time of the study (n=69, 47.6 %). Of these, the majority (n=44, 63.8 %) died at home and 9 (13.0 %) were referred less than one month before their death. Conclusions The high symptom burden of these young people highlights the need for early access to palliative care professionals with an appropriate skillset and access to quality, equitable psychological supports for this group.

The transition from adolescence to young adulthood presents an opportunity for health promotion and illness prevention. However, the transition from pediatric to adult healthcare services is complex and exposes systemic vulnerabilities in the healthcare system, particularly in access to care for marginalized youth. There exist high rates of discontinuity in primary care for young adults, amplifying health disparities. In the final stages of the transition process, the transfer to adult healthcare services is critical to continuity of care. There is a need to better understand and address access to care issues for young adults. This study explores barriers and facilitators to access to primary care for young adults in an urban Latinx community through community-based participatory research (CBPR) and youth participatory action research (YPAR). This study was developed in partnership with a hospital-affiliated community-based youth program and youth research leaders. Group concept mapping methodology was used to structure discussions with the organization’s youth and staff members. Results indicate that the highest priority factors for young adults in seeking primary care are related to the culture of the clinical setting, including intangible factors such as “respect by front desk staff” and “relationship with provider.” These factors are also perceived by young adults to be more feasible targets for improvement as opposed to, for example, insurance coverage. The findings provide a roadmap to advocate for interventions to transform young adult services within the healthcare system as well as a framework for integrating youth voices and leadership into the research process.