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Adolescent participation in health research studies is critical yet complex given the lack of clarity around issues such as consent. This study aimed to understand how those conducting research in Australia navigate research ethics in health research involving adolescents, through qualitative interviews. Purposive sampling was used to recruit 23 researchers involved in adolescent health research using semi-structured in-depth interviews. Interviews were conducted via Zoom and audio-recorded after obtaining informed consent. Thematic analysis was used to construct themes and data were organised using NVivo. Two contrasting positions emerged from the data: (1) framing of adolescents as inherently vulnerable, their participation in research understood in terms of risk and protection and (2) adolescent engagement in research is understood in terms of empowerment, emphasising their capacity to make decisions about research participation. We traced these positions through three key themes, particularly in relation to the role of ethics committees: (1) competing positions as a result of inferior or superior knowledge about adolescent lives, (2) competing positions resulting in a risk averse or an empowerment approach, and (3) reflections on processes of obtaining consent which involves gatekeeping and tokenism. Our study highlights the contentious topic of navigating ethics committee requirements for the needs of adolescents. Majority of participants felt the current research ethics establishment is not favourable for researchers or adolescents themselves. While it is imperative that perceptions of ethics committees also be studied in the future, our study provides preliminary understanding of how experiences and perceptions shape how researchers interact with the research ethics establishment. [ABSTRACT FROM AUTHOR]

This study investigates the relationship between baseline puberty hormones, self-reported physical pubertal status, academic motivation, and academic achievement. Using structural equation modeling among a sample of 342 young people (10–15 years of age), we examined a longitudinal model in which puberty hormones impact one's physical pubertal status, pubertal status predicts subsequent academic motivation (self-efficacy and valuing of school), and both pubertal status and motivation predict academic achievement. We found that beyond the effects of covariates (age, school stage, gender), puberty hormones predicted pubertal status, more advanced pubertal status (but not puberty hormones) was associated with lower self-efficacy and valuing, and lower self-efficacy and valuing were associated with lower achievement. Achievement was not significantly predicted by hormones or pubertal status; rather, motivation explained the bulk of its variance. These findings show that more advanced physical pubertal status is associated with lower academic motivation that in turn is associated with lower achievement. Numerous indirect effects were found between hormones and motivation and achievement via pubertal status and between pubertal status and achievement via motivation. With regards to covariates, findings identified puberty as a potentially more salient factor in motivation than participants' age, whether they are a boy or girl, or in elementary or high school. [ABSTRACT FROM AUTHOR]

Background: Puberty is a time of rapid growth and changing energy requirements and is a risk period for obesity. There is little high-quality evidence on the pubertal alterations of energy expenditure and intake, and this has limited our understanding of energy balance during this important life stage. Objective: The purpose of this study was to summarize existing evidence on pubertal energy expenditure and intake in healthy nonobese adolescents. Design: Studies were identified through CINAHL, the Cochrane Library, Embase, MEDLINE, and Web of Science databases up to August 2015. Articles presenting objectively measured data for basal or resting metabolic rate (BMR/RMR), total daily energy expenditure (TDEE), and/or energy intake (EI) for ≥2 categories of puberty were included. Relevant data adjusted for fat-free mass (FFM) also were extracted. Data were dichotomized into prepubertal and pubertal groups and compared through the use of standardized mean differences (SMDs). Heterogeneous study methodologies precluded meta-analysis. Results: The search netted 6770 articles, with 12 included for review. From these, 6 of 9 studies supported significantly higher absolute BMR/RMR during puberty (SMD: 1.10–5.93), and all of the studies favored significantly higher absolute TDEE during puberty (SMD: 0.46–9.55). These corresponded to a 12% difference and an 18% difference in absolute BMR/RMR and TDEE, respectively. Results adjusted for FFM were equivocal, with 3 studies favoring higher (1 significantly) and 3 favoring significantly lower adjusted BMR/RMR during puberty. Only 1 study reported EI, showing 41% and 25% greater absolute intakes in pubertal males and females, respectively. These differences were not significant after adjustment for FFM. Conclusions: Reasonably consistent evidence exists to support higher absolute BMR/RMR and TDEE in pubertal than in prepubertal adolescents. Differences are largely accounted for by FFM, among other potential factors such as growth- and puberty-related hormones. This review argues for further research into hormonal influences on pubertal energy balance and subsequent effects on obesity risk. [ABSTRACT FROM AUTHOR]

Purpose During human puberty, there is an approximate 30-fold increase in testosterone production in boys. This increase is often linked to changes in mood and behavior in adolescence such as aggression, an increase in risk taking, and depression. The aim of this systematic review was to determine what evidence exists on the effects of endogenous testosterone on behavior and mood in males during adolescence. Methods The following databases were searched: MEDLINE, Pre-MEDLINE, Education Resources Information Centre, PsycINFO, EMBASE, Scopus, and Web of Science. Only human studies were included. The study is community based, and the participants were healthy male adolescents within the age range of 9-18 years. Studies were required to have a validated mood and/or behavior assessment contemporaneous with a timed testosterone measurement. Results A total of 27 studies met the inclusion criteria of which only one was a longitudinal study. The remaining 26 studies were cross sectional in their analysis. As a variety of measurement tools were used, no meta-analysis was possible. Most studies focused on aggression. The one longitudinal study looking at testosterone and aggression showed little relationship with concurrent changes in aggression. Most of the cross-sectional studies of adolescent males observed relationships between aggression and testosterone levels. With respect to other behaviors and moods and/or affect, no consistent relationships with testosterone were observed in cross-sectional studies. Conclusions This systematic review concludes that there are insufficient longitudinal data of high methodological quality to currently confirm that changing testosterone levels during puberty are significantly associated with mood and behavior in adolescent males. To discount these findings is to risk apportioning blame inappropriately and missing other important diagnoses in adolescent males. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Prader–Willi syndrome (PWS) is a leading genetic cause of obesity, characterized by hyperphagia, endocrine and developmental disorders. It is suggested that the intense hyperphagia could stem, in part, from impaired gut hormone signaling. Previous studies produced conflicting results, being confounded by differences in body composition between PWS and control subjects. Design: Fasting and postprandial gut hormone responses were investigated in a cross-sectional cohort study including 10 adult PWS, 12 obese subjects matched for percentage body fat and central abdominal fat, and 10 healthy normal weight subjects. Methods: PYY[total], PYY[3–36], GLP-1[active] and ghrelin[total] were measured by ELISA or radioimmunoassay. Body composition was assessed by dual energy X-ray absorptiometry. Visual analog scales were used to assess hunger and satiety. Results: In contrast to lean subjects (p <0.05), PWS and obese subjects were similarly insulin resistant and had similar insulin levels. Ghrelin[total] levels were significantly higher in PWS compared to obese subjects before and during the meal (p <0.05). PYY[3–36] meal responses were higher in PWS than in lean subjects (p =0.01), but not significantly different to obese (p =0.08), with an additional non-significant trend in PYY[total] levels. There were no significant differences in self-reported satiety between groups, however PWS subjects reported more hunger throughout (p =0.003), and exhibited a markedly reduced meal-induced suppression of hunger (p =0.01) compared to lean or obese subjects. Conclusions: Compared to adiposity-matched control subjects, hyperphagia in PWS is not related to a lower postprandial GLP-1 or PYY response. Elevated ghrelin levels in PWS are consistent with increased hunger and are unrelated to insulin levels. [Copyright &y& Elsevier]

The prevalence of child and adolescent overweight and obesity is rapidly increasing and is associated with morbidity, both medical and psychosocial. Obesity is unlikely to resolve spontaneously. It is important that health professionals can assess obesity and initiate an action plan. The evidence base for what works best in the management of child and adolescent overweight and obesity is limited. It is uncertain whether protocols from clinical research trials can be translated into primary care. Dietary change, with an emphasis on lower fat intake and smaller portion size, should be commenced. There should be an increase in physical activity and a decrease in sedentary behaviours, combined with behavioural change and parental involvement. These are the elements of a lifestyle intervention. In the severely obese adolescent with obesity-related co-morbidity, the use of very low-energy diets and anti-obesity agents could be considered. Bariatric surgery may be indicated in carefully selected, older, severely obese adolescents. [Copyright &y& Elsevier]

Purpose Young adult males (YAMs) are understudied with respect to lifestyle interventions to address overweight and obesity in this group. This study reports on the participatory design of the structure and delivery of the Fit4YAMs text message–based lifestyle intervention for 18- to 25-year-old rural YAMs in Australia. Methods Two semi-structured focus group discussions were held with six overweight or obese YAMs. Sessions explored their preferences for the structure and delivery of a weight loss intervention. Focus groups were recorded, and the contents transcribed verbatim for thematic analysis. Results The YAMs were unanimous in their preference for a highly personalized intervention program, complete with personalized goal setting, personalized motivation and engagement strategies, and personalized text message content. A text message frequency of three–four messages per week was deemed optimal for this group. Minimal direct contact by the intervention team was requested, but with clear guidelines and reminders of key contacts whom they could contact should they require help and guidance. The YAMs also agreed that a comprehensive goal setting session and personalization session prior to commencement of the intervention would be best. Conclusions To engage rural YAMs in lifestyle interventions, a high degree of personalization of the program appears important. Although initially more time and resource intensive than a less personalized approach, it is essential to identify strategies to prevent and reverse weight gain in this hard to engage group. Maximizing their engagement using a more personalized approach could be the key to promoting long-term health outcomes in this group. [ABSTRACT FROM AUTHOR]

Menstrual dysfunction can impact both the physical and emotional health of young people. 1 Multiple chronic diseases have been associated with menstrual dysfunction in adults 2 ; however, there is little research in adolescents, despite nonadherence and suboptimal illness control in this group. We aimed to identify the impact of chronic illness on the age of menarche and the menstrual cycle in adolescents. Studies were extracted of female adolescents aged 10-19 who had a chronic physical illness. Data included outcomes on age of menarche and/or menstrual cycle quality. Exclusion criteria aimed to exclude diseases where menstrual dysfunction was a known part of the disease pathophysiology (ie, polycystic ovarian syndrome) 3 or in which medications were used that directly impacted gonadal function. 4 A literature search (to January 2022) was performed on the EMBASE, PubMed, and Cochrane library databases. Two widely used modified quality analysis tools were used. Our initial search netted 1451 articles, of which 95 full texts were examined and 43 met the inclusion criteria. Twenty-seven papers focused on type 1 diabetes (T1D), with 8 papers examining adolescents with cystic fibrosis and the remaining studying inflammatory bowel disease, juvenile idiopathic arthritis, coeliac disease, and chronic renal disease. Metanalysis of 933 patients with T1D vs 5244 controls demonstrated a significantly later age of menarche in T1D (by 0.42 years; P ≤.00001). There was also a significant association between higher HbA1c and insulin dose (IU/kg) and later age of menarche. Eighteen papers reviewed other aspects of menstruation, including dysmenorrhea, oligomenorrhoea, amenorrhea, and ovulatory function, with variable findings. Most studies were small and in single populations. Despite this, there was evidence of delayed menarche and some evidence of irregular menses in those with cystic fibrosis and T1D. Further structured studies are needed to evaluate menstrual dysfunction in adolescents and how it relates to their chronic illness. [ABSTRACT FROM AUTHOR]

The significant decline in academic engagement through the early stages of adolescence is well known, however, the relative contribution of the key factors explaining these adolescent patterns over time requires further investigation. Motivation has been a dominant research focus in past decades, while less empirical attention has been given to the comparative effects of puberty hormones (specifically, sex steroid hormones: estradiol and testosterone) that are often the subject of popular "storm and stress" stereotyping regarding adolescent development. From a baseline sample of 342 young people (11–13 years of age, 55 % males) assessed annually across 3 years, we examined the role of motivation (self-efficacy and valuing) and key puberty hormones in predicting males' and females' academic engagement and disengagement trajectories, controlling for personal and background attributes. Latent growth modeling demonstrated that: (a) compared to puberty hormones, self-efficacy and valuing were more strongly associated with engagement (positively) and disengagement (negatively) for both males and females, (b) puberty hormones were more strongly linked to students' disengagement than to their engagement, and (c) the significant links between puberty hormones and disengagement were more salient and consistent across time for males—with higher levels of testosterone and estradiol individually associated with higher disengagement. These findings are discussed in the context of psycho-educational and biopsychological perspectives on adolescents' academic development and hold implications for how to motivate and engage them in developmentally appropriate ways at school. • This study investigated the roles of motivation and puberty hormones in engagement and disengagement trajectories. • Self-efficacy and valuing were most strongly associated with engagement (positively) and disengagement (negatively). • Puberty hormones were more strongly linked to disengagement than to engagement. • Links between puberty hormones and disengagement were more salient for males than females. [ABSTRACT FROM AUTHOR]

Adolescence is characterized by rapid physical growth and sexual maturation. These changes may alter parents'' beliefs about their adolescents' weight status. This study aimed to examine the changes between early and mid-adolescence in: (a) the accuracy of maternal perception regarding her adolescent's weight status, (b) the degree of maternal concern about her adolescent's weight status, and (c) the predictors of maternal misclassification of adolescent overweight as average weight. A secondary analysis of the longitudinal Nepean Study data was conducted. Participants were Australian, free-living 13-year-olds in 2002-2003 (n=347) followed up at age 15 years (n=279) and their mothers. Participants'' body mass index (BMI) status (overweight, normal, or underweight) was calculated from measured height and weight. Maternal perceptions and concerns about adolescent's weight status were determined by items adapted from the Child Feeding Questionnaire. Sex-adjusted binary logistic regression models assessed potential predictors of maternal misclassification of adolescent overweight. Data were available on 224 adolescent-mother dyads. Approximately one fourth of mothers misclassified their adolescent's weight status, but this varied across groups (age 13 years [%]; age 15 years [%], respectively) underweight (75%; 70%), overweight (54%; 59%), and normal weight (12%; 9%). The endpoint data show that between 13 and 15 years of age, maternal concern regarding their adolescent's weight decreased in all weight-status groups. Predictors of maternal misclassification of adolescent overweight were adolescent BMI z score, recent weight-management practices, weight history, sex, and maternal concern regarding her adolescent's weight. These results reinforce the need for strategies in primary care that are implemented throughout adolescence to improve maternal awareness of childhood overweight. [Copyright &y& Elsevier]

Abstract Study Objective Understanding what constitutes a normal menstrual cycle during the first gynecological year (GY1) is a common concern of adolescents and clinicians. However, limited high-quality evidence exists. We aimed to summarize published literature regarding menstrual and ovulatory patterns in GY1. Design, Setting, Participants, Interventions, and Main Outcome Measures Electronic databases (MEDLINE, Pre-MEDLINE, Embase, Web of Science, CINAHL, Cochrane Library) were systematically searched from database inception to 2018. Eligible studies described menstrual cycles, symptoms, or validated ovulatory data in healthy adolescents in GY1. Two authors independently screened studies, extracted data, and assessed methodological quality. Results Twenty-two studies involving more than 2000 adolescents were included. Thirteen recorded menstrual cycle and/or symptom data and 14 measured ovulation. Mean cycle length ranged from 32 to 61 days and decreased throughout GY1. Mean menses length was 4.9 to 5.4 days. Frequent menstrual bleeding was reported in up to 23% of participants, infrequent menstrual bleeding in up to one-third, and "irregular menstrual bleeding" in up to 43%. Dysmenorrhea was reported by 30%-89% of participants. Prevalence of ovulatory cycles identified using luteal phase serum or salivary progesterone or urinary pregnanediol was 0 to 45% and increased throughout GY1. However, all used definitions that would be considered subovulatory in clinical practice. Conclusion Menstrual and ovulatory patterns in GY1 are diverse and differ from those of adults. A transitional phase of menstrual and ovulatory immaturity is common. However, ovulation, irregular cycles, and dysmenorrhea are not uncommon. As such, safe sexual practice should be advocated and prompt medical management should be accessible. [ABSTRACT FROM AUTHOR]