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Background: Moderate and vigorous physical activity is associated with improved outcomes in youth with multiple sclerosis (MS). Physical fitness may also influence disease and health outcomes in this population. Objectives: To determine if there were differences in physical fitness between youth with MS and healthy controls (HC). To examine relationships between physical fitness, physical activity (PA) level, fatigue, depression and disease activity in youth with MS and HC. Methods: Youth with MS ( n = 19) and HC ( n = 21) completed tests establishing cardiorespiratory-fitness (VO2peak), endurance via 2-minute walk test, and musculoskeletal strength via grip strength (GS). Questionnaires determined fatigue, depression, and PA levels. Weekly PA level was determined by accelerometry. Tests of differences and correlational analyses were used to evaluate physical fitness. Results: Youth with MS had lower VO2peak ( U = 279, p < 0.0001), endurance ( t = 2.6, p = 0.02), and higher body mass index (BMI) ( t = -5.9, p = 0.001) than HC. Higher VO2peak was associated with higher moderate to vigorous PAaccelerometer in HC (Spearman-Rho = 0.5, p = 0.03), but not in youth with MS (Spearman-Rho = 0.5, p = 0.06). Lower VO2peak and GS were associated with higher disability (Spearman-Rho = -0.6, p = 0.03) and relapses in MS (Spearman-Rho = -0.52, p = 0.04). Conclusions: Youth with MS have lower levels of fitness, compared with HC. Higher levels of fitness were associated with lower disease activity and disability in youth with MS.

In this study, the factor structure and psychometric properties of a French adaptation of the well-established Loneliness and Aloneness Scale for Children and Adolescents (LACA) was investigated in a French-speaking sample of Belgian adolescents (N = 641; Mage = 14.35, SD = 2.03; 53.4% girls). In addition, measurement invariance analyses across the two main language groups in Belgium (i.e., Dutch-speaking and French-speaking) and across age and gender were conducted on a combined sample of French-speaking and Dutch-speaking Belgian adolescents (N = 1282; Mage = 14.36 years, SD = 2.03; 53.6% female). Subsequently, group mean differences across language, age, and gender groups were investigated. Convincing support was found for the expected four-factor structure of the French adaptation of the LACA and the measure showed good reliability. Results further indicated that Belgian adolescents from the two principal language groups and from different age and gender groups interpreted the items of the LACA similarly. Therefore, analyses of group mean differences could be compared. Given the small effect sizes that accompanied the obtained effects, replication research is needed to further investigate these group mean differences. Keywords Loneliness . Attitudes toward aloneness . Measurement invariance . Regional differences . Belgium Loneliness is Bthe unpleasant experience that occurs when a person's network of social relations is deficient in some important way, either quantitatively or qualitatively^ (Perlman and Peplau 1981, p. 31). Loneliness is a universal phenomenon that occurs throughout the lifespan, but is particularly salient during adolescence (Qualter et al. 2015). More specifically, loneliness in the relationships with peers and with parents tends to peak during adolescence (Marcoen and Goossens 1993). Adolescents are typically confronted with numerous changes in their social world, such as a more pronounced preoccupation with their social status and higher expectations about social relationships in the peer realm, and greater autonomy in their relationship with their parents (Heinrich and Gullone 2006;Laursen and Hartl 2013). These changes make adolescents highly vulnerable to experiencing feelings of loneliness, which in turn is associated with several negative mental and physical health problems (Heinrich and Gullone 2006).Aloneness is the objective experience of being without company (Long and Averill 2003) and is not the same as loneliness. One can feel lonely when alone but also when surrounded by people. From early adolescence onwards, young people spend a greater amount of time alone and their experience of being alone changes substantially (Larson 1997;Larson and Richards 1991). Aloneness emerges as a constructive domain of experience in adolescents' life, represented by a positive association between time spent alone and adolescents' well-being (Larson 1997). In addition, adolescents may have more or less positive or negative attitudes toward aloneness. These attitudes toward aloneness may funct...

A single session with an ophthalmoscopy simulator can improve diagnostic accuracy in postgraduate pediatric trainees. Use of ophthalmoscopy simulation represents a novel addition to traditional learning methods for postgraduate pediatric residents that can help trainees to improve their confidence and accuracy in performing this challenging examination.