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1.  Who decides? Decision making and Fertility Preservation in Teens with Cancer: A Review of the literature 
The knowledge that cancer treatment may impair fertility in pediatric populations is an emerging aspect of quality of life in this population. However, decision making and use of fertility preservation among adolescent cancer patients and their families has not been well studied. This review summarizes the available literature on aspects of decision making and fertility preservation in adolescent cancer patients.
An electronic search was performed to identify peer reviewed studies published between 1999-2009 using key MESH terms and inclusion criteria. Inclusion criteria limited eligible studies to those that focused on adolescent decision-making in cancer treatment or fertility preservation, fertility concerns in pediatric oncology, capacity for decision-making, and health decision making in pediatrics. Studies were excluded that did not meet at least one of these criterion.
A total of 29 articles were reviewed and summarized. Three categories of results were seen: a focus on adolescent decision making in oncology, decision making in chronic illness, and decision making in cancer related infertility and preservation.
The majority of studies showed adolescents have a strong desire to participate in decisions about their cancer treatment and many have concerns regarding their future fertility although barriers often prevented these discussions. More research is needed to explore the role of teens and parents in decisions about fertility in relation to cancer treatment.
PMCID: PMC3179606  PMID: 21939862
Fertility; Decision Making; Teens; Cognition; Cancer
2.  BMI and Physical Activity Among at-Risk Sixth- and Ninth-Grade Students, Hillsborough County, Florida, 2005-2006 
Preventing Chronic Disease  2010;7(3):A48.
During the past 3 decades, the number of overweight adolescents increased while adolescent engagement in physical activity decreased. We investigated the prevalence of overweight and physical activity levels among economically disadvantaged and minority middle- and high-school students in a school district in Florida. In particular, data on physical activity levels of middle-school students are limited and needed for prevention and intervention planning. In addition, because of state education policies, students in Florida are less likely than students nationally to enroll in physical education, placing them at a higher risk for decreased physical activity levels.
We used multivariate methodology to analyze physical activity levels among 526 students from 3 middle and 2 high schools in southwest Florida.
Forty percent of students met criteria for overweight or obesity. Overall, less than 45% of students reported engaging in daily physical activity. Boys reported higher levels of physical activity than did girls, and a decline in physical activity levels was observed between grades 6 and 9, especially among minority girls (ie, African American and Latino). Lack of time was identified as the greatest barrier to engaging in physical activity.
This study documents health disparities among minority students from economically disadvantaged backgrounds in an urban school district. Participation in daily physical activity was below recommended guidelines across grades. We found numerous barriers to engaging in physical activity, which will enable local education agencies to evaluate their current physical activity policies and identify alternative physical activities for these youth.
PMCID: PMC2879980  PMID: 20394687

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