{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:46:23Z","timestamp":1792111583275,"version":"4.4.0"},"reference-count":71,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T00:00:00Z","timestamp":1724889600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Sobi"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Adolescents with hemophilia are a patient population with special requirements, having to manage their condition alongside the typical challenges of adolescence. Given the psychosocial impact of hemophilia and a desire to fit in with non-hemophilic peers, they may perceive treatment as more of a burden than a benefit. This can result in low adherence and a high risk of hemophilia-related complications. Hemophilia management has changed over time. To best inform shared decision-making with adolescent patients and their families, healthcare professionals must consider all the currently available evidence, highlighting treatment benefits as appropriate. They should also appreciate the requirements of all adolescents affected by hemophilia, including individuals with non-severe disease and girls\/women. We discuss specific issues relating to the management of adolescents with hemophilia: prevention and management of bleeds, treatment adherence, joint health and physical activity, and other health-related issues. A multidisciplinary approach is advocated, and the potential role of digital technology in helping to equip patients with self-management skills to fully engage with treatment is considered. Currently, available hemophilia management generally enables adolescents with hemophilia to lead normal lives, participating in physical activities while maintaining good joint health. However, more work is required to help address both actual and perceived limitations.<\/jats:p>","DOI":"10.3390\/jcm13175121","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T03:40:39Z","timestamp":1724902839000},"page":"5121","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Teenagers and Adolescents with Hemophilia\u2013Need for a Specific Approach"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4597-2439","authenticated-orcid":false,"given":"Christoph","family":"K\u00f6nigs","sequence":"first","affiliation":[{"name":"Goethe University, University Hospital, Department of Paediatrics and Adolescent Medicine, Clinical and Molecular Haemostasis, 60590 Frankfurt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayashree","family":"Motwani","sequence":"additional","affiliation":[{"name":"Department of Paediatric Haematology, Birmingham Children\u2019s Hospital, Birmingham B4 6NH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3937-3499","authenticated-orcid":false,"given":"V\u00edctor","family":"Jim\u00e9nez-Yuste","sequence":"additional","affiliation":[{"name":"Hematology Department, Hospital Universitario La Paz-IdiPaz, Aut\u00f3noma University, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Blatn\u00fd","sequence":"additional","affiliation":[{"name":"Department of Paediatric Hematology, University Hospital and Masaryk University Brno, 601 77 Brno, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,29]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2024, July 31). Adolescent Health. Available online: https:\/\/www.who.int\/health-topics\/adolescent-health#tab=tab_1."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/S2352-4642(18)30022-1","article-title":"The age of adolescence","volume":"2","author":"Sawyer","year":"2018","journal-title":"Lancet Child. Adolesc. Health"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1111\/ejh.12582","article-title":"Challenges in the management of haemophilia on transition from adolescence to adulthood","volume":"95","author":"Brand","year":"2015","journal-title":"Eur. J. Haematol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"S17","DOI":"10.1002\/ajh.24219","article-title":"Unmet needs in the transition to adulthood: 18- to 30-year-old people with hemophilia","volume":"90","author":"Quon","year":"2015","journal-title":"Am. J. Hematol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1111\/j.1365-2516.2012.02893.x","article-title":"From boy to man: Recommendations for the transition process in haemophilia","volume":"18","author":"Young","year":"2012","journal-title":"Haemophilia"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"163","DOI":"10.2147\/PPA.S232393","article-title":"The perspectives of adolescents and young adults on adherence to prophylaxis in hemophilia: A qualitative study","volume":"14","author":"Hoefnagels","year":"2020","journal-title":"Patient Prefer. Adherence"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"862","DOI":"10.1111\/hae.13621","article-title":"Adherence to prophylactic haemophilic treatment in young patients transitioning to adult care: A qualitative review","volume":"24","author":"Strand","year":"2018","journal-title":"Haemophilia"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"S9","DOI":"10.1097\/00001721-200406002-00003","article-title":"Use of factor IX concentrates in active teenagers with hemophilia B","volume":"15","author":"Tagariello","year":"2004","journal-title":"Blood Coagul. Fibrinolysis"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/hae.14046","article-title":"WFH guidelines for the management of hemophilia, 3rd edition","volume":"26","author":"Srivastava","year":"2020","journal-title":"Haemophilia"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Okaygoun, D., Oliveira, D.D., Soman, S., and Williams, R. (2021). Advances in the management of haemophilia: Emerging treatments and their mechanisms. J. Biomed. Sci., 28.","DOI":"10.1186\/s12929-021-00760-4"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Urasi\u0144ski, T., Pacz\u00f3ska, K., Badowska, W., Bobrowska, H., Dakowicz, \u0141., Dobaczewski, G., Latos-Gra\u017cy\u0144ska, E., Karolczyk, G., Klukowska, A., and Ko\u0142tan, A. (2023). Real pandemic world results of pharmacokinetic-tailored personalized prophylaxis of bleeds in Polish children and adolescents with severe hemophilia A. Front. Pediatr., 11.","DOI":"10.3389\/fped.2023.1084539"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e90","DOI":"10.1016\/S2352-3026(23)00270-3","article-title":"Advancements in haemophilia A and health equity: Is it time to redefine severity?","volume":"11","author":"Weyand","year":"2024","journal-title":"Lancet Haematol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1111\/hae.14379","article-title":"European principles of care for women and girls with inherited bleeding disorders","volume":"27","author":"Lavin","year":"2021","journal-title":"Haemophilia"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1111\/hae.14535","article-title":"Health issues in women and girls affected by haemophilia with a focus on nomenclature, heavy menstrual bleeding, and musculoskeletal issues","volume":"28","author":"Weyand","year":"2022","journal-title":"Haemophilia"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"207","DOI":"10.2147\/JBM.S50644","article-title":"Optimal management of hemophilic arthropathy and hematomas","volume":"5","author":"Lobet","year":"2014","journal-title":"J. Blood Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1136\/bmj.1.6161.469","article-title":"Patterns of bleeding in adolescents with severe haemophilia A","volume":"1","author":"Aronstam","year":"1979","journal-title":"Br. Med. J."},{"key":"ref_17","unstructured":"Richter, D., Heller, C., Heuer, M., Stein, M., Schultze-Strasser, S., Schwabe, D., and K\u00f6nigs, C. (2017, January 16). Care, needs and perceptions of adolescents and young adults growing up with hemophilia A or B. Proceedings of the Annual Meeting of the Society of Thrombosis and Hemostasis (GTH), Basel, Switzerland."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1935","DOI":"10.1111\/jth.12672","article-title":"Subcommittee on Factor VIII, Factor IX and Rare Coagulation Disorders of the Scientific and Standardization Committee. Definitions in hemophilia: Communication from the SSC of the ISTH","volume":"12","author":"Blanchette","year":"2014","journal-title":"J. Thromb. Haemost."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1097\/MBC.0000000000000571","article-title":"Pain and pain management in haemophilia","volume":"27","author":"Auerswald","year":"2016","journal-title":"Blood Coagul. Fibrinolysis"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1111\/hae.13956","article-title":"Barriers and challenges for the fast treatment of bleeds in the non-haemophilia treatment centre hospital setting","volume":"26","author":"Davis","year":"2020","journal-title":"Haemophilia"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1111\/hae.13826","article-title":"Assessing the supportive care needs of parents with a child with a bleeding disorder using the Parental Needs Scale for Rare Diseases (PNS-RD): A single-centre pilot study","volume":"25","author":"Khair","year":"2019","journal-title":"Haemophilia"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1111\/hex.12083","article-title":"Self-management and skills acquisition in boys with haemophilia","volume":"18","author":"Khair","year":"2015","journal-title":"Health Expect."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1111\/hae.12904","article-title":"Promoting self-management and adherence during prophylaxis: Evidence-based recommendations for haemophilia professionals","volume":"22","author":"Schrijvers","year":"2016","journal-title":"Haemophilia"},{"key":"ref_24","unstructured":"World Health Organization (2024, July 31). Adherence to Long-Term Therapies: Evidence for Action. Available online: https:\/\/iris.who.int\/handle\/10665\/42682."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1111\/j.1365-2516.2006.01189.x","article-title":"Practice patterns in haemophilia A therapy\u2014Global progress towards optimal care","volume":"12","author":"Geraghty","year":"2006","journal-title":"Haemophilia"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1111\/hae.12360","article-title":"Better adherence to prescribed treatment regimen is related to less chronic pain among adolescents and young adults with moderate or severe haemophilia","volume":"20","author":"McLaughlin","year":"2014","journal-title":"Haemophilia"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1111\/j.1365-2516.2008.01948.x","article-title":"Haemophilia care in adolescents\u2014Compliance and lifestyle issues","volume":"15","author":"Petrini","year":"2009","journal-title":"Haemophilia"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1007\/s42843-022-00059-4","article-title":"Assessment and treatment of adolescents with chronic medical conditions","volume":"48","author":"Russo","year":"2022","journal-title":"J. Health Serv. Psychol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1111\/j.1365-2516.2007.01478.x","article-title":"Should prophylaxis be used in adolescent and adult patients with severe haemophilia? An European survey of practice and outcome data","volume":"13","author":"Richards","year":"2007","journal-title":"Haemophilia"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"100852","DOI":"10.1016\/j.blre.2021.100852","article-title":"Optimising prophylaxis in haemophilia A: The ups and downs of treatment","volume":"50","author":"Berntorp","year":"2021","journal-title":"Blood Rev."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1844","DOI":"10.1016\/j.jtha.2024.04.010","article-title":"Ultra-Long factor VIII: A major step forward toward a hemophilia-free mind","volume":"22","author":"Hermans","year":"2024","journal-title":"J. Thromb. Haemost."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1111\/hae.14976","article-title":"Benefits and risks of non-factor therapies: Redefining haemophilia treatment goals in the era of new technologies","volume":"30","author":"Mancuso","year":"2024","journal-title":"Haemophilia"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"102163","DOI":"10.1016\/j.rpth.2023.102163","article-title":"Long-term outcomes of prophylaxis with a recombinant factor VIII Fc or recombinant factor IX Fc in patients with hemophilia previously treated on demand","volume":"7","author":"Shapiro","year":"2023","journal-title":"Res. Pract. Thromb. Haemost."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2368","DOI":"10.1182\/blood-2016-02-683169","article-title":"Prophylaxis usage, bleeding rates, and joint outcomes of hemophilia, 1999 to 2010: A surveillance project","volume":"129","author":"Soucie","year":"2017","journal-title":"Blood"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1111\/hae.12539","article-title":"Controlled, cross-sectional MRI evaluation of joint status in severe haemophilia A patients treated with prophylaxis vs. on demand","volume":"21","author":"Oldenburg","year":"2015","journal-title":"Haemophilia"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1365-2516.2011.02615.x","article-title":"Joint protection in haemophilia","volume":"17","author":"Aznar","year":"2011","journal-title":"Haemophilia"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1111\/hae.14734","article-title":"Synovitis and joint health in patients with haemophilia: Statements from a European e-Delphi consensus study","volume":"29","author":"Mancuso","year":"2023","journal-title":"Haemophilia"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1111\/j.1365-2516.2007.01456.x","article-title":"Participation in sports and physical activity of haemophilia patients","volume":"13","author":"Fromme","year":"2007","journal-title":"Haemophilia"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1111\/hae.14636","article-title":"Long-term joint outcomes in adolescents with moderate or severe haemophilia A","volume":"28","author":"Schmidt","year":"2022","journal-title":"Haemophilia"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.1111\/sms.13666","article-title":"Sports participation and sports injuries in Dutch boys with haemophilia","volume":"30","author":"Versloot","year":"2020","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1111\/hae.14282","article-title":"A systematic review of physical activity in people with haemophilia and its relationship with bleeding phenotype and treatment regimen","volume":"27","author":"Kennedy","year":"2021","journal-title":"Haemophilia"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1097\/MBC.0000000000000565","article-title":"Physical activity in individuals with haemophilia and experience with recombinant factor VIII Fc fusion protein and recombinant factor IX Fc fusion protein for the treatment of active patients: A literature review and case reports","volume":"27","author":"Wang","year":"2016","journal-title":"Blood Coagul. Fibrinolysis"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Moretti, L., Bizzoca, D., Buono, C., Ladogana, T., Albano, F., and Moretti, B. (2021). Sports and children with hemophilia: Current trends. Children, 8.","DOI":"10.3390\/children8111064"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1046\/j.1365-2516.2001.00504.x","article-title":"Motor performance and disability in Dutch children with haemophilia: A comparison with their healthy peers","volume":"7","author":"Schoenmakers","year":"2001","journal-title":"Haemophilia"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1111\/j.1365-2516.2006.01214.x","article-title":"Exercise may decrease further destruction in the adult haemophilic joint","volume":"12","author":"Harris","year":"2006","journal-title":"Haemophilia"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1046\/j.1365-2516.2002.00575.x","article-title":"The effect of resistance training on the frequency of bleeding in haemophilia patients: A pilot study","volume":"8","author":"Tiktinsky","year":"2002","journal-title":"Haemophilia"},{"key":"ref_47","unstructured":"National Bleeding Disorders Foundation (2024, July 31). Steps for Living. Available online: https:\/\/stepsforliving.hemophilia.org\/."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Ai, D., Huang, K., Li, G., Zhen, Y., Wu, X., Zhang, N., Huo, A., Chen, Z., and Wu, R. (2022). Exploration of the minimum necessary FVIII level at different physical activity levels in pediatric patients with hemophilia A. Front. Pediatr., 10.","DOI":"10.3389\/fped.2022.1045070"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1111\/hae.14965","article-title":"Physical activity and factor VIII levels in patients with haemophilia: A real-world prospective observational study","volume":"30","author":"Tomschi","year":"2024","journal-title":"Haemophilia"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1097\/JCMA.0000000000000047","article-title":"Obesity and overweight in patients with hemophilia: Prevalence by age, clinical correlates, and impact on joint bleeding","volume":"82","author":"Chang","year":"2019","journal-title":"J. Chin. Med. Assoc."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1055\/s-0039-1677874","article-title":"Prevalence of Obesity in young patients with severe haemophilia and its potential impact on factor VIII consumption in Germany","volume":"39","author":"Olivieri","year":"2019","journal-title":"Hamostaseologie"},{"key":"ref_52","first-page":"e101","article-title":"Association between weight status and joint function in adult and pediatric patients with hemophilia","volume":"28","author":"Prather","year":"2022","journal-title":"Haemophilia"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1007\/s11136-017-1696-0","article-title":"Health-related quality of life, developmental milestones, and self-esteem in young adults with bleeding disorders","volume":"27","author":"Limperg","year":"2018","journal-title":"Qual. Life Res."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"100008","DOI":"10.1016\/j.rpth.2022.100008","article-title":"Quality of life in children and adolescents with hemophilia A: A systematic review and meta-analysis","volume":"7","author":"Zanotto","year":"2023","journal-title":"Res. Pract. Thromb. Haemost."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1111\/j.1365-2516.2010.02249.x","article-title":"Towards comprehensive care in transition for young people with haemophilia","volume":"16","author":"Breakey","year":"2010","journal-title":"Haemophilia"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1046\/j.1365-2516.2002.00647.x","article-title":"Sexuality and haemophilia: Connections across the life-span","volume":"8","author":"Parish","year":"2002","journal-title":"Haemophilia"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"243","DOI":"10.2147\/PROM.S211339","article-title":"Hemophilia and sexual health: Results from the HERO and B-HERO-S studies","volume":"10","author":"Blamey","year":"2019","journal-title":"Patient Relat. Outcome Meas."},{"key":"ref_58","unstructured":"Banchev, A. (2023). Sexual activity and the adolescent with haemophilia. Acta Biomed., 94."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"e159","DOI":"10.1097\/MPH.0000000000001664","article-title":"Assessment of self-image with the offer self-image questionnaire in adolescents with hemophilia: A single-center experience","volume":"42","author":"Kaygusuz","year":"2020","journal-title":"J. Pediatr. Hematol. Oncol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1093\/jpepsy\/jsx142","article-title":"Barriers to transition from pediatric to adult care: A systematic review","volume":"43","author":"Gray","year":"2018","journal-title":"J. Pediatr. Psychol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1055\/s-0039-3402804","article-title":"Health care transition of adolescents and young adults with haemophilia: The situation in Germany and the Munich experience","volume":"40","author":"Bidlingmaier","year":"2020","journal-title":"Hamostaseologie"},{"key":"ref_62","unstructured":"The Haemophilia Society (2024, July 31). Career Choices. Available online: https:\/\/haemophilia.org.uk\/support\/day-day-living\/other-information-sources\/career-choices\/#:~:text=Choosing%20a%20career&text=Our%20members%20have%20various%20roles,%2C%20catering%2C%20farming%20and%20engineering."},{"key":"ref_63","unstructured":"O\u2019Connell, D. (2024, July 31). Career Decisions for Teens with Bleeding Disorders. Available online: https:\/\/hemaware.org\/life\/career-decisions-teens-bleeding-disorders."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"10760296211070002","DOI":"10.1177\/10760296211070002","article-title":"Multidisciplinary team care of patients with hemophilic arthropathy: A qualitative assessment of contemporary practice in the UK and Canada: Canada\/UK: MDT practices for hemophilia","volume":"28","author":"Chowdary","year":"2022","journal-title":"Clin. Appl. Thromb. Hemost."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1080\/21642850.2020.1718501","article-title":"Adherence to prophylaxis in adolescents and young adults with severe haemophilia: A qualitative study with healthcare professionals","volume":"8","author":"Ryder","year":"2020","journal-title":"Health Psychol. Behavi Med."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"e12042","DOI":"10.2196\/12042","article-title":"Use of technology-based tools to support adolescents and young adults with chronic disease: Systematic review and meta-analysis","volume":"7","author":"Low","year":"2019","journal-title":"JMIR Mhealth Uhealth"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e12685","DOI":"10.1002\/rth2.12685","article-title":"First experience of a hemophilia monitoring platform: Florio HAEMO","volume":"6","author":"Zapotocka","year":"2022","journal-title":"Res. Pract. Thromb. Haemost."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"e239","DOI":"10.2196\/resprot.6558","article-title":"Development of a Web-Accessible Population Pharmacokinetic Service-Hemophilia (WAPPS-Hemo): Study protocol","volume":"5","author":"Iorio","year":"2016","journal-title":"JMIR Res. Protoc."},{"key":"ref_69","first-page":"e290","article-title":"Social networking for adolescents with severe haemophilia","volume":"18","author":"Khair","year":"2012","journal-title":"Haemophilia"},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Kerekes, N., Bador, K., Sfendla, A., Belaatar, M., Mzadi, A.E., Jovic, V., Damjanovic, R., Erlandsson, M., Nguyen, H.T.M., and Nguyen, N.T.A. (2021). Changes in adolescents\u2019 psychosocial functioning and well-being as a consequence of long-term COVID-19 restrictions. Int. J. Environ. Res. Public. Health, 18.","DOI":"10.3390\/ijerph18168755"},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Pop, L.M., Iorga, M., and Iurcov, R. (2022). Body-esteem, self-esteem and loneliness among social media young users. Int. J. Environ. Res. Public. Health, 19.","DOI":"10.3390\/ijerph19095064"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/17\/5121\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:44:40Z","timestamp":1760111080000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/17\/5121"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,29]]},"references-count":71,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2024,9]]}},"alternative-id":["jcm13175121"],"URL":"https:\/\/doi.org\/10.3390\/jcm13175121","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,29]]}}}