Volume 24, Issue 4

No abstract available.

The Internet has revolutionized education and social communication in the 21st century. This article reviews the growing literature identifying a number of adolescents and young adults with a pathologically excessive Internet use leading to many potential consequences. Current research dilemmas in this area include that Internet addiction is a broad topic with no standard definition and no standard measurement tools. Management of youth with identified problematic Internet use or misuse centers on behavioral therapy and treatment of comorbidities. Pharmacologic approaches are limited at this time but are undergoing research, such as use of opioid antagonists and antidepressants in adults with pathological gambling. Efforts should be expanded on not only the education of all adolescents regarding the benefits but also the potential negative consequences of Internet use. It is vital that we do this for Generation Z, whereas Generation ALPHA will soon benefit or suffer from our efforts in this regard today.

The purpose of this study is to examine the association of deficits of executive function (EF) and neurodevelopmental disorders in preterm children and the potential of assessing EF in infants as means of early identification. EF refers to a collection of related but somewhat discrete abilities, the main ones being working memory, inhibition, and planning. There is a general consensus that EF governs goal-directed behavior that requires holding those plans or programs on-line until executed, inhibiting irrelevant action and planning a sequence of actions. EF plays an essential role in cognitive development and is vital to individual social and intellectual success. Most researchers believe in the coordination and integrate cognitive–perceptual processes in relation to time and space, thus regulating higher-order cognitive processes, such as problem solving, reasoning, logical and flexible thinking, and decision-making. The importance of the maturation of the frontal lobe, particularly the prefrontal cortex, to the development of EF in childhood has been emphasized. Therefore, any abnormal development in the prefrontal lobes of infants and children could be expected to result in significant deficits in cognitive functioning. As this is a late-maturing part of the brain, various neurodevelopmental disorders, such as autism spectrum disorders, attention deficit hyperactivity disorder, language disorders, and schizophrenia, as well as acquired disorders of the right brain (and traumatic brain injury) impair EF, and the prefrontal cortex may be particularly susceptible to delayed development in these populations. The deficits of EF in infants are persistent into childhood and related to neurodevelopmental disorders in childhood and adolescence.

Objective: The purpose of the study was to assess care-seeking practices for contraception and human immune deficiency virus (HIV) testing services among young women (14–24 years) in a peri-urban district of Uganda. Methods: A formative study assessed care-seeking practices among women in Wakiso district, Central Uganda. A survey was carried out in 11 randomly selected parish clusters targeting women in the reproductive age group. Data on current use of contraception, information from women who had been tested for HIV, future desire for an HIV test, and choice of care were captured. Results: A total of 10,993 women were interviewed of whom young women were 5384 (49.0%). The proportion of young women using a method of contraception was less, 2446 (45.8%), compared with 2832 (54.3%) for older women, p=0.0001. Few adolescents (14–19 years), 850 (45.3%), had tested for HIV compared with older women, p=0.0001, whereas majority of the young women, 1321 (75.5%), wished to have an HIV test compared with older women, 742 (66.0%), p=0.0001. Fear for an HIV test was common among women of both age groups, p=0.9. Data further show that young women were less likely to deliver at hospitals, 1582 (50.8%), compared with older women, 2586 (53.3%), p=0.0001. Similarly, a lesser proportion of young women, 845 (50.4%), sought contraception at hospitals compared with older women, 1432 (54.4%), p=0.004. The factors that most influenced access to services were age, educational level, source of care, marital status, and future intention to use a particular service. Conclusions: Young women are less likely to access contraception and HIV testing services in this district. These results will be useful in designing and evaluating future interventions targeting young women.

Objective: The purpose of this study is to determine the perinatal profile of adolescent mothers with surviving offspring against the backdrop of limited community-based data on the outcomes of adolescent pregnancy in low-income countries. Methods: A case-control study of adolescent mothers (13–19 years) attending four community-based clinics for routine childhood immunization from July 2005 to March 2008 in Lagos, Nigeria, matched for infant age and sex. Maternal and infant factors associated with adolescent mothers were determined using unconditional and conditional multivariable logistic regression analyses. Results: A total of 241 adolescent mothers (mean age, 18.2±1.2 years) were consecutively recruited over the study period and matched with 1205 controls (mean age, 27.3±3.9 years). Adolescent mothers in this population were significantly more likely to be unmarried, of the Hausa ethnic tribe, without postsecondary education, unemployed, and primiparous. Although all received antenatal care, they were also more likely to deliver outside hospital without skilled attendants, and their offspring were likely to be undernourished. Conclusions: Socio-demographic profile of adolescent girls who become pregnant is likely to have a significant influence on their health-seeking behavior for obstetric services. Teenagers especially from the most vulnerable ethnic groups in resource-poor countries should be educated on the developmental risks of early childbearing in their surviving offspring.

The purpose of this study is to examine US parental knowledge of human papillomavirus (HPV) in males, views on vaccination, and correlation to vaccination rates. The survey was conducted of clinic population about parental knowledge and beliefs of male HPV health outcomes and vaccination. There were a total of 102 participants who completed the survey. Perceived parental knowledge about the virus was reported as “a lot” by 11%, “some” by 50%, and “very little/nothing” by 38% of the participants. However, knowledge of HPV was moderate, with only 14% of the respondents answering all knowledge questions correctly; 64% of the respondents correctly identified HPV as a cause of genital warts in males, 43% identified at least one HPV-related cancer, and 30% were unable to identify any health outcomes in males. There was a statistically significant correlation between perceived and actual knowledge, with >15% of the survey respondents correctly identifying that HPV does not clear up on its own (p=0.004). Of the participants who did not vaccinate, reasons included the following: 54% fulfilled the child’s wish not to be vaccinated, 38% reported belief vaccine is unsafe, and 38% indicated that their children are too young and/or expressed fear that the vaccine would negatively affect behavior. This study supports the fact that parental beliefs and attitudes are more important than actual knowledge about HPV or HPV vaccination. The implication to physicians is to tailor discussions to address fears about the dangers or complications, emphasize the safety of the vaccine, and address sources of misinformation.

Adolescent girls in India carry a disproportionate burden of health and social risks; girls that do not finish secondary education are more likely to have an earlier age of sexual initiation, engage in risky sexual behavior, and consequentially be at greater risk of dying from pregnancy-related causes. This paper presents a comparison of girls in school and girls not in school from 665 participants in rural West Bengal, India. The social cognitive theory (SCT), a comprehensive theoretical model, was used as a framework to describe the personal, behavioral, and environmental factors affecting the lives of these adolescent girls. There were significant differences between girls in and out of school in all three categories of the SCT; girls in school were more likely to have heard of sexually transmitted diseases or infections than girls not in school (p<0.0001). Girls in school were also more likely than girls not in school to boil water before drinking (p=0.0078), and girls in school lived in dwellings with 2.3 rooms on average, whereas girls not in school lived in dwellings with only 1.7 rooms (p<0.0001). Indian adolescent girls who are not in school are disadvantaged both economically and by their lack of health knowledge and proper health behaviors when compared with girls who are still in school. In addition, to programs to keep girls in school, efforts should also be made to provide informal education to girls not in school to improve their health knowledge and behaviors.

Cervical cancer is a major cause of death in the developing world. The Papanicolaou (Pap) smear is a screening test that detects abnormal cells before they advance to cancer. The objective of this study was to assess the knowledge, attitude, and practice of cervical cancer screening among Greek students. A sample of 472 female students participated in the present study. Interviews were performed using a structured questionnaire. Of the participants, 94.07% were aware of the Pap test and 67.34% reported that the Pap test should be done yearly. The majority of them were informed about cervical cancer screening test by their parents. Of the participants, 44.82% had received Pap testing at least once in their life, whereas 36.2% had a Pap test yearly. The reported mean time of the respondents’ first Pap test was 13.3±10.6 months after their first sexual intercourse. The reasons given by the participants for being noncompliant were lack of appreciation of the importance of the screening, embarrassment, fear, and high cost. Of the participants, 9.23% declared that those who had been administered the human papillomavirus vaccine do not need a Pap test. The results highlight the need for additional education and health promotion regarding cervical cancer screening.

This study examined the relationship between perceived built environment attributes and physical activity, physical fitness and body weight among adolescents aged 14–16 years in Sarawak. This was a cross-sectional study, using multi-stage sampling. A set of questionnaires consisting of socio-demographic information, a self-administered physical activity checklist and a Neighborhood Environment Walkability Scale-Youth (NEWS-Y) was used. Body mass index (BMI) was measured and physical fitness was tested using a maximal multistage 20 m shuttle run test. Data analysis was done using SPSS version 17.0. A total of 316 respondents participated. The mean BMI for boys was almost equal to the mean BMI for girls. Only 7.9% of the sampled population was found to be overweight or obese. The overall mean duration spent per day on physical activity was 128.4 min (SD 118.43), with mean of 56.1 min (SD 73.94) after school time. Girls reported to spend longer each day taking physical activity before and during school. Boys were found to have significantly higher VO 2max of 27.79±5.91 mL/kg/min as compared to girls (t=11.22, p<0.000). Based on comparison with other countries, the NEWS-Y scores indicated a mixture of low and high walkability neighborhoods. Respondents who had lower BMIs reported living in lower residential density areas and less risk of crime, and respondents who had better physical fitness reported less suitable infrastructure for walking. Promotion of exercise at all levels should be continuously encouraged as it would lead to improvement in the well-being of an individual.

Background: Bright-light treatment is a safe and effective treatment for the management of winter seasonal affective disorder (SAD). In a recent study, we found that the relative duration of reading was positively associated with likelihood of remission after six weeks of light treatment. Methods: Two technicians measured the illuminance of a light box with a light meter directed towards the center of reading material that was placed on a table in front of the light box. The measurement was also performed after reading material was removed. The two measurements were performed in a randomized order. Friedman analysis of variance with Wilcoxon post-hoc tests were used to compare illuminance with vs. without reading. Results: The presence of the reading material increased illuminance by 470.93 lux (95% CI 300.10–641.75), p<0.0001. Limitations: This is a technical report done under conditions intended to mimic those of typical ambulatory light treatment as much as possible. Conclusions: As reading materials reflect light from the light box, reading during light therapy increases ocular illuminance. If confirmed by future studies using continuous recordings in randomized design, instructing SAD patients to read during light therapy may contribute to a more complete response to light treatment. The downside of specific relevance for students, is that reading, in particular, with bright light in the late evening/early night may induce or worsen circadian phase delay, adversely affecting health and functioning.

This study examines the relationship between sex-related perceptions and engagement in sexual intercourse among adolescents in Japan who were heavy users of text massaging. Using the data from the 6th National Survey on Youth Sexual Behavior of 548 high school students who heavily use text messaging, multinomial logistic regression analyses on variables constructing sexual norms and gender-role attitudes were conducted to assess the relationship with sexual activity status as the first step. A backward stepwise elimination method of multinomial logistic regression was used as the second step at which variables for each set of two factors were tested, and as the third step at which variables of two factors were simultaneously tested. The study results showed that perceptions were related to engagement in sexual intercourse among adolescents who heavily used text messaging. In particular, those who perceived that sex is an act to be engaged in at an earlier stage of a relationship and that men have a stronger sex drive tended to be sexually active or have experienced sexual intercourse. These findings could be utilized to design more effective sexual health education messages for Japanese adolescents who are at an elevated risk.

Children who have been severely maltreated tend to perform significantly below their non-maltreated peers in standardized tests, earn lower grades and have the most discipline issues in the school setting. There is evidence that self-esteem (SE) may be a protective factor for youth with regard to negative emotional outcomes. The role of self-esteem needs to be explored further in more collectivistic cultures. The purpose of this study was to explore the relationship between physical abuse, SE and school attitudes. Participants included 14 females rescued from a city landfill in Nicaragua (ages 7–17 years, M =12.44), half of whom had reported being beaten. SE and attitude toward school (ATS) were assessed using the Spanish Behavior Assessment System for Children. Grade point average (GPA) was obtained from their schools. Females who were beaten had significantly lower SE and a more negative ATS. Their GPA was lower, but not significantly. When SE and abuse were considered together, the effect of abuse on school attitudes was non-significant, suggesting that SE is a protective factor for the effects of abuse on ATS.

This study explored the relationship between intellectual ability, socioeconomic status (SES), academic achievement and self-efficacy in a cross-cultural sample. Data from 90 students (63 students from Central America and 27 from the US) showed that regardless of culture or IQ, students from low SES families had significantly lower grade point averages than students from medium- or high-SES families. Unexpectedly, data showed that regardless of culture or IQ, students from high-SES families had the lowest self-efficacy, but the highest academic performance. Results suggest that self-efficacy is likely to be related to expectations and self-perception beyond IQ or culture.

Western literature provides an array of information regarding resilience within at-risk youth. Resilience research within non-Western contexts, and more specifically with exploited youth, is more limited. Despite exploitation, some youth develop a hardy ability to overcome adversity, allowing them more mastery over their environments and even increased psychological steadfastness. This project involved exploring the protective factors of resilience and psychological functioning in Cambodian youth, specifically a group of 24 survivors of sexual trafficking and another group of 24 rural youth without reported exploitation. The ages of participants ranged from 13 to 22 years, with the average age being 15.62 years [standard deviation (SD=2.68)]. Results indicated resilience constructs (mastery and relatedness) correlated with psychological functioning (anxiety and depression), as expected. The sense of relatedness was moderately associated with age. Also, as predicted, the trafficked young women demonstrated more resilience and less pathology. Consistent with previous research, earlier trauma is believed to inoculate survivors of trauma against further stress, mobilize them to better confront adversity and reduce psychological disruptions. Understanding these issues can help in understanding the relationship between resilience factors and psychological functioning as well as the strengths of many trauma survivors. Their strengths are particularly useful for developing effective treatment protocols for traumatized youth from non-Western backgrounds.

Aim: Arab Palestinians have experienced intense political, domestic and economic stressful conditions, which can increase the risk of self-harm. No previous studies haves been published to describe the patterns and rates of deliberate self-harm, particularly self-poisoning, in the Palestinian Authority. The objective of this study was to investigate deliberate self-poisoning in the Palestinian Authority. Methods: All patients admitted to the emergency department of Al-Watani Governmental Hospital from May 2008 to April 2009 and identified as deliberate self-poisoning were investigated. The demographic and clinical data of the subjects were analyzed using SPSS16. Results: A total of 54 individuals were identified. The mean age of these patients was 23.8±7.9 years and less than one-third (16; 29.6%) were under 18 years of age. The majority of the patients were female (35; 64.8%). Two-thirds (37; 68.5%) of the patients were Nablus city residents. An overdose of pharmaceutical products (39; 72.2%) was the most common method of self-poisoning. Significant associations were found between the type of material used in self-poisoning and place of residence (p=0.008) as well as gender (p=0.021). Gastric lavage was performed for 23 (42.6%) individuals, while only four (7.4%) received activated charcoal, and six (11.1%) had both. Conclusion: Rates of deliberate self-poisoning in the Palestinian Authority are lower than those reported from developed countries, but higher than that reported from other Arab countries. Regulations regarding the sale and storage of poisonous agricultural chemicals are needed in the Palestinian Authority.