Volume 27, Issue 1

Background: In Colombia, the use of alcohol is one of the main risky behaviors carried out by adolescents, given that alcohol is the principal drug of abuse in this age group. Understanding how adolescents learn about risk and behavior is important in developing effective prevention programs. The Theory of Social learning underlines the importance of social interaction in the learning process. It suggests that learning can occur in three ways: a live model in which a person is enacting the desired behavior, verbal instruction when the desired behavior is described, and symbolic learning in which modeling occurs by influence of the media. This study explores these three forms of learning in the perception of risk and behavior related to the use of alcohol in a group of students between 12 and 14 years of age in Bogotá, Colombia. Materials and methods: This is a qualitative research study, which is part of a larger study exploring the social representations of risk and alcohol use in adolescents and their communities. The sample group included 160 students from two middle schools (7th and 8th graders) in Bogotá, Colombia. Six sessions of participant observation, 12 semi-structured interviews, and 12 focus group discussions were conducted for data collection. Data were analyzed using the Atlas ti software (V7.0) (ATLAS.ti Scientific Software Development GmbH, London, UK), and categories of analysis were developed using a framework analysis approach. Results: Adolescents can identify several risks related to the use of alcohol, which for the most part, appear to have been learned through verbal instruction. However, this risk recognition does not appear to correlate with their behavior. Parental modeling and messages conveyed by the media represent two other significant sources of learning that are constantly contradicting the messages relayed through verbal instruction and correlate to a greater extent with adolescent behavior. Conclusion: The three different forms of learning described by Social Learning Theory play a significant role in the construction of risk perception and behavior in adolescents. This underlines the necessity of consciously evaluating how examples set by adults as well as the ideas expressed by the media influence adolescents’ attitudes and behavior, ensuring that these do not directly contradict and ultimately obliterate the messages we are constantly trying to convey to this age group.

Objective: This study aims to determine and compare the level of basic nutrition knowledge of adolescents with eating disorders and their parents to adolescents without eating disorders and their parents. Materials and methods: This six-month convenience based survey recruited a total of 182 adolescents with and without an eating disorder and their parents. The surveys were conducted in a suburban adolescent medicine office. Main outcome measures were based on the 18 basic nutrition questions, while means, standard deviations, Wilcoxon Rank Sum Test, and χ 2 were all employed for the analysis. Results: None of the groups correctly answered more than half of the questions. In terms of the percentage of correct responses, there was a statistically significant difference between adolescents with eating disorders and their parents compared with adolescents without an eating disorder and their parents. Fewer than 16% of respondents in each group correctly answered the recommended daily caloric balance of fats, carbohydrates, and proteins. Conclusions: There is a deficiency in basic nutrition knowledge among adolescents with and without eating disorders and their parents. A significant increase in basic nutrition education needs to occur in order to increase the understanding of what is a “healthy” diet.

Background : Critical illness and long-term or repeated hospitalization can affect normal adolescent development. As a result, adolescents may feel isolated and “misplaced” on both pediatric and adult departments. The mission of the Center of Adolescent Medicine is to improve conditions for adolescent patients. To achieve this, the social educator offers an individualized social-pedagogical intervention for young people during long-term or repeated hospitalization . Objective: The aim of this study was to identify the impact of the social-pedagogical intervention using a qualitative approach. Materials and methods: A trained anthropologist interviewed seven adolescents who had individual sessions with a social educator during their hospital stay. The interviews were recorded and transcribed verbatim, and the transcripts were coded and thematized continuously . Results: Through qualitative analysis, the following themes emerged: Recreation; Structure, participation, and motivation; and Friends and social network. The social-pedagogical approach is a combination of interpersonal relationships and individually tailored recreational activities. Even small entertaining activities changed the focus from patient identity and contributed to the feeling of being “normal.” All young patients reported that the increased opportunities for decision-making and influence on the daily structure supported the feeling of being recognized and respected as an individual person as well as increased their motivation to go through their treatment. The interviewees emphasized the importance of experiencing something that was worth telling their friends about to help them stay in touch. Conclusion: Although the young patients emphasized the recreational aspects, the time spent with the social educator facilitated training in social competencies as well as conversations about emotional and sensitive topics.

The present study investigated the effect of low, medium, and high traffic road noise as well as irrelevant background speech noise on primary school children’s reading and mathematical performance. A total of 676 participants (324 boys, 47.9% and 352 girls, 52.1%) of the 4th and 5th elementary classes participated in the project. The participants were enrolled in public primary schools from urban areas and had ages ranging from 9 to 10 years and from. Schools were selected on the basis of increasing levels of exposure to road traffic noise and then classified into three categories (Low noise: 55–66 dB, Medium noise: 67–77 dB, and High noise: 72–80 dB). We measured reading comprehension and mathematical skills in accordance with the national guidelines for elementary education, using a test designed specifically for the purpose of this study. On the one hand, children in low-level noise schools showed statistically significant differences from children in medium- and high-level noise schools in reading performance (p<0.001). On the other hand, children in low-level noise schools differed significantly from children in high-level noise schools but only in mathematics performance (p=0.001). Girls in general did better in reading score than boys, especially in schools with medium- and high-level noise. Finally the levels of noise and gender were found to be two independent factors.

Introduction: One variable that has been consistently associated with adolescents’ physical activity is perceived activity competence. Perceived physical (or sport) competence is considered a sub-domain to the physical self-esteem or self-worth (i.e., a person’s valuation of what is good and worthy in their self-description). Objective: This study aimed to describe levels of and inter-correlations among physical self-esteem, physical activity, and body mass index in a longitudinal design spanning adolescence to early adulthood. Materials and methods: At mean ages of 12.7, 15.7, 17.7 and 22.7 years, we measured perceived physical self-esteem in 39 (22 boys) Swedish adolescents. Physical activity (steps/day) for four consecutive schooldays, height, and weight were also measured. Results: No significant difference between the four time points for any variable of perceived physical self-esteem was seen, neither in boys nor girls. In general, all physical self-variables revealed non-linear trajectories across time, where the general trend was an increase during the younger ages followed by a decrease during older ages. At ages 12 and 15 years in boys and girls physical condition and physical strength as well as body attractiveness and physical strength, respectively, had the strongest correlations to physical self-esteem. At age 17 and 22 years sports competence had the strongest correlation to self-esteem in girls, while body attractiveness and physical strength had the strongest correlation to self-esteem in boys. Conclusion: An overall stability in physical self-esteem was found. However the impact of a sub-domain upon physical self-esteem vary during adolescence and early adulthood. Such information may be useful when creating physical activity programs that support and develop physical self-esteem.

Street hawking is the commonest form of child labor in Nigeria. Although street hawking is very pervasive, there is the increasing need to fully understand its pattern and effects on those involved in hawking particularly adolescents who combine schooling with hawking. In Nigeria, data on the effects of street hawking on in-school adolescents are generally scanty. Therefore, the present study was undertaken in Ife Central Local Government Area (LGA) of Osun State, Nigeria to assess the pattern, determinants of street hawking among in-school adolescents and its effect on school performance. A cross-sectional study of 435 adolescents (aged 10–19) attending public secondary schools was done. Data were collected using facilitated self-administered questionnaires alongside a review of class records. Appropriate statistical analysis including multiple regression was done. Results showed mean age of respondents to be 14.6±2.1 years with prevalence of street hawking at 37.2%. Early adolescents (10–13 years) were more likely to engage in street hawking compared to their counterparts in late adolescence (aged 17–19). Female adolescents and students of trading mothers were significantly more likely to engage in street hawking. Respondents engaged in street hawking were significantly more likely to have failed the last academic term examination. The findings from this study will be useful for stakeholders as they develop policies and programmes to address the challenge of street hawking among adolescent school goers.

Objective: To describe outcomes of adolescents with eating disorders treated by an interdisciplinary adolescent medicine service at a large children’s hospital and to identify factors, including hospitalization, associated with outcome. Design: The study design was a retrospective chart review of patients. Setting: The setting was an inpatient and outpatient adolescent service in a large urban children’s hospital. Participants: A total of 218 adolescents diagnosed with anorexia nervosa, bulimia nervosa, or eating disorder not otherwise specified participated in the study. Intervention: Interdisciplinary inpatient and outpatient treatment for eating disorders was adopted for intervention. Outcome measures: Patient outcomes were categorized as fully recovered, partially recovered/improved, or poorly recovered/exhibiting chronicity. Results: Being admitted to the study hospital once and longer duration of follow-up were associated with full or partial recovery. In contrast, being readmitted to the study hospital and longer duration of illness prior to the initial contact with this service were associated with poor recovery. Premorbid obesity was unrelated to outcome. Conclusions: Earlier detection and referral of adolescents with eating disorders are needed because a high percentage of patients, especially those with anorexia nervosa, required hospitalization at initial contact. The benefits of inpatient admission may extend beyond medical stabilization of the most medically compromised patients to include improved therapeutic relationship with the treatment team and improved follow-up. Many patients prematurely terminate treatment; factors contributing to premature termination of therapy need further exploration.

Background: One of the most important and basic needs of adolescent girls is reproductive health services and education, which is different from that required by adults. Objectives: The aim of this study was to determine reproductive health education needs from the perspective of adolescent girls living in urban and rural areas, as well as to explore adolescents’ understanding of reproductive health needs. Subjects: The first phase was a cross-sectional study conducted on 1274 female adolescents. In the second phase, 77 girls in the form of 11 groups participated in focused group discussions. Methods: This sequential explanatory mixed methods study using follow-up variants was conducted in two phases. Questionnaires, including items on socio-demographic characteristics and reproductive health needs from adolescents’ perspectives, were completed using the self-administered method. Results: The quantitative results of the study revealed city and village girls’ perspectives on reproductive health education needs. These results showed that village adolescents were nearly 1.5–2 times more in favor of a same sex counselor, reproductive health group education, and the need for sexual health education than city adolescents. A review of the transcripts of the qualitative phase led to the extraction of two themes including the characteristics of the reproductive health educator and priorities of reproductive health education, which explains the adolescent girls’ understanding of reproductive health education needs. Conclusion: The findings of this study confirm the importance of determining reproductive health education needs from the perspective of adolescent girls. The present study shows how a sequential mixed design can be used for a better understanding of reproductive health needs of adolescent girls. The results of this study can be used in health research, education, policy making, and planning associated with adolescent health.

Background : The gynecological health needs of girls with disabilities is an issue related to their rights as individuals. Objective : The objective of this study is to describe the menstrual pattern of girls with disabilities. Materials and methods : A descriptive study was undertaken on thirty girls with different types of disabilities in a residential institution. The diagnosis, type of disability, secondary sexual characters, age at menarche, menstrual pattern and practice of menstrual hygiene was noted. Results : The girls with intellectual disabilities had later age of menarche, irregular cycles and more behaviour problems. The girls with hearing impairment and locomotor disabilities had normal menstrual pattern. The girl with low vision had earlier menarche and regularized cycles. Girls with normal intelligence and mild intellectual disabilities were independent in maintaining menstrual hygiene. The menstrual disorders are managed conservatively in accordance with latest guidelines. Conclusion : Onset of menarche is towards the extremes of normal age range in girls with intellectual disabilities or visual impairment but not in girls with hearing impairments or locomotor disabilities. Girls with disabilities have potential for independent menstrual care. Menstrual disorders were managed conservatively.

Background: There had been reports of adolescents using hand sanitizers to obtain alcohol and ending up in emergency departments with alcohol poisoning. Objective: This study aimed to describe the pattern of adolescent ingestions of hand sanitizers reported to a statewide poison center system. Subjects: Our study subjects included patients aged 13–19 years who reported hand sanitizer ingestions as reported to Texas poison centers during 2000–2013. Materials and methods: The distribution of the ingestions was determined for various demographic and clinical factors. Results: Of 385 total cases, 61% of the patients were male, and the mean age was 15.3 years. The ingestion reason was unintentional (61%), intentional abuse/misuse (18%), and malicious (10%). Ingestion site was most frequently reported to be the patient’s own residence (53%), followed by school (35%). About 77% of the patients were managed on site. The medical outcome was serious (moderate effect or unable to follow-potentially toxic) in 5% of the cases. The most frequently reported adverse clinical effects were vomiting (5%), abdominal pain (4%), nausea (4%), throat irritation (4%), and drowsiness (2%). Conclusion: Adolescents who ingested hand sanitizers were more likely to be male and younger. One-third of the ingestions occurred at school, suggesting that school personnel might be made aware of the potential problem of hand sanitizer ingestions by adolescents. Nevertheless, despite the potential for serious outcomes from adolescent hand sanitizer ingestion, most of the ingestions reported to poison centers are not likely to be serious and can be successfully managed outside of a healthcare facility.

Aim: Health care providers have considerable influence on adolescents’ health promotion. Thus, it is important to focus on the views of this group as one of the most reliable sources in the evaluation of teenagers’ health needs. The aim of this study was to compare the attitudes of Iranian health care providers and adolescents towards the latter’s health education needs. Materials and methods: A quantitative cross-sectional survey, including 72 health care providers and 402 female students from 14 high schools in northern Iran, was carried out in 2011. Topics in a self-administrated questionnaire covered the participants’ perspectives towards the educational health needs of adolescents in a five-point Likert scale. Results: Findings revealed from health care providers’ views indicate that the highest mean score was assigned to “Education about prevention of sexual high risk behavior”, which was significantly different from adolescents’ perspective (t=8.42, p<0.05). Results showed that health care providers and adolescents both emphasized on the mothers’ role as the most reliable source of adolescents’ education (t=1.85, p>0.05). Conclusion: Provision of health education programs for adolescents, which are based on integration of health care providers’ perspectives and the adolescents’ views, are essential in meeting adolescents’ educational health needs.

Background: Unsafe abortion accounts for a significant proportion of maternal and reproductive health related mortalities and complications in developing countries. In Ghana and sub-Saharan Africa in general, abortion remains a significant barrier to achieving the health related MDGs. Yet, there exist a dearth of information on the determinants of abortion decisions among adolescents, students and other populations at risk. Objectives: This study explores the factors that are likely to influence abortion decisions among University students in Ghana. It also explores their knowledge and perceptions on abortion. Methods: Data were collected from 142 randomly sampled students of the University of Ghana through focus group discussions. Questions focused on their knowledge on abortion and the key determinants of their decisions to abort. The results were recorded, transcribed, and analysed qualitatively using the thematic analysis approach. Results: The students were knowledgeable on abortion. In making decisions on abortion, the students considered their education, religious beliefs, health, economic factors, and family. Conclusions: Factors such as societal pressure and peer influence that, to date, have been the backbone of sexual and reproductive health, anti-abortion stigma, and unsafe abortion education and interventions have minimal influence on abortion decisions among the students. Rather, these interventions must focus on their education, religious beliefs, health, economic factors, and family to make maximum impact.

Background: Bully-victimization is a widespread public health issue with significant negative effects on both social function and psychological well-being. Existing research in Peru shows high prevalence of bullying. However, researchers have yet to fully understand the phenomenon of victimization in developing regions. Objectives: The purpose of this study was to characterize victimization patterns over time, along with the predictors of victimization from a cohort of Peruvian adolescents enrolled in the young lives (YL) study. Materials and methods: This study examined data from YL, a longitudinal study of poverty, health, and development, which examined data from the older cohort of children in Peru across three rounds (ages 8, 12, and 15 years). The sample consisted of 714 children from 74 communities that represent 20 districts in Peru. Results: After adjusting for urban/rural setting, there remained a significantly lower wealth index for children who were bullied at ages 8 and 12 years. Exploratory analysis showed that although those in the lowest quartile of body mass index (BMI) were significantly more likely to be bullied at age 8 years, this association waned over time. A worse caregiver assessment of child’s health compared with others was associated with a significantly greater risk of bully-victimization. At age 8 years, caregiver education was significantly lower among those bullied compared with those who were not bullied. Conclusion: This study showed several factors as the predictors of victimization in the early years, including being male and having low BMI, low socioeconomic status, and low parental/caregiver education. Further longitudinal studies should be conducted to determine the extent to which these predictors vary in significance over time.

Objective: As there is a lack of information on eating disorders in Bangladesh, the aim of this study was to explore the eating disorder attitudes and behaviors among undergraduate university students in the country. Materials and methods : A cross-sectional questionnaire survey and anthropometric measurement were conducted with undergraduate students who were recruited randomly from classes. The Eating Attitudes Test (EAT-26) was used to determine the prevalence of disordered eating attitudes. The sample included 800 university students (56.6% men and 43.4% women), with a mean age of 21.0 years (SD=32.5). Results : Using the EAT-26, 37.6% of the students were classified as being at risk for an eating disorder. In multivariate analysis, being a late adolescent (17–19 years), high religious involvement, overweight body perception, low body appreciation, having had cosmetic surgery, and current binge drinking were found to be associated with an eating disorder risk. Discussion: Very high rates of eating disorder risk were found. This result calls for increased awareness and understanding of eating disorders, and related risk factors and interventions in university students in Bangladesh.

The transition from adolescence to adulthood is associated with many physical, social, and psychological changes. In addition, adolescents also have to deal with structural changes. An example of one such structural change is the transition from school to university or to other vocational establishments. Structural changes can also entail changes in overall framework conditions and daily life patterns and thus also in dietary habits and physical activity levels. The aim of the present paper was to draw attention to the research deficit in this area with the help of the results of our analyses. The results show that significant changes take place as a consequence of the transition from school to a vocational establishment. However, our analyses could not identify the exact catalysts and the time framework of these changes. In this respect, further research is urgently warranted.