Volume 28, Issue 1

To estimate the prevalence, to compare the impact of dysmenorrhea on routine life among adolescent girls, to compare the practices and perceptions regarding Dysmenorrhea and to ascertain the reason for difference if any, a cross-sectional study was conducted in urban, rural and slum areas of Chandigarh, India. 300 girls in age group of 11–18 years, who had attained menarche were included in the study. A questionnaire including the Demographic and Family profile, menstrual history, Symptoms of Dysmenorrhea, Effect of pain on daily activities, Faces scale, Practices regarding Dysmenorrhea, Beliefs about menstruation was used. Analysis was done by percentage and chi square prevalance of dysmenorrhea was 61.33%. Sickness absenteeism due to dysmenorrhea was reported in 24.45% girls. Most common symptom experienced by the girls was stomach ache which was experienced by 139 girls; others symptoms experienced during menstruation were backache (107), and general body pain (80). Only 11.63% of the girls ever visited physician due to pain during menstruation. During menstruation only 10 girls use hot water bottle, 71 skip meal. Due to poor knowledge the practices were not optimal for pain management, which affected their school attendance. Formal as well as informal channels of communication, such as mothers and peers, need to be emphasized for the delivery of such information particularly linking instructions on menstrual hygiene to an expanded programme of health education in schools.

Background: Adolescents affected by a severe disease who undergo high-risk treatment may experience stress, pain, extreme frustration, depression, and anger. In this large spectrum of emotions, several situations must be considered carefully. To improve coping and quality of services offered to adolescents in paediatric hospitals, we elaborated a semi-structured interview and a short questionnaire (Quality of life-adolescent-Istituto Giannina Gaslini, QoL-adol-IGG scale) to investigate the quality of life, the needs and expectations of adolescent in-patients. Methods: The study sample includes 117 in-patients aged between 10 and 20 years coming from several Italian regions who were admitted to the G. Gaslini Research Children’s Hospital for a period of 10 days or more, regardless of the disease. The QoL-adol-IGG scale was administered – after obtaining informed consent from the children and their parents – in one single encounter by trained psychologist. The distribution of the answers was evaluated after stratification by patient’s age, gender, area of residence, and clinical diagnosis. Continuous data were compared using the Kruskal-Wallis, while the χ 2 -test was used for categorical data. Results : Seventy-two percent had difficulty practicing normal daily activities during their stay in the hospital, not only because of the disease (40%), but also because of the poor organization within the hospital, the lack of proposals/activities and space for spare time, and the limited access to technologies. Adolescents ≥15 years were more frequently dissatisfied than youngsters concerning the access to Internet and other technologies, the possibility to make new friends and to take part in social activities. Conclusion: The results of this study, which evaluated the hospital’s organization, but also psychological functioning in a representative sample of patients, may contribute to optimize internal procedures of clinical departments where adolescent in-patients are present, on the basis of their requests and taking into account their age.

Background: Cigarette smoking remains a major preventable public health problem associated with premature deaths worldwide. Adolescence is a unique developmental stage between childhood and adulthood. Smoking is a lifestyle habit acquired during adolescence and into adulthood, with its associated morbidity and mortality. It is therefore important to determine the factors associated with cigarette smoking in these adolescents in order to institute preventive measures and health policies to protect these adolescents early. Objective: This study aims to determine the prevalence of smoking, factors associated with smoking, and knowledge of the harmful effects of smoking in these adolescents. Methods: A cross-sectional study of 1120 adolescents aged 10–19 years selected from 10 secondary schools in Port Harcourt was conducted using a multistage sampling technique. The Global Youth Tobacco Survey (GYTS) core questionnaire was used to collect data from the subjects. A smoker was defined as one who had ever smoked a cigarette or who had one or two puffs, while a current smoker was defined as one who had taken a puff or smoked cigarettes in the last 30 days preceding the day of the questionnaire’s completion. Results: Eighty subjects (7.1%) were smokers. This was significantly (p=<0.001) higher in males (9.7%) than in females (4%). Thirty seven (3.3%) subjects were current smokers. The mean age at which smoking was initiated was 12.47±3.0 years. Twenty six (32.5%) of the smokers reported that they were initiated into cigarette smoking by their friends, 36 (45%) just wanted to experiment, 7 (8.8%) were influenced by media advertisements while 5 (6.3%) were due to parental exposure. Parental history of smoking and poor knowledge of cancer of the lungs as a harmful effect of smoking, was significantly (p=<0.05) associated with cigarette smoking. Conclusion: The prevalence of smoking in adolescents in Port Harcourt is high and is associated with parental smoking and poor knowledge of cancer of the lungs as a harmful effect. We recommend that adolescent health education with an emphasis on the harmful effects of smoking be included in the curriculum of all secondary schools.

Background: Adolescent obesity is a chronic disease that is impacted from each patient’s biopsychosocial milieu. Successfully treating pediatric obesity requires long-term, innovative, systematic involvement to facilitate patient and family engagement and change. Methods: Extensive chart review was done for three obese adolescents who underwent comprehensive weight management in an adolescent clinic seen within the past 5 years. The charts were reviewed starting from the time of initial contact through the last visit in the clinic. The patients are no longer receiving care within the clinic. Results: The patients presented with BMI>99th percentile, family history of obesity, severe psychosocial stressors, and multiple obesity-related comorbidities. Their treatment involved comprehensive multidisciplinary intervention in an adolescent weight management clinic within a tertiary care center. In addition to rigorous support through frequent office visits, these patients all eventually required temporary, alternative living arrangements to successfully implement recommendations. One patient resided with another family member; two went to inpatient weight management program care for 2–3 months. All subjects successfully lost weight when away from their primary residence, and they demonstrated improvement or resolution of comorbidities. Conclusions: This case series of three adolescents who underwent comprehensive obesity evaluation and treatment demonstrates multidisciplinary care across interconnected treatment programs and active engagement of family. Those who maintained successful weight loss reduced sedentary time, demonstrated family support (e.g., key members attending follow-up visits), and altered their living environment and were committed to their own health goals.

Aim: This study attempted to evaluate the real and perceived body weight, exercise habits and weight-altering dietary supplement use by adolescents attending schools in Trinidad and Tobago. Methods: A de novo questionnaire was administered prospectively to 15–19-year-old to determine their exercise habits, their perceived body weights, and their use of any weight gain or weight loss supplements. A subset of students had their actual height and weights recorded and BMI calculated. Results: Five hundred and eighty-three students did the questionnaire (88% response rate), and 363 students had BMI calculated. Some 14.9% (54/363) of the students were overweight, and 15.4% (56/363) were obese, and more than 75% of the obese students had attempted weight loss in the past. These measures included exercise in the majority of the students and use of dietary supplements in the minority. Only 6% of the obese students exercised five or more times per week. About 28% of the students misclassified their body weights, and perception of body weight influenced weight loss behaviors more than actual body weights. Conclusion: Almost one third of the students were overweight or obese. Overweight students were motivated to lose weight, and these students need to have some structured health promotion program, which educates them on correct exercise habits, safe measures to lose weight, and which informs them of their actual body weight.

Purpose: Oral health has a profound impact on the health of adolescents. The aim of the present study was to obtain information on habits, knowledge and oral hygiene attitudes of Portuguese teenagers and to study the gender differences concerning these issues. Methods: A total of 1203 adolescents participated in the study (55.8% females; mean age, 14.9 years). To recruit participants, a national network of community dental hygienists, working in the health centers, was created, and adolescents were contacted at the schools. A questionnaire was applied in the classroom, during school hours, under supervision of one researcher and the classroom teacher, after collection of informed consent forms. Results: Portuguese adolescents do not seem to have dental fear but have some anxiety when at the dental office; girls are more anxious than boys. Girls are also more concerned with esthetics and aware of dental problems and care about oral health of family and friends. Parental supervision is more relevant for boys in order to obtain better compliance with dental care; however, 97.2% of the adolescents do not consider maintaining teeth throughout the lifetime as relevant. Conclusion: Teenagers recognize dental professionals as educators and oral health as relevant in their lives. It is possible to assume that gender has an influence on adolescent’s habits, behavior and attitudes regarding oral hygiene. There is a difference between boys and girls concerning their habits, knowledge and attitudes in dental hygiene; this difference may show the need to create different strategies for oral health promotion for these two groups of adolescents.

Background: This study aimed to determine whether the viewing of a personal photoaged photograph had the capacity to alter Western Australian teenagers’ pro-tanning attitudes. Method: Semi-structured interviews were conducted with fifteen teenagers. Findings: The teenagers’ pro-tanning attitudes prior to viewing their photoaged photograph are encapsulated in the study’s central theme: ‘You’ve got to look after your skin and use sunscreen, but I always forget!’. Post-viewing their photoaged facial image many teenagers reiterated their intentions to adopt (when they remembered) skin-protective measures. However, photoaged photography did not alter other teenagers’ intention to tan. New knowledge: Teenagers who choose to continue to tan were aware of the long-term health risks associated with ultra-violet over-exposure. However, their desire remained strong to emulate the media promoted image of bronzed youth being popular individuals. Indeed, the social benefits of being considered attractive to their peers became an attitudinal barrier to the teenagers’ adoption of skin-protective behaviours. Those teenagers who changed their pro-tanning attitudes following their viewing of their ultra-violet photoaged photograph did so because of the shock they received when they saw their sun-damaged facial image. This suggests that photoageing photography can be effective with many adolescents because it reduces the cause-and-effect delay that exists between the occurrence of sun-damage and its visual presentation in later-life. Conclusion: Greater effort needs to be focused on increasing teenagers’ understanding of how sun-damage occurs, when it is appropriate to apply sunscreen, as well as in changing the prevailing media image of an attractive body being a tanned body.

Background: Pesticides, particularly when misused, can cause serious morbidity and mortality. There is limited literature on pesticide exposures among adolescents. Objective: The purpose of this study was to describe adolescent pesticide exposures reported to poison centers and compare them to adult exposures. Subjects: Pesticide exposures reported to Texas poison centers during 2000–2013 where the patient was age 13 years or greater. Methods: Cases were divided into adolescents (13–19 years) and adults (20 years or more). The distribution of the cases was determined for various factors, and comparisons were made between the two age groups. Results: There were 2772 adolescent and 33,573 adult pesticide exposures. The most common types of pesticide among adolescent and adult cases, respectively, were insecticides (71% vs. 76%), herbicides (6% vs. 9%), repellents (11% vs. 8%), and rodenticides (10% vs. 5%). Adolescent patients were 56% male and 43% female; adult patients were 45% male and 55% female. The most common exposure routes among adolescent and adult cases, respectively, were dermal (29% vs. 38%), inhalation (22% vs. 33%), ingestion (47% vs. 29%), and ocular (14% vs. 13%). The exposure reason for adolescent and adult exposures, respectively, were unintentional (82% vs. 89%), intentional (13% vs. 7%), adverse reaction (2% vs. 3%), and other/unknown (3% vs. 1%). Conclusion: Compared to adult exposures, adolescent pesticide exposures were more likely to involve repellents and rodenticides, involve males, occur by ingestion, and be intentional.

Background: Parenting adolescents poses challenges that are exacerbated by immigration. Aqui Para Ti [Here for You] (APT) is a clinic-based, healthy youth development program that provides family-centered care for Latino youth and their families who are mostly immigrants from Mexico and Latin America. Objectives: To present the APT model of care and report the experiences of youth and their parents. Subjects: APT patients between 11 and 24 years (n=30) and parents (n=15). Most youth patients were female, between 11 and 17 years, and from Mexico. Most parents were female, 40 years or younger, and from Mexico. Methods: Youth participants completed a survey and participated in an individual semi-structured interview, and parent participants attended focus groups. Descriptive statistics summarized survey data. Interviews and focus groups were transcribed and analyzed in Spanish using content analysis by two independent coders. Quantitative and qualitative findings were integrated using side-by-side comparisons. Researchers not involved in the coding process contributed with the interpretation of the findings. Results: Youth and parents were satisfied with the services received at APT. Youth felt listened to by their providers (100%), felt they could trust them (100%) and valued comprehensive care. Eighty-seven percent reported that their experiences at APT were better than at other clinics. Parents valued the family parallel care, confidentiality, family-centeredness, and the cultural inclusivity of the APT services. Conclusion: Patients and parents were satisfied with the services offered at APT. Family parallel care could be a positive alternative to deliver confidential and family-centered services to immigrant families.

Facebook has been used in health research, but there is a lack of literature regarding how Facebook may be used to recruit younger adolescents. A Facebook Page was created for an adolescent cohort study on the effects of puberty hormones on well-being and behaviour in early adolescence. Used as a communication tool with existing participants, it also aimed to alert potential participants to the study. The purpose of this paper is to provide a detailed description of the development of the study Facebook Page and present the fan response to the types of posts made on the Page using the Facebook-generated Insights data. Two types of posts were made on the study Facebook Page. The first type was study-related update posts and events. The second was relevant adolescent and family research and current news posts. Observations on the use of and response to the Page were made over 1 year across three phases (phase 1, very low Facebook use; phase 2, high Facebook use; phase 3, low Facebook use). Most Page fans were female (88.6%), with the largest group of fans aged between 35 and 44 years. Study-related update posts with photographs were the most popular. This paper provides a model on which other researchers could base Facebook communication and potential recruitment in the absence of established guidelines.

Background: Adolescents’ physical activity decreases from the stage of childhood to adulthood. This study was addressed to explain adolescents’ insufficient physical activity (IPA) and its related factors. The subjects were 1201 adolescents in the quantitative phase and 25 adolescents in the quantitative phase. Methods: An explanatory sequential mixed methods design with follow-up explanations variant was used, which involved collecting quantitative data (1201 adolescents) first and then explaining the quantitative results with in-depth interviews and written narrative (25 adolescents) during a qualitative study. Results: The quantitative results showed that 98.8% of adolescents did not have the recommended physical activity. Five themes were extracted in the qualitative phase including the inhibitory effect of the school environment and peers, as well as the inhibitory effect of the family environment, lack of availability and cultural barriers for the presence of girls in the community, the effect of self-feeling and self-understanding, and physical and mental exhaustion and permutation. According to the qualitative findings of the study, physical and mental exhaustion expressed the fact that, although adolescents had an unfavorable sense of IPA, they were under the effects of the intrinsic and extrinsic factors. Conclusion: The comparison of these themes indicates that this behavior is imposable but not optional.

High sensation seekers engage in more frequent substance use and perceive a host of potentially dangerous activities as less risky than do low sensation seekers. However, despite a plethora of research on these topics, no study has examined the extent to which personal substance use mediates the association between sensation seeking and perceived risk of substance use. To address this question, we recruited a sample of 79 young adults (mean age=19.1 years, standard deviation=1.4). Participants completed questionnaire measures of sensation seeking, substance use, and perceived risk of co-occurrent substance use. Results from path-analytic modeling indicated that both alcohol use and marijuana use mediated the influence of sensation seeking on perceptions of risk for moderately risky, but not highly risky, pairs of substances. Strengths and limitations of the present study were discussed and directions for future research were suggested.

Objective: The study aimed to describe the medical, psychiatric, and cultural features of adolescent males with an eating disorder (ED). Materials and methods: This retrospective evaluation took place at Hacettepe University, İhsan Doğramacı Children’s Hospital, Ankara, Turkey, and covered a 4-year period between 2010 and 2013. Sixty adolescents were diagnosed with an ED during this period, 47 (78.3%) were females and 13 were males (21.7%) male. All 13 male patients who met full criteria for an ED according to the DSM criteria were included. Medical and psychiatric records of male patients treated for an ED were re-evaluated. Results: The most striking finding of the study was that the female to male ratio became 3.6:1, with the increasing number of male adolescents with an ED. In our study, medical findings and complications of males with ED were similar to those seen in females. However, the most predominant gender difference was the co occurrence of a comorbid physical or mental illness. Conclusion: It is imperative to raise awareness of EDs in males. Although the medical findings of the study suggest that male and female adolescents with EDs are clinically similar to each other, the understanding of certain gender-specific risk factors shown in our study, such as a medical illness and/or obesity and co-morbid psychiatric diagnosis, are essential in raising suspicion. Further studies that especially evaluate cultural and social factors that affect parenting styles for boys are important in addessing possible risk factors for the development of EDs in males within different societies.

Introduction: The majority of existing research regarding cochlear-implanted patients focuses on acoustic perception and language skills in children and adolescents, or on the postoperative quality of life in adults. Purpose: We hypothesized that a patient’s psychological reaction to a cochlear implant (CI) may be influenced by the temperament of the implanted subject. This case study aims to assess whether temperament plays a role in the adaptation to CIs and if certain temperamental and character traits may be risk or protective factors for surgery and rehabilitation outcomes. Method: We evaluated a 21-year-old male patient presenting a history of traumatic hearing loss. The Temperament and Character Inventory (TCI) was employed to obtain a psychological evaluation. Results: The findings suggest a connection between the scores obtained on the TCI questionnaire and the patient’s behavior toward the CI. The effects of the operation may be mediated by some temperamental and character traits. Conclusion: In the field of clinical psychology and hearing rehabilitation, psychological evaluation may contribute a more profound understanding of the personality dynamics that influence the patient’s reaction toward traumatic hearing loss, compliance, and CI surgery outcomes.

Megalourethra is a diffuse dilatation of the anterior urethra due to lack of corpus spongiosum with or without corpora cavernosa; it usually presents as a dilatation of that part of the urethra. The absence of these structures causes a ballooning of the urethra despite there being no mechanical obstruction. A 7-year-old boy presented with the complaints of weak stream, ballooning of the penis before and during voiding urine and post voiding dribbling. After examination and micturating urethrogram, he was diagnosed as having megalourethra, which was then corrected using reduction urethroplasty. These days megalourethra is diagnosed with prenatal ultrasonogram. This was a case of isolated delayed presentation of megalourethra without any associated anomaly.

Problematic Internet use (PIU), defined as Internet use that is risky, excessive, or impulsive in nature and leads to adverse life consequences, is an emerging health concern among adolescents worldwide. Social networking site (SNS) use is among the most popular and common Internet use activities for youth; however, risks of SNS use for PIU remain unexplored. The purpose of this study was to determine the prevalence of adolescents at risk for PIU within a national school-based sample of Dutch adolescents and to explore associations between SNS use and PIU. Adolescents were recruited from six public schools in the Netherlands to complete a survey, which included SNS use questions and the Problematic and Risky Internet Use Screening Scale (PRIUSS). Logistic regression models were used to test associations between risk for PIU and demographic or SNS use variables. A total of 474 adolescents participated (98% response rate), and 11% (n=51) of adolescents were at risk for PIU. Risk for PIU was significantly associated with gender (p=0.015), increased age (p=0.034), and posting on SNS more than four times a day (p=0.003). Risk for PIU was not associated with number of SNS profiles, SNS preference or the number of online friends. Findings illustrate high risk groups for PIU includes males and older teens. Findings also illuminate that risk for PIU related to SNS was not associated with a specific SNS or number of SNSs used but was related to one’s personal investment in SNSs by posting four or more times a day.