Volume 30, Issue 4

Introduction: Implementation of a healthy lifestyle at an early age is described as a successful intervention to prevent non communicable diseases. However, successful programs are not necessarily sustainable. The purpose of this study was to evaluate a 1-year sustainability of a 3-year comprehensive intervention conducted to promote a healthy lifestyle among schoolchildren. Materials and methods: A cohort study of 204 schoolchildren enrolled in middle schools was conducted after a quasi-experimental study in the region of Sousse, Tunisia. The survey lasted 1 year. An exposed group (n=105) was selected from the intervention group and the not-exposed group (n=99) was selected from the control group. The exposition was the intervention. The same questionnaire used at pre-intervention and post-intervention was self-administered to collect data about tobacco use, physical activity and eating habits. The biometric measurements were taken by trained medical doctors at schools. Results: After 1 year of follow-up, none of participants became smokers in the exposed group. However, in the not-exposed group five (5.1%) participants became smokers. The proportion of schoolchildren who experimented with tobacco for the first time increased insignificantly by 2.9% (p=0.77) in the exposed group versus a significant increase by 11.1% (p=0.001) in the not-exposed group. Concerning the recommended physical activity practice, fast food and fried food consumption and overweight, there were no significant changes in the two groups. Conclusion: A 3-year non communicable diseases prevention program has limited sustainable effects among schoolchildren in the short-term. Its repetition or a continued program through multisectoral actions is required.

Aim: The aim of this study was to identify factors that promote and impede other-sex (OS) friendships in adolescent girls. Methods: A qualitative study conducted with 20 adolescent girls recruited in public places in Tehran, Iran. Information was collected through semi-structured interviews and coded via the conventional qualitative content analysis approach. Results: Four factors were identified that appeared to promote entry into OS friendships. These factors include (a) a poor understanding of perceived risks, (b) weak religious beliefs, (c) processes of identity formation, and (d) low self-esteem. In addition, six factors appeared to impede entry into these friendships: (a) self-confidence, (b) prioritizing education, (c) maintaining particular entertainment preferences, (d) awareness of prior unpleasant experiences with boys, (e) having strong religious convictions, and (f) shaming from significant others. Conclusion: These findings provide unique insights into the factors that stem from different levels of social complexity, which affect participation in a fundamental form of human experience.

Objective: [1] To highlight the effectiveness of multi-family psychoeducation group therapy (MFPGT) in children with mood or anxiety disorders; [2] to measure change in knowledge and awareness of mood and anxiety disorders in families and children; and [3] to compare the relative effectiveness of online compared to live MFPGT. Method: Participants included families of children (12 years or younger) referred with a mood or anxiety disorder to the Division of Child and Adolescent Psychiatry at Queen’s University (n=16) who were on a waitlist to see a psychiatrist. Change was measured through questionnaires for all parents before and after the program. Using SPSS v22, comparisons between the online (n=6) and live (n=10) groups were made using the Mann-Whitney U test and within group comparisons were made using Wilcoxon signed-rank test. Results: The online and live education groups showed similar overall improvements in knowledge acquisition and expressed emotion in participating families. However, statistical significance must be interpreted with caution due to the small sample size. Conclusions: Online MFPGT may be an effective way to increase knowledge, provide resources and support and build on skills thus giving individuals more control and confidence when dealing with a mood or anxiety disorder while on a waitlist. MFPGT showed equal efficacy in live and online groups, indicating that the online program has the potential to be a more convenient and accessible program for families. More research is needed with a greater sample size.

The Arab region has the largest proportion of young people in the world and many of the factors that contribute to the onset of depression. Yet, very little is known about the current situation of depression and its associated stigma in this region. The purpose of this pilot study was to obtain preliminary data examining clinically significant depressive symptoms, depression stigma, and attitudes towards seeking professional help for depression among a sample of Arab adolescents from Jordan. Cross-sectional data were collected from 88 adolescents attending public schools in Jordan using self-report questionnaires that were available in, or translated into, Arabic. Among the 88 adolescents, 22% reported scores suggesting mild depression and 19% reported scores suggesting moderate depression, while 24% reported scores suggesting severe depression. The most frequently reported depressive symptoms were changes in sleep patterns (76%), changes in appetite (63%), agitation (62%), and crying (61%). The majority (73%) had moderate depression stigma, and 43% had negative attitudes towards seeking professional help. Yet, 67% believed they would find relief in psychotherapy if they ever had a serious emotional crisis. Findings suggest that the prevalence of depressive symptoms may be high among Jordanian adolescents. Further, many of these adolescents may experience depression-related stigma that affects their attitudes and willingness to seek professional help. To determine the true scope of these issues, including the prevalence of depression among Jordanian adolescents, future research should obtain data from a nationally representative sample.

Background: The number of adolescents who use caffeine is constantly increasing. As juvenile age is vulnerable, it is reasonable to expect that they will differently perceive reason and react to caffeine use than adults, and be more prone to unwanted physiological and psychological consequences of its consumption. Aim: Analysis of the scope and pattern of caffeine consumption among adolescents in Serbia. Study design: The cross-sectional survey was implemented in the study population of 191 Serbian adolescents during 2010. Results: The median daily intake of caffeine was 95.6 mg. The major source of caffeine was brewed coffee, and the most common reasons for caffeine intake were leisure, peer influence, or habit. Only 57.6% of the subjects were aware that caffeine is present in consumed beverages. Sex affected the pattern, but not the overall level, of caffeine consumption. No association between caffeine consumption and smoking status, frequency of caffeine use in the family, or negative personal experience with caffeine effects was observed. Conclusion: Our investigation provides first and rather detailed insight into caffeine-containing beverage consumption scope and pattern among Serbian adolescents. For accurate estimation and analysis of caffeine intake in this population, randomized studies with prospective longitudinal design, caffeine content measurement, and more subjects involved are warranted.

Ideal partner traits and how they relate to a young woman’s current partner and relationship is a knowledge gap in the literature. The objectives of this study were 1) to assess any differences in interpersonal characteristics between a young woman or her partner and relationship and 2) to examine the impact of this difference on sexual monogamy, condom use and frequency of vaginal sex. Study participants (n=387, 14–17 years at enrollment, 90% African American) were recruited from three primary care adolescent health clinics serving areas with high rates of unintended pregnancy and sexually transmitted infection (STI); data were drawn from a longitudinal cohort study of sexual relationships and behaviors among young women. Nineteen interpersonal characteristics, including physical, financial, communication and personal characteristic variables, were found to have varying influences on relationships and sexual behaviors with ‘like him’ and ‘like us’ as referents. Monogamy increased as a male partner wanted to get somewhere in life [OR 5.41, (1.25, 23.52, p<0.05)], was intelligent [OR 3.42, (1.09, 10.76, p<0.05)] and had money [OR 1.55, (0.272, 0.595, p<0.001)] in a partnership; monogamy similarly increased when a partner wanted to get somewhere in life [OR 6.77, (1.51, 30.36, p<0.01)], was intelligent [OR 4.02, (1.23, 13.23, p<0.05)], and had money [OR 2.41, (1.51, 3.84, p<0.001)] compared to the young woman. The likelihood of using a condom at last sex increased when the male partner had a nice body [OR 1.42, (1.02, 1.99, p<0.05)], was popular [OR 1.60, (1.12, 2.29, p<0.01)], cared for others [OR 3.43, (1.32, 8.98, p<0.01)], was good at sports [OR 1.35, (1.06, 1.73, p<0.05)] and expressed his feelings [OR 2.03, (1.14, 3.60, p<0.01)]. The condom use ratio increased when the male partner was able to take care of himself [OR 0.076, (0.017, 0.136, p<0.01)], was cute [OR 0.190, (0.082, 0.30, p<0.001)], and had a nice body [OR 0.044, (0.001, 0.09, p<0.05)] in a dyad; the condom use ratio also increased when a male partner could take care of himself [OR 0.091, (0.014, 0.168, p<0.05)], was cute [OR 0.194, (0.077, 0.311, p<0.001)] compared to the young woman. Coital frequency increased when the male partner was described as being able to take care of himself [OR 3.33, (0.138, 6.52, p<0.05)]. Such influences are important in discussions with young women regarding personal and partner choices in sexual health as partners, behaviors and motivations for choice frequently change.

Background: The Brazilian population presents an ever-increasing number of sedentary people with poor oral health issues, including children and adolescents. Both physical inactivity and poor oral health have shown associations with various systemic diseases. Objective: The aim of this study was to verify the association between physical inactivity and oral health conditions. Subjects: Three hundred and fifty-three adolescents (mean age 13 and 17 years). Methods: An epidemiological cross-sectional study. Assessment of the presence of caries was made by using the decayed, missing, filled (DMF) index. Gingival bleeding and quality of oral hygiene were also examined to evaluate the oral conditions. The International Physical Activity Questionnaire (PAQ-C) was used to assess physical activity. The confidence parameter was set at p=0.05. Results: The results of this study showed that 74.3% were sedentary adolescents, the great majority of whom were girls (86.4%, p=0.001). There was a positive association between sedentary lifestyle and tooth decay (p=0.001), dental plaque (p=0.009), and time spent watching television (p=0.001). Conclusion: This study concluded that there was a positive association between physical inactivity and poor oral health.

Objective: The United States has the highest rate of adolescent pregnancy of the industrialized nations. Previously reported patient barriers to the use of contraception included an ambivalence about pregnancy; method side effects; difficulty using methods; lack of satisfaction with methods; concerns about safety; expense; and a lack of knowledge about long-acting reversible contraception (LARC). This survey aims to determine if there are additional barriers to contraception use and adherence among an ethnically diverse urban population. Methods: A 16-item survey with good interrater reliability was utilized in a pilot study to assess patient demographics, and contraceptive methods was distributed to female patients aged 13–21 years at Metropolitan Hospital Center from January to October of 2014. Data analysis was performed using the χ 2 -square analysis, ϕ-coefficient, Contingency Coefficient, Cramer’s V, and Satterthwaite methods of analyses. Results: Concerns about contraceptive method side effects, more specifically, weight gain, irregular bleeding and long-term health risks, and worries about parents discovering their contraceptive habits were the major barriers to contraceptive use. Conclusion: The identification of these barriers is critical in order to reduce the high rates of pregnancy in adolescents. Educating parents and their teenagers regarding the most effective methods may increase compliance and adherence. This study offers further support for the use of LARC to overcome perceived patient barriers.

Background: To assess the relationship between eating attitudes and nutritional status. Methods: This cross-sectional study was conducted among 400 adolescent girls (258 aged 14–17 years and 142 aged 18–21 years) from the city of Howrah, West Bengal. Eating attitude was measured using eating distress syndrome (EDS) questionnaire. Nutritional status was assessed using body mass index, waist-hip ratio (WHR) and body fat percentage (BF%). Results: Participants with disordered eating attitudes revealed significantly higher values for body mass index (BMI), WHR and BF% than those with normal eating attitudes (p≤0.01). Hierarchical linear regression analyses show that eating attitudes and socio-demographic characteristics (like mothers’ education and occupation, age and birth order of the participants) significantly predict nutritional status. Conclusion: The nutritional status of adolescents depends on their eating attitudes and socio-demographic characteristics.

Background: As adolescents transition from childhood to adulthood, effective mother-daughter communication on sexuality plays a role in reducing high-risk behaviours linked to human immunodeficiency virus (HIV) infection and early pregnancy and childbirth. The objective of the study was to examine the prevalence of mother-daughter communication on sexuality and associated factors in Sagamu, southwest Nigeria. Methods: Using multistage sampling, surveys were conducted using 234 female youth enrolled at a secondary school. The chi-square or Fisher’s exact test was used to examine associations between categorical variables. The independent sample t-test was used to compare mean values of variables with reported evidence of mother-daughter communication on sexuality. Results: The mean age of respondents was 16+1.56 years. The majority (89.7%) had engaged in mother-daughter communication on sexuality, but three-quarters (80.8%) of the respondents could not freely discuss sexuality with their mothers. About one-third (31.6%) of the respondents reported at least one sexual encounter with the mean age of sexual debut of 14.23±2.12 years. Mother-daughter communication on sexuality was significantly associated with religion (p=0.047), mother’s age (p=0.019), who the respondents live with (p=0.029), mother’s highest educational status (p<0.001), age of sexual debut (p=0.030), and condom use (p<0.001), but not with freedom to discuss sexuality with their mother (p=0.552) or freedom to introduce male friends to their mother (p=0.077). Conclusion: Despite the high prevalence of mother-daughter communication on sexuality, mothers’ approach appeared unfriendly, as most girls could not freely discuss topics concerning sexuality with their mothers. Poor communication on sexuality was associated with sexual risk behaviours. Mothers should engage in adolescent-friendly transferring of knowledge on sexuality in order to reduce pregnancy rates and HIV transmission in female adolescents.

Foreign bodies in the urethra and bladder are mostly due to self-insertion, iatrogenic insertion, migration from surrounding organs or through penetrating injuries. Self-insertion of a foreign body through the urethra is mostly related to sexual gratification, psychiatric conditions or to get relief from the intractable voiding symptoms. We present a case of a 17-year-old male who self-introduced an extremely long 120 cm electrical wire into his bladder for sexual gratification. The wire was removed by supra-pubic cystotomy to avoid urethral injuries.

The popularity of synthetic cannabinoids (SCBs) is increasing the chance for adverse health issues in the United States. Moreover, social media platforms such as YouTube that provided a platform for user-generated content can convey misinformation or glorify use of SCBs. The aim of this study was to fill this gap by describing the content of the most popular YouTube videos containing content related to the SCBs. Videos with at least 1000 or more views found under the search terms “K2” and “spice” included in the analysis. The collective number of views was over 7.5 million. Nearly half of videos were consumer produced (n=42). The most common content in the videos was description of K2 (n=69), followed by mentioning dangers of using K2 (n=47), mentioning side effects (n=38) and showing a person using K2 (n=37). One-third of videos (n=34) promoted use of K2, while 22 videos mentioned risk of dying as a consequence of using K2. YouTube could be used as a surveillance tool to combat this epidemic, but instead, the most widely videos related to SCBs are uploaded by consumers. The content of these consumer videos on YouTube often provide the viewer with access to view a wide array of uploaders describing, encouraging, participating and promoting use.

Introduction: Reproductive health of adolescent girls is crucial as it determines the health of future generations. School girls when experiencing menarche find themselves in a setting without water, toilets or a supportive female teacher to explain the changes happening in their body. An important concern for adolescent girls is to have adequate, correct knowledge along with facilities and the cultural environment to manage menstruation hygienically and with dignity. Hence, the present study was done to assess knowledge and practices about menstruation in adolescent school girls of an urban slum. Methodology: This was a descriptive cross-sectional study conducted among girls of a Government School located in an urban slum of western Maharashtra. A total of 250 girls participated. Data collection was through a pilot-tested questionnaire. The data thus collected were entered into Microsoft Excel and analyzed using the SPSS 20 software. All girls were educated about menstrual hygiene after the study. Results: The mean age of the students was 14.9±1.75 years. The mean age at menarche was 11.97 (95% CI: 11.94–11.99). It was observed that only half (56.4%) had acquired prior knowledge about attaining menarche. Out of these in a large proportion, the knowledge was imparted to them by their mothers (60.7%), followed by friends (31.8%). There was no significant association between educational status of mother and awareness in respondent about menstruation. Regarding the organ of menstrual blood flow, half (50.7%) knew the correct answer (i.e. uterus); whereas the rest believed that it was stomach/kidney, etc. Most of the school girls (90.5%) used sanitary pads. Almost 90% of the young women faced physical complaints or health problems during menstruation. Most of the participants had some kind of restrictions on them during the menstruation and most of these were religious restrictions (69.7%) followed by physical (41.2%) and social restrictions (22.3%). All of them were unsatisfied with the toilets and hand washing facilities available inside the school premises. Conclusion: Correct knowledge in adolescent young girls regarding menstruation is lacking. Lack of awareness is a roadblock in adopting safe and hygienic menstrual practices. It also hinders them from overcoming traditional beliefs, misconceptions and restrictions regarding menstruation. This will empower them as they transition into womanhood.