Volume 31, Issue 3

Background Intentional injuries refer to injuries resulting from purposeful human action, whether directed at oneself or others. This study was performed to assess intentional injuries in Iranian university students. Methods This cross-sectional study was carried out with 430 female and male university in three higher education institutions located in the northern part of Iran in the year 2015. Samples were chosen through the stratified cluster random sampling method. They were requested to fill out the demographic data form and the Persian version of the Youth Risk Behavior Survey Questionnaire. Descriptive and inferential statistics were used for data analysis via the SPSS v.13 software. Findings Intentional injuries were more frequent in the male university students than female (p < 0.05). Also, 9.1% and 6.7% of the university students were physically injured or sexually assaulted by a boy/girl friend. No statistically significant difference was reported in dating violence between the male and female university students. The logistic regression test showed that the history of stealing money from parents without their permission, son’s preferences in the family and gender are the most important predisposing factors for the university students’ intentional injury. Conclusion It is suggested that health policy makers consider the role of family in programs that have been designed for improving the health of young people.

Objective: Low self-esteem and low self-directedness (SD) are considered a risk factor for the development of eating disorders (EDs). The aim of this study was to test the hypothesis that low self-esteem and low SD lead to a higher risk for EDs through the mediation of anxiety and depression. Methods: Seventy-seven female teenagers answered the Eating Disorder Inventory 3 (EDI-3), the Intolerance of Uncertainty Scale (IUS), the Temperament and Character Inventory-Revised (TCI-R), the Rosenberg Self-Esteem Scale (RSES), and the State and Trait Anxiety Inventory (STAI), and the Symptom Checklist-90-Revised (SCL-90-R). To test the hypothesis, a structural equation model (SEM) was used. Results: According to the EDI3-EDRC scores, 23/77 (29.9%) participants demonstrated positive results in the screening. Participants who had positive results in the screening had significantly higher scores on trait and state anxiety, depression, and IU, and lower means of self-esteem and SD. The SEM demonstrated good fit indices and all paths were significant in the predicted directions, confirming the hypothesized model. Conclusions: The current results confirm the role of self-esteem and SD in the development of an ED among adolescent females through the mediating action of IU, anxiety, and depression.

Background The Build, Educate, Advance, Transition, in Sickle cell disease (BEATS) music therapy program was developed to address health challenges faced by adolescents/young adults (AYA) with sickle cell disease (SCD) during the transition to adult medical care. Objective The purpose of this study was to investigate the effects of BEATS on self-efficacy, trust, knowledge about SCD, and adherence in adolescents/young adults (AYA) with SCD. Subjects Thirty AYA with SCD, 18–23 years old, recruited from an adult SCD clinic agreed to participate in four BEATS sessions over 1 year. Methods Self-efficacy, trust and SCD knowledge were measured prospectively at baseline and months 3, 6, 9, and 12. Adherence to clinic appointments and healthcare utilization were measured retrospectively from medical records. A repeated measures linear mixed-effect model with compound symmetry covariance structure was used to fit the data. Results BEATS participants demonstrated a significant improvement in SCD knowledge (p = 0.0002) compared to baseline, an increase in acute care clinic, but not emergency department, utilization (p = 0.0056), and a non-significant improvement in clinic attendance (p = 0.1933). Participants’ subjective evaluations revealed a positive response to BEATS. There were no significant changes in self-efficacy, trust, hospital admissions, or blood transfusion adherence. Conclusion Culturally tailored, developmentally appropriate music therapy transition interventions can concretely improve SCD knowledge and may improve transition for AYA with SCD.

Purpose The current study explored girls’ perceptions of the impact of sanitary pads’ intervention on their school attendance and grades. Methods Participants included 150 girls in 6th, 7th, and 8th grade in two rural schools in Kenya. Participants completed a questionnaire on menstrual health issues and the perceived impact on school attendance and academic performance. Results Results indicated that of all participants (150), those who had passed menarche and had cloth pads had similar comfort levels at school as those who had not yet had their period. Of those who had reached menarche (with pads n = 34, without pads n = 91), they answered questions about how much their period interfered with their attendance and grades. Those who had received the pads reported significantly less negative influence on their attendance and schoolwork than those who did not have pads. They also reported significantly lower levels of wanting to hide their menstrual cycle from friends and family. In addition, they reported significantly higher levels of comfort at home and school than those who did not have pads. Finally, those with pads reported significantly lower levels of fear during their period. Conclusion These findings suggest providing girls with pads minimizes the barriers to successful schooling.

Gynecomastia is defined as an enlargement of the male breast. Although it is commonly seen during puberty, it is often overlooked by many physicians. As adolescent medicine specialists, we believe there is a gap in the literature concerning both the etiology and maybe more importantly the care of these adolescents. Thus, we have been dedicated to conducting research on this topic. The aim of this review article was to evaluate the studies concerning pubertal gynecomastia that took place at the Division of Adolescent Medicine, Hacettepe University, published between the years 2003 and 2016. The review covers in detail both the short- and long-term effectivity and safety of tamoxifen used for the treatment of pubertal gynecomastia. As the exact basis for the pathogenesis of gynecomastia remains unknown, we also evaluate three studies that aimed to answer this question. We additionally review a study that aimed to assess the psychological distress and effect on body image that gynecomastia may have on the adolescent male. An important contribution this review article adds to the literature is as a conclusion to all the studies performed, we present the ‘Hacettepe indications for tamoxifen treatment for pubertal gynecomastia’. These indications will aid physicians when considering treating these patients.

Objective This cluster randomized control trial was performed to evaluate the effectiveness of a web-based anger management program for mother-female adolescents’ conflicts. Methods Eight out of 23 high-schools in District Two of Shiraz, Iran were chosen using random cluster sampling and randomly assigned to an intervention and a control group (each group consisted of four schools). The conflict tactics scale was filled out by all eligible third grade high school students in both groups and 140 students who had the scores higher than 30 were randomly selected; 70 adolescents in the intervention group participated in an 8 week intervention, while 70 adolescents in the control group did not undergo any intervention. Data collection was performed at the end of the intervention and 1 month later. Results The results of the t-test revealed no statistically significant differences between the study groups regarding the total conflict tactics scores (p = 0.935) or any of the three subscales before the intervention (p > 0.05). However, a significant difference was observed between the two groups in this regard immediately and 1 month after the intervention (p < 0.05). The results of repeated measure analysis of variance (ANOVA) demonstrated a significant difference between the intervention and control groups regarding the conflict scores and its subscales during the three study periods and groups (F = 79.43, p < 0.001). Conclusion This study highlighted the importance of applying a web-based anger management program in decreasing mother-female adolescents’ conflicts. Similar studies are recommended to be conducted on the issue.

Background Existing studies on the association between physical activity (PA), screen based time and sleeping show conflicting results. Objective This study investigates the association between chronic pain at different body regions and self-reported PA, screen based time and sleeping hours in high school students. Subjects A total of 969 students aged 13–19 years old. Methods Participants completed a questionnaire on chronic pain, time spent in moderate and vigorous PA, screen based time watching televivsion (TV)/digital versatile discs (DVD), playing, using mobile phones and computers and sleeping hours. Univariate and multivariate associations between pain and PA, screen based time and sleeping hours were investigated. Results In the univariate model time spent in moderate and vigorous PA, in screen based activities and sleeping were associated with pain in at least one body site. In the multivariate model, screen based activities were not associated with pain; sleeping 7 h or less and increased time in moderate PA were associated with pain at almost all body sites [odds ratio (OR) between 2.69–3.66 and 1.06–1.10, respectively]. Conclusion Time spent in PA and sleeping increased the risk of chronic pain in almost all body regions and might confound the association between screen based time and pain.

Introduction In spite of its importance, the psychological health requirements of adolescents are ignored; due to the occurrence of mental disorders in this age group and also public interest in the use of supplementary and alternative treatments such as herbal drugs for mental disorders, this study was carried out aimed at examining the impact of the Melissa officinalis capsule on the psychological health of female adolescents. Methodology In this randomized clinical trial study, 100 female adolescents were assigned to two groups of either drug and placebo groups. The data collection tool includes demographic information recording note and General Health Standard Questionnaire (GHQ). Intervention has been done in the menstrual cycle during 3 successive months and patients received two 600 mg drug daily in the intervention group, and the control group received placebo. After the intervention, the scores of the participants’ psychological health were measured in both groups and data were analyzed through independent t-test using SPSS software version 16. Results The study results showed that psychosomatic symptoms score (p < 0.001), anxiety and sleeping disorder (p < 0.001), and social function disorder (p = 0.021) in the experiment group was significantly less than that of the placebo group. Conclusion Based on the findings of this study, Melissa officinalis can decrease psychosomatic symptoms, sleeping disorder and anxiety, depression and disorder in social function in female adolescents.

Objective Students living in dormitories are at increased risk for meningococcal disease. Our aim was to evaluate Greek students planning to study abroad about their level of meningococcal disease awareness and attitudes and practices towards meningococcal vaccination. Methods We studied 231 Greek ERASMUS students using a questionnaire. Results Students had a mean number of 4.1 correct answers out of six questions. In particular 66.5% 79.3%, 72.3% and 82.3% of them answered correctly about the etiology, transmission, epidemiology and treatment of meningococcal disease, respectively. Only 23.4% were vaccinated, whereas 14.7% were planning to do so in the near future. Students who answered correctly ≥5 questions were more likely to be male, vaccinated against meningococcal meningitis and science students. Conclusion We found an overall good level of knowledge about meningococcal disease among Greek students planning to study or already studying abroad. Knowledge about meningococcal disease was associated with vaccine uptake. However, vaccination rate against meningococcal disease was low.

Background Several studies have shown that there is a significant relationship between teenagers and parental smoking behavior. This study was to empower parent (smokers and non-smokers) to raise parents’ concern, to describe teenagers’ knowledge about smoking and its dangers, to reduce the status of teenage smoking behavior, and to decrease the number of cigarettes smoked/day. Methods This was a quasi-experimental study, with a pretest-posttest group design. The respondents were 649 students from the 8th grade in junior high schools from three provinces in Indonesia divided into two intervention groups and one control group. The dependent variable was the implementation of parent educators (smokers and non-smokers) who were trained about smoking and its dangers. Data were analyzed by analysis of variance (ANOVA) and the Kruskal-Wallis test, with a significant level of 0.05. Results The results showed that the smoking parent educator model increased the frequency of parent concern significantly and improved knowledge about the dangers of smoking insignificantly; whereas the non-smoker parent educator model decreased the number of respondents’ frequent smoking status insignificantly and reduced the number of cigarettes smoked /day by the frequent smoker respondents significantly. Conclusion The parent educator model can be used for preventing teenage smoking behavior.

Background Subthreshold depression (StD) is more common than major depressive disorder. Objective The study aimed to identify common words to improve self-confidence in Japanese university students with StD for developing a smartphone application to help those with StD. Methods In this cross-sectional study, words participants used to improve their self-confidence were gathered using self-report questionnaires in 154 university students in Japan. The words used to improve self-confidence were categorized using a computerized text analysis method based on the frequency of appearance. Results Participants were 154 male and females [StD group (n = 82) and healthy control (HC) group (n = 72); median age = 20 years]. A total of 290 words for improving self-confidence were identified. In the StD group, the keywords that appeared with the highest frequencies were “can”, “let’s try”, “good luck”, “able”, and “don’t worry”. The keywords that occurred with the highest frequencies (the top eight) were common across both groups. The keywords were grouped into eight categories. The “encouragement” and “praise” categories were found in the responses of more than 80% of participants in both groups. Frequencies of the “determination” and “trust” categories were significantly higher in the StD group than in the HC group. Conclusions We conclude that “can”, “let’s try”, and “good luck” are the most common words that Japanese students with StD use when describing how they improve their self-confidence. Future work will use these common words to develop a smartphone application to help those suffering from StD.

Objective To investigate cross-correlates of pocket-money on diet quality and weight status of Greek adolescents. Methods A total of 172 adolescents (55.2% boys), aged between 10 and 15 years old were recruited. Body weight and height were measured, body mass index (BMI) was computed. Weight status was assessed according to the International Obesity Task Force criteria and diet quality was evaluated via the Healthy Eating Index (HEI) – 2010. Results Adolescents were allowed a mean allowance of €4.63 ± 3.66 daily. Among boys participants, BMI correlated with pocket money (r = 0.311, p ≤ 0.002) and normoweight boys received statistically less money than their overweight peers (p ≤ 0.019). In both sexes, normoweight was more prevalent in the lowest monetary quartiles. Pocket money was not associated with HEI. Among boys, moderate HEI was more prevalent in the third quartile of pocket money, significantly higher compared to all others (p ≤ 0.01 for all). For girls, the prevalence of moderate HEI declined by each ascending pocket money quartile (p ≤ 0.05 for all). Conclusion In our sample, adolescents exhibited high rates of pooled overweight including obesity. The majority of the participants followed a diet of moderate quality. Pocket money was associated with BMI only among boys. As pocket money was not associated with diet quality, it is highly possible that adolescents might choose to spend their money on items other than foods. Our study shows that pocket money should be controlled during adolescence and teenagers should be educated on spending their money on healthier food choices.