Volume 33, Issue 1

Background Menstruation is a physiological process. Unfortunately, there is substantial lacuna in knowledge related to menstrual hygiene among females. Objectives To assess the awareness and prevailing practices of menstrual hygiene, prevalence of symptoms related to genito-urinary tract infection, and the factors influencing menstrual hygiene practices, among women of reproductive age in rural Puducherry. Methodology The study was conducted in March 2017 in rural Puducherry adopting a mixed-methods approach. A pre-tested semi-structured questionnaire was used for a quantitative survey among 357 women of reproductive age. Qualitative data was collected through focused group discussions (FGDs). Results The mean age of the participants was 28.25 + 9.25 years. Thirty-three percent of the respondents had menstrual knowledge prior to menarche. A total of 90.8% were aware that menstruation is a physiological process. The majority of respondents 94.1%, used sanitary napkins as absorbents during menstruation and 60.7% of them changed it 3 times a day. Regarding the method of disposal, 47.6% participants threw it into the routine waste and 43.8% burnt it after use. Among 8.9% of cloth users 62.5% used a new cloth for each cycle and 37.5% of respondents washed and reused the cloth. Satisfactory cleaning of external genitalia was practised by 62.2%. Only 11.2% respondents had symptoms related to genito-urinary tract infection. From FGDs it was observed that the several socio-cultural factors and taboos restrict them from practising safe menstrual hygiene practices. Conclusion Our study has revealed that most of the females are still unaware of menstrual hygienic practices which suggest the need for appropriate health intervention measures to be implemented for their well-being.

Television (TV) is a popular and effective media in the formation of behaviours, beliefs and emotions. Watching TV is a main hobby in people’s lives, and has become an increasingly more common hobby for children nowadays as opposed to several decades ago. However, while many studies have reported the negative effects, there have been little to no studies investigating whether a positive effect may exist. The aim of this study was to determine whether individuals who watch medical dramas are generally more knowledgeable about medicine than those who do not watch medical dramas. This was a cross-sectional survey of adolescents and young adults using an e-questionnaire. The questionnaire had four sections – a consent form, demographics of respondents, TV show(s) respondents watched and assessment of medical knowledge. Questionnaires were circulated to the international community, with a focus on respondents in Canada, the US and Nigeria. Responses were analysed using statistical analysis software. Between August and December 2017, a total of 746 consenting respondents completed the questionnaire. The average knowledge score of all respondents on medical terminologies was 6.80 out of 10. For respondents who had a history of watching medical TV shows, they were more knowledgeable than those without such a history (p = 0.0008). Additionally, those who watched more than one season of TV were more knowledgeable than those who had watched less than one season (p < 0.0001). The results suggest that people who have a history of watching TV shows are more knowledgeable than those without such a history, and also that those who watch more hours of medical TV shows are more knowledgeable than those who watch only a few hours. Future studies could investigate whether medical TV shows causes higher knowledge (as this study suggests association), and to ultimately determine whether it can be an essential component of increasing medical knowledge of the population, and in turn, patients.

Purpose To investigate, through a spatio-temporal analysis, the association between the percentages of live births of adolescent mothers (LBAM) and the human development index (HDI), including the three components: income, education and longevity. Methods The percentage of LBAM was obtained from the Brazilian Live Births Information System for the state of Minas Gerais, Brazil in the period 2000–2015 and the HDI data and its components were obtained from United Nations Development Program’s (UNDP) Human Development Reports. A generalized additive model (GAM) was used to estimate the relative risk of LBAM in relation to the HDI and to identify spatial clusters of the geographical distribution of LBAM, the Moran global and local index was used. Results There is an association between the HDI and its components with LBAM. The high values of relative risk are spatially concentrated in the northern part of the state of Minas Gerais. The graphs indicated a nonlinear relationship between LBAM over the years. Conclusions There is a strong spatial dependence of LBAM in Minas Gerais, which suggests that a geographical location plays a fundamental role in understanding it. The regional disparity confirmed in this study is inherent in the process of human development, it is important for planning actions aimed at the development of these regions in order to minimize existing disparities.

The aim of this study was to estimate the prevalence and correlates of having had sexual intercourse among adolescents in Brunei Darussalam. The sample included 2599 school-going adolescents that responded to the Global School-based Student Health Survey (GSHS) [mean age 14.7 years, standard deviation (SD) = 1.4]. Sexual behaviour with a range of other health behaviours and protective factors were assessed based on a self-report. The relationship between socio-demographic, substance use, psychosocial, protective factors and ever had sexual intercourse were assessed using logistic regression analyses. Results indicate that 11.3% ever had sexual intercourse and 2.1% had two or more sexual partners in their lifetime. Among the sexually active students, 50% had early sexual debut (<14 years), 38.3% had used a condom at last sex, and 31.8% had used other birth control at last sex. In adjusted analysis, older age [odds ratio (OR) = 1.58, confidence interval (CI) = 1.04, 2.42], current tobacco use (OR = 1.67, CI = 1.10, 2.52), current alcohol consumption (OR = 2.26, CI = 1.26, 4.93), history of attempted suicide (OR = 1.96, CI = 1.20, 3.19) and bullying victimisation (OR = 1.43, CI = 1.00, 2.05) were associated with ever having had sexual intercourse. Significant sexual risk behaviour was found and several risk factors identified for incorporation in comprehensive sex education.

Introduction Adolescence is associated with physical, social and personality changes. Adolescents usually face some fears during this period, the removal and adjustment of which requires family and teachers’ support and the lack of attention to the issues of maturity will have negative effects on their health, awareness and self-esteem. The aim of this study was to investigate the relationship between anxiety and social support among male and femaille students in high schools in the southeast of Iran. Materials and methods In this cross-sectional study that was conducted as a descriptive comparison, 452 students who were studying in the first period of high school in Kerman (junior high schools) were selected as the entire population by the cluster sampling method and the data collection instruments were: a demographic questionnaire, Philips Social Support Scale and the Cattle Anxiety Scale. As well as descriptive statistics, to test the hypothesis of this study by SPSS software, and in the case of abnormal distribution of each variable, non-parametric tests were used. Results The results showed that anxiety in girls is great than in boys, also data analysis through Pearson’s test showed that there is a negative and significant relationship between anxiety and social support in girls (r = −0.428, n = 226, p < 0.001) and boys (r = −0.378, n = 226, p < 0.001). Conclusion The results of research showed that by increasing perceptions of social support in students, their anxiety decreases. Therefore, paying attention to the social determinants of health such as social support is important and necessary to reduce the anxiety of students.

The study aimed to assess the prevalence of cannabis and amphetamine use and socio-ecological (proximal and distal) factors among adolescents in eight countries of the Americas. We analysed cross-sectional survey data from 44,904 adolescents [mean age 14.6 years, standard deviation (SD) = 1.4] from Argentina, The Bahamas, Barbados, Belize, Bolivia, Chile, Peru and Trinidad and Tobago that participated in the Global School-Based Student Health Survey (GSHS) in 2011–2013. The prevalence of the past month’s cannabis use was 8.3% and lifetime amphetamine use was 3.0%. In adjusted mixed-effects logistic regression analysis older age, male gender, personal attributes (anxiety, suicidal ideation, current tobacco use, current alcohol use, school truancy and sexual risk behaviour) and environmental stressors (having been in a physical fight, hunger, being bullied) were positively and parental support and peer support were negatively associated with the past month’s cannabis and/or lifetime amphetamine use. Measures to prevent and control cannabis and amphetamine use in this adolescent population should include personal attributes (mental health, substance use, school truancy and sexual risk behaviour), environmental stressors and parental and peer support.

Background/aim Sport-related concussion is associated with various short- and long-term health consequences, especially among adolescent athletes. Yet, many concussions go unreported and/or unrecognised. The purpose of this study was to assess high school athletes’ concussion-related knowledge, attitudes, intentions and reporting behaviours, and to explore whether gender differences are evident. Methods A total of 435 high school athletes (52.2% female; mean age, 14.55 ± 1.67 years) participated in the survey. Questions assessed athletes’ knowledge, attitudes, reporting intention and reporting behaviours, in respect to sports-related concussion. Comparisons between male and female athletes were explored using Mann-Whitney tests and chi-squared (χ 2 ) tests as appropriate. Results We found that 60% of the participants stated that they have played in practice or during a game (this season) with concussion symptoms. Males expressed more negative outcomes of concussion reporting and lower concussion reporting intention, compared to females. We found no significant gender differences in concussion-reporting behaviours. Conclusion Our findings suggest that knowledge, favourable attitudes towards reporting and reporting intention alone are not enough to create an environment that encourages the disclosure of concussion symptoms. Health promotion communication campaigns, coupled with concussion education and awareness programmes, should be utilised to further highlight the importance of timely concussion management, and to create a culture in which the reporting of concussion is considered normative.

Background Childhood overweight and obesity is a major public health concern all over the world. Overweight or obese children have a higher risk of becoming obese in adulthood and are at higher risk of associated chronic diseases. Objective The aim of this study was to determine the risk factors associated with overweight and obesity among urban school children and adolescents in Bangladesh. Materials and methods A case-control study was conducted among students aged 10–16 years in 10 schools of Dhaka city. A structured questionnaire was used to collect socio-demographic information and students’ exposure to various risk factors. Data were analyzed by using SPSS 23. Results Family income (p = 0.000), mother’s weight (p = 0.036), school activity (p = 0.046), total physical activity (p = 0.008), sedentary activities (p = 0.014), eating fast food (0.008) and cakes/biscuits (p = 0.018) were found as potential determinants of overweight and obesity of children and adolescents. A multiple logistic regression revealed family income >50,000 per month [adjusted odds ratio (AOR) = 3.07, p = 0.001], no physical activity (AOR = 38.3, p = 0.004), more than 4 h of sedentary activities (AOR = 4.84, p = 0.02), regular consumption of fast food (AOR = 3.05, p = 0.042) are risk factors associated with childhood overweight/obesity. Whereas, having a normal weight mother (AOR = 0.51, p = 0.037) and eating cakes/biscuits less than 3 days a week (AOR = 0.33, p = 0.02) were found as protective factors. Conclusion Findings from this study will be very useful for public health professionals to increase awareness regarding risk factors of overweight and obesity, in order to reduce the future burden of obesity-associated chronic diseases.

Introduction Addiction to the Internet and mobile phones in adolescents could be related to loneliness. However, less research has been conducted on this topic in developing countries. This study aimed to examine addiction to the Internet and mobile phones and its relationship with loneliness in adolescents in Iran. Method This was a cross-sectional and analytic study that was conducted between 2015 and 2016 in Rasht, in the north of Iran. Subjects were selected through cluster sampling from female and male teens who were studying in the public and private schools. The Kimberly’s Internet Addiction Test, Cell phone Overuse Scale (COS), and the University of California , Los Angeles (UCLA) Loneliness Scale were used for data collection. Results The mean age of participants was 16.2 ± 1.1 year. The mean of addiction to the Internet was 42.2 ± 18.2. Overall, 46.3% of the subjects reported some degrees of addiction to the Internet. The mean of addiction to mobile phones was 55.10 ± 19.86. The results of this study showed that 77.6% (n = 451) of the subjects were at risk for addiction to mobile phones, and 17.7% (n = 103) of them were addicted to their use. The mean of loneliness was 39.13 ± 11.46 in the adolescents. Overall, 16.9% of the subjects obtained a score higher than mean in loneliness. A statistically significant direct relationship was found between addiction to the Internet and loneliness in the adolescents (r = 0.199, p = 0.0001). The results also showed a statistically significant direct relationship between addiction to mobile phones and loneliness in the adolescents (r = 0.172, p = 0.0001). Conclusion The results of this study revealed that a high percentage of adolescents who have some degrees of addiction to the Internet and mobile phones experience loneliness, and there are relationships between these variables.

Background The World Health Organisation has reported that mental disorders are one of the leading causes of disability worldwide. Social phobia is one such mental disorder that can have significant impact on the livelihood of adults if not detected at an early stage. There have been very few studies done on social phobia among adolescents in South India. Hence, this study was done to determine the prevalence of social phobia and factors associated with it among the school-going adolescents in rural Puducherry. Methodology A community-based cross-sectional study was conducted among 1018 school going adolescents from December 2017 to January 2018 in rural Puducherry. Information on socio-demographic characteristics was collected by a pre-tested semi-structured questionnaire and social phobia was assessed using the validated Social Phobia Inventory (SPIN) questionnaire. Results Among 1018 participants, 738 (72.5%) belonged to early adolescence (10–13 years); 520 (51.1%) were boys; 557 (54.7%) were studying in a middle class; 931 (91.5%) were Hindus; 978 (96.1%) had siblings. The prevalence of social phobia among adolescents was found to be 22.9% (95% CI: 20.4–25.5%). The prevalence of mild social phobia was 18% [95% confidence interval (CI): 15.7–20.4%], moderate social phobia was 4% (95% CI: 2.9–5.4%), severe social phobia was 0.7% (95% CI: 0.3–1.3%) and very severe social phobia was 0.2% (95% CI: 0.03–0.64%). Higher age, female gender, lack of counselling services and specialist visits at school were found to be determinants of social phobia. Conclusion The current study showed that one in every five adolescents was at risk of developing social phobia. Health education for students, teachers and family members needs to be given to make them aware of the importance of social phobia.

Introduction Almost all the bone mass in females is accumulated during adolescence and especially in the years immediately following menstruation. Self-efficacy plays an important role in moderating the relationship between knowledge and behavior. This study aimed to determine the self-efficacy of osteoporosis preventive behaviors and its predictors in female high school students. Methodology This descriptive-analytical cross-sectional study was conducted on 330 female high school students in Saveh, Iran during 2016–2017. A two-stage cluster sampling method was used to select the participants. Data were collected using a socio-demographic questionnaire, the Osteoporosis Knowledge Test (OKT) and the Osteoporosis Self-Efficacy Scale (OSES). A general linear model was used to determine the self-efficacy predictors of osteoporosis preventive behaviors. Results The mean [standard deviation (SD)] of the total OKT score was 11.08 (4.08) of attainable range from 0 to 32. The mean (SD) of the total OSES score was 121.97 (37.36) of attainable range from 0 to 200. The mean (SD) of the exercise and calcium subscales of OSES were 58.39 (22.56) and 63.57 (21.02), respectively. There were significant relationships between the total OKT score with the total OSES score (r = 0.16, p = 0.003) and its subscales, including exercise (r = 0.16, p = 0.002) and calcium (r = 0.11, p = 0.03) scores. According to the adjusted general linear model, the variables of economic status, educational level and osteoporosis knowledge were predictors of the self-efficacy in the studied students. Conclusion Findings suggested that most of the students had moderate levels of knowledge and self-efficacy regarding osteoporosis preventive behaviors; therefore, improving the knowledge and self-efficacy of this group can play a significant role in promoting their health.

Introduction Head lice infestation is one of the main public health problems worldwide and a sanitary, cultural and economic indicator for communities’ health. This study aims to estimate the prevalence of head lice infestation among female primary school children in selected districts of Mazandaran Province, Iran. Methods In this cross-sectional study, 3033 female school children were recruited using the consensus method. Head lice infestation was defined as visible adult lice, nymph or egg with the naked eye. Data were described by percent frequency and analyzed using the chi-squared test and multivariate logistic regression models. A p-value less than 0.05 was considered significant. Results Prevalence of head lice infestation among female school children was estimated at 7.9%. The adjusted odds ratios (OR) [95% confidence intervals (CI)] for rural residents, low level educated mothers, family size more than five and not combing their hair were 1.96 (1.41–2.78), 2.46 (1.35–4.49), 2.04 (1.12–3.70) and 3.94 (1.73–8.96), respectively. In addition, considering first grade students as a reference group, the ORs (95% CI) for second and third grades were 1.89 (1.18–3.05) and 1.69 (1.05–2.74), respectively. Conclusion Our study showed that studying in urban schools, low educational level of mothers, grade, family size and no history of regular combing were predictors of head lice infestation.

Introduction Adolescence is a time of social and self-affirmation, search of autonomy and pleasure. An early sexual debut and substance use are still public health problems. Objectives To assess the prevalence of illicit drug use and sexual behavior of adolescents, ages 15– 17, followed in a Portuguese Family Health Unit. Material and methods This was a cross sectional descriptive study of a random convenience sample. Data were obtained from an anonymous and confidential questionnaire, given to patients at adolescent consultation, between the months of May and July 2016. Statistical significance p < 0.05. Results This study involved a sample of 134 adolescents, 54.5% girls. It was revealed that 73.1% of adolescents have tried alcohol, from which 18.7% experienced intoxication at least once. Regarding tobacco, 35.1% have tried it, 23.4% are regular users. Regarding cannabinoids, 7.5% of adolescents stated to have tried them once, or to consume them regularly. Adolescents start to experiment with tobacco earlier than with alcohol (9 years old vs. 11 years old), with a mean age of 15 years old. Regarding sexual behavior, 23.8% are sexually active, from which 9.4% do not use any form of contraception. Smoking behavior was a predictor of the consumption of illicit drugs, and it was found a significantly statistic association between sexual activity and substance use, p = 0.04. Discussion By descending order, the alcohol, tobacco and illicit drugs consumption are still worrisome and can affect the life of adolescents. Primarily health care and pediatric consultation should provide strategies for prevention and promotion of a healthy lifestyle for adolescents.

The links between the use of tobacco and health risks are well known. Most of the younger smokers reside in Asia which includes Qatar, the focus country of this study. Cigarette smoking among children is rising at an alarming rate worldwide including Qatar. As youth make up a significant percentage of the population and to achieve the health objectives of the Qatar Vision 2030, it is essential to ensure the health and well-being of adolescents, as they are the future of Qatar. This study focuses on exploring the patterns of tobacco use and its impacts on the adolescents by conducting a survey in different schools across Qatar. The questionnaire was administered in five schools, selected by proportional random sampling. The responses were recorded from the sample for general questions regarding interest in physical activities, relationship with family and friends, mental satisfaction, health, academics and access to cigarettes.

Background Adolescence is considered as a transition period from childhood to adulthood. This transition leads to various types of risk behaviors. Ten percent of adolescents suffer from a chronic illness that can limit their daily activities and which may exhibit higher rates of risk behaviors than those without chronic illnesses. Objective To evaluate the prevalence of risk behaviors in chronically ill adolescents compared to adolescents without chronic illnesses and their associated risk factors. Methods We enrolled 312 patients aged 10–20 years who visited Ramathibodi Hospital from January 2015 to December 2017. There were 161 adolescents with chronic illnesses and 151 without a chronic illness. We used a computer-based program for the Youth Risk Behaviors Survey as well as a confidentiality interview. Statistical analyses included the chi-squared (χ 2 ) and Student’s t-tests as appropriate. Results The risk behaviors in chronically ill adolescents were the following: learning problems, 86.3%; excessive screen time, 62.3%; unintentional injuries, 60.2%; depression, 38.5%; low self-esteem, 18.1%; substance abuse, 13% and sexual behavior, 6.2%. Youths with a chronic illness were more likely to report significantly higher risk of excessive screen time (62.3% vs. 48%, p = 0.01), depression (38.5% vs. 15.9%, p < 0.01) and, also low self-esteem (18.1% vs. 8.6%, p = 0.01) compared to those without chronic illness. Conclusions These results indicated that adolescents with chronic illnesses engage more in health risk behaviors and are prone to mental health and learning problems. These data emphasize the importance of health risk behavior screening and preventive counseling for young patients with chronic illnesses where these risks might worsen their disease.

Purpose This study aims to identify the prenatal and early life predictors of adolescence sleep problems. Methods Sleep data (n = 5081) from the 14-year (13.92 ± 0.34 years) follow-up of a birth cohort were analyzed to explore the predictors of adolescence trouble sleeping, nightmares, snoring and sleep talking/walking. Data from the antenatal period till adolescence were explored for identifying predictors of adolescence sleep problems. Modified Poisson regression with a robust error variance was used to identify significant predictors. Results Our results suggest that about a quarter of adolescents in our study sample had sleep maintenance problems (nightmares: 27.88%, snoring: 23.20%, sleepwalking/talking 27.72%). The prevalence rate of sleep initiation problems was even higher (trouble sleeping: 40.61%). Our results suggest that antenatal and early-life factors, e.g. maternal smoking, anxiety, sleep problems in childhood, attention deficit hyperactivity disorder (ADHD) symptoms, and poor health are significant predictors of adolescence sleep problems. Conclusions This study demonstrates the predictive role of prenatal and early life risk factors in adolescence sleep problems. It seems that exposure to prenatal and early life risk factors increase the vulnerability for sleep problems later in life, which is further supported by poor health and lifestyle choices in adolescence. Therefore, close observation and mitigation of factors associated with early life risk factors could be a potential strategy for preventing sleep problems later in life.

Background Healthy dietary behaviors have a significant impact on children’s health and development. Diets high in fruit and vegetables demonstrate a strong and consistent pattern for decreasing the risk of and providing benefits against cardiovascular disease, diabetes, obesity and many cancers. Yet, little is known about the pattern of fruit, vegetables and dairy products consumption among children in Saudi Arabia. Objectives The aim of this study was to investigate the consumption of fruit, vegetables and milk products and their dietary correlates among school boys in Saudi Arabia. Materials and methods A multistage stratified cluster cross-sectional survey, using a pre-tested questionnaire was conducted among school-children. The study sample comprised of 725 school students from ten randomly selected schools in Saudi Arabia. Results All surveyed schools (100%) neither provide nor sell fruit, fresh juices or vegetables on their premises. During regular weekdays, the majority of the children did not consume fruit (69%) and vegetables (71.4%) on daily basis. More than one third (32.4%) of the children did not consume dairy products daily. The daily consumption of fruit and dairy products were associated with young age [odds ratio (OR) = 1.5, confidence interval (CI): 1.1–2.2, p = 0.040] and (OR = 2.4, CI: 1.6–3.7, p = 0.001), respectively. Daily consumption of fruit was positively associated with daily consumption of vegetables (OR = 6.6, CI: 4.5–9.5, p = 0.001). Also, daily consumption of vegetables was positively associated with daily consumption of dairy products (OR = 1.5, CI: 1.1–2.2, p = 0.040) and inversely correlated with daily consumption of sweets (OR = 0.6, C.I: 0.4–0.9, p = 0.012). Moreover, the daily consumption of dairy products was associated with consuming high fat food daily (OR = 1.7, CI: 1.2–2.4, p = 0.002). Conclusion The findings indicated that a high percentage of children in Saudi Arabia had an unhealthy low consumption of fruit, vegetables and milk products. Thus, an intervention program to promote healthy dietary patterns is highly recommended. Improving school environments and establishing school-based nutrition programs are extremely needed to promote healthy dietary behaviors among this age group.

Background While studies on reproductive health issues are discussed widely, until recently early marriage among adolescent has not received enough attention across stakeholders in Indonesia. This research aims to analyze the determinants of early marriage among female adolescents in Indonesia. Methods This study employs data from the Indonesia Demographic and Health Survey (IDHS) 2012 on females aged 15–19 years (n = 7207). The analytical methods used to determine factors of early marriage were chi-square and multiple logistic regression. Results The results from this research revealed that four determinants are significantly related to early marriage among female adolescent. Females who have not completed primary school tend to be involved in an early marriage more often than those who graduated from high school. Furthermore, underprivileged females tend to get married earlier than those with a high socio-economic status. Additionally, females living in rural areas are more prone to early marriage than those living in urban areas. Finally, well-informed females tend not to get married as early as females who do not have access to media information. Conclusion A stakeholder policy is required that promotes the status of females by improving access to national education, particularly for females in rural areas and those who live in poverty. Marketing and advertising media campaign targeting adolescent are needed to ensure greater access to information.

Background Adequate attention to adolescents’ health is considered an investment for the future of any country. Adolescents face many social and cultural challenges when they enter a new stage of social life. The advancement of adolescent social health depends on the recognition of their needs. This study aimed to explain the concept of social health needs from the perspectives of male adolescents to improve the health of both adolescents and the society. Method In this qualitative study with a content analysis approach, 52 male adolescents aged 13–18 years participated in 10 semi-structured individual interviews and seven focus group discussions. They expressed their experiences and opinions regarding social health needs. Purposive sampling was performed to recruit the adolescents in different areas of Tehran in 2017. Collected data was analyzed using the conventional content analysis method. Results The findings were divided into four main themes and eight sub-themes including “need to have a healthy family (healthy family relationships and family responsibility)”, “need to have a healthy society (favorable social status and favorable economic situation)”, “need to have educational facilities (promoting productivity in schools and public education facilities)”, “need to have communication with peers (healthy communication with peers and setting up for communication with peers of the opposite gender)”. Conclusion To promote social health in adolescents, it is necessary to plan for the empowerment of community, family, schools and mass media by health authorities and devise appropriate health policies.

Electromagnetic radiation is the fastest growing environmental factor due to the vast development in technology in the last decades. Awareness about radiation has received more attention worldwide due to its health hazards. Adolescents are exposed to radiation from various sources on a daily basis. The number of studies conducted to assess the knowledge and perception of adolescents and young adults regarding radiation and its risks is limited, especially in the Middle East. The aim of this study was to assess the knowledge and perception about radiation and its associated hazards among adolescents and young adults. Additionally, our aim was to identify the best methods of education regarding radiation and its protective measures. A cross-sectional study was conducted among 506 participants in Saudi Arabia. It was found that the overall knowledge and awareness on radiation sources and its hazards among adolescents and young adults is inadequate. The majority of participants had misconceptions regarding radiation sources and its detriments to health. Socio-demographic variables were associated with the participants’ perception. Educating adolescents on radiation and its safety measures is much needed. It was found that the most preferred methods of education are social media and health care providers. The findings of this study will provide insight when designing future interventions to promote specific messages to enhance knowledge and improve awareness regarding radiation.

Objective This qualitative research aims to understand how Bangkok youths perceive social media usage effects on their physical, psychological, social and spiritual health. Methods A total of 74 Bangkok youths, aged 15–24 years old, divided according to each age and gender group participated in in-depth interviews and mobile phone search observations. Health impact was categorized into the four health aspects through content analysis according to sociological perspectives. Results Bangkok youths view social media to have both positive and negative effects on their health. Increased awareness of negative results was shown with increased age. While younger youths use social media for entertainment, older youths also use social media for self-development. Interests and degree of sensitivity varied among the genders. Conclusion Effective health education can only be achieved through future youth-centered research on social media usage based on age, gender and cultural variations.

Background The syntactic structures used by adolescents can be calculated by measuring various markers that have the scope of developing with age. The use of such markers can be influenced by the type and modality of discourse on the individual uses. Aims The present study was aimed at exploring the syntactic development in 10–16-year-old Indian adolescents using markers such as sentences, clauses, subordinators, coordinators, T-units and the subordination index (SI) using written expository texts. Methods The study followed a cross-sectional study design following a non-random convenient sampling procedure. A total number of 180 typically-developing adolescents divided into six groups participated in the study. Phase 1 of the study comprised the preparation of the stimuli; Phase 2 included the data collection; Phase 3 focused on the data analysis; and Phase 4 involved the statistical analysis performed on the obtained data. Results One-way analysis of variance (ANOVA) revealed a main level of significance at p < 0.05 for all variables (except SI) indicating an overall change in the development across the six age groups. Bonferroni’s post hoc analysis indicated poor significance between the groups in almost all the six variables. Conclusions Understanding the syntactic markers in the language of adolescents is essential to determine the academic and communicative effectiveness of these individuals.

Background Orofacial trauma is one of the most prevailing oral health problems among the children. This study aimed to assess the prevalence and distribution of traumatic injuries and to correlate the causes, specific age groups, socio-economic status, occlusal relationship and ascertain the percentage of those seeking the treatment among school children in Indore (Madhya Pradesh, India). Materials and methods Five thousand school going children aged between 3 and 17 years belonging to different zones of Indore were randomly selected and divided into three age groups, Group I – 3–5 years; Group II – 6–11 years and Group III – 12–17 years. The study was carried out by a single investigator and assisted by a well-trained cooperative alert assistant. An American Dental Association (ADA) type 3 examination was carried out using a mouth mirror and explorer under sufficient natural light. Traumatic injuries to the anterior teeth were recorded according to the Ellis and Davey classification. Details were noted concerning the gender, age and socio-economic status of patient; cause of trauma, number, type and relationship of teeth, lip competence and the level of unmet treatment needs. Results One thousand and seventeen children had traumatized anterior teeth with a mean prevalence of 20.34%. Prevalence was more in boys than in girls with a ratio of 2:1. Single tooth injury was observed in 81.7%. The prevalence of trauma was highest in the upper socio-economic class (31.4%) and least was seen in lower class (14.8%). The most common cause of trauma was from a fall (36.72%). Maximum prevalence was seen in either class II division 1 malocclusion or distal step terminal plane primary molar relationship. Only 2.95% of the children had undergone treatment for traumatically injured anterior teeth. Conclusion High prevalence of traumatized teeth with the low percentage of children receiving treatment emphasizes the need for education programs about traumatic dental injuries that should be directed towards the children, parents and school teachers.

Background The aim of the study was to evaluate the dynamic thiol/disulfide homeostasis (TDH) with a new method in patients with pubertal gynecomastia and also to investigate the relationship between sex hormones. Methods Thiol/disulfide homeostasis, involving native thiol (SH), disulfide (SS) and total thiol (SS + SH), was evaluated between 20 adolescent boys with gynecomastia in mid-puberty and 50 healthy adolescents, who were matched for age, body mass index (BMI) and pubertal stage. The correlations of total serum testosterone (TT) and estradiol (E2) levels with the oxidative parameters were also determined. Results No significant difference was found between the total thiol, native thiol, disulfide/native thiol and disulfide/total thiol ratios of the patient and control groups. The mean disulfide concentrations, disulfide/native thiol and the disulfide/total thiol ratios were statistically significantly higher in the patient group than in the controls. A positive correlation was found between the E2 and native thiol levels, also there was a negative correlation between the E2 and disulfide levels. TT was negatively correlated with both native thiol and disulfide levels. All these did not statistically differ between the patients with unilateral and bilateral gynecomastia. Conclusions There was an impaired thiol/disulfide homeostasis in patients with pubertal gynecomastia. According to this result, we can postulate that oxidative stress may be an etiologic factor that contributes to initiation and/or progression of gynecomastia.

Background The majority of students spend time in writing, which is a prime performance measure in examinations. Enhancement in handwriting should benefit students to attain better academic performance. Objective To assess the effectiveness of taping and exercises on hand function, writing speed, self-perception of writing and to compare these techniques. Methods A randomized control trial was conducted using cluster sampling in adolescent children across four schools in an urban city. A 4-week intervention study was conducted on 123 students divided into taping, exercise and control groups. Outcome measures were grip strength, pinch strength, 12-min writing speed test and the Writer Self-Perception Scale (WSPS). For intra-group analysis, a paired t-test was used for parametric values and the Wilcoxon signed rank test was used for non-parametric values. For inter-group analysis, one-way analysis of variance (ANOVA) for parametric values and the Kruskal-Wallis test for non-parametric values was used. Results The taping group showed a significant improvement in grip strength (1.79 kg; p = 0.00), pinch strength [1.67 lb (757.4 g); p = 0.00] and writing speed (39.77 words/12 min; p = 0.00). The exercise group showed significant improvement in grip strength (2.09 kg; p = 0.00), pinch strength (1.28 lb; p = 0.00), writing speed (28.38 words/12 min; p = 0.00). In the control group, there was a significant increase in pinch strength (1.023 lb; p = 0.01) and writing speed (12.94 words/12 min; p = 0.02). Inter-group analysis showed significant difference in writing speed (p = 0.002) and grip strength (p = 0.00). There was no significant difference in perception (p = 0.071). Conclusion Taping and exercise are equally effective for enhancement of hand function, writing speed and self-perception in adolescent school children.

Aim The reported incidence of isolated hemihyperplasia (IH) has a very wide range (from 1:13,000 to 1:86,000 live births) and further clarification is needed. We hypothesized that a survey of the birth prevalence of IH among newborn infants may underestimate the incidence of IH by overlooking late-onset cases. Methods The prospective international multicenter study utilized the two-steps selection tool for an anonymous survey of volunteers of 15–18 years old. The initial step was “three measurements-three questions” screening, or “face-palms-calves survey”. The subsequent step was an in-depth assessment of selected cases to exclude localized, lesional and syndrome-related cases as well as body asymmetry within normative range and to select suspected cases of IH. This step included measurements of various anatomical regions and a subsequent questionnaire. The participants that were selected in a risk group were advised to refer to medical institutions for clinical, genetic and instrumental investigation. Results Out of 6000 of selected participants (male, M 3452, female, F 2548), 229 (3.82%) were selected for detailed investigation and 57 (0.95%) were assigned to the risk group. Only 36 of them were actually referred to medical institutions and in two cases the diagnosis of IH was confirmed. Conclusion Our survey indicated the prevalence of IH at the age of adolescence as approximately 1:3000. While IH is a hereditary genetic disorder, it may not be detected in newborns and infants and the true prevalence of the disease can be estimated if older age children are screened.

Background Adolescent depression is a significant health problem which can lead to detrimental consequences. This study aimed to determine the prevalence of the depression in a sample of secondary school students, to identify its associated factors and to explore the co-occurrence with symptoms of anxiety disorders. Materials and methods We conducted, in March 2017, a cross-sectional study that included, using a cluster sampling technique, 386 students from five public secondary schools in El Kef (Tunisia). Data were collected using a socio-demographic questionnaire and the Arabic versions of the Beck Depression Inventory (13 items) and the Screen for Child Anxiety Related Disorders. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 20. Results The prevalence of depression among participants was 75.9%. Of depressed students, 30.4% had mild depression, 48.8% had moderate depression and 20.8% had severe depression. The logistic regression analysis showed an association between the depression and the female gender [odds ratio (OR) = 2.59, 95% confidence interval (CI): 1.52–4.17], the 1st and 4th school grades (OR = 1.79, 95% CI: 1.09–2.94), the low and medium socioeconomic status (SES) (OR = 1.91, 95% CI: 1.14–3.18), the school dissatisfaction (OR = 2.77, 95% CI: 1.41–5.44) and the anxiety disorders (OR = 5.86, 95% CI: 3.54–9.70). The comorbidity “depression and anxiety” was found in 86.1% of students. Conclusion This high prevalence of depressive symptoms reported in the present study seems to have many implications especially for school health-care services.

Introduction Human sexual activity is one of the main aspects of life. The present study intended to determine the status of sexual function in pregnant adolescents at their second trimester of pregnancy and its predictive factors. Materials and methods This cross-sectional research studied 136 adolescents aged 15–19 years in their 24th–30th gestational weeks. All eligible pregnant adolescents in all 80 health centers of Tabriz, Iran were considered as the study samples. The data were collected using a socio-demographic questionnaire, the Female Sexual Function Index (FSFI) and the Conflict Tactics Scale (CTS2). A general linear model was used to determine the relationships between sexual function and socio-demographic characteristics and intimate partner violence (IPV). Results The frequency of sexual dysfunction in pregnant adolescents was about 65%. The mean [standard deviation (SD)] of total sexual function score was 25.3 (5.9) from the attainable score of 2–36. The pregnant adolescents obtained the lowest and the highest mean scores in the sexual desire and sexual satisfaction subscales, respectively. Shorter marital duration and IPV were sexual function predictors. Conclusion Considering the high prevalence of sexual dysfunction in pregnant adolescent, and the impact of IPV on sexual function, midwives should take the necessary actions in identifying and consulting this disorder and IPV in their prenatal visits.

Background Earlier studies suggested a positive impact of spirituality on addictive disorders, but this effect has rarely been studied in a large adolescent and young adult population. Aim To examine the association between spiritual beliefs (general belief, the supporting role of spiritual belief, the critical role of spiritual belief) and potentially addictive behaviors (tobacco, alcohol, cannabis and other illegal drugs, excessive Internet use and gambling). Methods Data were collected using online self-report questionnaires among a sample of 5179 adolescents and young adults aged 15–24 years in post-mandatory education in Switzerland. Statistical analysis at bivariate and multivariate level was performed. Results At the bivariate level, spiritual beliefs were linked to a lower risk of tobacco smoking, alcohol misuse and cannabis use as well as an increased risk of Internet overuse and gambling. However, at the multivariate level, controlling for age, gender, language and place of birth, significant associations were found only for alcohol misuse, Internet overuse and gambling. Conclusion The study provides evidence that spiritual belief could protect youth from the risk of alcohol misuse but could also increase the risk of excessive Internet use and gambling. The role of spiritual beliefs in preventing or motivating these problematic behaviors is of great interest for adolescent health care providers and should be considered in the light of the separation-individuation process and transition from adolescence to adulthood.

Violence has a profound negative impact on the lives of youth. Exposure to violence may be a precursor to violence later in life. The purpose of this study was two-fold: (1) to estimate the prevalence of violence depicted in advertisements on LinkNYC kiosks in Manhattan, NYC, and (2) to determine if violent advertising varied based on the median annual income of the zip code in which the kiosk was located. This cross-sectional study involved observations of advertisements on 100 LinkNYC kiosks that were selected randomly from 500 that were listed in Manhattan, NYC. The frequency and type of violent depictions were recorded. The kiosks were grouped into quartiles of median annual income (1) $40,782 and below (2) $40,783 to $86,801 (3) $86,802 to $105,500 and (4) $105,501 and above. Of the 2025 total advertisements observed, including duplicates, a total of 190 (9.4%) included violent content. These 190 advertisements were observed on 68 of the 100 kiosks and included 339 depictions of violence. The overwhelming majority (n = 136; 71.6%) of violent depictions were for movies. There were significant differences in the frequency of violent content based on income quartiles, χ 2 (3, n = 190) = 19.00, p < 0.001. The highest two income quartiles had fewer violent advertisements than would be expected and the lowest quartile had more violent advertisements than expected. Symbols of violence were the most frequent type of violence portrayed observed in 85% of the violent advertisements observed (n = 161). Weapons, crime and fighting were observed in 5–11% of the advertisements. Our study suggests that greater alignment between the city’s aims to improve community health and reduce health disparities and advertising policies on LinkNYC warrants consideration.

Background Excessive sodium intake is a risk factor for developing systemic arterial hypertension. Increased blood pressure during childhood increases the risk of hypertension in adulthood. Assessing sodium intake across different eating places is important, as the meals offered in different places can influence dietary quality. Objective This study aimed to assess the contribution of different food groups to the mean of sodium intake of school-attending adolescents in the city of Niterói, a metropolitan area of Rio de Janeiro, Brazil. Subjects A total of 347 public school students aged between 10 and 18 years participated in the study. Methods Food consumption was based on two 24-h dietary recalls. The reported items were grouped into 31 food groups and the percentage of contribution of each food group to total mean sodium intake was estimated. Sodium intake according to eating place was also estimated. Results The food groups mostly contributing to total sodium intake were rice, beans, savory biscuits, breads, beef, poultry, processed meat, filled cookies, pasta and potatoes. The highest sodium intake within the food groups occurred at home, except for savory biscuits and pizza, which showed a higher sodium intake percentage at school. Savory biscuits were the third-most consumed item contributing to the total sodium intake and were the main source of sodium when consumed at school (48.9%). Conclusion Most sodium intake stemmed from ultra-processed food consumed at school. Therefore, actions to promote healthy eating habits within the school environment are necessary.