Volume 34, Issue 5

Objectives The study aimed to examine factors associated with past 30 days waterpipe use among high school students in Jakarta, Indonesia. Methods We surveyed a multistage cluster random sample of 1,318 students of grade 10th and 11th from 14 schools in Jakarta. Multiple logistic regressions were employed to examine the association between past 30 days waterpipe use with sociodemographic characteristics, cigarettes smoking status, parental and peer use, availability and affordability. Results Of 1,318 participants, 3.3% of female and 8.4% of male currently smoked waterpipe. Multivariate analysis revealed that current waterpipe use was significantly associated with family use (AOR: 4.844, 95% CI: 1.225–19.151), friend use (AOR: 2.554, 95% CI: 1.424–4.582), and availability (AOR: 2.143, 95% CI: 1.127–4.076). Being current smokers were six times more likely (AOR: 6.055, 95% CI: 3.123–11.739) to use waterpipe in the past 30 days. Conclusions The finding suggests that smoking by a family member, friends, use of conventional cigarettes, and availability are significantly associated with increased probability of current waterpipe used among adolescents.

Objectives Use of Psychoactive substances by young people poses an important public health threat despite mass campaigns and education. There have been documentations of rise in prevalence and use of psychoactive substances by Nigerian adolescents in urban areas of Nigeria. Few reports exist on in-school adolescents in rural areas, and differences in their sociodemographic profile such as public/private school attendance, day/boarding status and socioeconomic status of students. The study determined the rate and sociodemographic profile of psychoactive substance use among secondary school students in selected rural communities in Anambra state, Nigeria. Methods This was a cross-sectional study in which multistage sampling was used to select 494 students from selected secondary schools in Anambra state. Data on age, gender, socioeconomic status, student status, school category, alcohol, tobacco and intravenous drug use were obtained using pretested semi-structured questionnaires. Analysis of data was done using IBM SPSS statistics software version 20.0, frequency, percentages and means were calculated, with cross-tabulation done for variables (Chi-square and Fishers exact test where applicable). Level of significance for tests of association set at 5%. Results A total of 494 participants were studied of which 48.8% (n=241) were males. The mean age was 14.5 ± 1.8 years. The prevalence of lifetime use of psychoactive substance was 22.5%. Prevalence for individual substances were 21.9% (n=108), 1.8% (n=9) and 0.8% (n=4) respectively for alcohol, tobacco and illicit intravenous drugs. Neither gender {6 males (2.5%), 3 females (1.2%), p=0.890}, age {10–13 years (1.3%), 14–16 years (2.1%), >16 years (1.7%), p=0.329}, student status {day (2.6%), boarding (1.2%), p=0.320}, social class {upper (0.9%), middle (0.6%), lower (3.1%), p=0.208 } nor school category {private (1.5%), public (2.1%), p=0.742} of students was significantly associated with smoking and respectively. More males (73/241=30.3%, p<0.001) took alcohol than females (35/253 = 13.8%) and this was statistically significant. Participants from the lower socioeconomic class (30.3%, p<0.001) had a significantly higher rate of alcohol consumption than those from the upper (11.8%) and middle classes (16.7%) respectively. Higher rate was noted among those who attended public schools (30.8%, p<0.001) compared to those who attended private schools (13.8%). Day students (30.2%, p<0.001) indulged more in alcohol than boarding students (14.3%). There was no association between either the class (junior=22.5%, senior=21.3%, p=0.759) or age of participants (10–13 years=20.7%, 14–16 years=20.1%, >16 years=33.3%, p=0.071) and alcohol consumption. No association was found between age (0.7%, 1.1%, p=1.000), gender (male=1.2%, female=0.4%, p=0.362), social class (lower=1.3%, upper=0.9%, p=0.443), student status (day=0.9%, boarding=0.8%, p=1.000), school category (junior=0.8%, senior=0.8%, p=1.000) and intravenous drug use. Conclusions The rate of about 22% alcohol use by secondary school students in rural south eastern Nigeria, which is strongly associated with male gender, low socioeconomic status, day student status and public school attendance is high.

Background Recently television viewing and use of computers have increased considerably and has become a necessary evil in the society. The amount of Screen Time (ST) exposure of a child largely depends on the views of their parents. Screen time among adolescents have resulted in multiple problems Objective To explore the perceptions of parents of children aged 6–10 years and adolescents of 11–18 years residing in an area of urban Puducherry regarding screen-time and develop health education material to decrease ST. Materials and methods A community‐based, Qualitative study was conducted during April 2018 in Urban Puducherry. Two FGDs among the adolescents t and one FGD among the mothers of 6–10 years old children to capture their perceptions on ST Results and conclusion The three FGD included 30 participants. The main categories that evolved among the adolescents were Benefits, barriers and influencing factors of ST and ways to reduce them. Mothers expressed their concerns regarding screen time and efforts taken to reduce it. Our study showed that curtailing ST is possible by friendly parenting.

Objectives Hearing impairment and ear diseases are among the world’s leading causes of years lived with disability. Ear disorders are a major health problem in developing countries like India. The present research had been planned to screen the primary school children for ear morbidity and to study the various factors associated with ear morbidities so that corrective intervention can be initiated at the earliest. Methods A cross-sectional study was conducted among all primary school children of two schools in Aliganj, Delhi. Complete enumeration of all the school children of these two primary schools was planned for this study. Modified version of World Health Organization’s (WHO’s) “Ten Question Plus” screening instrument was used, followed by Otoscopy examination, in all children for confirmation of ear disease, if any. Descriptive data analysis was performed. Results Out of the total 430 study subjects, ear morbidities were found in 198 (46.0%) study participants. Presence of ear morbidity showed significant association with overcrowding, absence of a separate kitchen, passive smoking, feeding young child in lying down position, upper respiratory tract infection (URI)˃3 episodes/year and allergy (p<0.05). Conclusions This study has highlighted the need to detect ear diseases at the earliest thereby avoiding complications. The health examination in the schools must include screening students for ear diseases to reduce the burden of hearing disability. Inputs from the study may be used for effective prioritization and planning for prevention and management of ear diseases at the primary school level.

Objective School children are exposed to various social, environmental, nutritional and cultural changes which will influence their lifestyle and can impose behavioral change. This study was formulated to assess the lifestyle factors influencing the academic performance among secondary school students in an urban area of south India. Materials and Methods A cross sectional study was conducted among secondary school students of grade 8, 9 and 10 in public and private schools of an urban area. Data was collected using a pre-designed, pretested, questionnaire. Demographic data and socio-economic status was assessed. Lifestyle assessment included the dietary habits, physical activity, tobacco and other substance use and anthropometric measurements. Academic performance was assessed by attendance, past annual examination grades. Results were expressed in percentages and analysis was done using Chi-square test and Fischer exact test. Results Study participants included were 613. Overall prevalence of tobacco use 14.0%. Skipping breakfast was associated with poor performance (p=0.002) among public school students. Private school students’ academic performance was significantly associated with the BMI (p=0.03). Prevalence of underweight, overweight and obesity was 70.5, 5.0 and 5.5% respectively. Physical activity didn’t show any significant influence on academic performance (p=0.69, 0.76). Conclusion Academic performance of secondary school students is influenced by various factors including, regularity of attendance, socio-economic status, skipping breakfast and consumption of tobacco and other substances. Study establishes the need for proper motivation and reinforcement of safe healthy lifestyle practices to achieve complete academic excellence.

Objectives The existing level of the early age pregnancy necessitates in-depth discussions and study. The objective of this study is to explore the perception of rural population regarding adolescent pregnancy with reference to the perceived burden, causes and consequences. Methods A cross-sectional study through cultural domain analysis using free listing and participatory learning and action (PLA) tool of ten seed analysis was used for exploring the perceptions of the community. Cognitive salience was estimated using the Sutrop (Su) index. Results The perceived burden of adolescent pregnancy was around 18%. Early marriage (Su index = 0.274), love/relationship (Su index = 0.246), pre-marital sex (Su index = 0.215), rape/incest (Su index = 0.162), and poor educational status (Su index = 0.152) were the salient causes of adolescent pregnancy. The salient consequences identified were weak baby (Su index = 0.170), social stigma (Su index = 0.124), excessive bleeding during delivery (Su index = 0.114), mother may die (Su index = 0.112) and abortion (Su index = 0.109). Conclusions Teenage pregnancy is perceived as a problem by the community. The causes of teenage pregnancy in this setting are multi-dimensional and are deeply embedded in the system of local values, beliefs and practices.

Objectives Hair is important for individuals due to its cosmetic functions and its anatomical and physiological features. Hair loss in children significantly affects their social and psychological well-being and may lead to significant psychological distress in those not benefiting from medical and/or traditional therapies. Accordingly, the aim of the present study was to evaluate the self-esteem in children and adolescents with alopecia areata. Methods This comparative study included children and adolescents with the diagnosis of alopecia and age- and sex-matched healthy controls. Self-esteem was evaluated by the Rosenberg Self-Esteem Scale (RSES). Results The study included 64 patients with alopecia (M/F, 32/32; mean age, 12.2 ± 3.0 years) and 60 healthy controls (M/F, 30/30; mean age, 12.0 ± 3.0 years). Age (p=0.64) and sex (p=1.0) distributions were similar between the groups. Of the patients, 35 had alopecia areata, 21 had alopecia universalis, and eight had alopecia totalis. The RSES score of patients was significantly higher than that of the controls (median [interquartile range], 1 [0–2] and 1 [0–1], respectively; p=0.008). The distribution of the participants according to the level of self-esteem (low, moderate, and high) based on the RSES scores revealed that, the proportion of patients with low and moderate self-esteem were significantly higher as compared with controls (p=0.001). The diagnostic subtype and sex did not affect the distribution of self-esteem scores in both groups. Conclusions Hair loss is a significant factor affecting self-esteem of children and adolescents. Deteriorations in self-esteem may progress to psychological comorbidities if not approached, diagnosed, and treated timely and efficiently.

Objectives Adolescence, a crucial period for growth velocity including sexual maturation, is an important period of life and young adolescent girls need to have proper knowledge, positive attitudes and practice of balanced diet to achieve optimum growth and development. Considering its importance this study attempts to assess the knowledge, attitude and practice (KAP) of balanced diets among adolescent schoolgirls in Noakhali district, Bangladesh. Methods A descriptive cross-sectional study was conducted in three secondary schools in Noakhali district, Bangladesh. A multistage sampling techniques was used to select schools and study participants. A total of 485 adolescent school girls participated and a pre-designed, validated and structured questionnaire was used for data collection. In addition to descriptive statistics, chi-square test and logistic regression were employed for analysis. Results The results from the study revealed that more than half of the students did not have good knowledge about a balanced diet, 42.8% had a positive attitude, whereas the practice of consuming a balanced diet was rather low (only 4.5%). Students studying in government schools had better knowledge and attitudes than non-government school students. Moreover, 41.1% of students were underweight; more than 60% of respondent’s mothers did not have an education higher than secondary school and were mostly unemployed housewives. Parent’s education, mother’s occupation, and types of school have a strong association with KAP; however, father’s education and occupation showed an association of varying degrees. Being knowledgeable was related to positive attitudes, and students with good knowledge had (OR: 1.828; 95% CI: 1.270–2.631) more likely to have positive attitudes towards a balanced diet. Conclusions Thus, proper knowledge about a balanced diet should be introduced with basic nutritional knowledge to all levels of public education. Interventions and programs can be designed to improve knowledge, attitude, and more specifically the practice at the household level so that adolescent girls can have a proper diet during their sexual maturation phase.

Background Adolescent women are central for intergenerational health of human populations. Adolescent women are the most vulnerable to a range of reproductive health problems. One of the leading causes of death for adolescent women is complications from childbirth and pregnancy. Contraceptive prevents the occurrence of unwanted pregnancies and its complications, thus potentially lower the death rate for adolescent women. However, contraceptive use assumed to be affected by multilevel factors thus needs statistical modeling that account the effect of these factors. Understanding multilevel factors affecting contraceptive use among adolescent women is important for improving the access to and quality of health services. Objective The aim of this study was to assess the contraceptive use and its multilevel determinants among adolescent women in Tigray region. Methods A community based cross-sectional study was conducted. Women who were 15–19 years of age residing in the selected households at the time of data collection were included in the survey. Multi-stage cluster sampling was used to select study units. A multivariable two-level mixed effect binary logistic regression model was fitted to assess the effect of the explanatory variables on contraceptive use. Results A total of 1,755 adolescent women were participated. Of these 12.3% were contraceptive users. Pills (40%) and intrauterine device (30%) were commonly used contraceptive methods. Educational level, schooling, marital status, age, being informed about contraceptive, health facility visit, duration of stay at their residence, having partner and hearing of contraceptive use message through media were the most important determinants for use of contraceptive among adolescent women. Study participants who were not at school currently had more likely to use contraceptive methods compared to those who were at school (Adjusted odds ratio [AOR]=2.05; 95% confidence interval [CI]: 1.502, 4.183). Similarly, adolescent women who had no history of health facility visit had less likely to use contraceptive methods than those have history of health facility visit (AOR=0.057; 95% CI: 0.034, 0.096). Adolescent women who heard of contraceptive through median had two times (AOR=2.103; 95% CI: 1.207, 3.664) more likely to use contraceptive methods than those not heard contraceptive through media. Conclusion and recommendation The factors affecting use of contraceptive method among adolescent women were educational level, schooling, marital status, age, being informed about contraceptive, health facility visit, duration of stay at their residence, having partner and hearing of contraceptive use message through media. This study recommends that in order to increase use of contraceptive method among adolescent women, interventions should continue like the promotion of contraceptive methods through media.

Objectives Polycystic Ovarian Syndrome (PCOS) is one of the most common metabolic and reproductive disorders among women of reproductive age. In low income and developing countries like India, there are very high chances of developing PCOS due to marked variation between culture, ethnic groups, diet, lifestyle and genetic factors. This study aims to determine the burden of probable PCOS among college going students in Puducherry. Methods A cross sectional study was carried out among students aged 18 years and above in a Government College for Women located in urban Puducherry. A total of 610 students were selected through a cluster random sampling technique. A pretested validated proforma was administered after obtaining informed consent. Results 25.1% (21.8–28.7) of women were having probable PCOS, 18.7% (15.8–22.0) had irregular menstrual history, 8.4% (6.4–10.8) had Hirsutism and 2% (1.8–3.3) had both the symptoms. Regarding food habits, 43.1% were vegetarians and were having probable PCOS and this association was found to be statistically significant. No significant association was found between prevalence of probable PCOS and factors such as higher age, parental income, higher BMI and physical inactivity. Conclusions The present study found a high prevalence of probable PCOS among college going students, especially among study respondents who were obese, physically inactive and vegetarians compared to the counterpart. Earlier detection and proper management of the symptoms can avoid some major co-morbidity in the future. Therefore, screening is an important part in the diagnosis and management of PCOS among adolescent girls.

Objectives High school has been recognized as a critical period for many students. With the upcoming competition for university admission, they tend to encounter significant stress. Exceeding its optimal level, stress became debilitating and could escalate into school burnout, which entailed various negative outcomes. The current study, hence, was aimed to identify a protective factor that helped mediate the relationship between stress and school burnout in Thai high school students. Self-compassion was selected here, given its relevant conceptual grounds and its cultural relevance (i.e., Thai individuals shown to be particularly oriented toward self-compassion). Methods Data were collected from 170 Thai high school students, who responded to measures of stress, self-compassion, and school burnout. A structural equation model (SEM) was used to test the hypothetical model where the positive association between stress and school burnout was mediated by self-compassion. Results All indices of the model fits were confirmed, and the proposed model explained 80% of the variance in school burnout. Conclusion The role of self-compassion in alleviating the impact of stress on school burnout was shown and relevant implications were discussed.

Objectives Internet addiction is a pathological condition that drives a person to use technology excessively. Internet addiction can cause problems among adolescents to lose interest in everyday life and triggers social interaction problems. Aim: explaining the correlation between Internet addiction and adolescents’ social interaction. Methods This study was a correlational design with a cross-sectional approach. The sampling technique used was purposive sampling. Respondents in this study were high school adolescents aged 15–18 years (n=215). The independent variable used in this study was Internet addiction and dependent variable was adolescents’ social interaction (social interaction between adolescents and parents, peer, school environment and community). The level of Internet addiction was measured by the Internet Addiction Test (IAT) by Kimberly S. Young and Griffiths. The data obtained were analyzed using the Spearman rho. Results There was a significant that relationship between adolescent Internet addiction and interaction with parents (r=−0.568; p=0.000), peers (r=−0.587; p=0.000), and school environment (r=−0.213; p=0.002) but there was no relation between Internet addiction towards social interaction of adolescents with the community (r=−0, 090; p=0.191). Conclusions This study showed that Internet addiction could affect adolescent social interactions with parents, peers and their interactions in the school environment.

Objectives Malocclusion affects the psychological wellness and social interaction, impacting negatively on adolescents’ quality of life and self-esteem. Facial attractiveness is mostly based on the esthetics of the smile and patients seek orthodontic treatment mainly to improve aesthetics. The aim of this prospective clinical study is to compare the psychosocial impact of aligners (AL) and fixed appliances (FA) as orthodontic treatments in patients affected by craniofacial anomalies (CFA). Methods 100 syndromic Caucasian patients with CFA followed in two different hospitals were divided in two groups: 50 patients treated with AL and 50 patients treated with FA. The two groups were matched for gender, age and CFA and filled out a modified psychosocial impact of dental aesthetics questionnaire (mPIDAQ). Results Patients affected by CFA treated with AL reported a better psychosocial impact than patients treated with FA, showing higher esthetic self-perception and self-esteem, lower social interaction impairments, and lower physical/practical disturbances. Conclusions The results of this study suggest that AL could be a valid alternative, especially in complex patients with CFA. Since AL application requires more cooperative patients the orthodontist should dedicate more time to motivate the patient to adhere to the treatment schedule.

Objectives TikTok is a popular social media platform, especially among those who are 13–24 years of age. The purpose of this cross-sectional study was to describe the content of COVID-19 material on TikTok. Methods A total of 100 videos posted under the hashtag #Coronavirus were included in this study along with all (n=17) posts uploaded by the World Health Organization (WHO). Results Overall, these videos were viewed 1,194,081,700 times. The most commonly cited topics included anxiety (14.5%) with more than 190.6 million views and quarantine (10.3%) with 106.6 million views. Fewer than 10% of videos mentioned how the virus is transmitted, symptoms, and prevention. WHO videos more often focused on viral transmission and symptoms but covered these topics in fewer than 10% of the videos. Conclusions Although research suggests that cases of COVID-19 may be less severe in those under 18 years of age, social distancing remains paramount due to the possibility of transmission even in those with minimal or no symptoms. For young adults in particular, the WHO suggests staying connected through social media and making every attempt to stay positive. TikTok has the potential, not only to convey important health information, but to address these aspects of the COVID-19 pandemic as well.