Body Dissatisfaction and Health Risk Behaviors Among Middle School Girls

BACKGROUND

Previous studies demonstrate a relationship between body dissatisfaction and substance use and suicidal ideation among older adolescent girls and young women while less documentation exists for early adolescence. This study explored the relationship between reported weight loss attempts and substance use history and suicidal thoughts among younger female adolescents.

METHODS

Participants (n = 1656) were middle school female students who participated in the 2019 Youth Behaviors Risk Survey. Participants were coded as "Trying to lose weight" and "Not trying to lose weight." Two hierarchal multiple binary logistic regressions were conducted, 1 for each of the dependent variables: (1) substance use history and (2) suicidality.

RESULTS

Fifty-seven percent of the participants were trying to lose weight, 40% reported suicidal thoughts and 45% reported substance use history. Trying to lose weight was a significant predictor for both substance use (p < .01) and suicidality (p < .001).

CONCLUSIONS

Body dissatisfaction and its association with risky health behaviors highlight the need for prevention education at earlier ages while reinforcing the need for availability of school counselors.

Health Providers' Response to Female Adolescent Survivors of Sexual and Gender-Based Violence and Demand Side Barriers in the Utilization of Support Services in Urban Low-Income Communities of Nigeria

Survivors of sexual and gender-based violence (SGBV) are often hindered in their quest to access quality healthcare. This has a significant effect towards the achievement of Sustainable Development Goal SDG Target 3.7. to ensure universal access to sexual and reproductive healthcare services. This study is focused on identifying some of the demand side barriers in accessing health care services, particularly among young girls who are survivors of SGBV within intimate relationships in poor urban areas in Nigeria. The study used an ethnographic approach to solicit information from health providers, adolescents, and young women (AYW) in 10 low-income communities in two major cities in Nigeria, Ibadan and Lagos. Findings showed that there are structural limitations within the primary health care (PHC) system that posed a great challenge for survivors of SGBV to access services. Some of these include non-existing counseling services, a lack of rehabilitation centers, poor referral, and a lack of training for health providers in handling survivors of SGBV. There is also a lack of skills among health service providers that have negative influence on support services to survivors of SGBV. On the demand side, poor knowledge of possible health seeking pathways, a lack of education, and social support are barriers to accessing appropriate services among adolescent and young SGBV survivors. The study concluded that integrated services at the PHC level should include adequate and timely treatment for survivors of SGBV and targeted intervention to upscale skills and knowledge of health care providers.

Anemia in female adolescents at Karanganyar regency: A cross-sectional study associated with polymorphism of duodenal cytochrome B gene and daily consumptions of fruits and vegetables

BACKGROUND

The prevalence of anemia in female adolescents increases every year. A duodenal Cytochrome B (CYBRD1) enzyme is involved in the regulation of iron metabolism. G797A gene polymorphism of the CYBRD1 reduces nonheme iron transport into the enterocytes, which was mediated by the divalent metal transporter 1 protein. Daily consumption of fruits and vegetables has been recommended for the prevention of non- communicable diseases, including anemia.

AIM

This study aimed to analyze the association of CYBRD1 polymorphism and daily consumption of fruits and vegetables with anemia in female adolescents in the Karanganyar regency.

METHODS

This cross-sectional study recruited 233 female students in 6 senior and vocational high schools in Karanganyar regency, which were selected using purposive sampling. Data on fruit and vegetable consumption were collected using Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ). Polymorphism of the G797A CYBRD1 gene was determined using the amplification refractory mutation system polymerase chain reaction. All collected data were analyzed using chi-square and multiple logistic regression tests with p < 0.05.

RESULTS

Anemia was found in 13.73% of female students. Inadequate intakes of fruits and vegetables were found in 63.09 and 51.07% of female students, respectively. The AA genotype (OR =  5.779; 95%CI: 0.974-34.289; p = 0.053), inadequate fruit consumption (OR = 1.497; 95%CI: 0.603-3.718; p = 0.133), and inadequate vegetable consumption (OR =  11.99; 95%CI: 3.457-41.586; p < 0.001) increased higher risk of anemia, compared with their counterparts.

CONCLUSIONS

G797A CYBRD1 gene polymorphism and daily consumption of vegetables increase the risk of anemia but not for daily consumption of fruits in female adolescents in the Karanganyar regency.

Prevalence and Risk Factors of Internet Gaming Disorder Among Female Secondary School Students in Al-Ahsa, Kingdom of Saudi Arabia

OBJECTIVES

This study measured the prevalence and potential risk factors of Internet gaming disorder (IGD) among female secondary school students in Al-Ahsa, Kingdom of Saudi Arabia.

METHODS

This cross-sectional study was conducted between January and February 2023. A total of 400 female secondary school students in Al-Ahsa were recruited through multistage stratified cluster sampling. Data were collected by distributing a self-administered questionnaire among students. A chi-squared test was performed to compare categorical variables. The associations between IGD, depression, and anxiety scores were determined using the Pearson correlation coefficient.

RESULTS

Among the total sample, 282 were classified as "gamers" and included in our analysis. The prevalence of IGD was found to be 19%. We also found a statistically significant and moderately positive correlation between IGD and anxiety and depression scores. Spending more than four hours daily playing video games, starting to play video games at less than seven years of age, having depression, having anxiety, and playing an online game were found to be potential risk factors for IGD.

CONCLUSION

IGD among female adolescent students in Al-Ahsa is a public health concern that requires attention from the concerned parties. Health education projects on IGD, its risk factors, and its consequences should be designed for adolescents and their families.

Gaming among female adolescents: profiling and psychopathological characteristics in the Indian context

Objectives

Gaming is a predominant leisure time activity among adolescents, and the literature suggests that unrestrained gaming behavior might lead to gaming disorder. ICD-11 and DSM-5 have recognized gaming disorder as a psychiatric condition and grouped it under the behavioral addiction category. Research on gaming behavior and addiction is largely based on data from the male population, and problematic gaming has largely been understood from the male perspective. In this study, we are attempting to bridge the existing lacuna in the literature by exploring gaming behavior, gaming disorder, and its related psychopathological characteristics among female adolescents in India.

Methods

The study was conducted on a sample of 707 female adolescent participants who were contacted through schools and academic institutes in a city in Southern India. The study adopted a cross-sectional survey design, and data were administered using the mixed modality of online and offline data collection. The participants filled out the following set of questionnaires: socio-demographic sheet, Internet Gaming Disorder Scale-Short-Form (IGDS9-SF), Strength and Difficulties Questionnaire (SDQ), Rosenberg self-esteem scale, and Brief sensation-seeking scale (BSSS-8). The data gathered from the participants were then statistically analyzed using SPSS software version 26.

Results

The descriptive statistics revealed that 0.8% of the sample (i.e., five participants out of 707) obtained scores meeting gaming addiction criteria. Correlation analysis demonstrated a significant relationship between all the psychological variables with total IGD scale scores (p < 0.05). Total SDQ, total BSSS-8, and domain scores of SDQ, such as emotional symptoms, conduct, hyperactivity, and peer problems, were positively correlated, whereas total Rosenberg scores and domain scores of prosocial behaviors of SDQ were negatively correlated. The Mann-Whitney U-test was employed to compare "with gaming disorder" and "without gaming disorder" categories of female participants. Comparing these two groups revealed significant differences in emotional symptoms, conduct, hyperactivity/inattention, peer problem, and self-esteem scale scores. Furthermore, quantile regression was computed, showing that conduct, peer problem, and self-esteem displayed trend-level prediction for gaming disorder.

Conclusion

Female adolescents prone to gaming addiction can be identified through psychopathological characteristics of conduct, peer problem, and low self-esteem. This understanding can be useful in developing a theoretical model focusing on early screening and preventive strategies for at-risk female adolescents.

Sex for food: a transactional sex reaction to the COVID-19-induced rise in the prevalence of hunger among in-school female adolescents in Ogun State, Nigeria

Introduction

COVID-19 has doubled the proportion of people with acute hunger globally and Nigeria is categorized as having a "severe" form of hunger. Vulnerable groups responding more to hunger stressors include the female adolescents who transact sex for both survival and luxury purposes. This study assessed the engagement in transactional sex to obtain food among female adolescents in Ogun State, Nigeria.

Methods

this descriptive cross-sectional research was conducted among 668 in-school female adolescents that were selected through a multistage sampling method. Data were collected with a structured interviewer-administered questionnaire. Food security was assessed using a standard tool while engagement in transactional sex was elicited through self-report. Data analysis was done using Statistical package for the social sciences (SPSS) version 25. Logistic regression was used to find factors associated with transactional sex. P< 0.05 was taken as statistically significant.

Results

the mean age of the respondents was 15.18±1.35 years. More than two-fifths (41.5%) were staying in households without food security. Less than one-fifth (15.3%) were engaging in transactional sex. Having emotional stress (OR = 4.33; 95 CI: 1.37-13.63), mother´s education (OR =0.163; 95% CI: 0.057- 0.461), having sexual partner (OR = 0.132; 95% CI: 0.047-0.370 and missing classes (OR 3.35, 95% CI: 1.084-10.331) were significant predictors of engaging in transactional sex among female adolescents.

Conclusion

transactional sex is commoner among female adolescents who were missing classes, had sexual partners, and were emotionally stressed. There is a need for intervention programs to protect the female adolescent, delay sexual debut and improve academic performance among them.

Diversity of Profiles and Coping Among Adolescent Girl Victims of Sexual Dating Violence

Sexual dating violence (DV) is common among female adolescents, and victims may experience other forms of DV (physical, psychological, and cyberviolence) and report a history of child sexual abuse (CSA). Heterogeneity of these victimization experiences could influence how adolescent girls' cope. We aimed to identify distinct profiles of victimization experiences among adolescent girls who reported sexual DV and to explore if these profiles were associated to their coping strategies. Of an initial sample of 1,300 female adolescents who completed online questionnaires, 835 (M_age = 16.8 years) reported at least one experience of sexual DV and were included in the analyses. Hierarchical classification with the Two Step analysis revealed four distinct profiles of victimization. A first cluster named Moderate CSA & Cyber-sexual DV (21.4%) is characterized by moderate percentage of all forms of victimization. The second cluster CSA & DV excluding cyber-sexual DV (34.4%) included victims of traditional DV, moderate rates of CSA and no experience of cyber-sexual DV. A third cluster CSA & DV Co-occurrence (20.6%) regrouped victims who have experienced different forms of DV in co-occurrence and CSA. Finally, the fourth cluster, named No CSA & DV Co-occurrence (23.6%) involved victims who have experienced different forms of DV in co-occurrence, but did not report a history of CSA. Analyses revealed significant differences between the profiles on the use of avoidance coping, in their perceived social support, and on help-seeking strategies deployed toward a partner and a health professional. These findings offer cues for prevention and intervention efforts for victimized female adolescents.

Association of malnutrition and main-meal- and snack-predominant intake among female adolescent students in boarding schools in Tasikmalaya, Indonesia

Background: Balanced dietary intake is needed to prevent malnutrition which is one of the nutritional problems faced by adolescents. Aim: To study the association between predominant dietary intake and nutritional status of female adolescent students in boarding schools in Tasikmalaya, Indonesia. Method: This cross-sectional study was conducted on 323 female adolescent students residing full-time in eight boarding schools in Tasikmalaya, West Java. Students' dietary intake was measured using the 3-non-consecutive-day 24-h recall method. The association between the predominant dietary intake and nutritional status was evaluated using binary logistic regression. Results: Of the 323 students, 59 (18.3%) were overweight/obese (OW/OB) and 102 (31.6%) had stunted growth. The predominant dietary intake in the OW/OB group was snacks, whereas, in the stunted group, it was main meals. Snack-predominant dietary intake was a risk factor for overweight and obesity (p  =  0.008; adjusted odds ratio [AOR]: 2.276; 95% confidence interval [CI]: 1.244-4.164), but it was a protective factor against stunting (p  =  0.008; AOR: 0.521; 95% CI: 0.322-0.842). Conclusion: The predominance of main meals and snacks as components of total dietary intake affected the nutritional status of female adolescent students living in boarding schools. Therefore, the dietary intake interventions should tailor and design the nutritional contents of main meals and snacks according to the nutritional status of the targeted individuals.

Cyber Dating Abuse Victimization and Experiential Avoidance Among Chinese Female Adolescents: The Roles of Self-Compassion and Interpersonal Flexibility

Cyber dating abuse victimization (CDAV) among female adolescents is common and harmful; however, little is known regarding how CDAV relates to victims' experiential avoidance in the Chinese context. Drawing from general strain theory, this cross-sectional study investigated possible differences in the relationships among CDAV, experiential avoidance, and self-compassion according to female adolescents' levels of interpersonal flexibility (low vs. high). A sample of 420 female adolescents aged 13 to 17 years (mean age = 15.78 years) who had been in intimate relationships during the past year participated in a voluntary and anonymous paper-and-pencil survey. Participants completed four self-reported measures on CDAV experience, self-compassion, experiential avoidance, and interpersonal flexibility. The findings indicated that nearly 49% of participants had experienced CDAV in the last year; CDAV exposure was directly linked with experiential avoidance and indirectly related to experiential avoidance through self-compassion. Moderation analyses showed that the negative associations between CDAV and experiential avoidance and self-compassion were only significant among participants with low interpersonal flexibility. These findings deepen the understanding of CDAV as a risk factor for reduced self-compassion and increased experiential avoidance in female adolescents. However, high interpersonal flexibility is a potential protector. This study has implications for the prevention of experiential avoidance among female adolescents exposed to CDAV and supports incorporating self-compassion and interpersonal flexibility skills to combat the negative outcomes of CDAV.

The Relationship of Risky Online Behaviors and Adverse Childhood Experiences to Online Sexual Victimization Among Korean Female Adolescents

Prior research has demonstrated that online sexual victimization (OSV) is a significant social problem and is associated with adolescents' negative developmental outcomes. However, it remains unclear whether adolescents' risky online behaviors and offline victimization are related to the risk of OSV. The present study examined whether female adolescents' risky online behaviors (mood regulation through the Internet, ingratiating behavior, disclosure of personal information, harassing behavior, talking with someone met online, and sexual behavior) and offline victimization (adverse childhood experiences [ACEs]) would be associated with OSV. This study recruited female adolescents and their mothers within six metropolitan cities and provinces of residential areas of South Korea. A total of 509 female adolescents participated in the survey (aged 13-18 years). The present study employed multivariate regression to examine the relationship of risky online behaviors and offline victimization to the experience of OSV. Female adolescents' risky online behaviors (harassing behavior, talking with someone met online, and sexual behavior) were significantly associated with OSV, and those with high exposure to maltreatment and family dysfunction during childhood were more at risk of OSV than adolescents with low exposure to ACEs. The results suggest that it is important to address the effects of risky online behaviors and exposure to offline victimization on female adolescents' sexual victimization online. Identifying risky online behaviors and offline victimization related to OSV can help researchers and practitioners further understand female adolescents' online victimizations in the context of offline and online dynamics.

Determinants of Dietary Vitamin D Intake in Population-Based Cohort Sample of Polish Female Adolescents

Vitamin D has a pleiotropic effect and its deficiency is a risk factor for many diseases. The purpose of this study was to analyze the dietary intake of vitamin D and the factors determining this intake by female post-primary school students in Poland. The study was conducted on a nationwide sample of 4469 female Polish adolescents (aged 14-20) recruited from all regions across Poland. The vitamin D intake was assessed using VIDEO-FFQ (Vitamin D Estimation Only-Food Frequency Questionnaire). The median dietary vitamin D intake was 2.33 μg per day and it was lower than the 15 μg recommended in Poland for more than 98% of the group. The highest vitamin D intake per day was noted for fish (0.52 μg), whereas the lowest was noted for fats (0.04 μg). Factors that influenced the dietary vitamin D intake were the amount and species of fish consumed, region of residence, use of vitamin D supplements, and vegetarian or vegan diets. In contrast, vitamin D intake did not depend on body mass index and age. Based on the results of the survey, it can be concluded that the alarmingly low intake of vitamin D by Polish female adolescents is a result of the limited supply of vitamin D primarily from fish and fish products. This may be due to insufficient nutritional knowledge, indicating an urgent need to educate the surveyed population in this area.

Differences of EEG Frequency and Spatial Parameters in Depressive Female Adolescents With Suicidal Attempts and Non-suicidal Self-injuries

Background. Both non-suicidal self-injuries (NSSIs) and suicidal attempts (SAs) in adolescence represent significant risk factors for consequent suicide, but neurophysiological markers and predictors of these two forms of auto-aggressive behavior have been studied insufficiently. Objective. The aim of the study was to identify the differences of electroencephalographic (EEG) frequency and spatial parameters between depressive female adolescents with solely NSSI, and with combined NSSI + SA behavior in their history. Methods. The study included 45 female depressive in-patients aged 16-25 years. Baseline resting EEG spectral power, asymmetry, and coherence were analyzed in 8 narrow frequency sub-bands. Results. In the NSSI + SA subgroup (n = 24), the spectral power of parietal-occipital alpha-2 (9-11 Hz) was higher than in the NSSI subgroup, its focus was localized in the right hemisphere, and alpha-3 (11-13 Hz) spectral power was higher than alpha-1 (8-9 Hz). In the NSSI subgroup (n = 21) alpha-1 spectral power was higher than alpha-3, and foci of alpha-2 and alpha-3 were localized in the left hemisphere. EEG coherence was also higher in the NSSI + SA subgroup than in the NSSI subgroup, especially in frontal-central-parietal regions. Conclusions. The spatial distribution of the EEG frequency components in the NSSI + SA subgroup reflects the greater activation of the left hemisphere that is more typical for the EEG of individuals with an increased risk for suicide. In the NSSI subgroup, the right hemisphere is relatively more activated, and EEG coherence is lower, which is more typical for EEG in depressive disorders. The results obtained suggested the use of EEG to clarify the degree of suicidal risk in depressive female adolescents with NSSI.

Global and Regional Myocardial Work in Female Adolescents with Weight Disorders

Background: Anorexia nervosa (AN) and obesity (OB) lead to changes in SBP (i.e., loading conditions) that may affect left ventricular (LV) myocardial work (MW). The novel concept of LV pressure-strain loops allows non-invasive estimation of MW, this latter being correlated with cardiac energy metabolism. In addition, the study of regional MW can detect subtle alterations in cardiac function by highlighting an abnormal distribution of MW. Objective: The aim of this study was to assess the cardiac function of AN and OB patients by evaluating global and regional LV strains and MW. Methods: Eighty-seven female adolescents, comprising 26 with AN (14.6 ± 1.9 yrs. old), 28 with OB (13.2 ± 1.4 yrs. old), and 33 controls (14.0 ± 2.0 yrs. old) underwent speckle-tracking echography to assess global and regional LV strains and MW. Results: SBP was higher in adolescents with obesity than in AN patients or controls. Global MW was similar between groups. In AN patients and controls, longitudinal strains were higher at the apex than at the base of the LV, whereas they were similar in obesity patients, owing to a decrease in their apical longitudinal strain. Consequently, their MW was higher at the basal level than either of the other two groups (1854 ± 272 vs. 1501 ± 280 vs. 1575 ± 295 mmHg% in OB patients, AN patients, and controls, respectively. Conclusion: Despite altered SBP, the global MW of adolescents with weight disorders was unaffected. However, in adolescents with obesity, the distribution of their regional LV MW was altered, which might reflect specific regional remodeling.

Oral fosfomycin for treating lower urinary tract infections due to multidrug-resistant Escherichia coli in female adolescents

Fosfomycin trometamol (FT) has shown promising in vitro activity against multidrug-resistant (MDR) uropathogens; however, clinical data are limited in pediatric patients. We conducted a retrospective study to describe the clinical and microbiological outcomes of uncomplicated lower urinary tract infections (LUTIs) due to MDR Escherichia coli treated with oral FT in female adolescents. A total of 70 outpatients, with a median age of 13 years (range 12-16 years), were included. FT was initiated as definitive treatment of UTIs in all patients due to documented resistance against alternative oral agents. All patients received a single dose of 3 g oral FT. The post-treatment clinical and microbiological cure rates were 97% (68/70) and 94% (66/70), respectively. Only two (3%) patients reported mild, self-limited diarrhea. UTI relapse occurred in two (3%) patients. Our results suggest that oral FT might be an alternative option for outpatient treatment of uncomplicated LUTIs due to MDR E. coli in female adolescents.

Biological Age in Relation to Somatic, Physiological, and Swimming Kinematic Indices as Predictors of 100 m Front Crawl Performance in Young Female Swimmers

BACKGROUND

Some swimmers reach high performance level at a relatively young age. The purpose of this study is to determine the relationship between adolescent female swimmers' 100 m front crawl race (Vtotal100) and several anthropometry, body composition, and physiological and specific strength indices.

METHODS

Nineteen adolescent female swimmers were examined for biological age (BA) and body composition. Oxygen uptake was measured during water-flume stage-test front crawl swimming with ventilatory thresholds examination. Specific strength indices were assessed during 30 s of tethered swimming. Stroke rate (SR), stroke length (SL), and stroke index (SI) were also examined.

RESULTS

BA was strongly correlated with anthropometrics and tethered swimming strength indices, and showed moderate to strong correlation with ventilatory thresholds. Speed of swimming in the race was moderately to largely correlated with speed at V˙O2&nbsp;max-VV˙O2max (r = 0.47-0.55; p < 0.05)-ventilatory thresholds (VAT,&nbsp;VRCP) (r = 0.50-0.85; p < 0.05), SL (r = 0.58-0.62; p < 0.05), and SI (r = 0.79-0.81; p < 0.01).

CONCLUSION

Results confirmed a significant role of biological maturation mediation on body composition and body size, ventilatory indices, and specific strength indices. BA was not a significant mediation factor influencing the swimming kinematics (SL, SI) and speeds of VAT, VRCP or VV˙O2&nbsp;max, which were strong predictors of the 100 m race.

Body Appreciation in Light of Psychological, Health- and Weight-Related Variables Among Female Adolescents

Recent research has begun to focus on positive body image and how this can be supported in adolescence. Body appreciation is a key element of positive body image, and has been associated with self-reported health status, weight-related concern, family factors and psychological variables such as self-esteem. In this study we explored these associations among Hungarian adolescent females. Female high school students from two major towns in Csongrád county, Hungary (N = 454; age range from 14 to 20; M = 16.3 years, SD = 1.2) completed questionnaires assessing body appreciation, self-esteem, optimism, life satisfaction and health- and weight-related variables. Analyses revealed that body appreciation was most strongly related to self-esteem, as well as being positively associated with life satisfaction, self-perceived health, being in control of diet, and engagement in sport. Conversely, binge drinking, engaging in slimming behaviors and having eating disorders in the family were negatively associated with body appreciation. These findings provide some indications of factors that might be targetted in health education programs aiming to promote positive body image and to develop resilience against body dissatisfaction in this demographic group. Such programs should also include information of nutrition and media literacy.

Psychological Impact of Pro-Anorexia and Pro-Eating Disorder Websites on Adolescent Females: A Systematic Review

(1) Background: Teenagers (in particular, females) suffering from eating disorders report being not satisfied with their physical aspect and they often perceive their body image in a wrong way; they report an excessive use of websites, defined as PRO-ANA and PRO-MIA, that promote an ideal of thinness, providing advice and suggestions about how to obtain super slim bodies. (2) Aim: The aim of this review is to explore the psychological impact of pro-ana and pro-mia websites on female teenagers. (3) Methods: We have carried out a systematic review of the literature on PubMed. The search terms that have been used are: "Pro" AND "Ana" OR "Blogging" AND "Mia". Initially, 161 publications were identified, but in total, in compliance with inclusion and exclusion criteria, 12 studies have been analyzed. (4) Results: The recent scientific literature has identified a growing number of Pro Ana and Pro Mia blogs which play an important role in the etiology of anorexia and bulimia, above all in female teenagers. The feelings of discomfort and dissatisfaction with their physical aspect, therefore, reduce their self-esteem. (5) Conclusion: These websites encourage anorexic and bulimic behaviors, in particular in female teenagers. Attention to healthy eating guidelines and policies during adolescence, focused on correcting eating behavioral aspects, is very important to prevent severe forms of psychopathology with more vulnerability in the perception of body image, social desirability, and negative emotional feedback.

Characteristics of Functional Stability in Young Adolescent Female Artistic Gymnasts

The aim of this study was to determine whether young adolescent female artistic gymnasts demonstrate better functional stability than age- and sex-matched non-athletes. Different characteristics of the gymnasts’ postural control were expected to be observed. Twenty-two 10- to 13-year-old healthy females (ten national-level artistic gymnasts and twelve non-athletes) participated in the study. To assess their forward functional stability, the 30-s limit of stability test was performed on a force plate. The test consisted of three phases: quiet standing, transition to maximal forward leaning, and standing in the maximal forward leaning position. Between-group comparisons of the directional subcomponents of the root mean squares and mean velocities of the center of pressure and rambling-trembling displacements in two phases (quiet standing and standing in maximal leaning) were conducted. Moreover, anterior stability limits were compared. During standing in maximal forward leaning, there were no differences in the center of pressure and rambling measures between gymnasts and non-athletes (p > 0.05). The values of trembling measures in both anterior-posterior and medial-lateral directions were significantly lower in gymnasts (p < 0.05). Both groups presented similar values for anterior stability limits (p > 0.05). The comparisons of rambling components may suggest a similar supraspinal control of standing in the maximal leaning position between gymnasts and healthy non-athletes. However, decreased trembling in gymnasts may indicate reduced noise in their postural control system possibly due to superior control processes at the spinal level. The anterior stability limit was not influenced by gymnastics training in female adolescents.

The Relationships among Self-Worth Contingency on Others' Approval, Appearance Comparisons on Facebook, and Adolescent Girls' Body Esteem: A Cross-Cultural Study

The present study examined the relationship between appearance-related social comparison on social networking services (SNSs) and body esteem in a cross-cultural context (three European countries, i.e., Austria, Belgium, and Spain, versus one Asian country, i.e., South Korea). The role of self-worth contingency on others' approval was considered to be a psychological and cultural factor. Utilizing a large-scale cross-national survey of early and middle adolescents in 2017, the responses of female adolescents (N = 981) were analyzed. The results generally support the findings from previous studies but also reveal cultural differences. Appearance comparison on Facebook negatively influenced girls' body esteem in all European countries, but not in South Korea. Self-worth contingency on others' approval negatively influenced girls' body esteem across all four countries. Finally, a positive relationship between self-worth contingency on others' approval and appearance comparison on Facebook was found in all European countries, but not among Korean girls. These findings suggest the importance of self-worth contingency on others' approval and cultural contexts can be used to study the effects of body image-related SNS use.

Prevalence of Anemia and Its Associated Factors Among Female Adolescents in Ambo Town, West Shewa, Ethiopia

Objective

This study assessed the prevalence of anemia among female adolescents and factors associated with it in Ambo town, West Shewa, Ethiopia.

Materials and Methods

A community-based cross-sectional study was conducted among 523 randomly selected female adolescents living in Ambo town, Ethiopia from August 5–29, 2018. Data were collected through structured interview using a structured questionnaire. Anthropometric measurements were done and the hemoglobin value was measured on the field and adjusted for the altitude. Logistic regression analysis was done to identify predictors of anemia. Level of statistical significance was declared at P<0.05.

Results

In this study, 39% (95% CI= 34.8–43%) participants were anemic, of which 63 (30.9%) and 46 (22.5%) female adolescents were stunted and wasted, respectively. Anemia was considerably high among female adolescents with high dietary diversity score. Adolescents born to mothers who were unable to read and write (AOR= 3.27; 95% CI=1.79–5.97), who always take tea and/or coffee within 30 minutes after meal (AOR= 6.19; 95% CI=3.32–11.48), who were wasted (AOR=1.67; 95% CI=1.11–2.52), and who had already attained their menses (AOR=1.93; 95% CI=1.19–3.13) were more likely to be anemic compared to their counterparts.

Conclusion

Nearly four in ten female adolescents in the study setting were anemic. Anemia among female adolescents was a moderate public health problem. Adolescents born to mothers who were unable to read and write, who consumed tea/coffee within 30 minutes after a meal, who were wasted, and who had already attained menses should be prioritized for interventions aiming at addressing iron-deficiency anemia in female adolescents.

Alcohol Screening, Brief Intervention, and Referral to Treatment (SBIRT) for Girls and Women

Females ages 12 and older are the fastest growing segment of alcohol consumers in the United States, with the past decade showing a 16% increase in alcohol use per 12-month period and a 58% increase in high-risk drinking (i.e., > 3 drinks in a day and/or > 7 drinks in a week) per 12-month period. The increase in alcohol use and risk drinking poses unique and serious consequences for women. Women have a more rapid progression to alcohol-related problems and alcohol use disorders (AUD) than men, and if pregnant, women can potentially expose the fetus to alcohol. Screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based, integrated public health approach used to identify and address risky alcohol use among women in a variety of health and social service settings. This article presents the current status of SBIRT among girls ages 12 and older, women of childbearing age, and older women. Screening instruments, brief interventions, and implementation issues specific to women of all ages are described. Through this review of the current literature, care providers can determine best practices for the prevention and treatment of risk drinking in women of all ages presenting in health care settings.

A Constructed Reality? A Fairclough-Inspired Critical Discourse Analysis of the Danish HPV Controversy

The World Health Organization (WHO) reports that routine immunization coverage has declined in Europe. In this article, we present the findings of a Norman Fairclough-inspired critical discourse analysis undertaken to explore how the Danish media came to suggest a possible linkage between the human papillomavirus (HPV) vaccine and serious side effects. The findings of the analysis highlight the social consequences of the controversy over the HPV vaccine, identified within the framework of three perspectives: (1) overall criticism of vaccine efficacy and safety, rooted in an ideological opposition; (2) a growing societal tendency to question the authority of the official health bodies; and (3) the specific controversy over the HPV vaccine. We suggest that the controversy over the HPV vaccine is rooted in an ideological conflict, and the declining acceptance implies that the perception that the vaccine causes serious side effects has gained currency among the general public.

Female adolescent health needs and determinants

OBJECTIVE

Adolescence is a critical developmental period with characteristic health risks and needs. Assessing adolescent health needs helps to improve the planning and implementation of effective interventions. This study aimed to describe the health needs and determinants of female adolescents.

METHODS

This analytical descriptive study included 850 female students. The sampling method was multistage cluster sampling. Data were collected from a questionnaire consisting of two parts, the first probing into socio-demographic matters and the second into respondent health needs. Data analysis was performed via the Mann-Whitney and Kruskal-Wallis tests, and Mann-Whitney, Kruskal-Wallis, and Pearson correlation coefficients.

RESULTS

The results showed that individuals attending private high schools not living with their parents had higher health needs than other students. Students with older fathers - particularly fathers aged 50+ years - had increased health needs. Psycho-emotional care topped the list of health needs, whereas services in the field of spiritual belief were in last place.

CONCLUSION

Our study found that the most important factors related to healthcare needs were level of education, type of school (private vs. public), and living with parents. The results of this study can be useful in designing and implementing interventions to prevent high-risk behaviors and promote adolescent health.

Why Too Soon? Early Initiation of Sexual Intercourse Among Adolescent Females in Ethiopia: Evidence from 2016 Ethiopian Demographic and Health Survey

Background

Early sexual initiation - sexual activity that begun earlier than 18 years of age - is among risky sexual behaviors which may be associated with increased risks of adverse outcomes such as sexually transmitted infections (STIs), unwanted pregnancy and unsafe abortions. However, there is no nationally representative evidence on early initiation of sexual intercourse and its determinant factors among adolescent females in Ethiopia.

Methods

Data were extracted from the 2016 Ethiopian Demographic and Health Survey (EDHS) to assess early initiation of sexual intercourse and factors contributing to it in adolescent females. The analysis included a weighted sample of 3881 adolescent females aged 15-19 years. A multivariable logistic regression analysis was conducted and the results were presented as adjusted odds ratio (AOR) at 95% confidence interval (CI), declaring statistical significance at a p-value <0.05 in all analyses.

Results

About 1 in 5 (21.9%, 95% CI: 20.5%, 23.33%) adolescent females experienced early sexual debut. Administrative regions (Amhara, AOR = 2.3, 95% CI: 1.30, 4.09 and Gambella, AOR = 4.89, CI 95%: 1.08, 22.07), religion (Muslim, AOR = 1.76, 95% CI: 1.24, 2.49), substance use (e.g., ever chewed khat, AOR = 2.02, 95% CI: 1.47, 2.77, ever drunk alcohol, AOR = 1.83, 95% CI: 1.35, 2.48) and having no knowledge on family planning (AOR = 4.47, 95% CI: 2.22, 8.99) were found to have statistically significant association with early sexual debut in adolescent females. Whereas any levels of formal education decreased the odds of early sexual debut (primary, AOR = 0.44, 95% CI: 0.35, 0.56; secondary, AOR = 0.19, 95% CI: 0.13, 0.28, and higher, AOR= 0.31, 95% CI: 0.15, 0.63). Similarly, all categories of wealth indices as compared to the poorest were protective of early sexual initiation in adolescent females (AOR = 0.40-0.57) as was for education as compared to no education (AOR = 0.19-0.44).

Conclusion

A significant proportion of adolescent females initiate early sexual intercourse in Ethiopia and multifaceted factors appear to determine their early sexual experiences. Contextualized interventions including strengthening information, education and communication on adverse consequences of early sexual initiation in regions and improving contraceptive knowledge of teenagers will play a paramount role.

Unhealthy weight control behaviors among Ethiopian female adolescents

BACKGROUND

Unhealthy weight control behaviors are a serious concern, impairing the quality of life in adolescents. Although recent epidemiological studies indicate a high level of disordered eating in developing countries, such data in Ethiopia are scarce. Thus, this study aimed to determine the extent of unhealthy weight control behaviors (i.e., purging and nonpurging) and corresponding associated factors among urban Ethiopian adolescents.

METHOD

A cross-sectional study using self-administered questionnaires was applied to 690 randomly selected female high school adolescents in Addis Ababa, Ethiopia in 2017. Measures included unhealthy weight control behaviors, body mass index, subjective perception of body weight, appearance satisfaction, depressive symptoms, and socio-demographic factors. Logistic regression was applied for data analyses, that is, adjusted odds ratio (aOR) with 95% confidence interval (CI).

RESULTS

The level of unhealthy weight control behaviors (i.e., a score of at least once a week in the last 1 month) was 30.7% (N = 208). Specifically, the extent of purging and nonpurging weight control behaviors was 1.5% (N = 10) and 29.8% (N = 202), respectively. Factors that were significantly associated with unhealthy weight control behaviors were perception of being overweight [aOR = 3.01; 95%CI: 1.11-8.11], being overweight [aOR = 3.28; 95%CI: 1.54-7.01], severe depression [aOR = 4.09; 95%CI: 1.73-9.96], and high socio-economic status [aOR = 2.07; 95%CI: 1.30-2.80].

CONCLUSION

This study reveals a considerable level of unhealthy weight control behaviors among female adolescents in an urban setting in Ethiopia. Researchers and policy makers should focus their attention upon this emerging public health challenge and develop associated strategies.

Social and cultural factors perpetuating early marriage in rural Gambia: an exploratory mixed methods study

Background: Over the last two decades, early marriage in the Gambia declined significantly (from 58% to 30%). Yet evidence indicates that nearly 8.6% of marriages in the Gambia involved girls younger than 15, and 46.5% of marriages are with girls aged 18 or below. The reasons for the decline but continuing practice of early marriage, despite existing legislation prohibiting child marriage, are not very well understood. Very few studies have been conducted to find out what and how local factors influence decisions about early marriage in the Gambia. More information is therefore needed on underlying reasons for the persistence of early marriage in the Gambia so that program managers can use this information to design strategies towards accelerating the decline of early marriages.  Methods: The study was conducted in 24 rural settlements in Lower Baddibu District in the North Bank Region of the Gambia. It was based on a mixed-methods design including a cross-sectional household survey with a sample of 181 female adolescents and focus group discussions with 16 male and female parents. Focus group discussions were digitally-recorded, transcribed verbatim and analyzed using thematic content analysis, while survey data were analyzed using Stata. Results: Using multiple regression analysis, this study found that ethnicity more than other factors, exerts an independent effect on early marriage. Themes identified during focus group discussions also revealed that fear of premarital sex and loss of virginity outside marriage were major reasons for the perpetuation of early marriage. Conclusions: These findings suggest that the practice of early marriage in rural Gambia is associated with ethnicity and practices related to social and cultural norms. The findings also suggest that in order to decrease early marriages, future efforts should focus on allaying the fears around premarital sex and loss of virginity related to delay in marriage.

Association between Emotion Dysregulation and Distinct Groups of Non-Suicidal Self-Injury in Taiwanese Female Adolescents

Background: Previous studies revealed that female adolescents are more likely than males to engage in non-suicidal self-injury (NSSI) to regulate negative emotions; however, the dimensions of emotion regulation that are associated with NSSI behavior in adolescents require further examination. The present study aimed to identify Taiwanese female adolescent clusters with NSSI engagement frequency and to evaluate the association of specific forms of emotion dysregulation with NSSI. Methods: The participants were 438 female adolescents (mean age = 15.23 years, SD = 1.24, range between 13 and 18) recruited from 11 high schools. Self-report questionnaires assessing NSSI, difficulties in emotion regulation, and positive and negative affect were administered, and 37% of respondents reported a history of NSSI. Results: The analysis of NSSI frequency yielded three groups: severe, moderate, and non-NSSI. High negative affect, low positive affect, and difficulties in all aspects of emotion regulation differentiated female adolescents in the severe NSSI group from their counterparts in the non-NSSI group. The moderate and severe NSSI groups were further distinguished by age of onset, negative affect, emotion regulation strategies, and impulse control. Adolescents classified in the severe group reported earlier onset of NSSI, higher negative affect, less emotion regulation strategies, and more difficulty with impulse control. Conclusions: The results indicate that assessments of NSSI and emotion regulation should be incorporated in youth mental health screening. The clinical implications of NSSI behavior intervention require further discussion.

Risky sexual behaviour and contraceptive use in contexts of displacement: insights from a cross-sectional survey of female adolescent refugees in Ghana

Background

Difficulty in accessing sexual and reproductive healthcare is one of the challenges young refugee women face worldwide, in addition to sexual exploitation, violence and abuse. Although Ghana hosts several refugees, little is known about their sexual behaviour and contraceptive use. This study assesses sexual behaviour and contraceptive use among female adolescent refugees in Ghana.

Methods

A cross-sectional survey was conducted between June and August 2016. Respondents comprised 242 female adolescent refugees aged 14–19 years. Structured validated questionnaires were used to collect data. Descriptive statistical methods and multivariate logistic regression statistical analyses methods were used to analyze data.

Findings

Over 78% of respondents have had penetrative sex; 43% have had coerced sex; 71% have had transactional sex; 36% have had sex while drunk, 57% have had 4–6 sexual partners in the last 12 months before the study, and 38% have had both coerced and transactional sex.

Factors that predicted ever having transactional sex included being aged 14–16 compared to those aged 17–19 (AOR =4·80; 95% CI = 2·55–9·04); being from Liberia compared to being from Ghana (AOR = 3·05; 95% CI = 1.69–13·49); having a mother who had no formal education compared to having a mother with tertiary education (AOR = 5.75; 95CI = 1.94–14.99); and living alone (self) compared to living with parents (AOR = 3.77; 95CI = 1.38–10.33). However, having 1–3 sexual partners in the last 12 months as against having 4–6 partners significantly reduced the odds of ever having transactional sex (AOR = 0·02; 95% CI = 0·01–0·08). Awareness about contraceptives was 65%, while ever use of contraceptives was 12%. However, contraceptive use at last sexual intercourse was 8.2%, and current use was 7.3%. Contraceptive use was relatively higher among those who have never had sex while drunk, as well as among those who have never had transactional sex and coerced sex. Contraceptive use was similarly higher among those who had 1–3 sexual partners in the last 12 months compared to those who had 4–6 during the same time period.

Conclusion

In this time of global migration crises, addressing disparities in knowledge and access to contraception as well as high risk sexual behaviours in refugee situations is important for reducing inequalities in reproductive health outcomes and ensuring both universal health coverage and global health justice. Sex and contraception education and counselling, self-efficacy training, and skills acquisition are needed to help young refugee women negotiate and practice safe sex and resist sexual pressures.

Analysis of Heme and Non-Heme Iron Intake and Iron Dietary Sources in Adolescent Menstruating Females in a National Polish Sample

Iron intake and heme/non-heme iron proportions are crucial for iron deficiency anemia prevention. Women of childbearing age are indicated by World Health Organization as the primary target group, but maintaining iron balance is particularly challenging for adolescents. The aim of the presented study was to analyze heme and non-heme iron intake and dietary sources in adolescent menstruating females in a national Polish sample. The study was conducted in a representative sample of adolescents (aged 15-20) who were recruited from all regions of Poland based on secondary school sampling (random quota sampling), with 1385 female adolescents being included in the sample. The iron intake was assessed using the previously validated IRONIC-FFQ (IRON Intake Calculation-Food Frequency Questionnaire). The intakes of iron, heme iron, non-heme iron, and iron from food product groups were assessed and compared with those of male adolescents (n = 1025) who were recruited from the same schools, as well as between sub-groups stratified by age, body mass index, anemia history, following vegetarian diet, applying iron supplementation and school type. Compared with male individuals, females were characterized by a lower intake of all forms of iron. It was stated that non-heme iron intake was highest in younger ones, overweight ones, vegetarian ones, and comprehensive school students. Female adolescents with anemia history were characterized by similar iron intake as others. For the target group, there is inadequate nutritional education and a necessity to broaden the knowledge about specific sources of iron.

Development and psychometric properties of the female adolescents' sexual reproductive self-care scale

INTRODUCTION

The aim of this study was to design and evaluate the psychometric properties of an instrument for understanding female adolescents' reproductive and sexual self-care behaviors.

METHODS

A methodological study was conducted. In the qualitative phase, individual in-depth interviews were performed to develop the initial questionnaire. In the quantitative part, the psychometric properties of the questionnaire were evaluated.

FINDINGS

The initial questionnaire with 128 items was reviewed by the research team and taking into account the cut-off point 1.5 for the item impact and 0.62 for the content validity ratio (CVR), the number of questions fell to 82 items. S-CVR and S-content validity index (CVI) rations were 0.83 and 0.91, respectively. Exploratory factor analysis led to 74 items in seven dimensions. The alpha Cronbach's coefficient for the whole questionnaire was 0.895 and the intra-cluster correlation coefficient was 0.91.

CONCLUSION

The questionnaire developed in this study is reliable and valid for assessing female adolescents' sexual and reproductive self-care.

Temporomandibular joint magnetic resonance imaging findings in adolescents with anterior disk displacement compared to those with juvenile idiopathic arthritis

BACKGROUND

Deformation of the mandibular condyle can be associated with anterior disk displacement (ADD) or involvement of the temporomandibular joint (TMJ) by juvenile idiopathic arthritis (JIA). Diagnostic differentiation is critical for proper management.

OBJECTIVES

To compare morphology and inflammation between TMJs with ADD and JIA.

METHODS

Retrospective assessment of contrast-enhanced TMJ MRI in 18 adolescents (15 female, mean age 15.1 ± 1.9 years) with ADD and age- and gender-matched patients with JIA. Articular disk findings, inflammatory signs and osseous morphology were compared.

RESULTS

In the ADD group, 31 of 36 disks were displaced. In total, 28 of 31 displaced disks showed thickening of the bilaminar zone. In JIA patients, the disks were mainly flattened (19/36), centrally perforated (12/36) and/or anteriorly displaced (2/36). In total, 19 of 31 TMJs with ADD showed various degrees of inflammation, with joint effusion, synovial thickening and joint enhancement not significantly different from JIA patients. Osseous deformity was present in 27 of 31 TMJs with ADD, with frequent erosions in both groups (ADD 25/31; JIA 32/36, P = 0.55) but lower grades of condylar and temporal bone flattening than in JIA (P ≤ 0.001). Glenoid fossa depth was preserved in 28 of 31 joints with ADD and decreased in 26 of 36 joints with JIA (P < 0.0001). Mandibular ramus height was decreased in both groups.

CONCLUSION

In adolescents, inflammatory signs are common MRI findings in symptomatic TMJs with ADD and thus should not be considered diagnostic for JIA involvement. In this cohort, both entities had high rates of condylar deformity, while TMJs with ADD showed a better-preserved and often normal shape of the glenoid fossa.

Sex- and age-dependent effects of celiac disease on growth and weight gain in children with type 1 diabetes: Analysis of the type 1 diabetes Exchange Clinic Registry

BACKGROUND

Celiac disease (CD) is common in patients with type 1 diabetes (T1D) and effects of CD on growth in children with T1D remain unclear.

METHODS

We analyzed heights, weights, and body mass index (BMI) in 215 matched pediatric CD/control pairs in the T1D Exchange Clinic Registry. CD was defined by a clinic-reported diagnosis and positive celiac serology (n = 80) and/or positive small bowel biopsy (n = 135). Cases and controls were matched by age (mean: 14 years), diabetes duration (median: 7 years), sex (57% female), and clinic site. There were 5569 height/weight measurements.

RESULTS

Gluten was restricted for varying periods of time in 61% of females and 51% of males with CD. Females with CD were shorter than female controls at all ages (P = 0.01). Weight z-scores were initially lower in preschool females with CD but similar to controls by middle childhood. Males with CD were initially shorter but adult heights were similar. Height in both sexes and weight in males were lower in CD participants diagnosed at younger age. Growth in T1D children with biopsy-proven CD, 76% of them were gluten-restricted, was comparable to that of T1D controls.

CONCLUSION

Concurrent CD impairs linear growth in T1D females at all stages of development and in young T1D males. Young females with CD have lower weights, but both sexes have similar weights by middle childhood. Children younger at CD onset remain shorter throughout childhood; males younger at CD onset have persistently lower weights. Long-term gluten restriction may restore weight gain and linear growth in children with CD and T1D.

Suicidality and Other Health Risk Behaviors among Female Youth in Juvenile Detention

This study investigates suicidality and health-risk behaviors among female juvenile detainees and identifies the extent to which suicidal behaviors are correlated with other risky activities. This study also explores 12 health risk behaviors, their prevalence, and relative associations to suicidal behaviors within the sample-population. Researchers collected data from 104 female adolescents, ages 12 to 20, residing in a long-term, detention center in the southeastern region of the United States. Descriptive statistics and regression analysis were utilized. Suicidal ideations (40%) and suicide attempts (34%) were highly prevalent among female juvenile detainees. Results also suggest that the persistence of suicidal ideations was significantly influenced by exposure to various forms of interpersonal violence. Despite increased exposure to psychosocial factors strongly correlated to suicidal and high risk behaviors, little attention has been given to this particular population. Research recommendations are also discussed.

Cognitive-Behavioral and Psychodynamic Therapy in Female Adolescents With Bulimia Nervosa: A Randomized Controlled Trial

OBJECTIVE

The authors compared cognitive-behavioral therapy (CBT) and psychodynamic therapy (PDT) for the treatment of bulimia nervosa (BN) in female adolescents.

METHOD

In this randomized controlled trial, 81 female adolescents with BN or partial BN according to the DSM-IV received a mean of 36.6 sessions of manualized disorder-oriented PDT or CBT. Trained psychologists blinded to treatment condition administered the outcome measures at baseline, during treatment, at the end of treatment, and 12 months after treatment. The primary outcome was the rate of remission, defined as a lack of DSM-IV diagnosis for BN or partial BN at the end of therapy. Several secondary outcome measures were evaluated.

RESULTS

The remission rates for CBT and PDT were 33.3% and 31.0%, respectively, with no significant differences between them (odds ratio [OR] = 0.90, 95% CI = 0.35-2.28, p = .82). The within-group effect sizes were h = 1.22 for CBT and h = 1.18 for PDT. Significant improvements in all secondary outcome measures were found for both CBT (d = 0.51-0.82) and PDT (d = 0.24-1.10). The improvements remained stable at the 12-month follow-up in both groups. There were small between-group effect sizes for binge eating (d = 0.23) and purging (d = 0.26) in favor of CBT and for eating concern (d = -0.35) in favor of PDT.

CONCLUSION

CBT and PDT were effective in promoting recovery from BN in female adolescents. The rates of remission for both therapies were similar to those in other studies evaluating CBT. This trial identified differences with small effects in binge eating, purging, and eating concern. Clinical trial registration information-Treating Bulimia Nervosa in Female Adolescents With Either Cognitive-Behavioral Therapy (CBT) or Psychodynamic Therapy (PDT). http://isrctn.com/; ISRCTN14806095.

How peer conversations about HIV/AIDS media messages affect comprehension and beliefs of young South African women

Most existent research on the effects of interpersonal discussions about health campaign messages is based on surveys. In this study, we analysed actual conversations about an HIV/AIDS poster to find out possible effects. Young South African women in 59 dyads (n = 118) participated in conversations about a deliberately puzzling HIV and AIDS poster that cautioned the target group to be faithful to one sexual partner. We measured their comprehension of the poster and beliefs about the message, before and after the conversations. Overall, actual comprehension (AC) was low, and we observed a large discrepancy between actual and perceived comprehension. In general, conversations did not improve AC. It proved to be even more probable that a correct interpretation before a conversation turned into an incorrect interpretation than the other way around. However, having a well-informed conversation partner increased the chance of acquiring adequate subsequent comprehension. We found, in general, that conversations did not decrease undesirable beliefs. One important undesirable belief even became reinforced after the conversations. Conversations among peers might be valuable in health campaigns, but our study shows that intended positive effects do not automatically follow.

Comparative immunogenicity and safety of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine and HPV-6/11/16/18 vaccine administered according to 2- and 3-dose schedules in girls aged 9-14 years: Results to month 12 from a randomized trial

This observer-blind study (clinicaltrials.gov NCT01462357) compared the immunogenicity and safety of 2 doses of the HPV-16/18 AS04-adjuvanted vaccine (HPV-16/18(2D)) vs. 2 or 3 doses of the HPV-6/11/16/18 vaccine (HPV-6/11/16/18(2D) and HPV-6/11/16/18(3D)) in healthy girls aged 9–14 y. Girls were randomized (1:1:1) to receive HPV-16/18(2D) at months (M) 0,6 (N = 359), HPV-6/11/16/18(2D) at M0,6 (N = 358) or HPV-6/11/16/18(3D) at M0,2,6 (N = 358). The primary objective was non-inferiority/superiority of HPV-16/18 antibodies by ELISA for HPV-16/18(2D) vs. HPV-6/11/16/18(2D) at M7 in the according-to-protocol immunogenicity cohort (ATP-I) and total vaccinated cohort, respectively. Secondary objectives included non-inferiority/superiority of HPV-16/18(2D) vs. HPV-6/11/16/18(3D) at M7, non-inferiority/superiority at M12, HPV-16/18 neutralizing antibodies, frequencies of T-cells/B-cells, reactogenicity and safety. Antibody responses at M7 for HPV-16/18(2D) were superior to those for HPV-6/11/16/18(2D) and HPV-6/11/16/18(3D) (lower limit of 95% confidence interval for geometric mean titer ratio (GMR) was >1): HPV-16/18(2D)/HPV-6/11/16/18(2D) GMRs were 1.69 [1.49–1.91] for anti-HPV-16 and 4.52 [3.97–5.13] for anti-HPV-18; HPV-16/18(2D)/HPV-6/11/16/18(3D) GMRs were 1.72 [1.54–1.93] for anti-HPV-16 and 3.22 [2.82–3.68] for anti-HPV-18; p = 0.0001 for all comparisons. Non-inferiority/superiority was also demonstrated at M12. Among initially seronegative girls in the ATP-I, neutralizing antibody titers were at least 1.8-fold higher for HPV-16/18(2D) vs. HPV-6/11/16/18(2D) and HPV-6/11/16/18(3D) at M7 and M12. Frequencies of HPV-16/18-specific T-cells and B-cells were in similar ranges between groups. Reactogenicity and safety were in line with the known profile of each vaccine. In conclusion, superior HPV-16/18 antibody responses were elicited by 2 doses of the HPV-16/18 AS04-adjuvanted vaccine compared with 2 or 3 doses of the HPV-6/11/16/18 vaccine in girls (9–14 years).

Normal-weight and overweight female adolescents with and without extreme weight-control behaviours: Emotional distress and body image concerns

The objective of this study was to analyse emotional distress and concerns related to body image in 712 normal-weight and overweight adolescent girls. A total of 12.3 per cent of the normal-weight girls and 25 per cent of the overweight girls showed extreme weight-control behaviours. In normal-weight adolescents, their engagement in extreme weight-control behaviours was associated with high levels of somatic symptoms, a drive for thinness and control over eating. In overweight girls, high levels of drive for thinness and anxiety were associated with extreme weight-control behaviours. Finally, the implications for preventive and therapeutic programmes are discussed.

Body mass index trajectory throughout adolescence: a comparison of maltreated adolescents by maltreatment type to a community sample

BACKGROUND

Childhood maltreatment is associated with adult obesity, but there is conflicting evidence regarding the relationship between childhood maltreatment and obesity during adolescence.

OBJECTIVES

To compare the body mass index (BMI) trajectory of adolescents with a specific type of maltreatment (sexual abuse, physical abuse, emotional abuse or neglect) to adolescents with another type of maltreatment (maltreated sample n = 303) and to a comparison group (n = 151).

METHODS

Individual growth models were used to estimate average growth trajectories of BMI percentile separately by sex (ages 9 to 22 years). Unconditional and conditional linear and quadratic growth models were estimated and maltreatment types were added before including covariates (ethnicity, anxiety, depression and pubertal stage).

RESULTS

BMI growth trajectories of sexually abused girls and neglected girls were significantly different from comparison girls. Comparison girls had a growth trajectory that reached its apex at 15 years and then began to decline, whereas sexually abused girls and neglected girls had lower BMI than comparison girls until age 16-17 years when their BMI was higher than comparison girls.

CONCLUSIONS

Late adolescence appears to be the developmental period during which differences in BMI percentiles become pronounced between girls with sexual abuse or with neglect vs. comparison girls.

Sustained immunogenicity of the HPV-16/18 AS04-adjuvanted vaccine administered as a two-dose schedule in adolescent girls: Five-year clinical data and modeling predictions from a randomized study

In this randomized, partially-blind study ( clinicaltrials.gov ; NCT00541970), the licensed formulation of the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine (20 μg each of HPV-16/18 antigens) was found highly immunogenic up to 4 y after first vaccination, whether administered as a 2-dose (2D) schedule in girls 9-14 y or 3-dose (3D) schedule in women 15-25 y. This end-of-study analysis extends immunogenicity and safety data until Month (M) 60, and presents antibody persistence predictions estimated by piecewise and modified power law models. Healthy females (age stratified: 9-14, 15-19, 20-25 y) were randomized to receive 2D at M0,6 (N = 240 ) or 3D at M0,1,6 (N = 239). Here, results are reported for girls 9-14 y (2D) and women 15-25 y (3D). Seropositivity rates, geometric mean titers (by enzyme-linked immunosorbent assay) and geometric mean titer ratios (GMRs; 3D/2D; post-hoc exploratory analysis) were calculated. All subjects seronegative pre-vaccination in the according-to-protocol immunogenicity cohort were seropositive for anti-HPV-16 and -18 at M60. Antibody responses elicited by the 2D and 3D schedules were comparable at M60, with GMRs close to 1 (anti-HPV-16: 1.13 [95% confidence interval: 0.82-1.54]; anti-HPV-18: 1.06 [0.74-1.51]). Statistical modeling predicted that in 95% of subjects, antibodies induced by 2D and 3D schedules could persist above natural infection levels for ≥ 21 y post-vaccination. The vaccine had a clinically acceptable safety profile in both groups. In conclusion, a 2D M0,6 schedule of the HPV-16/18 AS04-adjuvanted vaccine was immunogenic for up to 5 y in 9-14 y-old girls. Statistical modeling predicted that 2D-induced antibodies could persist for longer than 20 y.

Immune response to the HPV-16/18 AS04-adjuvanted vaccine administered as a 2-dose or 3-dose schedule up to 4 years after vaccination: results from a randomized study

This randomized, partially-blind study (ClinicalTrials.gov registration number NCT00541970) evaluated the immunogenicity and safety of 2-dose (2D) schedules of the HPV-16/18 AS04-adjuvanted vaccine. Results to month (M) 24 have been reported previously and we now report data to M48 focusing on the licensed vaccine formulation (20 μg each of HPV-16 and -18 antigens) administered at M0,6 compared with the standard 3-dose (3D) schedule (M0,1,6). Healthy females (age stratified: 9–14, 15–19, 20–25 years) were randomized to receive 2D at M0,6 (n = 240) or 3D at M0,1,6 (n = 239). In the according-to-protocol immunogenicity cohort, all initially seronegative subjects seroconverted for HPV-16 and -18 antibodies and remained seropositive up to M48. For both HPV-16 and -18, geometric mean antibody titer (GMT) ratios (3D schedule in women aged 15–25 years divided by 2D schedule in girls aged 9–14 years) at M36 and M48 were close to 1, as they were at M7 when non-inferiority was demonstrated. The kinetics of HPV-16, -18, -31, and -45 antibody responses were similar for both groups and HPV-16 and -18 GMTs were substantially higher than natural infection titers. The vaccine had a clinically acceptable safety profile in both groups. In summary, antibody responses to a 2D M0,6 schedule of the licensed vaccine formulation in girls aged 9–14 years appeared comparable to the standard 3D schedule in women aged 15–25 years up to 4 years after first vaccination. A 2D schedule could facilitate implementation of HPV vaccination programs and improve vaccine coverage and series completion rates.

Selective cognitive empathy deficit in adolescents with restrictive anorexia nervosa

BACKGROUND

A growing, but conflicting body of literature suggests altered empathic abilities in subjects with anorexia nervosa-restricting type (AN-R). This study aims to characterize the cognitive and affective empathic profiles of adolescents with purely AN-R.

METHODS

As part of a standardized clinical and research protocol, the Interpersonal Reactivity Index (IRI), a valid and reliable self-reported instrument to measure empathy, was administered to 32 female adolescents with AN-R and in 41 healthy controls (HC) comparisons, matched for age and gender. Correlational analyses were performed to evaluate the links between empathy scores and psychopathological measures.

RESULTS

Patients scored significantly lower than HC on cognitive empathy (CE), while they did not differ from controls on affective empathy (AE). The deficit in CE was not related to either disease severity nor was it related to associated psychopathology.

CONCLUSION

These results, albeit preliminary, suggest that a dysfunctional pattern of CE capacity may be a stable trait of AN-R that should be taken into account not only for the clinical management, but also in preventive and therapeutic intervention.

Impact of exercise on affective responses in female adolescents with type I diabetes

BACKGROUND

Adolescent is a time of profound biologic, intellectual, psychological, and socioeconomic change that they will face a crisis. Therefore, compatibility may be exposed to many hazards, such as depression, anxiety, and other emotional problems. Nevertheless, a planned regular exercise enhances physical and mental health of adolescent female with diabetes. The aim of this study was to determine the effect of exercise on emotional reactions of female adolescents with type I diabetes.

MATERIALS AND METHODS

This study was a quasi-experimental research conducted in Endocrine and Metabolism Research Centre. A total of 72 patients were randomly allocated in the two groups. The intervention group did aerobic exercise for 45 minutes, while the control group did not aerobic exercise. Data were collected using a Symptom Checklist (SCL)-90 questionnaire. Data were analyzed and using descriptive and inferential statistics methods and SPSS software.

RESULTS

The results showed that the mean score for physical symptoms, depression, obsession-compulsion, interpersonal sensitivity, aggression, phobia, paranoid ideation, psychosis, and anxiety in the test group significantly decreased after intervention than before intervention. The average score in the control group did not differ. The average total score of emotional reactions in the test group after the intervention decreased before the intervention significantly (P = 0.001). However, in the control group, the mean scores did not differ (P = 0.97).

CONCLUSION

The findings showed that regular exercise is effective on affective responses of adolescent females with type I diabetes.

The composite first person narrative: Texture, structure, and meaning in writing phenomenological descriptions

This paper illustrates the use of composite first person narrative interpretive methods, as described by Todres, across a range of phenomena. This methodology introduces texture into the presently understood structures of phenomena and thereby creates new understandings of the phenomenon, bringing about a form of understanding that is relationally alive that contributes to improved caring practices. The method is influenced by the work of Gendlin, Heidegger, van Manen, Gadamer, and Merleau-Ponty. The method's applicability to different research topics is demonstrated through the composite narratives of nursing students learning nursing practice in an accelerated and condensed program, obese female adolescents attempting weight control, chronically ill male parolees, and midlife women experiencing distress during menopause. Within current research, these four phenomena have been predominantly described and understood through quantified articulations that give the reader a structural understanding of the phenomena, but the more embodied or "contextual" human qualities of the phenomena are often not visible. The "what is it like" or the "unsaid" aspects of such human phenomena are not clear to the reader when proxies are used to "account for" a variety of situated conditions. This novel method is employed to re-present narrative data and findings from research through first person accounts that blend the voices of the participants with those of the researcher, emphasizing the connectedness, the "we" among all participants, researchers, and listeners. These re-presentations allow readers to develop more embodied understandings of both the texture and structure of each of the phenomena and illustrate the use of the composite account as a way for researchers to better understand and convey the wholeness of the experience of any phenomenon under inquiry.

A prediction equation to estimate the maximum oxygen uptake of school-age girls from kolkata, India

BACKGROUND

The 20-metre multistage shuttle run test is a useful method for the regular monitoring of aerobic fitness. However, the validity of the test should be established in the particular population prior to application. The aim of the study was to validate the applicability of the 20-metre multistage shuttle run test in non-athlete, girls from Kolkata, India.

METHODS

Thirty-six untrained girls from different schools in Kolkata (age range 14-16 years) were recruited for the study. Direct estimation of cardiorespiratory endurance (VO(2)max) comprised treadmill exercise followed by expired gas analysis using Scholander micro-gas analyser. VO(2)max was indirectly predicted by the 20-metre multistage shuttle run test.

RESULTS

The difference between the mean (SD) VO(2)max values of the direct measurement, 32.91 (2.66) ml·kg(-1)·min(-1), and the 20-metre multistage shuttle run test, 33.79 (2.56) ml·kg(-1)·min(-1), was statistically significant (P < 0.01). However, limits of agreement analysis suggested that the 20-metre multistage shuttle run test can be applied for use with the studied population. Intra-class correlation coefficients also suggested good reliability of the 20-metre multistage shuttle run data.

CONCLUSION

The results suggest that the use of the 20-metre multistage shuttle run test for the prediction of VO(2)max is justified in the studied population. For better prediction of VO(2)max, a new equation has been developed based on the present data for untrained girls from Kolkata.

Substance use among early adolescent girls: risk and protective factors

Disquieting rates of alcohol and drug use among adolescent girls call for original research on gender-specific risk and protective factors for substance use. Particularly salient are data on theory-driven factors that can inform prevention programming. Surveying 781 adolescent girls and their mothers, we found relationships between girls' use of alcohol, prescription drugs, and inhalants and girls' after-school destinations, body images, depression, best friend's substance use, maternal drinking behavior, mother-daughter interactions, and family norms surrounding substance use. Study findings have implications for the design of responsive gender-specific prevention programs.

Adolescent school failure predicts later depression among girls

PURPOSE

Past research has found that social, academic, and behavioral problems are linked with depression during childhood and adolescence. The present study tests a longitudinal cascade model of adolescent problems predicting depression into adulthood, while additionally testing for gender differences.

METHODS

Using prospective longitudinal analysis with a sample of 808 youth followed from age 10 to 21, we tested whether social problems, school failure, and delinquency in adolescence increased risk for a major depressive episode in emerging adulthood. Structural equation modeling was used to test for gender differences.

RESULTS

Both early conduct problems and adolescent school failures predisposed girls to depression in young adulthood. Among the boys, none of the problems conferred risk for depression.

CONCLUSIONS

This study highlights the mutual interplay between school failure and psychological functioning. It is suggested that school adaptation in adolescence be considered a mental health issue.

Mental health and gambling in urban female adolescents

This study explores differences in mental health and behavioral disturbances between female gamblers versus nongamblers from a community sample of 232 female urban youth. Female adolescent recreational gambling was associated with high levels of childhood hyperactivity measured at age 6, past-year substance use, and past-year anxiety symptoms.

The next generation of HIV prevention for adolescent females in the United States: linking behavioral and epidemiologic sciences to reduce incidence of HIV

Given the increasing numbers of new HIV infections among adolescent females and limitations of the current generation of HIV interventions, a new generation of interventions is needed to prevent HIV and other infections in this population. Interventions available today are limited by their focus on single behaviors that have little epidemiologic significance, such as condom use, and their failure to be tested among the highest risk females. Recent advances in epidemiologic sciences suggest that the next generation of interventions should focus on parenting and parenting skills, sexual risk networks in which drug use and other high-risk behaviors are prevalent, and neighborhoods where these networks exist. Future research should include formative and observational studies to inform new intervention trials that reach the highest risk female youth.