5-year Olds Research Articles

Occupational and Environmental Health Benefits of Smoking ban not yet Arrived in Austrian Youth

The aim was to record the smoking behaviour of 13- to 16-year-old Austrian pupils and to investigate changes in smoking behaviour following amendments of legislation and gender-specific differences. The survey took place in Vienna, Lower Austria, Burgenland, Styria and Carinthia and was conducted at eight different school types. The data was collected by means of a questionnaire in a group setting at the beginning of a school lesson. The completion of the questionnaire was anonymous. 95,1% of the returned questionnaires could be used for this study, yielding data from a total of 1029 young people for analysis. 38.4% of the participants stated that they had at least once consumed tobacco or related products, with girls having tried them more often (41,6%) than boys (34,9%) (p = .028). At the time of the study, 3,3% used tobacco daily and 4,6% several times a week; thus 7,9% smoke regularly. Although friends or family are the most popular type of acquisition for girls and boys, girls buy their tobacco products from vending machines (11,6%) much more frequently than boys (6,0%) (p = .014) and prefer normal cigarettes (p < .001). The results of this study show that while the number of adolescents who smoke daily is decreasing, the number of occasional smokers is increasing. Already 38,4% of the 13 to 16-year olds have had some experience consuming tobacco. Austria must take the measures recommended by the WHO to reduce the smoking prevalence and protect minors from the health damage caused by tobacco smoke.

Self-Reported Health and Patterns of Romantic Love in Adolescents from Eight European Countries and Regions.

Purpose: Sexual minority youth (SMY) are at increased risk of poor health, but it remains unclear whether this phenomenon is universal. In this study, nationally representative samples of 15-year olds from eight European countries and regions were investigated to test if adolescents who have been in love with same- or both-gender partners report poorer health than those exclusively in love with opposite-gender partners or who have never been in love.Methods: A subsample of 13,674 adolescents participating in the 2014 Health Behaviour in School-aged Children (HBSC) study was used. We conducted binary logistic regression, adjusted for gender, region, and relative family affluence, to analyze associations between self-reported romantic love, multiple psychosomatic symptoms, and poor self-rated health.Results: Adolescents reporting same-gender love (adjusted odds ratio [aOR] = 1.50, 95% confidence interval [CI]: 1.11–2.02) and both-gender love (aOR = 3.57, 95% CI: 2.65–4.83) had significantly higher odds for multiple psychosomatic symptoms than those who reported opposite-gender love. Similarly, both SMY groups had higher odds of poor self-rated health (aOR = 2.95, 95% CI: 1.64–5.31 and aOR = 3.08, 95% CI: 1.79–5.31, respectively). Those who reported that they have never been in love had significantly lower odds for multiple symptoms. Adjustment for sociodemographic variables and stratifying by gender did not substantially change the odds ratios.Conclusion: Adolescents in love with same- and both-gender partners reported poorer subjective health outcomes than those in love with opposite-gender partners or who reported never being in love, suggesting that SMY health inequalities are found across various European countries and regions.

Weekly alternation of morning and afternoon school start times: implications for sleep and daytime functioning of adolescents.

To examine sleep patterns of adolescents attending school on alternating morning schedule (MS) and afternoon schedule (AS) and to explore the contribution of sleep characteristics on the AS to prediction of adolescents' daytime functioning. The Croatian adaptation of the School Sleep Habits Survey for a two-shift school system was completed by 2,033 students (11-18 years old, 54 per cent females) whose school start times alternated weekly between 08:00 am and 14:00 pm. All age groups of adolescents reported delayed sleep when on the school week with an AS as compared with a MS. The average delay of bedtime was 36 minutes, and delay of wake-up time 121 minutes, which resulted in average sleep durations from 9.80 hours in 11-year olds to 8.39 hours in 18-year olds. Having more delayed wake-up times on the AS predicted more substance use and poorer grades. Having more delayed bedtimes not only predicted poorer grades but also predicted less depressed mood. Obtaining relatively longer sleep on AS predicted lower sleepiness, less depressed mood, and less frequent substance use. The afternoon school start time enables sleep duration that is in line with adolescent sleep biology and contributes positively to daytime functioning. In many cases, a large delay in wake-up time is observed. At least part of that delay is not associated with adolescents' circadian biology and contributes negatively to some indices of their daytime functioning. Further research of factors associated with extreme delays of sleep and/or interventions that could limit extreme sleep irregularity is required.

Time trends in mid-upper-arm anthropometry from 1982 to 2011 in male children and adolescents from Kolkata, India.

The aim of this study was to investigate inter-generational changes in selected mid-upper-arm measurements of boys from Kolkata, India. The analysis was based on the anthropometric measurements of two cohorts of Bengali boys aged 7-16 from middle-class families, in 1982-83 and 2005-11. The two cohorts were compared in terms of their mid-upper-arm circumference (MUAC) and mid-upper-arm area (MUAA), mid-upper-arm muscle area (MUAMA), mid-upper-arm fat area (MUAFA) and Arm Fat Index (AFI). The significances of the differences were determined using two-way ANOVA. All features differed significantly between the examined cohorts and all showed a general positive secular trend. In most cases, the biggest differences were noted for 14- and 16-year olds and the smallest for the youngest boys. The contemporary boys seemed to have more favourable overall developmental conditions, probably related to socioeconomic progress in India over recent decades.

Women\u2019s economic empowerment, participation in decision-making and exposure to violence as risk indicators for early childhood caries

ObjectivesIn view of the association between early childhood caries (ECC])and maternal social risk factors, this study tried to determine if there were associations between indicators of processes, outputs and outcomes of women’s empowerment, and the prevalence of ECC.MethodsIn this ecological study, indicators measuring the explanatory variables - economic empowerment, decision-making and violence against women - were selected from the Integrated Results and Resources Framework of the UN-Women Strategic Plan 2018–2021 and WHO database. Indicators measuring the outcome variables - the prevalence of ECC for children aged 0 to 2 years, and 3 to 5 years - were extracted from a published literature. The general linear models used to determine the association between the outcome and explanatory variables were adjusted for economic level of countries. Regression estimates (B), 95% confidence intervals and partial eta squared (η2) were calculated.ResultsCountries with more females living under 50% of median income had higher prevalence of ECC for 3 to 5-year olds (B = 1.82, 95% CI = 0.12, 3.52). Countries with higher percentage of women participating in their own health care decisions had higher prevalence of ECC for 0 to 2-year-olds (B = 0.85, 95% CI = 0.03, 1.67). Countries with higher percentage of women participating in decisions related to visiting family, relatives and friends had higher prevalence of ECC for 3 to 5-year-olds (B = 0.67, 95% CI = 0.03, 1.32). None of the indicators for violence against women was significantly associated with the prevalence of ECC.ConclusionEmpowerment of women is a welcome social development that may have some negative impact on children’s oral health. Changes in policies and norms are needed to protect children’s oral health while empowering women.

The effects of methylphenidate on stress fractures in patients' ages 10–29: a national database study

ABSTRACT Objectives: Current literature is divided on the effect of methylphenidate (MP) on stress fracture development and if this medication increases fracture, or is actually protective for it. This study further investigates this effect utilizing a large national database. We hypothesized that individuals on MP would have a reduced risk of SF compared against controls. Methods: This study utilized the Humana insurance data set within the PearlDiver Patient Records Database (PearlDiver Inc, Fort Wayne, Indiana). All patients’ ages 10–29 were included and patients were identified without ADHD, with ADHD not on MP, and with ADHD on MP. ADHD and stress fracture diagnoses were identified by International Classification of Disease, Tenth Revision codes. Bivariate analysis of stress fracture occurrence was conducted using chi-square analysis. Multivariate logistic regression was used to calculate odds ratios, controlling for age, sex, race, and Charlson Comorbidity Index (CCI). Statistical analysis was performed using the PearlDiver software, which runs R, Version 1.1.442. An α value of .05 was set as the level of significance. Results: The study included 29,590 patients on MP and 831,439 patients not on MP from ages 10–29. The highest proportions of patients who filled MP prescriptions were in the age range 10 to 14 years old (51.2%), followed by 15 to 19 (41.0%). Patients rarely continue MP from years 20 to 24 (16.5%) or 25 to 29 (9.6%). ADHD patients on MP had the lowest calculated risk of stress fractures (0.45%) compared to patients without ADHD (0.54%) and ADHD patients not on methylphenidate (0.58%). In all three patient groups, most stress fractures occurred in 15 to 19-year olds. Patients with ADHD on MP conferred lower odds of stress fracture than ADHD patients not on MP and patients without ADHD (aOR = 0.64, p = 0.0002). The older age groups 20–24 and 25–29 involved less risk of stress fracture compared to the youngest age group 10–14 (p < 0.0001; p < 0.0001), as well as did male gender (p < 0.0001). Conclusions: This database-based study of the effect of MP on SF adds to the growing body of literature providing evidence that MP may offer protective benefit for stress fracture.

Are boys and girls just different? Gender differences in the Movement Assessment Battery for Children, 2nd edition (M ABC-2) suggests that they are.

The second edition of the Movement Assessment Battery for Children (M ABC-2) is a standardised, norm referenced assessment that is frequently used by therapists to identify children with motor difficulties. The norms for the M ABC-2 were derived from a sample of children in the United Kingdom (UK) and are combined across the age groups for boys and girls. The aims of this research were to investigate gender differences in the performance of 8- and 9-year-old Australian children and if the norms in our cohort differed from UK-based M ABC-2 norms. Children aged 8 or 9years of age who underwent major neonatal cardiac or non-cardiac surgery and healthy controls were assessed using the M ABC-2 as part of the Development After Infant Surgery (DAISy) study. There were statistically significant differences in the scores for boys and girls aged 8- and 9-years old on the M ABC-2. Girls performed better than boys in manual dexterity and on total standard scores. Our control group compared to the assessment norms scored significantly poorer in manual dexterity, aiming and catching and total standard scores. Caution should be used when interpreting the results of the M ABC-2 for Australian 8- and 9-year olds. Contemporary Australian, gender-specific M ABC-2 norms should be considered. Further research is required to investigate gender differences and differences in performance of Australian children compared to the assessment norms in other age groups on the M ABC-2.

Patterning strategies in early childhood: a mixed methods study examining 3- to 5-year-old children’s patterning competencies

ABSTRACT Despite increasing data on young children’s patterning skills and evidence of a link between early pattern knowledge and later mathematics performance, little is known about the strategies children use to solve patterning tasks. This mixed-methods study examined 3- to 5-year-old children’s informal strategies when solving eight patterning tasks with three different repeating patterns. In a sequential qualitative-quantitative design, patterning strategies were first longitudinally observed and categorized into five hierarchically ordered categories (n = 6), and then cross-sectionally tested and quantified (n = 174). Results show that young children use various different patterning strategies, and that both patterning strategies and skills organically develop between the age of three and five. However, despite high correct solution rates, the 5-year olds’ strategies still reflect little attention to the patterns’ structure, suggesting that a pattern and structure based instruction is needed to help young children abstract the unit of repeat.

Effectiveness of a modified comprehensive behavioral intervention for tics for children and adolescents with tourette's syndrome: A randomized controlled trial.

To evaluate the effectiveness of a modified four-session Comprehensive Behavioral Intervention for Tics programme for decreasing tics in children and adolescents with Tourette's syndrome. Comprehensive Behavioral Intervention for Tics programme has been shown to decrease tic severity. However, the lack of behaviour therapists in countries, such as in Taiwan, may preclude application of the standard eight-session, 10-week programme. Randomized controlled study. Participants aged 6-18years diagnosed with Tourette's syndrome or chronic tic disorder were recruited from February 2015 through September 2016. Participants in the control and intervention groups (N=23 each) received the routine care (daily pyridoxine [50mg] and psychoeducation). The intervention group received additional four behavioural intervention sessions over a 3-month period that included psychoeducation, habit reversal training, relaxation training, and education on tic relapse prevention. The outcome measures, Yale Global Tic Severity Scale scores, were assessed at before and after the completion of programme for both groups and again at 3months follow-up for the intervention group. The effect of the intervention on severity scores was assessed using a generalized estimated equation. Comparison of scores before and after intervention showed that the intervention significantly decreased the severity of total motor tics (B=-3.28, p<.01) and total tics (B=-5.86, p<.01) as compared with control treatment. YGTSS scores for the intervention group were lower at 3-month follow-up as compared with before treatment or immediately after treatment completion (total tics, p<.001). The modified four-session Comprehensive Behavioral Intervention for Tics programme was more effective than routine care for decreasing tic severity in our cohort of 6- to 18-year olds. This improvement was maintained 3months after intervention. Healthcare providers, including nurses, in countries currently not adopting Comprehensive Behavioral Intervention for Tics programme should be made aware of the positive effects of this modified intervention for Tourette's syndrome.

Effect of birth weight, exclusive breastfeeding and growth in infancy on fat mass and fat free mass indices in early adolescence: an analysis of the Entebbe Mother and Baby Study (EMaBs) cohort.

Background: There is limited data from Africa on the effect of pre- and post-natal growth and infant feeding on later body composition. This study's aim was to investigate the effect of birth weight, exclusive breastfeeding and infant growth on adolescent body composition, using data from a Ugandan birth cohort. Methods: Data was collected prenatally from pregnant women and prospectively from their resulting live offspring. Data on body composition (fat mass index [FMI] and fat free mass index [FFMI]) was collected from 10- and 11-year olds. Linear regression was used to assess the effect of birth weight, exclusive breastfeeding and infant growth on FMI and FFMI, adjusting for confounders. Results: 177 adolescents with a median age of 10.1 years were included in analysis, with mean FMI 2.9 kg/m 2 (standard deviation (SD) 1.2), mean FFMI 12.8 kg/m 2 (SD 1.4) and mean birth weight 3.2 kg (SD 0.5). 90 (50.9%) were male and 110 (63.2%) were exclusively breastfeeding at six weeks of age. Birth weight was associated with FMIin adolescence (regression coefficient β= 0.66 per kg increase in birth weight, 95% confidence interval (CI) (0.04, 1.29), P=0.02), while exclusive breastfeeding (β= -0.43, 95% CI (-1.06, 0.19), P=0.12), growth 0-6 months (β= 0.24 95% CI (-0.43, 0.92), P=0.48) and growth 6-12 months (β= 0.61, 95% CI (-0.23, 1.46), P=0.11) were not associated with FMI among adolescents. Birth weight (β= 0.91, 95% CI (0.17, 1.65), P=0.01) was associated with FFMI in adolescence. Exclusive breastfeeding (β= 0.17, 95% CI (-0.60, 0.94), P=0.62), growth 0-6 months (β= 0.56, 95% CI (-0.20, 1.33), P= 0.10), and growth 6-12 months (β= -0.02, 95% CI (-1.02, 0.99), P=0.97) were not associated with FFMI. Conclusions: Birth weight predicted body composition parameters in Ugandan early adolescents, however, exclusive breastfeeding at six weeks of age and growth in infancy did not.

The Dualistic Role of Child Noncompliance: Normal Developmental Process and Indicator of Child Psychopathology

Parent-collected home observations on Behavior Record Cards (BRCs) have yielded accurate and reliable frequencies of child noncompliance. In addition, prior cross-sectional clinic analog measurements have revealed dramatic improvement in child compliance probabilities after age 4.0 in normal children. The current project sought to extend the developmental transition in compliance probability to reductions in noncompliance frequency in the home. Four age groups (2-, 3-, 4-, and 5-year-old cohorts) of normal children participated. Parents were trained to detect and record noncompliance in the home for a two-week period on BRCs. Unlike the laboratory measurement of compliance probability, the transition point for reduced noncompliance frequency in the home for normal children was found to be age 5, rather than age 4, replicating prior observations of noncompliance frequency in the home. Several methodological differences may account for the inconsistent transition points, including sample size, coding accuracy, setting, and instruction quality. Since noncompliance is one symptom of Oppositional Defiance Disorder (DSM-5), data were transformed into daily occurrence percentages to determine if 5-year olds met the DSM-5 criterion of “at least once per week” and younger children met the DSM-5 criterion of “most days”. Virtually all these normal children (37 of 40) met DSM-5 criterion for symptomatic levels of noncompliance. Diagnostic implications are discussed and the lack of normative data based on observational measurements is lamented. It is recommended that both home noncompliance frequencies and clinic compliance probabilities be obtained to evaluate 2- to 6-year-old children referred for externalizing disorders.

Linking comparing and contrasting, generalising and justifying: a case study of primary students’ levels of justifying

Engaging students in comparing and contrasting, forming conjectures, generalising and justifying is critical to develop their mathematical reasoning, but there are untapped opportunities for primary school students to improve these reasoning processes in mathematics lessons. Through a case study of one task, this paper reports on levels of justifying and the connections to other reasoning processes of comparing and contrasting, forming conjectures and generalising observed among Year 3–4 Australian and Canadian students (9–10-year olds) using the mathematical reasoning actions and levels (MRAL) framework (Authors 2017). The findings revealed that examining commonalities and differences was critical to allow Year 3–4 students to form conjectures and generalise for themselves. Justifying by examples and seeking counterexamples to evaluate the conjecture were prevalent with some students attempting to develop logical argument. The findings have implications for frameworks that assess students’ levels of justifying and for teacher actions that encourage students to communicate their reasoning through oral and non-verbal as well as written communications.

Age-related differences in height gain with dairy protein and micronutrient supplements in Indian primary school children.

The efficacy of nutrient interventions to prevent/reverse stunting is considered to be restricted to early life. Whether such interventions are equally effective in later childhood is not clear. The present study evaluated the effect of a food-based high-quality protein and micronutrient intervention on the linear growth of Indian primary school children. A secondary analysis of a one-year milkprotein and micronutrient fortified food product intervention (protein-energy ratio: 12.8%) on the height of 550 children aged 6-10 years, of poor-socioeconomic background, was carried out. Height and weight increments were compared between groups of each year of age using multiple linear regression. Comparisons in prevalence of stunting and underweight between these groups was also made. The overall mean height increment at the end of 1-year was 6.10±1.07 cm, the highest being for 6-year olds (6.38±0.84 cm). The mean height increments in 6, 7 and 8-year-olds were significantly higher (all p<0.05) than the expected median growth. Height-forage score increased across all age-groups (by 0.14±0.18) and was significantly higher in 6-year olds compared to the rest. Stunting reduced by 12% in 6- year olds in comparison to the older age-groups. No significant association was observed between height gain and gender. The increased BMI-for-age scores were significantly lower for the 6-year olds compared to older children. Food supplements containing high-quality protein (like milk) along with micronutrients, can continue to influence height of children even in primary school, although the most effect is seen in younger children.

Constructs of sleep disturbance and mental wellbeing in older UK adolescents

Poor sleep quality can have far reaching physical and mental health consequences (Alvaro et al., 2014; Ribeiro et al., 2012). This study explores sleep quality in older adolescents; specifically, whether insomnia constructs have unique patterns of association to depression, anxiety and stress. Data from 16–19-year olds (N=198) recruited from further education colleges were obtained. Sleep quality was assessed using the diagnostic criteria for insomnia (DSM-5), Insomnia Severity Index and self-report. The Depression Anxiety Stress Scale (DASS-21) was used to measure mental health state. A large proportion (42–52 per cent) reported sleep difficulties lasting four weeks or more, with 17 per cent short-sleepers (&lt;7hrs.). Regression analysis indicated 12.1 per cent–17.8 per cent of variance in mental health was explained by sleep quality. Specifically, ‘non-restorative sleep’ and ‘daily impact’ consistently predicted depression, anxiety and stress levels. Interestingly, ‘maintaining sleep’ and ‘early wakings’, were associated with anxiety and stress respectively. Results indicate for a potentially large group of adolescents; sleep quality is poor. The cumulative effect of poor sleep appears particularly detrimental. Results provide preliminary indications that sleep behaviours could provide a means for early identification of mental health concerns. Findings can inform tailored interventions aimed at improving sleep quality in adolescents thereby having clear benefits in relation to both short, and longer term, health outcomes.

Swedish School Results, Student Background, Competition and Efficiency

Sweden’s declining results in the Programme for International Student Assessment (PISA) for 15-year olds and other international tests between 2000 and 2012 have raised concern about the efficiency of the Swedish school system, even though results improved recently. Furthermore, inequality in educational outcomes between socio-economic groups have widened. A specificity of the Swedish school system is that it allows free choice between public and private schools. This has triggered a lively debate on the implications of competition for school results and educational inequality. Against this backdrop, this paper presents an econometric analysis of lower secondary school performance in Sweden, using a panel covering most schools in the country over the period 2013–17. We find that for-profit private schools underperform non-profit and public schools on average, although with large heterogeneity. School competition is associated with lower results in schools with a high share of pupils from weaker socio-economic backgrounds, which is consistent with negative peer effects in left-behind schools. Panel Stochastic Frontier Analysis points to a relatively narrow distribution of inefficiency across schools, with relatively few schools performing very poorly after controlling for their resources and the socio-economic background of their pupils. These results call for better targeting resources towards supporting the pupils most in need and steering competition and school choice so that they benefit pupils from all socio-economic groups equally.

Alopecia Risk and the Thickness, Number, and Frequency of Scalp Skin Harvests.

The aim of this study was to elucidate the relationships between the thickness, number, and frequency of scalp skin harvests and alopecia risk.In a PubMed search, the search terms (scalp AND graft AND alopecia) were used, resulting in 148 papers. Among 21 abstracts, 11 full papers were reviewed, and 3 papers were ultimately analyzed.The donor-site alopecia rate was significantly higher in patients who experienced hair growth on their grafts than in those who did not (odds ratio = 10.875, 95% confidence interval, 2.677-44.178; P < 0.001). The depth of the infundibulum can be estimated to be 451.8 μm at 5 years of age, 528.8 μm at 10 years, 605.8 μm at 15 years, and 682.8 μm at 20 years. Therefore, the limits of safe thickness for graft harvesting from the scalp are <18/1000 inches for 5-year olds, 21/1000 inches for 10-year olds, 24/1000 inches for 15-year olds, and 27/1000 inches for 20-year olds. The safe number of harvests (intersection of the alopecia and nonalopecia groups) was 2.7, and the safer number of harvests (limits of 2 standard deviations of the alopecia group) was 1.0. The safe time interval between harvests was 14.0 days, and the safer time interval between harvests was 15.6 days. The safe single minimal interval (SMI) between harvests was 12.7 days, and the safer SMI was 13.7 days.Since the safe thickness for graft harvesting from scalps exceeds the thickness in usual practice, following the safer SMI between harvests (13.7 days) is expected to be more important for minimizing alopecia risk.

The Use of Reflective Mulch in Soybean-Oil Palm Intercropping System

Demand for soybean is increasing nowadays as it provides a high nutrition food at affordable price. To fulfill the demand, an intercropping system of soybean-oil palm may increase the production of soybean. However, shading by the oil palm canopy would reduce the amount of radiation reaching the soil surface. Theoritically, application of reflective mulches may increase the amount of solar radiation intercepted by the shaded plants, hence it gives a positive effect for plant growth. The study aimed to analyze the effect of an increased radiation transmission with reflective mulch on the growth and development of soybean under an intercropping system with 4-year olds oil palm. The experiments were carried out on PT. Perkebunan Nusantara VIII located in Cimarga District, Lebak Regency, from March to June 2018. There were three treatments based on mulch application, namely soil without mulch (R0), soil with black silver plastic mulch (R1), and soil with dry palm oil leaf mulch (R2). The results showed that a canopy of 4-year-olds oil palm transmitted around 42% of an incoming radiation. The use of mulch as radiation reflector has a positive effect on an increased interception of solar radiation and potential productivity. Under R1 and R2 treatments, intercepted radiation was 25% and 15% larger than that of R0. In addition, mulch increased radiation use efficiency (RUE) by 2.3 times under R1 (1.6 g/MJ) and 1.7 times under R2 (1.2 g/MJ). The potency of productivity also increased (1.48 and 1.42 times higher under R1 and R2, respectively). The finding confirmed that mulch application did not affect the plant development in any treatment. Furthermore, we suggest that an intercropping system of soybean and 4-year-olds oil palm may be applied to increase the soybean production in Indonesia.

Children struggle beyond preschool-age in a continuous version of the ambiguous figures task

Children until the age of five are only able to reverse an ambiguous figure when they are informed about the second interpretation. In two experiments, we examined whether children’s difficulties would extend to a continuous version of the ambiguous figures task. Children (Experiment 1: 66 3- to 5-year olds; Experiment 2: 54 4- to 9-year olds) and adult controls saw line drawings of animals gradually morph—through well-known ambiguous figures—into other animals. Results show a relatively late developing ability to recognize the target animal, with difficulties extending beyond preschool-age. This delay can neither be explained with improvements in theory of mind, inhibitory control, nor individual differences in eye movements. Even the best achieving children only started to approach adult level performance at the age of 9, suggesting a fundamentally different processing style in children and adults.

Are preschoolers who spontaneously create patterns better in mathematics?

Early patterning competence has recently been identified as an important precursor of mathematical development. Whereas the focus of this research has been on children's ability regarding repeating patterns, children might also differ in their spontaneous attention to patterns. The present study aimed to explore 4- to 5-year olds' Spontaneous Focusing On Patterns (SFOP) and its association with their patterning and mathematical ability. Participants were 378 children (Mage =4years 10months; 191 boys) from 17 preschools. Spontaneous Focusing On Patterns was measured with a construction task in which children had to build a tower with 15 blocks of three different colours. The constructions of the children were grouped into three categories (i.e., pattern, random, and sorting). We additionally administered tasks assessing their patterning ability, mathematical ability, spatial ability, and visuospatial working memory. When building a tower, 37% of the preschoolers spontaneously created a pattern, 49% made a random construction, and 14% sorted the blocks per colour. Preschoolers who spontaneously created a pattern had better patterning and mathematical ability than children in the random group. Group differences in patterning ability and spatial skills accounted for the difference in mathematical ability. The current data suggest that children's spontaneous attention to patterns is an important component of their mathematical ability. Children's spontaneous pattern constructions may provide opportunities to discuss and practice patterns in preschool settings or at home, but more research is required to further analyse the role of SFOP in early mathematical development.

Sexual and reproductive health knowledge among adolescents in eight sites across sub-Saharan Africa.

To examine knowledge of menstruation, HIV and STIs other than HIV across eight sites in SSA to develop effective programmatic interventions enabling adolescents to achieve positive SRH as their transition to adulthood. We combine data from eight Health and Demographic Surveillance Sites across sub-Saharan Africa, from an adolescent-specific survey that included 7116 males and females age 10-19years old. We provide pooled and site-specific estimates from multiple analytic models examining the how year-specific age, school attendance and work correlate with knowledge of menstruation, HIV knowledge and knowledge of sexually transmitted infections (STIs) other than HIV. Many adolescents lack knowledge of menstruation (37.3%, 95% CI 31.8, 43.1 do not know of menstruation) and STIs other than HIV (55.9%, 95% CI 50.4, 61.3 do not know of other STIs). In multivariate analysis, older age, being in school and wealth are significant positive correlates of STI knowledge. Older adolescent age, female sex and being in school are significant positive correlates of knowledge of menstruation. Knowledge of HIV is high (89.7%, 95% CI 8.3, 12.7 know of HIV) and relatively similar across adolescent age, sex, wealth and school and work attendance. Knowledge of HIV is widespread across adolescents in these communities in sub-Saharan Africa, but knowledge of other dimensions of sexual and reproductive health - menstruation and other STIs in this study - is lacking especially for early adolescents (10- to 14-year olds). The dissemination of more comprehensive sexual and reproductive health information is needed within these and similar communities in SSA to help adolescents gain insight on how to make their own decisions towards positive adolescent sexual and reproductive health and protect them from risks.