Older Girls Research Articles

The Potential Impact of a Single-Dose HPV Vaccination Schedule on Cervical Cancer Outcomes in Kenya: A Mathematical Modelling and Health Economic Analysis

Background: Human Papillomavirus (HPV) is the primary cause of cervical cancer. Single-dose HPV vaccination can effectively prevent high-risk HPV infection that causes cervical cancer and accelerate progress toward achieving cervical cancer elimination goals. We modelled the potential impact of adopting single-dose HPV vaccination strategies on health and economic outcomes in Kenya, where a two-dose schedule is the current standard. Methods: Using a validated compartmental transmission model of HPV and HIV in Kenya, we evaluated the costs from the payer’s perspective to vaccinate girls by age 10 with either one or two doses and increasing coverage levels (0%, 70%, 77%, 90%). Additionally, we modelled single-dose strategies supplemented with either catch-up vaccination of adolescent girls and young women or vaccination for all by age 10, funded with the first five-years of cost savings of switching from a two- to one-dose schedule. Costs and outcomes were discounted at 3% annually, and incremental cost-effectiveness ratios (ICERs) were calculated per disability-adjusted-life-year (DALY) averted. Results: All one-dose and the two-dose 90% coverage strategies were on the efficiency frontier, dominating the remaining two-dose strategies. The two-dose 90% coverage strategy had a substantially higher ICER (US$6508.80/DALY averted) than the one-dose 90% coverage (US$197.44/DALY averted). Transitioning from a two- to one-dose schedule could result in US$21.4 Million saved over the first five years, which could potentially fund 2.75 million supplemental HPV vaccinations. With this re-investment, all two-dose HPV vaccination scenarios would be dominated. The greatest DALYs were averted with the single-dose HPV vaccination schedule at 90% coverage supplemented with catch-up for 11–24-year-old girls, which had an ICER of US$78.73/DALYs averted. Conclusions: Considering the logistical and cost burdens of a two-dose schedule, a one-dose schedule for girls by age 10 would generate savings that could be leveraged for catch-up vaccination for older girls and accelerate cervical cancer elimination in Kenya.

Social norms and social opportunities: a qualitative study of influences on tobacco use among urban adolescent girls in Ghana

BackgroundTobacco use is a global public health threat and a leading preventable cause of death in the world. While cigarette use among youth has been decreasing in high-income countries, low- and middle-income countries have contrastingly high rates of adolescent smoking. In Ghana, smoking prevalence is lower than in other parts of the African continent and more common among men than women; however the gender gap in tobacco use among adolescents has narrowed, with shisha use among girls recently surpassing boys. These trends toward increased relative use among adolescent girls are a cause for concern and highlight the need for interventions to prevent and/or reduce tobacco use in this population.MethodsWe conducted in-depth interviews with girls aged 13–20 (n = 148) and their parents (n = 7) in Ghana’s largest two cities – Accra and Kumasi, to explore the physical, social, and psychological context underlying smoking perceptions and behavior.ResultsWe identified 11 key insights into influences on smoking behavior, organized into the broader themes of perceptions of smoking, environmental factors, and internal factors. Findings underscore that perceptions around smoking are very much driven by girls’ social world, which is generally small and parent-centric for non-smokers at younger ages but can start to expand as girls get farther along in school or leave school entirely. After what may have been a sheltered adolescence, many older girls in Ghana look for ways to express their independence in decision-making and a few may use their developing agency to rationalize limited or infrequent tobacco use if they perceive the benefits to them outweigh the potential consequences.ConclusionsOur findings highlight strong social influences on girls’ perceptions, exposure to opportunities, and decision-making in ways that can often be protective against smoking, particularly at younger ages, but may also leave girls unprepared to manage challenging situations later in life. Understanding this context in Ghana will be important for any future programming aiming to prevent smoking initiation among adolescents.

Young People’s Reasons for and Emotional Reactions to Sexting in Intimate Relationships

ABSTRACT Although sexting is a widespread phenomenon among today’s youth, little is known about their experiences of sexting with their intimate partners. This study addresses this gap by examining young people’s reasons for sexting and emotional reactions to sending and receiving sexts in their intimate relationships, as reported by 764 (48.7% girls) 15–20-year-olds in Finland. Both younger and older girls and boys reported mostly positive reactions to both sending and receiving sexts. However, girls reported more negative reactions than boys did. Girls’ reasons for sending sexts were more frequently related to their own desire to feel sexy or flirtatious, their need for validation from their partner, or the pressure that their partner put on them to sext, whereas boys’ reasons more often indicated normative ideas of sexting as a typical component in a romantic relationship and responding to sexts sent to them by their partners. The results suggest that although it is mostly consensual and reciprocal, sexting within intimate relationships may carry different meanings for boys and girls, reflecting gendered heterosexual norms.

Benefits from Kipsigis Women Engaging in Socio-Economic Activities in Kericho and Bomet Counties, Kenya

Purpose: To investigate the impact of Kipsigis women group economic activities and how the public perceive this new undertaking in Kericho and Bomet Counties in Kenya. Methodology: The study used a qualitative research design, where different components of the study addressed the research problem. Probability sampling technique was used to select the participants in the study. The methods used to interrogate the participants included: focus group discussions, observation and face to face interviews. Each participant responded to the questions individually, as posed in the interview guide. This was later collected by the researcher for perusal and recording of the result that was compiled along with those from other methods. Along with the focus groups discussions, the researcher selected topics related to the topic of the study for discussion in the groups. The questions used in the different methods were posed to the participants who had been purposively selected to represent the rest of the population. This was done with the view of collecting the data that was later analyzed using tools such as NVivo or done manually. This study manually analyzed the data collected from the participants through the afore-mentioned research techniques for collecting the data. Findings: The findings showed that there was recognition of women’s contribution in society. The results from Bomet County indicated that 52% have embraced and supported women’s group activities, 24% see such group activities as making the women responsible and hardworking while another 24% feel that the women are not well supported in their group economic activities. In Kericho County, the results indicated that 54% felt that women’s contribution would improve living standards and another 46% felt that the group ability would significantly improve. The study also sought to find out the effect of women engaging in socio-economic activities on the home and family. The results from women in Kericho County show that 96% indicated that there was a positive effect on family and society as stated in the research outcome, 4% said there was no effect. The results from Bomet County showed that 98% of participants agreed that the women involvement in economic activities had a positive effect on family and society. Two percent were of the feeling that there was no effect on the home and family. Bomet had a percentage of respondents who indicated that women have not contributed much through their involvement in economic activities. Unique Contribution to Theory, Practice and Policy: The Critical Social Theory helps in understanding social functioning and behavior among gender groups in the society, where men and women roles among the Kipsigis is very distinct. Women assigned roles are undertaken by women and girls as their responsibilities lies in the kitchen and around the home. This is where the small children and the elderly are, and the women and the older girls are expected to undertake those roles without question.

Trajectories of personal agency by gender and pubertal development among adolescents in Kinshasa: Longitudinal evidence from the GlobalEarly Adolescent Study

BackgroundEmpowerment research has largely focused on adult women with little focus on younger adolescents. Additionally, despite recognition that empowerment is a process, few studies have longitudinally explored its development. MethodsWe used secondary data from four waves of the Global Early Adolescent Study to explore trajectories in the development of three domains of agency (i.e. the internal processes composing empowerment) - Freedom of Movement, Voice, and Decision-Making - for 1188 boys and 1153 girls in Kinshasa, Democratic Republic of Congo. Respondents were age 10–14 at enrollment and followed through age 14–18. We created scales for each domain and conducted gender- and age-stratified latent growth curve modeling with random effects, comparing age 10–14 to age 15–18, accounting for clustering within individuals over waves. We examined the role of puberty within each domain in the analysis of age 10–14. ResultsScores across all domains increased with age for boys and girls, with the exception of Voice amongst boys 10–14. Rates of change varied by age group and gender; for boys, scores increased at a faster rate for older boys relative to younger boys for Freedom of Movement (ß(10-14): 3.98 versus ß(15-18): 6.12) and Voice (ß(10-14): .50 versus ß(15-18): 2.54). Relative to younger girls, scores amongst older girls increased at a faster rate for Freedom of Movement (ß(10-14): 1.76 versus ß(15-18): 3.72) and a slower rate for Decision-Making (ß(10-14): 6.41 versus ß(15-18): 2.80). Puberty was associated with significant increases in scores across all domains for both genders, with the exception of Decision-Making for girls. InterpretationYoung people develop/acquire different forms of agency at different stages of adolescence and development is not uniform across forms. Gender inequalities in agency amplify at puberty, signaling the need to intervene at or before this critical stage of development.

Measuring adolescent girls' agency.

The last decade has experienced a surge of interventions focused on improving adolescent girls' agency. Yet measuring adolescent girls' agency continues to be a challenge, limiting the ability to track impact. This study addresses this evidence gap by constructing and validating a multidimensional measure of agency among adolescent girls in Ethiopia. This study utilized cross-sectional data from 3033 in school adolescent girls aged 10-12 years and 15-17 years and their adult female caregivers collected as part of the Gender and Adolescent: Global Evidence study in 2017-2018 in Ethiopia. This study constructed a measure of agency among the sample and evaluated both known group and convergent validity of the scale. Twenty-two indicators across three domains (decision-making, voice, and mobility) were used to characterize adolescent girls' agency. The data was randomly divided into two halves for exploratory and confirmatory factor analyses separately. While six factors of agency emerged from the initial exploratory analysis, two factors (decision-making and mobility factors) defined adolescent girls' agency from the confirmatory factor analysis. Known-groups validity of the agency scale was confirmed-the scores on the two domains (decision-making and mobility) and the overall agency scale was higher for older girls compared to younger girls and for girls in urban households compared to those in rural households. Convergent validity of the scale was not confirmed. This study advances adolescent girls' agency measurement by providing a validated multidimensional measure that can be used to support future policy and research.

How do adolescents perceive body image and respond to body dissatisfaction?

To assess adolescents' attitudes, satisfaction, and practices regarding their body image across body mass index (BMI) categories. In this cross-sectional survey (2019-2020), we recorded anthropometry of 2,089 girls and boys between 13and 17 years from semi-urban schools in western India.Multidimensional Body-Self Relations Questionnaire (MBSRQ) was used for multidimensional attitudinal assessment of body image and weight-related variables. The Stunkard scale was used to assess body shape perception. In higher age categories, boys were more satisfied with their appearance (p=0.012, p linearity=0.001), cared more about grooming (p=0.007, p linearity=0.001), and regarded themselves more physically fit (p=0.003, p linearity 0.030 up to 16 years). Boys with normal BMI were more satisfied with their appearance (p=0.001), fitness (p=0.024), and more alert about symptoms of illness (p<0.000) than others. With increasing BMI, older girls and boys were morepreoccupied with their weight and perceived themselves to be heavier (p=0.001). A majority of underweight girls perceived their weight as normal. Students engaged in weight loss practices irrespective of their BMI category. Boyswanted a bigger, and girls a smaller body shape than their current shape. We found body shape dissatisfaction in66.4 % adolescents, more in boys than in girls (p=0.001). Body shape dissatisfaction is quite common among semiurban adolescents, with boys outnumbering girls. BMI, age, and sex are associated with weight perception and attitude toward body image. Unindicated weight loss practices are prevalent.

Egalitarian preferences in young children depend on the genders of the interacting partners

In decisions between equal and unequal resource distributions, women are often believed to be more prosocial than men. Previous research showed that fairness attitudes develop in childhood, but their—possibly gendered, developmental trajectory remains unclear. We hypothesised that gender-related fairness attitudes might depend not only on the gender of the Allocator, but also on that of the Recipient. To examine this, we tested 332 three to 8-year-old children in a paired resource allocation task, with both boys and girls acting as Allocators and Recipients. We indeed found gender-related effects: girls more than boys aimed to reduce advantageous inequity, and Allocators of both genders were more averse against male Recipients being better off. Notably, older girls exhibited an envy bias, i.e., they tolerated disadvantageous inequity more when the resource allocation was in favour of other girls than when it favoured boys. We also observed a gender-related spite gap in boys aged 7-8: unlike girls, boys treated other boys with spite, i.e., they valued unfair distributions in their own favour over equal outcomes, especially if rejecting advantageous inequity was costly. This pattern hints at contextualised gender-related fairness preferences that evolve with age that could depend on same- and cross-gender past interaction experiences.

Comparing approaches for chemoprevention for school-based malaria control in Malawi: an open label, randomized, controlled clinical trial

School-age children in sub-Saharan Africa suffer an underappreciated burden of malaria which threatens their health and education. To address this problem, we compared the efficacy of two school-based chemoprevention approaches: giving all students intermittent preventive treatment (IPT) or screening and treating only students with detected infections (IST). In a three-arm, open-label, randomized, controlled trial (NCT05244954) in Malawi, 746 primary school students, aged 5-19 years, were individually randomized within each grade-level to IPT (n=249), IST with a high-sensitivity rapid diagnostic test (hs-RDT, n=248), or control (n=249). At six-week intervals three times within the peak malaria transmission season (February-June 2022) treatment with dihydroartemisinin-piperaquine (DP) was administered to girls <10 years and all boys, and chloroquine to older girls. The primary outcome was Plasmodium falciparum (Pf) infection detected by PCR 6-8 weeks after the final intervention. Secondary outcomes included anaemia, clinical malaria, and scores on tests of attention, literacy, and math. Analysis was by modified intention-to-treat. Outcomes analyses included 727 (97%) participants. At the end of the study, prevalence of Pf infection was 17% (41/243) in the IPT arm, 24% (58/244) in the IST arm, and 53% (127/240) in the control arm. Compared to controls, IPT and IST reduced the odds of Pf infection (IPT adjusted odds ratio [aOR]: 0.18 (95% CI: 0.11, 0.27); p<0.0001; IST aOR: 0.27 (95% CI: 0.18, 0.40); p<0.0001). However, only participants receiving IPT had a lower incidence of clinical malaria (0.19 cases per person per six months (95% CI: 0.14, 0.27) vs 0.56 (95% CI: 0.46, 0.68); incidence rate ratio: 0.38 (95% CI: 0.26, 0.55); p<0.0001)) and prevalence of anaemia (8% [20/243] vs 15% [36/240]; aOR: 0.49 (95% CI: 0.27, 0.91); p=0.023) compared to controls. Literacy scores were higher in both intervention arms. No between group differences in tests of attention or math or number of serious adverse events were found. Results support implementation of IST with hs-RDTs or IPT for reduction in the prevalence of infection. Based on reductions in clinical malaria, IPT may provide additional benefits warranting further consideration by school-based malaria chemoprevention programs. Doris Duke Charitable Foundation Clinical Scientist Development Award 2021191, U.S. NIH K24AI114996 & K23AI135076.

Head and neck ice hockey injuries in children: an analysis of the NEISS database

ObjectiveOur objective was to describe non-concussion head and neck ice hockey injuries in children in the US. MethodsThis is a retrospective cohort study using data from the NEISS database. The NEISS database was reviewed from 2010 to 2021 for injuries in the head, neck, mouth, eye, and ear related to ice hockey in children 1–18 years old. Records where the only injury was a concussion or internal head injury were removed. Frequencies were calculated and chi-squared tests were performed. Results475 children were included, with mean age of 13.1 years old (95 % CI 12.7–13.4), and 426 (89.7 %) were male. Females were significantly younger with mean age 11.8 years versus 13.2 years for males (t = −2.4, df = 473, p = .018). 110 (23.2 %) injuries were related to hockey sticks, 92 (19.4 %) involved a fall, and 32 (6.7 %) were subsequent to body checking. 301 of the injuries (63.4 %) were lacerations, 71 (14.9 %) contusions or abrasions, and 26 (5.5 %) strains and sprains. The type of injury varied according to head and neck region (p < .001). 231 (82.8 %) of facial injuries, 16 (76.2 %) of ear injuries, and 33 (62.3 %) of oral injuries were lacerations. Eight (1.7 %) patients were admitted or observed overnight, while the rest were discharged home. ConclusionFemale ice hockey players sustain injuries at younger ages than males, which may reflect the loss of older girls from the sport. In older boys, injury rates may reflect the loss of mandated full face protective shields.

Behind the Sadness of Teen Girls: A Retrospective Survey Analysis Amidst the COVID-19 Crisis of 2021

(1) Background: Adolescent girls have increasingly faced mental health challenges. We examined prevalence trends and associated risk factors for depression among adolescent girls. (2) Methods: Data for girls aged 12 to 17 years (N = 4346) from the 2021 cross-sectional National Survey on Drug Use and Health were analyzed. Factors associated with depression were examined using multiple regression analysis. (3) Results: Rates of severe depression were significantly higher (p &lt; 0.001) in older girls (adjusted odds ratio [AOR]: 1.63, 1.61), those who did not have authoritative parents (AOR: 3.40), and those with negative school experiences (AOR: 4.03). Black and Asian/Native Hawaiian or other Pacific Islanders were less likely to report severe depression than white girls. As previously reported, non-white girls were significantly less likely to receive treatment for depression (p &lt; 0.05). Parents’ characteristics and school experiences had no effect on the likelihood of receiving mental health treatment. (4) Conclusions: Depression has become increasingly common among American adolescent girls, who are now three times as likely as adolescent boys to have had recent experiences with depression. Our results show that family structure, parenting style, and negative school experiences significantly contribute to the rate of depression and that treatment disparities exist with regard to race and ethnicity. The results of our research could be valuable for policymakers, healthcare professionals, and educators in developing specific preventative initiatives and support networks that effectively address these unique challenges.

Optimal human papillomavirus vaccination strategies in the context of vaccine supply constraints in 100 countries

Countries are recommended to immunise adolescent girls routinely with one or two doses of human papillomavirus (HPV) vaccines to eliminate cervical cancer as a public health problem. With most existing vaccine doses absorbed by countries (mostly high-income) with existing HPV vaccination programmes, limited supply has been left for new country introductions until 2022; many of those, low- and middle-income countries with higher mortality. Several vaccination strategies were considered by the Strategic Advisory Group of Experts on Immunization to allow more countries to introduce vaccination despite constrained supplies. We examined the impact of nine strategies for allocating limited vaccine doses to 100 pre-introduction countries from 2020 to 2030. Two algorithms were used to optimise the total number of cancer deaths that can be averted worldwide by a limited number of doses (knapsack and decreasing order of country-specific mortality rates), and an unoptimised algorithm (decreasing order of Human Development Index) were used. Routinely vaccinating 14-year-old girls with either one or two doses and switching to a routine 9-year-old programme when supply is no longer constrained could prevent the most cervical cancer deaths, regardless of allocation algorithm. The unoptimised allocation averts fewer deaths because it allocates first to higher-income countries, usually with lower cervical cancer mortality. To optimise the deaths averted through vaccination when supply is limited, it is important to prioritise high-burden countries and vaccinating older girls first. WHO, Bill & Melinda Gates Foundation.

Region, Location, and Age-Specific Comparison of Nutritional Status of In-School Adolescent Girls (10-19 years) in Nigeria

Objective: This study was conducted to assess the nutritional status of adolescent girls using anthropometric indices. Methods: Descriptive cross-sectional study of 2261 in-school adolescent girls aged 10 -19 was conducted. A multistage stratified random sampling procedure was used to select participants from three geopolitical zones in Nigeria. Two states selected from each zone; North Central (Kogi and Niger States), South East (Abia and Imo States) and South West (Osun and Ondo States). Body Mass Index-for-age, Waist-Hip-Ratio (WHR), and Waist-Height-Ratio were calculated by anthropometry of weight, height, hip, waist and Mid-Upper Arm Circumferences. Data were analysed on SPSS Version 24. Frequency, percentages, mean and standard deviations were used for descriptive while logistic regression and chi-square analyses were used for inferential statistics. Significance was taken at p&lt;0.05. Results: Mean age was 14.86 years (± 1.78 years) and actual body weight was 47.81 kg (± 9.02 kg), which is lower than the ideal weight of 54.52 kg (± 9.05 kg). The negative variance of -6.71 kg shows that the girls weighed 6.71 (±9.73) kg less than their ideal weight. Overweight/Obesity/Risk of Abdominal Obesity was highest in South East region (p = .005) while underweight/undernourishment was highest in South West (p = .005). However, no significant difference was recorded between the urban and peri-urban populations (p = .005). Older girls; 14 -16yrs (OR = 2.311, 95%CI = 1.263 – 4.229) and 17 -19yrs (OR = 2.182, 95%CI = 1.253 – 3.799) were twice more likely to be Overweight/Obesity compared to 10 -13yrs. Those who were within the 14 -16yrs age range were thrice more likely to have higher WHR (OR = 3.043 95%CI = 2.334 -3.978) than those younger. Conclusion: There was a significant difference in the nutritional status of adolescent girls across regions and age ranges hence a need for regional nutrition-sensitive intervention programmes among adolescent girls. Keywords: High School Girls; Health Status; Body Stature; Body Measurement; Nigeria Region

Socioeconomic inequalities in the incidence of COVID-19 in Barcelona students

ObjectiveThis study aimed to assess socioeconomic inequalities in schools regarding the COVID-19 incidence during different epidemic waves among Barcelona students, differentiating by sex and educational stage. Study designCross-sectional ecological study. MethodsWe included in the study all students from childhood to secondary education in Barcelona city. The unit of analysis was the schools. The study covered the epidemic waves coinciding with the 2020-21 and 2021-22 school courses. The cumulative incidence (CI) per school and wave was calculated. Bivariate and multivariate analyses using Poisson regression were conducted to estimate relative risks. The population attributable risk, by sex and educational stage, was calculated as a measure of impact. ResultsIn the second wave, higher CI in students was associated with greater school socioeconomic deprivation in all groups. In the younger girls, 24.5 % (5.2–41.4) of the CI was attributed to school socioeconomic vulnerability, increasing to 33.1 % (15.1–47.2) in older girls. During the sixth wave, the impact was lower in the most vulnerable schools in all strata. ConclusionsSocioeconomic factors significantly impacted the incidence of COVID-19 in schools, reflecting social inequalities in Barcelona. There was an inversion of the pattern of inequalities in the sixth wave compared to the previous ones. The results emphasize the need for urgent action and targeted resources to address health inequalities in education and understand the impact of epidemic dynamics on socioeconomic context.

Promoting adolescent girls' active school travel in Ghana: Contextualizing health belief model and theory of planned behavior

In recent years, efforts to promote safer active school travel (AST), i.e., walking and cycling behaviors in girls, have heightened in light of huge gender disparities in micromobility adoption. In developing countries where transport infrastructure is not advanced, and AST adoption is influenced by societal perceptions, theorizing empirical studies will help better explore and understand the travel needs of girls for effective planning. This study investigated the factors influencing AST behaviors of 232 adolescent girls in primary, junior, and senior high schools based in Sunyani Municipality, Ghana. A novel combination of the Health Belief Model and the Theory of Planned Behavior was employed to formulate a conceptual model that was evaluated using SEM-MIMIC modeling. Results revealed that age plays a significant role in AST preferences, with younger girls favoring walking and older girls showing interest in cycling. Interventions can capitalize on this to promote cycling habits during the transition to senior high school. Moreover, environmental attitudes have the most decisive influence on the perceived social benefits of AST, while perceived parental support positively impacts safety self-efficacy. Together with perceived parental support, safety self-efficacy, and distance/accessibility barriers, they significantly influence girls' intentions to use active transportation. Authorities can adopt proposed targeted interventions such as the walking school bus and bicycle train concepts to make AST more attractive to girls.

Developmental changes of bodily self-consciousness in adolescent girls

The body and the self change markedly during adolescence, but how does bodily self-consciousness, the pre-reflexive experience of being a bodily subject, change? We addressed this issue by studying embodiment towards virtual avatars in 70 girls aged 10–17 years. We manipulated the synchrony between participants’ and avatars’ touch or movement, as well as the avatar visual shape or size relative to each participant’s body. A weaker avatar’s embodiment in case of mismatch between the body seen in virtual reality and the real body is indicative of a more robust bodily self-consciousness. In both the visuo-tactile and the visuo-motor experiments, asynchrony decreased ownership feeling to the same extent for all participants, while the effect of asynchrony on agency feeling increased with age. In the visuo-tactile experiment, incongruence in visual appearance did not affect agency feeling but impacted ownership, especially in older teenage girls. These findings highlight the higher malleability of bodily self-consciousness at the beginning of adolescence and suggest some independence between body ownership and agency.

‘Managing’ tech and a growing family

David and Freya Flatman have four daughters – 14, 11 and 2 years old and a 6-month-old baby – and live in the UK. Their older two daughters are from David’s first marriage and the younger two are from his marriage to Freya. For part of the week, the two older girls live with David and Freya and their younger sisters. In the interview, David reflects on how his older daughters use tech, with contributions from Freya and prompted by questions from the interviewer.

The Effect of Time Variables as Predictors of Senior Secondary School Students' Mathematical Performance Department of Mathematics Education Freetown Polytechnic

This study aimed to investigate the effect of time variables as predictors of senior secondary school students' mathematical performance in Kossoh Town, Western Rural. The time variables considered in this study included the time of day when the math test was administered, the amount of time spent studying math outside of school, and the time of year when the test was taken. A sample of 250 Senior Secondary School Students from different public schools participated in the study. They were administered a standardized math test at three different times of the day (morning, afternoon, and evening), and their scores were recorded. Additionally, the students were asked to report the amount of time they spent studying math outside of school and the time of year when they took the test. The results of the study indicated that the performance of girls in the mathematics tests varied depending on the time of the day and their age group. The highest pass rates were observed in the morning and the lowest in the evening. Additionally, older girls and boys (above 20) generally had lower pass rates compared to younger age groups. This means time variables had a significant impact on the students' mathematical performance. Furthermore Students who took the test in the morning scored higher on average compared to those who took the test in the afternoon or evening. Additionally, students who reported studying math outside of school for a longer period of time had higher scores on the test. Finally, students who took the test later in the school year scored higher compared to those who took the test earlier in the year. Overall, the findings of this study suggest that time variables play a crucial role in predicting Senior Secondary School.

Problematic social media use and psychological symptoms in adolescents

PurposeThis study examined time trends in significant child and adolescent psychological symptoms and explored the association of frequent and problematic social media use with these symptoms.MethodsTime trends in psychological symptoms were assessed using data from five waves of the international survey of Health Behavior in School-aged Children (HBSC), conducted between 2001 and 2018 (N = 1,036,869). The associations of frequent and problematic social media use with significant psychological symptoms were assessed by hierarchical multinomial logistic regression using data from 2001–2002 and the 2017–2018 survey waves. The direction of effect between social media use variables and psychological symptoms was explored using Linear Non-Gaussian Acyclic Models (LiNGAM).ResultsPrevalence of more severe psychological symptoms increased from 6.7% in 2001–2002 to 10.4% in the 2017–2018 survey waves. The increase was especially large among 15-year old and older girls: from 10.9 to 19.1%. The higher prevalence of more severe psychological symptoms in 2017–2018 compared with 2001–2002 was eliminated after adjusting the model for problematic social media use. LiNGAM analysis supported the direction of effect going from social media use and problematic social media use to psychological symptoms.ConclusionsThe findings suggest that frequent and problematic use of social media contribute to the increasing trend of psychological symptoms in adolescents in recent years.

Final Validation of the Quality of Life after Brain Injury for Children and Adolescents (QOLIBRI-KID/ADO) Questionnaire.

Until recently, no disease-specific health-related quality of life (HRQoL) questionnaire existed for pediatric traumatic brain injuries (TBIs). In this revalidation study, the psychometric properties and the validity of the 35-item QOLIBRI-KID/ADO questionnaire in its final German version were examined in 300 children and adolescents. It is the first self-reported TBI-specific tool for measuring pediatric HRQoL in individuals aged between 8 and 17 years. The six-factor model fits the data adequately. The questionnaire's internal consistency was excellent for the total score and satisfactory to excellent for the scale scores. Intraclass correlations indicated good test-retest reliability, and the measure's construct validity was supported by the overlap between the QOLBRI-KID/ADO and the PedsQL, which measures generic HRQoL. The discriminant validity tests showed that older children and girls reported a significantly lower HRQoL than comparison groups, and this was also true of children who were anxious or depressed, or who suffered from post-concussion symptoms, replicating the results of the questionnaire's first developmental study. Our results suggest that the QOLIBRI-KID/ADO is a reliable and valid multidimensional tool that can be used together with the adult version in clinical contexts and research to measure disease-specific HRQoL after pediatric TBI throughout a person's life. This may help improve care, treatment, daily functioning, and HRQoL after TBI.