School-aged Girls Research Articles

Disordered Eating Styles Are Associated with School-age Girls’ Weight Status

Disordered Eating Styles Are Associated with School-age Girls’ Weight Status

The Validation of the Greulich and Pyle Atlas for Radiological Bone Age Assessments in a Pediatric Population from the Canary Islands.

Bone age assessments measure the growth and development of children and adolescents by evaluating their skeletal maturity, which is influenced by various factors like heredity, ethnicity, culture, and nutrition. The clinical standards for this assessment should be up to date and appropriate for the specific population being studied. This study validates the GP-Canary Atlas for accurately predicting bone age by analyzing posteroanterior left hand and wrist radiographs of healthy children (80 females and 134 males) from the Canary Islands across various developmental stages and genders. We found strong intra-rater reliability among all three raters, with Raters 1 and 2 indicating very high consistency (intra-class coefficients = 0.990 to 0.996) and Rater 3 displaying slightly lower but still strong reliability (intra-class coefficients = 0.921 to 0.976). The inter-rater agreement was excellent between Raters 1 and 2 but significantly lower between Rater 3 and the other two raters, with intra-class coefficients of 0.408 and 0.463 for Rater 1 and 0.327 and 0.509 for Rater 2. The accuracy analysis revealed a substantial underestimation of bone age compared to chronological age for preschool- (mean difference = 17.036 months; p < 0.001) and school-age males (mean difference = 13.298 months; p < 0.001). However, this was not observed in females, where the mean difference was minimal (3.949 months; p < 0.239). In contrast, the Atlas showed greater accuracy for teenagers, showing only a slight overestimation (mean difference = 3.159 months; p = 0.823). In conclusion, the GP-Canary Atlas demonstrates overall precision but requires caution as it underestimates the BA in preschool children and overestimates it in school-age girls and adolescents.

Effects of recreational artistic gymnastics on bone mineral density and content of school-age girls

Aims :This study aimed to evaluate whether Artistic Gymnastics (AG) practice has beneficial effects on Bone Mineral Density (BMD) and Bone Mineral Content (BMC) of young gymnasts.Methods : All girls involved in AG training from the city of Pelotas, aged 6 to 12 years were recruited. Control group participants could not be involved in any extracurricular sports activity. Predictive equations based on anthropometric and physical tests were used to assess bone mass (BMD and BMC).Results : When compared to control group, AG group showed higher Femoral neck (0.672 ± 0.147 vs 0.561 ± 0.172) and Upper limbs (1.482 ± 0.159 vs 1.289 ± 0.178) BMD. In addition, Lumbar spine BMD was higher in AG group regardless of the predictive equation used. When compared with girls not involved in extracurricular activities, AG practitioners presented higher upper limbs, femoral neck and lumbar spine BMD.Conclusion : However, caution is required when using predictive equations to assess BMD and BMC.

The Evaluation of human papillomavirus vaccination coverage for school aged girls in Badung District, Bali, Indonesia, 2016 – 2018

Background and purpose: Since 2016, Badung District, Bali has implemented a free HPV vaccination program for school children, with vaccination coverage reported to be over 90% in 2016-2018. This study aims to objectively assess the coverage of HPV vaccination among school children in Badung District. Methods: This survey used a cross-sectional design that conducted between March and June 2019. Sample selection was done by systematic random sampling, following the WHO guidelines. A total of 216 families met the sample criteria, with a total of 249 children from all families. Respondents in this study were eligible girls' mothers or families who knew the child's vaccination history. Variables of this study were sociodemographic characteristics of respondents and children, HPV vaccination recall and HPV child vaccination validation. The data collected were analyzed descriptively to calculate the coverage of recall and validation of HPV vaccination. Results: The majority of respondents were mothers (70.83%) with a high school education (51.85%). The median age was 43 years (IQR=8 years). Each family had a mean of 1.15 eligible children (SD=0.39). Of the 249 children, most were aged 16-19 years (43.37%), with age at vaccination mostly ≤12 years (46.52%). HPV vaccination coverage by recall was 82.32% (95%CI: 77.56-87.09), with HPV vaccination coverage by validation was 76.59% (95%CI: 70.74-82.43). Conclusion: After validation, vaccination coverage was lower than vaccination coverage by recall. The health office needs to improve the vaccination registration system, in particular the uniformity of registration and record keeping to ensure proper traceability of vaccination history.

Physical Activity Habits and Sleep Duration According to Gender: A Cross-Sectional Study of Elementary School Children.

(1) Background: The main goals of this study were to describe the physical activity (PA) and sleep habits of 8-12-year-old children according to their gender and to evaluate the relationship between PA and sleep habits (i.e., duration and timing). (2) Methods: A total of 236 children (114 boys and 122 girls) completed the Physical Activity Questionnaire for Older Children (PAQ-C) and an ad hoc sleep habits questionnaire. (3) Results: Boys were more physically active than girls (2.62 ± 0.51 vs. 2.46 ± 0.48, p = 0.026) and enacted higher PA levels in school recess (3.82 ± 1.36 vs. 3.56 ± 1.38, p = 0.003), during the afternoon (3.37 ± 1.20 vs. 2.89 ± 1.12, p = 0.003), and during weekends (3.54 ± 1.20 vs. 3.18 ± 0.48, p = 0.009). Per sleep habits, boys had a significantly later bedtime (21:53 ± 2:08 vs. 21:34 ± 2:14, p = 0.009) and a significantly smaller total sleep duration (9.64 ± 0.86 vs. 9.89 ± 0.87 h, p = 0.023) than girls. No significant correlations between PA and sleep habits were found. (4) Conclusions: We found differences in the PA and sleep habits between school-age boys and girls. Institutions and entities should consider designing specific interventions to improve PA and sleep habits according to gender.

Analysis of Lyme infections among children hospitalised in the Provincial Specialist Children’s Hospital in Olsztyn in 2013–2018

Introduction and objective: Lyme disease is the most common chronic, infectious, multisystem, multiform disease. The region of Warmia and Mazury, as well as Podlasie, and the region of Lower Silesia are endemic areas for Lyme disease in our country. The aim of the study was to analyse the prevalence of Lyme disease among children from the Warmian-Masurian Voivodeship hospitalised in the Provincial Specialist Children’s Hospital in Olsztyn. Materials and methods: The study group consisted of 109 patients admitted to a hospital with Lyme disease diagnosis. The study used a retrospective method based on the analysis of the medical history of patients admitted to the hospital in the period from January 2013 to December 2018. Results: More than half of the cases (56.88%) were elective hospital admissions, while 43.12% were emergency admissions. The largest number of patients complained of headaches (68.81%). In about half of the patients (54.13%), the first symptoms of the disease appeared in less than 3 months. Conclusions: Among hospitalised patients diagnosed with Lyme disease, urban school age girls were significantly more likely to be affected. Most patients hospitalised due to Lyme disease denied a tick bite. The majority of patients hospitalised during the study period presented with non-specific symptoms of Lyme disease. The time between symptom onset and the diagnosis of Lyme disease was significantly shorter in children under 7 years of age. The time of hospitalisation of children under the age of 7 years was significantly shorter than in other age groups.

Impact of mobile health technologies on human papillomavirus vaccination uptake among mothers of unvaccinated girls aged 9-14 years in Lagos, Nigeria (mHealth-HPVac): Study protocol of a randomised controlled trial.

Despite the availability of effective vaccines, human papillomavirus (HPV) vaccine uptake remains low in most resource-limited settings including Nigeria. Mobile health technology (mHealth) may empower patients to control their health, reduce inequalities, and improve the uptake of HPV vaccination. The "mHealth-HPVac" study will assess the effects of mHealth using short text messages on the uptake of HPV vaccination among mothers of unvaccinated girls aged 9-14 years and also determine the factors influencing the uptake of HPV vaccination among these mothers. This protocol highlights a randomised controlled trial involving women aged 25-65 years who will be enrolled on attendance for routine care at the General Outpatient clinics of Lagos University Teaching Hospital, Lagos, Nigeria between July and December 2024. At baseline, n=224 women will be randomised to either a short text message or usual care (control) arm. The primary outcome is vaccination of the participant's school-age girl(s) at any time during the 6 months of follow-up. The associations between any two groups of continuous variables will be tested using the independent sample t-test (normal distribution) or the Mann-Whitney U test (skewed data) and that of two groups of categorical variables with Chi-square (X2) or Fisher's exact test where appropriate. Using the multivariable binary logistic regression model, we will examine the effects of all relevant sociodemographic and clinical variables on HPV vaccination uptake among mothers of unvaccinated but vaccine-eligible school-age girls. Statistical significance will be defined as A P<0.05. The mHealth-Cervix study will evaluate the impact of mobile technologies on HPV vaccination uptake among mothers of unvaccinated but vaccine-eligible school-age girls in Lagos, Nigeria as a way of contributing to the reduction in the wide disparities in cervical cancer incidence through primary prevention facilitated using health promotion to improve HPV vaccination uptake. PACTR202406727470443 (6th June 2024).

Awareness of Menstrual Hygiene Management Rights and Perception of Risks, Self-Efficacy, and Behavior.

Menstrual Hygiene Management stands as a critical health concern for girls entering reproductive age on a global scale. This transition often induces fear and anxiety due to inadequate knowledge about menstruation and a lack of resources to comprehend bodily changes. Notably, school-aged girls in marginalized communities face formidable barriers to MHM, given the insufficient facilities, supplies, and awareness in educational institutions. A Mixed method study was conducted adopting a mixed-methods approach. It engaged 562 respondents across five local levels of Bajura district, including three municipalities (Badimalika, Budhiganga, and Tribeni) and two rural municipalities (Gaumul and Khaptad Chhedaha). The study unveiled over 90% awareness on on five out of seven MHM rights related statements and over 85% self-efficacy on 5 out of 8 statements regarding MHM among female adolescent respondents. However, their actual practices fell short of expectations, marked by the prevalence of restrictive norms and perceived risks pertinent to MHM. Notably, 27% (N=154) expressed fear of divine consequences for not adhering to menstrual customs. Malpractices were observed, including 66% using cloth during menstruation, inadequate pad changing frequencies, and some girls staying in Chhaugoth during menstruation. Despite a high awareness (97%) of menstrual rights, behavioral practices did not consistently align with this awareness. The study highlights high awareness and self-efficacy in menstrual hygiene management among female adolescents, yet challenges persist due to cultural norms, perceived risks, and insufficient infrastructure, necessitating multifaceted solutions for behavioral change and access to resources.

Impact of mobile health technologies on human papillomavirus vaccination uptake among mothers of unvaccinated girls aged 9–14 years in Lagos, Nigeria (mHealth-HPVac): study protocol of a randomised controlled trial

BackgroundDespite the availability of effective vaccines, human papillomavirus (HPV) vaccine uptake remains low in most resource-limited settings including Nigeria. Mobile health technology (mHealth) has the potential to empower patients to manage their health, reduce health disparities, and enhance the uptake of HPV vaccination.AimThe “mHealth-HPVac” study will assess the effects of mHealth using short text messages on the uptake of HPV vaccination among mothers of unvaccinated girls aged 9–14 years and also determine the factors influencing the uptake of HPV vaccination among these mothers.MethodsThis protocol highlights a randomised controlled trial involving women aged 25–65 years who will be enrolled on attendance for routine care at the General Outpatient clinics of Lagos University Teaching Hospital, Lagos, Nigeria between July and December 2024. At baseline, n = 123 women will be randomised to either a short text message or usual care (control) arm. The primary outcome is vaccination of the participant’s school-age girl(s) at any time during the 6 months of follow-up. The associations between any two groups of continuous variables will be assessed using the independent sample t-test for normally distributed data, or the Mann-Whitney U test for skewed data. For two groups of categorical variables, the Chi-square (X2) test or Fisher’s exact test will be used, as appropriate. Using the multivariable binary logistic regression model, we will examine the effects of all relevant sociodemographic and clinical variables on HPV vaccination uptake among mothers of unvaccinated but vaccine-eligible school-age girls. Statistical significance will be reported as P < 0.05.DiscussionThe mHealth-Cervix study will evaluate the impact of mobile technologies on HPV vaccination uptake among mothers of unvaccinated but vaccine-eligible school-age girls in Lagos, Nigeria as a way of contributing to the reduction in the wide disparities in cervical cancer incidence through primary prevention facilitated using health promotion to improve HPV vaccination uptake.RegistrationPACTR202406727470443 (6th June 2024).

Time trends and disparities of obesity and related national policies and programs in Nepal: a systematic review

ObjectiveOverweight and obesity prevalence has increased in low-income countries. This study systematically reviewed the obesity trend, disparities, and prevention and control efforts in Nepal. MethodsWe searched PubMed and Google Scholar for articles and reports published between January 1, 2004 and December 31, 2022. Additional information on National policies and programs related to obesity prevention was retrieved from governmental websites and consultation with relevant experts. Overweight and obesity were defined using the World Health Organization body mass index cut points. Thirty-two studies and reports were included. ResultsOverall, overweight and obesity rates increased in all groups in Nepal although nationally representative data remained limited. The combined overweight and obesity (OW/OB) and obesity rates in women aged 15‒49 years increased from 8.5% to 22.2% and from 0.9% to 5.1% between 2006 and 2016, respectively. OW/OB and obesity rates in men were 17.1% and 2.5% based on data from the 2016 Demographic and Health Survey. OW/OB rate in under-five children increased from 0.6% to 2.8% between 2006 and 2016. Obesity rates for school-age (5‒9 years) boys and girls in 2016 were 2.4% and 2.8%, respectively, and were 1.1% and 1.4% for male and female adolescents aged 10‒19 years, respectively. OW/OB prevalence was much higher among women, residents in urban areas and central provinces, and in higher socioeconomic status groups. Projected prevalence of OW/OB and obesity for 2030 in adults aged 15‒49 was 44.7% and 8.3%, respectively, while it was 2.2% for OW/OB in preschool children. Policies and direct interventions that specifically focused on obesity prevention and control are limited. ConclusionsOW/OB prevalence in Nepal has increased during the past 1.8 decades, disproportionately affecting population groups. Existing interventions mostly focused on undernutrition with some indirect implications for obesity prevention. In the future, Nepal needs to develop population-based programs for obesity prevention.

Peran Biro Kesejahteraan Rakyat Provinsi Jawa Timur dalam Upaya Penurunan Stunting di Provinsi Jawa Timur Melalui Penguatan Tim Pembina Unit Kesehatan Sekolah (TP UKS/M)

Peran Biro Kesejahteraan Rakyat Provinsi Jawa Timur dalam Upaya Penurunan Stunting di Provinsi Jawa Timur Melalui Penguatan Tim Pembina Unit Kesehatan Sekolah (TP UKS/M)

Menstrual health and hygiene knowledge among post menarche adolescent school girls in urban and rural Tanzania.

Adolescent girls' capacity to lead healthy lives and perform well in school has been hampered by their lack of awareness about menstruation and the requirements for its hygienic management. Lack of enabling infrastructure, improper menstrual supplies, and limited socioeconomic support for good menstrual health and cleanliness are characteristics of schools in Africa South of the Sahara. We evaluated school-age girls' knowledge of menstrual hygiene and identified bottlenecks that could affect policy and programming for menstrual health and hygiene. A school-based cross-sectional study involved 8,012 adolescent school girls in the age group of 11-18 years (mean age = 14.9 years). The study evaluated students' knowledge of menstrual health and hygiene (MHH) from the viewpoints of schools and communities using a combination of qualitative and quantitative approaches. Data was collected using self-administered surveys, focus group discussions, in-depth interviews, and site observations. Girls' older age (AOR = 1.62, P 0.001), having a female guardian (AOR = 1.39: P = 001), and having a parent in a formal job (AOR = 1.03: P 0.023) were positively associated with Menstrual health and Hygiene Knowledge. MHH knowledge levels varied significantly between girls attending government (53.3) and non-government schools (50.5%, P = 0.0001), although they were comparable for girls attending rural and urban schools. Only 21% of the study's schools had at least one instructor who had received training in MHH instruction for students. We have established that the majority of adolescent girls in schools have inadequate knowledge on menstrual health and hygiene, and that school teachers lack the skills to prepare and support young adolescents as they transition into puberty. Concerted actions aimed at building supportive policy are paramount, for school-aged teenagers to learn about and reap the long-term advantages of good menstrual health practices.

Associations between nutritional deficiencies and food insecurity among adolescent girls: A cross-sectional study.

There is a research gap in understanding the relationship between nutrient deficiency and food insecurity among adolescent girls in Afghanistan. The objective of this study was to investigate the associations between nutrient deficiencies and food insecurity among middle and high school-aged girls in Kabul. We conducted a cross-sectional study of 380 randomly selected 11-18-year-old girls attending public schools in grades 6-12. We assessed girls' food insecurity, food and nutrient intake, socioeconomic status, and physical activity. Nutrient consumption was calculated using Nutritionist IV software. Statistical analyses, including one-way analysis of variance, Chi-square tests, and t-tests, were used to assess the association between dietary intake and food insecurity. More than half (52.9%) of the participants were food insecure, with 35.8% experiencing hunger and 17.1% without hunger. Vitamin B3, C, selenium, and iron had the highest sensitivity, specificity, and accuracy and were the best indicators of food insecurity with and without hunger. The most prevalent nutrient deficiencies were vitamin B9 and E, calcium, magnesium, and zinc inadequacies. Food security was positively associated with fruit, vitamins E and K, dairy products (e.g., milk, yogurt, and cheese), meat products (e.g., chicken, meat, red meat, and egg), and nut intake. Our findings suggest that adolescent girls in Kabul may benefit from food programs that enrich nutrients such as B9 and E, calcium, magnesium, and zinc, which were found to be the most prevalent nutrient deficiencies. These findings highlight the importance of addressing food insecurity and nutrient deficiencies among adolescent girls in Afghanistan.

Changes in Somatic Indicators, Body Posture and Health-Oriented Fitness among Younger School-Age Female Pupils

Background and Aim of Study: Currently, we are observing a worsening trend in the field of health-oriented fitness and postural health of the school population. The aim of the research was to compare and expand knowledge in the areas of monitoring somatic changes, indicators of health-oriented fitness, motor performance, and body posture among 10-year-old female school populations. Material and Methods: The sample consisted of ????n=292 female pupils, with n=150 from 2012 and n=142 from 2022 at the elementary school in Žilina (ZA), Slovakia. An ex post facto study was applied. Standardized methods of measurement and testing applicable for school practice were used to obtain data. Differences between groups of female pupils were examined using the Kruskal-Wallis H-test and the Mann-Whitney U-test. To determine the effect size and measure the difference in average values, Cohen's d and r were used. The differences found were evaluated at the (p&lt;0.05) level of statistical significance. Results: When comparing the average body weight of female pupils from ZA in 2012 and 2022, we found a significant difference (p&lt;0.05) (H=4.87, p=0.02733) in favor of female pupils from 2012. The same finding in favor of female pupils from 2012 was recorded when comparing the average body mass index (BMI) (H=4.8182, p=0.02816), as well as in evaluating the average health-oriented fitness using the Ruffier test (H=13.1965, p=0.00028). The Beep test was also used to evaluate the endurance abilities of female pupils, where current ZA female pupils in 2022 showed significantly worse results (H=5.752, p=0.01647). Similarly, we also observed significant (p&lt;0.05) worse findings in overall body posture among female pupils from ZA in 2022. Conclusion: On the basis of our findings, we consider the current state of body weight, posture, health-oriented physical fitness and endurance skills in younger school-aged girls to be unsatisfactory and health-threatening. It is necessary to further deal with the stated facts and look for preventive measures. These findings indicate a declining and deteriorating trend in health-oriented fitness in relation to body weight, body posture, and endurance abilities.

Multi-omic analysis of precocious puberty girls: pathway changes and metabolite validation.

Precocious puberty (PP) is a prevalent endocrine disorder affecting the physical and mental wellbeing of children. Identifying the triggering factors of PP has become a central issue. This study seeks to investigate the metabolomic and transcriptomic alterations in PP. First, 37 school-aged girls diagnosed with PP and 25 age-matched prepubertal control girls were recruited, and the fecal samples were collected for non-targeted metabolomic analysis to screen for differentially expressed metabolites (DEMs). Subsequently, an animal model of PP was constructed by danazol administration to neonatal female rats, and both fecal non-targeted metabolomics and serum next-generation transcriptomic sequencing were performed to screen DEMs and differentially expressed genes (DEGs) in PP. Moreover, the DEM co-existing in clinical and animal models was administrated to PP rats to explore the role of the target metabolite in PP. A total of 24 DEMs in PP clinical samples and 180 DEMs and 425 DEGs in PP animal samples were identified. The Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis showed that these DEMs and DEGs were enriched in disease-associated pathways, including fatty acid synthesis, glycerolipid metabolism, pyrimidine metabolism, steroid hormone biosynthesis, progesterone-mediated oocyte maturation, and gonadotropin-releasing hormone (GnRH) signaling pathway, forming a tight DEM-DEG pathway regulatory network. Further DEM validation demonstrated that thymine supplementation delayed the opening of the vagina and development of PP in model rats. This study reveals that the metabolomic and transcriptomic changes, along with enriched pathways, are implicated in PP based on clinical and animal analyses. The findings may provide new strategies and research avenues for PP treatment.

Washing machine ownership and girls' school attendance: a cross-sectional analysis of adolescents in 19 middle-income countries

Excessive work among adolescents may compromise educational development. Without home appliances, household work can take over 50 h a week and an additional 30 h when an infant is present. School-aged girls are often tasked with doing laundry, which is time-consuming and inflexible without a washing machine. We determined the association between washing machine ownership and school attendance among adolescents ages 10–19 years in 19 middle-income countries between 2000 and 2021 (N = 1,622,514). We controlled for socioeconomic and demographic characteristics, all neighborhood-level factors, and examined differences by sex, age, household wealth, and period. No relationship between washing machine ownership and school attendance was found in most countries: However, there was a substantial association for girls in Türkiye and a small to moderate association for girls in Egypt and Albania. In Türkiye, for example, girls living in households with a washing machine had 28% (95% CI 19, 37) greater school attendance compared to girls living in households which did not. No association was observed for boys. The results suggest that household ownership of a washing machine does generally not improve school attendance among girls, except possibly in specific contexts.

Диагностика трудностей в обучении в области социальной адаптации у младших школьников

&lt;p&gt;The work is the result of studying the difficulties in teaching younger schoolchildren in the field of social adaptation. The materials of an empirical study obtained on a sample (N=2030) of students aged 9-11 years in various regions of the Russian Federation (Republic of Tatarstan (20,5%), Lipetsk Region (16,5%), Volgograd Region (20,0%), Chuvash Republic (22,4%), Samara Region (20,5%)) are presented. The method "Strengths and difficulties" by R.N. Goodman (SST) was used, which allows to assess behavior, emotional sphere and relationships with peers, the method of self-assessment and the level of claims by Dembo-Rubinstein modified by A.M. Prihozhan and the Scale of apparent anxiety CMAS by J. Taylor in the adaptation of A.M. Prihozhan. The results obtained make it possible to say that the difficulties of establishing cooperative or friendly relations with peers, rejection by peers, aggressiveness towards others, irritability, difficulty or unwillingness to follow the rules of behavior are the most characteristic for younger schoolchildren. In girls of primary school age, emotional difficulties come to the fore, i.e. they are more susceptible to stress and its manifestations, anxiety and fears, while girls are more prone to manifestations of voluntary behavior designed to benefit another person and society as a whole, adherence to generally accepted rules, attentiveness to others.&lt;/p&gt;

Cognition, academic achievement, and adaptive behavior in school-aged girls with fragile X syndrome

BackgroundFragile X syndrome (FXS) is the leading monogenic cause of intellectual disability and autism in males and females. Females with FXS typically display a milder cognitive phenotype than males, despite experiencing significant developmental, behavioral, and social-emotional issues. AimsTo measure and distinguish the cognitive-behavioral profile of girls with FXS relative to verbal IQ-matched peers. Methods and proceduresNinety-seven participants (NFXS=55, Ncomparison=42) six to 16 years of age completed assessments evaluating cognition, academic achievement, and adaptive behavior. The comparison group consisted of age-, sex-, and verbal IQ-matched peers. Outcomes and resultsConsistent with previous studies, the FXS group demonstrated mean cognitive skills, academic achievement, and adaptive behavior in the borderline to low average range. On average, the FXS group showed poorer nonverbal reasoning, visual pattern recognition, verbal abstraction, math abilities, attention, inhibitory control, and working memory than the comparison group. There were no significant group differences in adaptive behavior. Different patterns of associations between cognition and selected outcomes emerged in each group. Conclusions and implicationsResults highlight the importance of identifying specific cognitive-behavioral profiles in girls with FXS to inform more targeted interventions for optimizing outcomes and quality of life in this population.

1 Perceived Cognitive Impairment in High School Students in the United States During the COVID-19 Pandemic

Objective:The Youth Risk Behavior Survey (YRBS), conducted by the United States Centers for Disease Control and Prevention (CDC) in 2019, revealed that a large percentage of boys (30%) and girls (45%) reported serious difficulty concentrating, remembering, or making decisions as a result of a physical, mental, or emotional problem. In 2021, the CDC conducted the Adolescent Behaviors and Experiences Survey (ABES). The ABES included similar methodology and content as the YRBS. This study analyzed ABES data to examine correlates of perceived cognitive impairment among high school students in the United States during the COVID-19 pandemic.Participants and Methods:The ABES was a one-time, online survey that was conducted to assess and evaluate the challenges that high-school aged youth experienced during the COVID-19 pandemic. Students’ perceived cognitive impairment was assessed using the same question used in the 2019 YRBS: 'Because of a physical, mental, or emotional problem, do you have serious difficulty concentrating, remembering, or making decisions?' Response options were binary: 'Yes’ or 'No.' The students’ responses were evaluated in relation to nine adversity, mental health, and lifestyle variables.Results:Participants were 6,992 students, age 14 to 18, with 3,294 boys (47%) and 3,698 girls (53%). A large proportion endorsed experiencing serious difficulties concentrating, remembering, and making decisions (45%). Girls (56%) were significantly more likely to endorse perceived cognitive impairment compared to boys (33%) [X2(1)=392.55, p&lt;.001; OR=2.66, 95% CI=2.41-2.93]. Youth who reported that their mental health was poor most of the time or always were very likely to report perceived cognitive impairment (boys: 67%; girls: 81%). Binary logistic regressions were used to examine the associations between perceived cognitive impairment, adversity, and lifestyle variables while controlling for mental health. These analyses were conducted separately for boys [X2(9)=596.70, p&lt;.001; Nagelkerke R2=.24] and girls [x2(9)=883.35, p&lt;.001; Nagelkerke R2=.30]. After controlling for current mental health, significant independent predicters of cognitive problems in boys and girls included: a lifetime history of discrimination based on race or ethnicity, lifetime history of being sexually assaulted or abused, lifetime history of using illicit drugs, being bullied in the past year, current marijuana use, and getting insufficient sleep (5 of fewer hours per night). Participation in sports and exercising regularly were both independently associated with lower rates of cognitive impairment.Conclusions:Perceived cognitive impairment was endorsed by a strikingly high percentage of high school students in 2021 during the COVID-19 pandemic. More than half of high school aged girls and one third of boys reported having serious difficulty concentrating, remembering, and making decisions. These rates are considerably higher than in 2019. Current mental health, unfair treatment because of race or ethnicity, being sexually assaulted, being bullied, drug use, and insufficient sleep were associated with perceived cognitive impairment. Indicators of a physically active lifestyle (participation in sports and exercising regularly) were associated with lower rates of cognitive problems.

Implementing the free HPV vaccination for adolescent girls aged below 14 in Shenzhen, Guangdong Province of China: experience, challenges, and lessons

Cervical cancer is a major public health concern in China, accounting for almost one-fifth of the global incidence and mortality. The recently prequalified domestic bivalent human papillomavirus (HPV) vaccine offers a practical and feasible preventive measure. In response to the global call for action, the National Health Commission issued an Action Plan to eliminate cervical cancer by 2030, with promotion of the HPV vaccination for school-aged girls as a critical step. Despite this, implementation of the vaccination has been patchy, with very low coverage among eligible girls. To address this, from December 2021 to December 2022, a demonstration project was launched in Shenzhen, Guangdong Province, to promote the inclusion of HPV vaccine in local immunisation programme and to address existing barriers to implementation. Using multiple sources of data, this article presents a case study of the demonstration project, analysing its impact on rolling out HPV vaccination among eligible girls and identifying any challenges encountered during implementation. The demonstration project has shown promising results in increasing the HPV vaccination rate, promoting public awareness and acceptance of the domestic HPV vaccine, and establishing a model for quickly scaling up the vaccination at the municipal level. The success of the project can be attributed to several factors, including strong governmental commitment, sufficient funding, multi-sectoral collaboration, ensured vaccine accessibility and affordability, improved vaccination services, and effective health education and communication strategies. Lessons learned from Shenzhen can provide valuable insights for future advocacy and implementation of the vaccination in other areas of China, but challenges must be addressed to achieve universal coverage. These include addressing vaccine hesitancy, expanding the programme to cover a broader age range, and ensuring consistent quality of vaccination services in primary care facilities. Overcoming these challenges will require innovative strategies, public-private partnerships, and sustained funding and resources. Future research should focus on evaluating the long-term effectiveness of the vaccination programme and identifying contextual factors that may impact its implementation in different settings. Overall, the effective control of cervical cancer in China will rely on the “political will” to ensure the incorporation of preventive interventions into policies and universal programme coverage.