Acute affective responses to prescribed and self-selected exercise intensities in young adolescent boys and girls

This study examined the patterning of acute affective responses to prescribed and self-selected exercise intensities in a young adolescent population. Twenty-two young adolescents (13.3 +/- .33 years) completed a maximal exercise test to identify ventilatory threshold (VT). Participants then completed two prescribed intensities (one set above and one below the VT) and a self-selected intensity. Pre-, during, and postexercise affective valence was measured. Results revealed that during exercise, affective valence assessed by the Feeling Scale (FS) remained positive in the self-selected and low-intensity conditions but declined in the high-intensity condition. Postexercise FS responses rebounded to preexercise levels, eradicating divergent trends that occurred during exercise.     

Exposure to violence and associated health-risk behaviors among adolescent girls.

OBJECTIVE: To examine the relationship between exposure to violence and health-risk behaviors. DESIGN: Cross-sectional survey. SETTING: University-based outpatient family planning clinic. PATIENTS: Sexually active adolescent girls younger than 18 years (N = 517) who presented for contraceptive care. MAIN OUTCOME MEASURES: Prevalence of witnessing or experiencing violence and the associations with health-risk behaviors, including high-risk sexual behaviors, substance use, and self-injury. RESULTS: Compared with adolescents who had not been exposed to violence, those who had only witnessed violence were 2 to 3 times more likely to report using tobacco and marijuana, drinking alcohol or using drugs before sex, and having intercourse with a partner who had multiple partners. Those who had experienced, but not witnessed violence were at increased risk of these same behaviors and were 2 to 4 times more likely than those who had neither witnessed nor experienced violence to report early initiation of intercourse, intercourse with strangers, multiple partners, or partners with multiple partners, tobacco, alcohol and drug use, or to have positive test results for a sexually transmitted disease. Individuals who had both witnessed and experienced violence demonstrated the greatest risk of adverse health behaviors. These adolescents demonstrated 3 to 6 times greater risk of suicidal ideation (odds ratio [OR], 3.1; 95% confidence interval [CI], 2.2-4.0) or suicide attempts (OR, 4.5; 95% CI, 2.2-9.4), self-injury (OR, 5.8; 95% CI, 2.6-12.9), and use of drugs before intercourse (OR, 6.2; 95% CI, 3.0-12.9) than those who had neither witnessed nor experienced violence. CONCLUSIONS: Adolescents exposed to violence are at increased risk of multiple adverse health behaviors. Programs designed to improve health outcomes should target this high-risk group.     

Gynecological concerns in young and adolescent physically active girls

Young girls should be advised to develop the regular exercise habit and to maintain it throughout life. Prepubertal athletes are more likely than their sedentary friends to experience menarcheal delay. Postmenarcheal athletes have increased susceptibility to oligomenorrhea and amenorrhea. Athletes with delayed puberty deserve examination and possibly further evaluation. Adolescent athletes with oligomenorrhea or amenorrhea deserve examination and hormonal evaluation. Hormonal replacement therapy is unnecessary prior to age 16, is optional between ages 16 and 18, and is recommended after age 18.     

Serious injuries and deaths of adolescent girls resulting from interpersonal violence: characteristics and trends from the United States, 1989-1998

BACKGROUND: Little published data are available concerning the death and disability of adolescent girls resulting from interpersonal violence (adolescents are defined as those aged 12-18 years in this study). OBJECTIVES: To determine whether there were sex differences in (a) the characteristics of those who were injured or died, (b) injury severity and outcomes, and (c) injury mechanism; and to describe time trends in these differences. DESIGN: Analysis of data concerning serious injuries due to assaults, recorded in the National Pediatric Trauma Registry (from January 1, 1989, through December 31, 1998), and homicides, recorded in the Web-Based Injury Statistics and Query Reporting System database (from January 1, 1990, through December 31, 1997). SETTING: Patient data from participating pediatric trauma centers (National Pediatric Trauma Registry) in 45 states and national death certificate data (Web-Based Injury Statistics and Query Reporting System). PATIENTS: Six hundred twelve adolescent girls who were seriously injured because of an assault were compared with 2656 adolescent boys who were seriously injured because of an assault. Three thousand four hundred eighty-seven adolescent girls who died due to a homicide were compared with 17 292 adolescent boys who died due to a homicide. RESULTS: Assaulted adolescent girls were more likely to have preexisting cognitive or psychosocial impairments than were adolescent boys (odds ratio, 1.68; 95% confidence interval, 1.12-2.51). Adolescent girls trended toward more injury-related impairments at discharge from the hospital (odds ratio, 1.16; 95% confidence interval, 0.92-1.47). Adolescent girls were more likely to have been stabbed, and less likely to have been shot. Also, adolescent girls were more likely to have been injured at a home or a residence. Compared with all National Pediatric Trauma Registry admissions, assaults declined at the same rate for adolescent girls and boys. The proportion resulting from penetrating trauma declined more slowly for adolescent girls. CONCLUSIONS: Interpersonal violence causes considerable morbidity and mortality for young women. Research and interventions should be developed to respond to adolescent girls who experience interpersonal violence.     

Deleterious functional impact of anemia on young adolescent school girls

Iron deficiency anemia during adolescence may reduce physical work capacity and cognitive function. OBJECTIVES: To assess the physical work capacity and cognition of underprivileged anemic schoolgirls in Vadodara in early adolescence as compared to their non-anemic counterparts. DESIGN: Prior to initiating anemia control interventions, schoolgirls in early adolescence were studied with regard to their hemoglobin status, physical work capacity and cognitive functions. SETTING: Schoolgirls from four municipal primary schools in the age of 9 - 14 years were studied. METHODS: In four Primary Municipal schools, hemoglobin of subjects was assessed using standard methods; physical work capacity using Modified Harvards Step test and cognitive functions using selected tests from the modified Wechsler Intelligence Scale for Children (WISC), suitably adapted for this group (n = 230). RESULTS: The mean hemoglobin was 11.32 g/dL, and anemia prevalence: 67%. A higher number of steps were climbed and a shorter time was taken to revert to the basal pulse rate (recovery time) by non-anemic girls compared to anemic girls (P < 0.001). Significantly lower scores in digit span and visual memory test were seen in anemic compared to non-anemic girls. The adverse impact of anemia remained after controlling for undernutrition (BMI). CONCLUSION: Anemia is likely to adversely affect physical work capacity and cognition in young adolescent girls undergoing pubertal development. Further research should be conducted in both school and community based settings to cover non-school going children.     

Weight-related behaviors among adolescent girls and boys: results from a national survey

OBJECTIVE: The study objectives were to assess (1) the prevalence of dieting and disordered eating among adolescents; (2) the sociodemographic, anthropometric, psychosocial, and behavioral correlates of dieting and disordered eating; and (3) whether adolescents report having discussed weight-related issues with their health care providers. DESIGN: Cross-sectional school-based survey. STUDY POPULATION: A nationally representative sample of 6728 adolescents in grades 5 to 12 who completed the Commonwealth Fund surveys of the health of adolescent girls and boys. MAIN OUTCOME MEASURES: Dieting and disordered eating (binge-purge cycling). RESULTS: Approximately 24% of the population was overweight. Almost half of the girls (45%) reported that they had at some point been on a diet, compared with 20% of the boys. Disordered eating was reported by 13% of the girls and 7% of the boys. Strong correlates of these behaviors included overweight status, low self-esteem, depression, suicidal ideation, and substance use. Almost half of the adolescents (38%-53%) reported that a health care provider had at some point discussed nutrition or weight with them. Discussions on eating disorders were reported by lower percentages of girls (24%) and boys (15%). CONCLUSIONS: The high prevalence of weight-related concerns suggests that all youth should be reached with appropriate interventions. Special attention needs to be directed toward youth at greatest risk for disordered eating behaviors, such as overweight youth, youth engaging in substance use behaviors, and youth with psychological concerns such as low self-esteem and depressive symptoms.     

Douching: a problem for adolescent girls and young women.

OBJECTIVE: To compile available published data on the prevalence of douching practices in adolescent girls and young women and the effects of douching on gynecologic health, including studies of gynecologic changes due to douching in adolescent girls and young women, surveys that demonstrated the prevalence of douching in the populations, and policy statements or lack thereof from professional and medical organizations with regard to the practice of douching. DATA SOURCES: We did Internet searches, including a MEDLINE search, a literature review, and used the telephone, mail, and e-mail to contact professional organizations. RESULTS: Douching has been found to be strongly associated with increased risk for pelvic inflammatory disease, bacterial vaginosis, and ectopic pregnancy, the former of which is especially prevalent in adolescent girls and young women. Douching is practiced by 15.5% of adolescent girls and young women in the United States, with significantly higher prevalences in certain groups in the population. We have not found any official position of professional and medical organizations on the practice of douching. CONCLUSIONS: Because vaginal douching has been shown to be associated with bacterial vaginosis, pelvic inflammatory disease, and ectopic pregnancy, and because no benefits are conferred on those who practice it, douching should be discouraged among adolescent girls and young women. There is a great need for further studies, particularly prospective ones, to determine if there is evidence of a direct causative influence of douching on pelvic inflammatory disease, ectopic pregnancy, and/or bacterial vaginosis, and to determine why adolescent girls and young women douche.     

Sexual orientation and tobacco use in a cohort study of US adolescent girls and boys

OBJECTIVE: To examine sexual-orientation group disparities in tobacco use in adolescent girls and boys. DESIGN: Survey data from 10685 adolescent girls and boys participating in 1999 in the Growing Up Today Study were examined cross-sectionally. SETTING: Community-based population of adolescents living throughout the United States.Main Outcome Measure Prevalence of tobacco use. RESULTS: Ninety-two percent of the participants described themselves as heterosexual (n = 9296), 5% as mostly heterosexual (n = 511), 1% as lesbian/gay/bisexual (n = 103), and 2% as unsure (n = 226). Ages ranged from 12 to 17 years. Compared with heterosexuals, mostly heterosexual girls were 2.5 (95% confidence interval, 1.8-3.5), lesbian/bisexual girls were 9.7 (95% confidence interval, 5.1-18.4), and mostly heterosexual boys were 2.5 (95% confidence interval, 1.4-4.6) times more likely to smoke at least weekly. In contrast, gay/bisexual boys were not more likely to smoke. Findings persisted even when controlling for multiple sociodemographic and psychosocial covariates. CONCLUSION: Our findings indicate that mostly heterosexual adolescents of both sexes and lesbian/bisexual girls are at heightened risk for tobacco use.     

Menstrual patterns under hormonal contraception in adolescent girls and young women

Adolescents are more likely to discontinue hormonal contraception because of disturbances in their menstrual patterns. Menstrual disturbances occur as spotting, breakthrough bleeding, as well as missed withdrawal bleeding depending on both the prevailing levels of estrogens and the more or less suppressed endometrium. Patients on cyclic prescribed oral combined micro-pills are found to have the fewest menstrual disturbances compared with all other hormonal regimens. Combined micro-pills as long term therapy should be given for medical indications only. Oral gestagen-only mini-pills are suitable for adolescent girls when estrogens are contraindicated. Irregular bleeding was found in more than 50% of patients. Long term contraceptives of all hormonal contraceptives show the highest rate of menstrual disturbance. They are suitable for adolescent girls in special indications only.     

Height and weight of school children and adolescent girls and boys in Oslo 1970.

Height and weight measurements of the school children of Oslo in 1970 (aged 7 to 19 years) are reported. Weights show considerably skewed distributions with long tails towards higher weights. Weight precentiles are calculated by interpolation in the empirical distributions. Percentiles and tables for both sexes, showing height for age, weight for height and weight for age, are presented. A comparison with existing Norwegian data from Sundal, 1956, Bergen shows that the application of statistics based on normal distribution for weight, has introduced considerable error in these percentiles. Oslo children in 1970 are taller by 5-6 cm at age eighteen, than USA (Iowa) standards and 4-5 cm taller compared to Tanner-s English percentiles. Oslo children are also taller than Swedish children, and have reached a stature higher than found in any other comparable study.     

Weekly vs daily iron and folic acid supplementation in adolescent Nepalese girls

OBJECTIVE: To compare the effectiveness of weekly vs daily iron and folic acid supplementation for control of anemia in adolescent Nepalese girls. DESIGN: Randomized controlled trial. SETTING: A Government Girl School in Dharan, Nepal, an urban foothill town that is 305 m above sea level. SUBJECTS: Consecutive healthy adolescent girls (n = 209, median age 15 years) randomized to 3 groups matched for age, anthropometry, and personal and sociodemographic characteristics. Of 209 subjects, 181 completed the trial. Two girls had adverse reactions to treatment and were excluded. INTERVENTION: Group A (n = 70) received a 350-mg ferrous sulfate and 1.5-mg folic acid combination once daily for 90 to 100 days. Group B (n = 67) received the tablet under supervision once a week for 14 weeks. Group C (n = 72) did not receive any drugs. OUTCOME VARIABLE: Presupplementation and postsupplementation differences in prevalence of anemia and change in hematocrit. RESULTS: Prevalence of anemia (defined as hematocrit <36%) declined from 68.6% and 70.1% in groups A and B to 20% and 13.4%, respectively, postsupplementation (P<.001), whereas the prevalence in group C changed little (68.1% to 65.3%, P =.81). There was a significant rise in the mean hematocrit of both supplemented groups (group A, 32.9% +/- 3.5% to 41.0% +/- 5.6%, P<.001; group B, 33.2% +/- 3.6% to 40.4% +/- 4.9%, P<.001) but no appreciable change in controls (34.2% +/- 2.9% to 34.1% +/- 3.3%, P =.91). Net change in mean hematocrit in both the supplementation groups was comparable (P =.57). CONCLUSIONS: The prevalence of anemia in adolescent Nepalese girls is high. Supervised iron and folic acid therapy once a week is an effective alternative to daily administration and helps lower the prevalence of anemia in adolescent girls.