Adolescent Pregnancy and Parenthood in South Africa

South Africa's total fertility rate is estimated to be one of the lowest in sub-Saharan Africa, fewer than three births per woman nationally and declining. At the same time, adolescent childbearing levels remain high: More than 30 percent of 19-year-old girls are reported to have given birth at least once. Evidence from focus-group discussions conducted in urban and rural areas in South Africa with young black women and men, and with the parents of teenage mothers, is used to consider the experience of early parenthood, including the role of paternity, education, work opportunities, and subsequent fertility. In South Africa, in contrast to many other settings, teenage mothers may return to school once they have given birth, and this opportunity is strongly related to a long delay before the birth of a second child. Educated girls also tend to bring more bridewealth, which may encourage parents to support their daughters' schooling, and perhaps their return to school following childbirth. The support of the child, however, is often subject to paternal recognition and commitment, even though boys are unwilling to admit paternity because it jeopardizes their educational and employment opportunities.     

Understanding and Evaluating Adolescent Behavior Problems

A knowledge of normal adolescent development and the adolescent's own stage of psychosocial development is necessary in evaluating the significance of his behavior. Understanding the youngster's previous development is useful as those experiences will influence how well he will master the adolescent task of identity formation. Issues which directly impact on this developmental task include separation from parents, peer support, changes in body and body image, sexuality, development of abstract reasoning, and career choice. Difficulty in resolving any of these issues may result in a behavior disturbance. The evaluation of the adolescent's functioning in various life spheres at school, with peers, and at home should enable the professional to better determine whether a teenager's behavior is normal or a symptom of an emotional problem. Professionals, particularly those in schools, should take advantage of their interaction with adolescents in order to asssess behavior and identify the presence of underlying problems.     

A Social-Ecological Approach to Understanding Adolescent Sexting Behavior

Archives of Sexual Behavior - This study examined the extent to which active and passive sexting behaviors are associated with family-, school-, peer-, and romantic-level variables. Young people...     

News From Health Research: Toward a Better Understanding

News about health research findings, especially regarding controversial topics, can seem confusing and conflicting to students and the general public. Many people eventually develop a "turned-off" attitude toward all health news. Yet medical information is one of the key factors involved in health decision-making, because it influences a person's judgment about the potential health impact of a behavior choice. As part of their health education, youngsters need to learn skills to better understand and evaluate reports of research news, so the information available for health decision-making will be more complete and accurate. Such news is already abundant in television, radio, newspaper and magazine reports and will continue to increase as research advances, knowledge expands and health "facts" are revised. This article outlines concepts and skills to help teachers and students understand the changes and controversies in health news. To most effectively use new information generated by medical research, students need to: 1) understand basic concepts about the nature of research and the research process; 2) apply critical thinking approaches to health news; and 3) locate additional health information resources. Generating ways to address these needs is a high priority of the school health education work at the National Heart, Lung and Blood Institute. Comments are invited on this approach.     

Understanding the Association Between Authoritative Parenting and Adolescent Smoking

Background: Research on adolescent cigarette smoking has attempted to measure the role of parents in preventing smoking experimentation and uptake. However, aspects of parental influence have often been limited to parental smoking behavior or antismoking socialization. Only a limited number of studies considered the hypothesis that the influence of parenting on adolescent current cigarette smoking may extend beyond parental behavior and antismoking socialization to consider broader measures of the parent–child relationship, such as parenting style. Methods: The sample was nationally representative and included 17,287 high school students nationwide. Data were used to categorize the parenting style—authoritative, permissive, autocratic, and unengaged—experienced by each respondent. Logistic regression analysis was used to assess the association between parenting style and adolescent current cigarette smoking. Results: Authoritative parenting was associated with a reduction in the odds of adolescent current cigarette smoking (OR: 0.74, 99% CI: 0.58, 0.95). When authoritative parenting is simultaneously considered with believing parents’ opinions about smoking are important, authoritative parenting was no longer a significant correlate of adolescent current cigarette smoking, while believing parents’ opinions about smoking are important was associated with a 45% (99% CI: 0.48, 0.64) reduction in the odds of adolescent current cigarette smoking. Authoritative parenting was associated with a more than three-fold increase (OR: 3.65, 99% CI: 2.87, 4.66) in the odds of believing parents’ opinions about smoking are important. Discussion: Interventions may want to educate parents about authoritative parenting, which includes the importance of having appropriate and routine conversations with their children, requiring chores, and implementing general rules and boundaries.     

Understanding the Mechanism Behind Maternal Imprisonment and Adolescent School Dropout

This study empirically tested 3 mechanisms commonly suggested to disadvantage youths whose mothers are incarcerated in prison. An event history analysis of school dropout was conducted on a sample of 6,008 adolescents in a large city created by merging several Illinois state administrative data. Findings revealed that adolescents are indeed at greater risk of school dropout during the year(s) their mothers are incarcerated. Children who are removed from maternal guardianship and placed under the guardianship of a relative adult are observed to have higher odds of school dropout than children who remain under maternal guardianship after the mother's imprisonment. Lastly, attending a school in which maternal imprisonment is fairly common is not found to place adolescents at greater risk of school dropout after controlling for school quality.     

Understanding Neurodegeneration from a Clinical and Therapeutic Perspective in Early Diabetic Retinopathy

Recent evidence indicates that neurodegeneration is a critical element of diabetic retinopathy (DR) pathogenesis. The neuronal cells’ apoptosis contributes to microvascular impairment and blood–retinal barrier breakdown. Therefore, neurodegeneration represents an early intervention target to slow and prevent the development of microvascular alterations visible on clinical examination. Multimodal imaging features and functional assessment can permit the identification of neuronal damage in a subclinical stage before the recognition of DR signs. Clinical features of neurodegeneration are crucial in identifying patients at high risk of developing a vascular impairment and, thus, serve as outcome measures to understand the efficacy of supplementation. The optimal approach for targeting neurodegeneration contemplates the use of topical compounds that possibly act on different elements of the pathogenic cascade. To date, clinical trials available on humans tested three different topical agents, including brimonidine, somatostatin, and citicoline, with promising results.     

Parenthood: towards a framework for education and support

Whilst parent education is attracting increasing interest and debate, a review of current initiatives in schools, in antenatal services and in support services for families reveals considerable confusion with regard to aims, objectives and methodology. Schemes and services tend to be limited in number, piecemeal and uncoordinated, with little thought being given either to content or to the most appropriate stages of an individual's life at which to offer education, preparation, support, or where necessary, intervention. A more coordinated approach is suggested, offering parents and prospective parents a range of services which build upon their own parenting skills, rather than undermining their self-confidence with 'professional expertise'.     

Reducing Sexual Risk Behavior in Adolescent Girls: Results From a Randomized Controlled Trial

PurposeTeenage girls in low-income urban settings are at an elevated risk for HIV, sexually transmitted infections, and unintended pregnancies. The purpose of this study was to evaluate the efficacy of a sexual risk-reduction (SRR) intervention, supplemented with postintervention booster sessions, targeting low-income, urban, sexually active teenage girls.MethodRandomized controlled trial in which sexually active urban adolescent girls (n = 738) recruited in a midsize northeastern U.S. city were randomized to a theory-based SRR intervention or to a structurally equivalent health promotion control group. Assessments and behavioral data were collected using audio computer-assisted self-interview at baseline, then at 3, 6, and 12 months postintervention. Both interventions included four small-group sessions and two booster sessions.ResultsRelative to girls in the control group, girls receiving the SRR intervention were more likely to be sexually abstinent; if sexually active, they showed decreases in (a) total episodes of vaginal sex at all follow-ups, (b) number of unprotected vaginal sex acts at 3 and 12 months, and (c) total number of sex partners at 6 months. Medical record audits for girls recruited from a clinical setting (n = 322) documented a 50% reduction in positive pregnancy tests at 12 months.ConclusionsTheory-based behavioral interventions tailored to adolescent girls can help to reduce sexual risk and may also reduce unintended pregnancies. Although sexually active at enrollment, many of the girls receiving the intervention were more likely to practice secondary abstinence. Continued refinement of SRR interventions for girls is needed to ensure they are feasible, appealing, and effective.     

Parenthood: towards a framework for education and support

Whilst parent education is attracting increasing interest and debate, a review of current initiatives in schools, in antenatal services and in support services for families reveals considerable confusion with regard to aims, objectives and methodology. Schemes and services tend to be limited in number, piecemeal and uncoordinated, with little thought being given either to content or to the most appropriate stages of an individual's life at which to offer education, preparation, support, or where necessary, intervention. A more coordinated approach is suggested, offering parents and prospective parents a range of services which build upon their own parenting skills, rather than undermining their self‐confidence with ‘professional expertise’.     

Adolescent Sexuality in the Soviet Union—A Personal Perspective

Russian pediatricians, psychiatrists, nurses, and midwives believe that adolescent sex education belongs in the home. Soviet society then has the responsibility of reinforcing the standards and attitudes instilled by the parents. The markedly puritanical sexual standards in Russia are similar to those seen in the United States at the turn of the century.     

The Social Context of Adolescent Smoking: A Systems Perspective

We used a systems science perspective to examine adolescents'' personal networks, school networks, and neighborhoods as a system through which emotional support and peer influence flow, and we sought to determine whether these flows affected past-month smoking at 2 time points, 1994–1995 and 1996. To test relationships, we employed structural equation modeling and used public-use data from the National Longitudinal Study of Adolescent Health (n = 6504). Personal network properties affected past-month smoking at both time points via the flow of emotional support. We observed a feedback loop from personal network properties to emotional support and then to past-month smoking. Past-month smoking at time 1 fed back to positively affect in-degree centrality (i.e., popularity). Findings suggest that networks and neighborhoods in this system positively affected past-month smoking via flows of emotional support.Adolescent cigarette smoking remains a complex public health problem in the United States. Although lifetime smoking and current frequency of smoking among adolescents decreased between the late 1990s and 2003, prevalence remained unchanged from 2003 through 2005.¹ Smoking prevalence among adolescents is currently estimated to be around 23%,¹ posing ongoing challenges for tobacco-control efforts.Several streams of literature suggest that adolescent smoking is inextricably connected to the social context in which it occurs. Literature shows that an adolescent''s smoking behavior will tend to be similar to that of his or her peers.^2–6 There is a longstanding debate over why this similarity occurs; some studies suggest that it is caused by peer influence on an individual adolescent''s smoking,^7,8 whereas others suggest that it is caused by the individual''s selection of smoking peers,⁸ and still others attribute the cause to both influence and selection.² Some of the literature implicating adolescents’ social contexts in their smoking behavior examines youths’ social networks of friends and peers from a structural perspective. Such studies focus on how structural and positional characteristics of these networks relate to adolescent smoking. Structural characteristics reflect information about linkages among individuals, and positional characteristics indicate the significance of occupying different network positions. In general, studies find that isolated youths are likely to smoke, although some studies have found that popular youths are likely to smoke.^3–5,9–12 Implicit in each study is the notion that adolescents’ social context of friends and peers plays a critical role in their own smoking behavior.Given the relevance of adolescents’ social context to their smoking behavior, it is important to understand how to conceptualize and measure this context. Previous research has used ecological models to inform the theoretical specification of the context of adolescent smoking and other substance-use behaviors.¹³ Ecological models allow this context to be theoretically partitioned into levels of influence. Although there are valuable insights yet to be gained from such models, more theoretically informed research is necessary to elaborate the complexity of the social context of adolescent smoking. Moreover, because various theories are often integrated at different levels in such models, it is difficult to ensure that conceptual coherence is achieved across and within levels, given the possibility that the theories applied at each level make incongruous assumptions. Furthermore, such models do not provide specific guidance about mechanisms through which levels of influence relate to outcomes such as adolescent smoking. There is a need for theoretical models that more specifically and holistically elaborate features of the social context of adolescent smoking and how they act in concert.     

Exploring the Role of Family and Peers in Adolescent Self-Representation: Toward a Dialectical Perspective

This study is a qualitative investigation of the role of family and peer groups in the development of a stable identity in adolescence. A content analysis of the autobiographical accounts of five female and two male participants resulted in the identification of five recurring processes that reflect a dynamic and complex interrelationship between family and peer contexts in the formation of self-representation. The five identified processes were (a) subjective experience/idealized image discrepancy, (b) duplicating and mutually reinforcing evaluations of the self, (c) resolution of discrepancy and acceptable losses, (d) complementarity of gains and losses, and (e) protective mechanisms.