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Objective: The aim was to describe the anthropometry, bone mineral content (BMC), bone mineral density (BMD), dietary calcium intake and 25(OH)D3 levels in 11- and 12-year-old children in a peri-urban area. Design: A cross-sectional, descriptive study in the quantitative domain was undertaken. Setting: Bronkhorstspruit, Gauteng, South Africa. Subjects: Children, conveniently selected, were assessed in two groups. The first group comprised 70 children. From the 70 children, 20 children were conveniently selected to form a sub-sample (n = 20). Outcome measures: Anthropometric data (weight, height) and dietary data (three quantified /multi-pass 24-hour recalls). Children in the sub-sample additionally underwent body composition assessment (dual-energy X-ray absorptiometry; DXA scan) and a finger prick for 25(OH)D3. Results: BMI and body composition data (body fat mass and lean fat mass) showed that the girls exceeded the boys in all measurements. The girls had a non-significantly higher BMD and BMC than the boys. The mean and median values for 25(OH)D3 were lower than the reference range values. Dietary intake results showed that the children had a sufficient macronutrient intake, but a deficient intake of calcium, phosphate and vitamin D. The sub-sample had a mean vitamin D intake of 3.2 mcg. Conclusion: The girls exceeded the boys in all the anthropometric and body composition measurements. The calcium and vitamin D intake of the children were of concern. There were no significant differences or relationships in the bone measurements and vitamin D status between the boys and girls.

Despite a general decrease of attention-deficit/hyperactivity disorder (ADHD) symptoms during adolescence, these may persist in some individuals but not in others. Prior cross-sectional studies have shown that parenting style and their interaction with candidate genes are associated with ADHD symptoms. However, there is a lack of longitudinal research examining the independent and interactive effects of parenting and plasticity genes in predicting the course of attention-deficit/hyperactivity disorder (ADHD) symptoms across adolescence. Here, we investigated how children perceived their parents’ parenting style (i.e., rejection, overprotection, and emotional warmth) at the age of 11, and their interaction with DRD4,MAOA, and 5-HTTLPR genotypes on parent-reported ADHD symptoms at three time points (mean ages 11.1, 13.4, and 16.2 years) in 1730 adolescents from the TRacking Adolescents’ Individual Lives Survey (TRAILS). Growth Mixture Modeling in Mplus identified four ADHD symptom trajectories: low, moderate stable, high decreasing, and high persistent. Perceived parental rejection predicted class membership in the high persistent trajectory compared to the other classes (p

In the context of cognitive characteristics, it is not yet known which ones would be discriminating for the sports performance of athletes from different sports, as well as, it is not known which cognitive characteristics need to be considered to discriminate an athlete who is more likely to be successful in sports. Thus, it is necessary to understand whether the level of cognitive characteristics such as Inhibitory Control (IC) makes a difference or not for the sports performance of adolescent athletes. We verified the association between IC and neuromuscular performance (NP) in adolescent athletes and compared the NP of athletes with different levels of IC. Sample of 239 school athletes is (12.0 ± 1.41 years, 42% boys, 58% girls). IC was assessed by Stroop task measured by computerized Stroop test. Upper Limb Performance (ULP), Sargent Jump (SJ) and body speed with change of direction (BScD) were evaluated. IC groups were formed using analysis of k-cluster averages. IC was associated with NP in the sample in both sexes (p

Background: Moyamoya disease (MMD) and peripheral pulmonary artery stenosis (PPAS) are relatively rare and demonstrate steno-occlusive vascular lesions in different organs. Genetic studies identified RNF213 polymorphism c.14576G>A (rs112735431) as a susceptibility variant for East Asian MMD. RNF213 polymorphism c.14576G>A is further associated with various vascular lesions of other organs. In this study, we aimed to clarify the incidence and clinical manifestations of PPAS in MMD patients and analyze the correlation between RNF213 genotype and PPAS. Methods: This retrospective case-control study investigated the association between RNF213 polymorphism and PPAS in 306 MMD/quasi-MMD patients, reviewing the medical charts and imaging records of consecutive patients with MMD admitted from January 2015 to December 2020. Results: PPAS was observed in 3 MMD/quasi-MMD patients (0.98%, 3/306). RNF213 polymorphism c.14576G>A was determined for all 306 MMD/quasi-MMD patients. The incidence of PPAS in RNF213-wildtype, RNF213-heterozygote, and RNF213-homozygote MMD/quasi-MMD patients was 0% (0/101), 0.5% (1/200), and 40% (2/5), respectively. The association between PPAS and homozygote polymorphism of RNF213 c.14576G>A was statistically significant in MMD/quasi-MMD patients (p = 0.0018). In all cases, pulmonary artery hypertension due to PPAS was evident during their childhood and young adolescent stages. Surgical indications for MMD were discouraged in 1 case due to her severe cardiopulmonary dysfunction. Conclusions: The homozygote variant of RNF213 polymorphism c.14576G>A can be a potential predisposing factor for PPAS in MMD/quasi-MMD patients. Despite the relatively rare entity, PPAS should be noted to determine surgical indications for MMD/quasi-MMD patients.

The study investigates peer aggression and sexual harassment among young adolescents in Finland and Turkey. Sex differences and the interaction effect between country of residence and sex are also examined. A questionnaire was completed by 1,747 adolescents (1, 268 from Finland, 479 from Turkey, Mage = 14.1). Six different forms of aggression (physical, verbal, indirect, cyber, verbal sexual harassment, physical sexual harassment) were examined. More adolescents from Turkey, and more boys, were found to be involved in aggression as both victims and perpetrators compared to adolescents from Finland and girls. The interaction effect was significant between country of residence and sex with being a boy from Turkey was related to having the highest involvement in cyber aggression, verbal sexual harassment, and physical sexual harassment, as both victim and perpetrator. Regarding victimization from indirect aggression, girls from Finland scored higher than Turkish girls, while boys from Turkey scored higher than Finnish boys.

Very preterm (VPT) children and adolescents show executive, behavioural and socio-emotional difficulties that persists into adulthood. This study aims to assess the effectiveness of a mindfulness-based intervention (MBI) in improving these competencies in VPT young adolescents using a randomised controlled trial design. 56 young adolescents aged 10–14 years, born before 32 gestational weeks, were randomly assigned to an “intervention” or a “waiting” group and completed an 8-week MBI in a cross-over design. Executive, behavioural and socio-emotional competencies were assessed at three different time points via parent and self-reported questionnaires, neuropsychological testing and computerised tasks. The data were analysed using an intention-to-treat approach with linear regression modelling. Our findings show a beneficial effect of MBI on executive, behavioural and socio-emotional competencies in VPT young adolescents measured by parent questionnaires. Increased executive competencies were also observed on computerised task with enhanced speed of processing after MBI. Two subgroups of participants were created based on measures of prematurity, which revealed increased long-term benefits in the moderate-risk that were not observed in the high-risk subgroups of VPT young adolescents. MBI seems a valuable tool for reducing detrimental consequences of prematurity in young adolescents, especially regarding executive, behavioural and socio-emotional difficulties.Clinical Trial Registration ClinicalTrials, NCT04638101. Registered 20 November 2020—Retrospectively registered, https://clinicaltrials.gov/show/NCT04638101.

Background The prevalence of teenage pregnancies in Malawi is 29%. About 25% of those are married while 30% are unmarried adolescents (15–19 years old) who use contraceptives. Data on contraceptive use has focused on older adolescents (15–19 years old) leaving out the young adolescents (10–14 years old). This study assessed factors that influence contraceptive decision-making and use among young adolescents aged 10–14 years. Methods This was a qualitative study that used the Theory of Reasoned Action (TRA) model to understand the processes that influence contraceptive decision-making among young adolescents (10–14 years old) in urban Lilongwe. The study was conducted in six youth health-friendly service centers and 12 youth clubs. Two focus group discussions and 26 in-depth interviews were conducted among sexually active in and out of school young adolescents and key informants. The results are organized into themes identified during the analysis. Results Results showed that contraceptive decision-making is influenced by social factors (individual, interpersonal, society) and adolescents’ perceptions regarding hormonal contraceptives. There is also a disconnect between Education and Adolescent Sexual and Reproductive Health policies. Conclusion The findings suggest that interventions that scale up contraceptive use need male and female involvement in decision making. Addressing myths around contraceptives, and harmonization of Education and Sexual and Reproductive Health policies in the country would motivate adolescents to use contraceptives., Plain language summary There is limited data on modern family planning method use of young adolescents aged 10–14 years compared to older adolescents aged 15–19 years. The study assessed factors that influence modern family planning method decision-making and use among young adolescents aged 10–14 years. The Theory of Reasoned Action model was applied to understand the processes that influence modern family planning method decision-making and use among young adolescents. The study was conducted in 6 youth health-friendly services clinics and 12 youth clubs where adolescents access contraceptives. We conducted 2 focus group discussions and 26 in-depth interviews. The study involved sexually active, in and out of school young adolescents and influential decision-makers in reproductive health. The results are presented in a narrative format using themes identified during analysis in line with study objectives. The study discovered that modern family planning method decision-making is influenced by social factors; hormonal side effects of modern family planning methods and improper linkage between Sexual and Reproductive Health Rights and Education policies. The findings suggest the need to empower girls in decision-making. Address myths surrounding modern family planning methods. Then harmonize Sexual and Reproductive Health Rights and Education Policies in the country.

As the prevalence of obesity in adolescents has reached an alarming level of 16%, the rate of metabolic bariatric surgery (MBS) in this population is also rising in several countries.This study aimed to compare the trends in types of MBS, short-term safety, and revisional rates, in younger adolescents aged18 years, compared with older adolescents (aged 18-19 yr) and adults aged20 years.Clinical research center, general hospital in France.Using a national administrative database (Programme de Médicalisation des Systèmes d'Information [PMSI]), data regarding all patients undergoing MBS between 2008 and 2018 in France were examined. Demographic parameters, body mass index (BMI), co-morbidities, types of surgery, early complications, and long-term revisional rates were analyzed, comparing younger adolescents (18 yr), older adolescents (18-19 yr), and adults (≥20 yr).The number of bariatric procedures in adolescents initially increased from 59 in 2008 to 135 in 2014, and then progressively declined to 56 procedures in 2018. Adjustable gastric banding (AGB) decreased from 83.1% (n = 49) of procedures to 32.1% (n = 18) of procedures during the study period, while sleeve gastrectomy (SG) increased from 6.8% (n = 4) to 46.4% (n = 26). In the early postoperative period, younger adolescents undergoing MBS experienced fewer episodes of reoperation (1.0% versus 1.3% in older adolescents and 2.6% in adults, P.001) and intensive care unit (ICU) stays (.2% versus .2% in older adolescents and .6% in adults, P.001), and no deaths were observed in younger adolescents (.02% in older adolescents and .1% in adults, P = .18). At 10 years, the AGB removal rate was lower in younger adolescents (24.8%) compared with that in older adolescents (29.6%) and adults (50.3%, P.001). Similarly, rates of revisional surgery after SG were different in the 3 groups: 2.9%, 4.6% and 12.2% in younger adolescents, older adolescents, and adults, respectively.Despite significantly lower early complication rates and long-term revisional rates in young adolescents (18 yr), we observed a progressive decrease in the utilization of MBS in this population in France, compared with adults (≥20 yr) and older adolescents (18-19 yr).

In this communication, the members of the Porto group (the European Society for Paediatric Gastroenterology, Hepatology and Nutrition [ESPGHAN], inflammatory bowel diseases [IBD] working group) provide the current available evidence regarding vaccination of children and young adolescents with IBD against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Our intent is to help provide meaningful answers to the concerns that parents and adolescents may have.

Twin block therapy is highly effective in patients with remaining growth potential. However, its successful use is confounded by many patient related factors such as age, gender, compliance of the patient and other miscellaneous criteria’s. If treated within time, growth modification and orthopedics can harness suitable forces to cause skeletal correction of the malocclusion. The appliance is highly successful in a patient with retruded mandible and presenting with a positive visual treatment objective. This paper discusses a case of 11-year-old female patient with characteristic twin block appliance indication in which successful skeletal modification was achieved.

Adolescent birth is a major global concern owing to its adverse effects on maternal and child health. We assessed trends in adolescent birth and examined its associations with child undernutrition in Bangladesh using data from seven rounds of Demographic and Health Surveys (1996–2017, n = 12,006 primiparous women with living children, Adolescent birth is a major global concern owing to its adverse effects on maternal and child health. We assessed trends in adolescent birth and examined its associations with child undernutrition in Bangladesh using data from seven rounds of Demographic and Health Surveys. Our analysis demonstrates that birth during adolescence, a common occurrence in Bangladesh, is associated with child undernutrition.

Ingrown toenails are a common condition in general medicine and dermatology, and they occur when the nail curves inward and pierces the nail fold. Symptoms include pain in the affected toe, erythema and edema. The diagnosis is made clinically and, if left untreated, ingrown toenails can lead to infections and even cellulitis and osteomyelitis. Conservative treatments involve clipping on the spicule and topical antibiotics. However, the mainstay of treatment is matricectomy to reduce the recurrence rate. The risk of ingrown toenail development can be reduced by wearing proper footwear, keeping toenails cut straight and overall foot hygiene. Ingrown toenails can affect various patient populations but are more prevalent in males, young adolescents and pregnant patients. Risk factors include obesity, diabetes, improper toenail clipping and improper footwear. This review explores the clinical manifestations of ingrown toenails, along with their diagnosis and treatment, providing a concise review for physicians to accurately identify and effectively treat patients with ingrown toenails or their resultant complications.

Objective For youth with type 1 diabetes (T1D), the early adolescent period is associated with worsening diabetes management and high rates of negative psychosocial issues, including depressive symptoms and family conflict. Alternative clinical models may help improve both diabetes and psychosocial outcomes. Our study aims to investigate whether Team Clinic, a shared medical appointment model developed specifically for adolescents with T1D, will improve psychosocial outcomes for middle school-aged youth. Methods Youth with T1D, 11-13 years of age, and their caregivers, participated in a randomized controlled trial comparing Team Clinic to traditional clinic visits (control group). Diabetes characteristics were obtained at every visit. Participants and caregivers completed depression screening and family conflict questionnaires at baseline and end of study. Changes in mean scores on clinical and psychosocial outcomes from baseline to end of study were compared between groups using linear mixed-effects models. Results Eighty-six youth (51% female; 74% White; 10% Hispanic) completed at least one visit during the twelve-month study period. At the end of the study, control group participants reported increases in Emotional Problems compared to Team Clinic participants, including higher levels of Negative Mood/Physical Symptoms (p=0.02). Team Clinic participants reported reduced family conflict surrounding diabetes at study end, compared to control group participants (p=0.03). Caregivers did not report change in depressive symptoms or family conflict during the study. Hemoglobin A1C levels did not change over time in either group. Conclusions Participation in Team Clinic was associated with improved psychosocial outcomes in middle school-aged participants with T1D. This article is protected by copyright. All rights reserved.

OBJECTIVE: This study sought to determine whether gastric symptoms are associated with later eating disorder (ED) symptoms during early adolescence, and whether this relationship is moderated by parental warmth/acceptance and/or the child's sex. METHOD: Longitudinal data from the Adolescent Brain Cognitive Development(SM) Study were utilized. Participants ages 9–10 years old (N = 4,950; 2,370 female) completed measures at baseline and 1 year later (Y1). At baseline, gastric symptoms were measured by parent-reported items from the Child Behavior Checklist (CBCL), and perceived parental acceptance was measured by youth report on the Children's Report of Parent Behavior Inventory (CRPBI) Acceptance subscale separately for mothers and fathers. ED symptoms at Y1 were assessed by parent report on a computerized version of the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS). Linear mixed-effects models were conducted separately for maternal and paternal acceptance to test relationships among variables. RESULTS: A three-way interaction between baseline gastric symptoms, sex, and maternal acceptance predicted Y1 ED symptoms (β = 0.08; p < .01). Post-hoc analyses revealed that the interaction between gastric symptoms and maternal acceptance was significant for girls only (β = −0.06, p < .01), such that low maternal acceptance was associated with a stronger relationship between baseline gastric symptoms and Y1 ED symptoms. No statistically significant main effects or interactions were found in the model for paternal acceptance. DISCUSSION: Gastric symptoms and low perceived maternal acceptance may interact to result in heightened risk for EDs in young adolescent girls.

Purpose: This meta-analysis aimed to analyze the effects of smoking prevention programs for young adolescents at early smoking stages to identify the appropriate characteristics of prevention programs for this population.Methods: Searches of health-related databases and Google Scholar were conducted, and 23 randomized studies were included in the analysis. The main outcome variable was smoking behavior. The analysis was conducted using Comprehensive Meta-Analysis software (version 3.0).Results: Smoking prevention programs significantly reduced smoking behaviors (OR=0.85, 95% CI=0.77~0.93). School-based programs (OR=0.79, 95% CI=0.75~0.83), programs by trained teachers or educators (OR=0.77, 95% CI=0.71~0.83), high-intensity programs (OR=0.82, 95% CI=0.75~0.91), and programs in an in-school setting (OR=0.82, 95% CI=0.74~0.90) had the most significant effect on reducing smoking behavior.Conclusion: For young adolescents, smoking prevention programs are most effective when they are school-based or highintensity programs, and when conducted by teachers or educators with proper training. Further studies are required since there was insufficient research to explore the effect of web-based programs or family-centered programs on adolescent smokers.

This study examines the proposition that friend characteristics forecast changes in perceptions of relationship negativity. The participants (ages 9 to 11) were 240 pre- and young adolescents (114 boys, 126 girls) involved in 120 same-sex best friendships that were stable across a period of 4 to 12 weeks. Each friend described perceptions of negativity in their relationship. Prosocial behavior and relational aggression were assessed via peer nominations. Dyadic analyses indicated that one friend's prosocial behavior and relational aggression uniquely forecast changes in the other friend's perception of negativity in the relationship. Greater initial levels of prosocial behavior anticipated decreases in perceived negativity, whereas greater initial levels of relational aggression forecast increases in perceived negativity.

Transitioning from an acute psychiatric care setting to a less restrictive environment after a suicidal event is arguably the most critical period of suicide risk for adolescents, making comprehensive safety and coping plans for this population ever more critical. In this paper we provide theoretical and empirical rationale for the need for developmental adaptations to current safety planning procedures for suicidal adolescents, as well as the standardization of pediatric safety plans for broader use across settings that provide acute psychiatric care to adolescents. We describe how we developed the Adolescent Safety and Coping Plan (ASCP) using qualitative in-depth interviews with 20 adolescents and their parents, explain the specific components of the ASCP, and give a case example of the ASCP being used with a young adolescent and her parents. Finally, we conclude with a discussion of the barriers and facilitators of the use of the ASCP in settings that provide acute psychiatric care, as well as the need for future research to test the ASCP with diverse adolescent and family populations and settings.

Aim Levels of American Heart Association-defined cardiovascular (CV) health behaviours have not been fully reported among young adolescents in low- and middle-income countries (LMICs). We describe poor, intermediate and ideal levels of American Heart Association-defined CV health behaviours among young adolescents in LMICs. Methods We categorised the levels of CV health behaviours (smoking, body mass index, physical activity and diet) as poor, intermediate, or ideal and calculated the prevalence of each level and the cumulative number of ideal CV health behaviours using the latest data from the global school-based health survey during 2009-2015. The weighted prevalence and 95% confidential intervals were calculated for the whole sample and for sub-groups stratified by gender and age. Pooled overall and regional estimates were calculated using a random-effects model. This study included 153 759 young adolescents from 45 countries. Results Overall, 86.3% (95% confidence interval, 82.7-89.9), 80.1% (79.8-80.4), 15.4% (13.7-17.2) and 1.7% (1.1-2.2) of respondents reported ideal levels for smoking, body mass index, physical activity and a healthy diet score, respectively. Overall, 0.3% (0.2-0.4) of respondents had 'four' cumulative ideal CV health behaviours. This 'percentage' was lowest in the Americas (0.2%) and highest in Southeast Asia (0.5%). Conclusions Consistently low proportions of young adolescents in LMICs met the ideal levels of physical activity and a healthy diet score or had 'four' ideal CV health behaviours. For this population, physical activity and a healthy dietary pattern should be strongly prioritised.

Catatonia is a syndrome characterized as a cluster of difficulties in verbal and motor behavior that interferes with everyday function. This study analyzed the effects of a prompt-fading behavioral treatment package on the verbal behavior of an adolescent girl with autism and catatonia. Data were collected on three verbal responses previously observed in the participant's repertoire, including "Hi," "That sounds great," and "Excuse me." Instructors provided full manual guidance, in conjunction with a verbal model, when needed, to assist the participant in emitting the verbal responses. A functional relation was demonstrated between the prompt-fading package and the three verbal responses, and independent verbal responding emerged as manual prompts were faded. Responding was displayed across unfamiliar adults and maintained over time.

Background: Children and adolescent mortality remains a public health concern in developing countries. This study aimed to describe risk factors and aetiologies of mortality among children and young adolescents at a tertiary hospital in the town of Douala, Cameroon. Methods: We carried out a retrospective cohort study from January 1st to May 31st, 2019 among deceased patients aged 1 month to 15 years admitted to the paediatric ward of the Gynaeco-Obstetric and Paediatric Hospital. Data of interest were collected and analysed. Results: Out of 3088 children admitted, 123 death cases were recorded. The overall hospital mortality rate was 3.98%. Females accounted for 51% of the deceased patients. Fever was the main reason for consultation. Severe malaria was the most common diagnosis. In univariate logistic regression analysis, factors associated with mortality included hyperthermia (OR = 0.24; 95% CI 0.80 - 1.33; p = 0.012), coma/impaired consciousness (OR = 0.30; 95% CI 0.10 - 0.88; p = 0.029), pneumonia (OR = 3.95; 95% CI 1.42 - 10.97; p = 0.008), antipyretic therapy (OR = 0.28; 95% CI 0.11 - 0.73; p = 0.009), and no medication (OR = 4.50; 95% CI 1.05 - 9.29; p = 0.043). In multivariate regression analysis, coma/impaired consciousness was found to be the only factor associated with mortality (OR = 6.24; 95% CI 1.15 - 33.73; p = 0.034). Conclusion: The present study reveals that most of death cases were due to preventable causes, especially infectious diseases. Efficient reduction in children and adolescent mortality could be achieved by adequately addressing these causes.

An increasing number of young adolescents who identify as transgender or nonbinary are presenting to the health care system for gender affirmation therapy before the full progression of puberty. Gender-affirming therapy may impair future fertility, but options exist for fertility preservation. This perspective reviews these options for transmasculine and nonbinary youth, and explores related ethical considerations. The authors support the right of transgender and nonbinary youth to utilize available reproductive technologies, provide recommendations for treating health professionals, and advocate for increased research efforts and tools to aid patient decision making.

At the 62nd annual meeting of the American Society of Hematology (ASH) 2020—which took place virtually for the first time—numerous clinical studies and research results were presented. The latest trends and exciting developments in the field of stem cell transplantation can be found in the following article, e. g. how transplantations with a mismatch donor can be safely performed, important studies regarding MDS and ALL patients, a promising second-line treatment in chronic GVHD, why the nutritional status and the microbiome should be part of the pre-transplant work-up and that lifelong follow-up for children and young adolescents after an allogeneic transplantation is essential.

Around 60–70% of the world population are residing in Asia and each year approximately 200,000–250,000 children and young adolescents aged less than 20 years are expected to develop cancer. The Asian continental branch of the International Society of Pediatric Oncology (SIOP Asia) was founded in 1995 and its first meeting was held in Singapore in 2000. Since the SIOP Asia is an academic society under the umbrella of SIOP, foundation of its action team named as Asian Pediatric Hematology and Oncology Group (APHOG) was proposed and agreed to be built by the representatives from many Asian countries in 2012 at the time of the 7th SIOP Asia congress in Yogyakarta. APHOG is an Asian children’s cancer clinical study group which works as one of the two wheels of a cart with SIOP Asia. One of its new missions is to support the WHO Global Initiative for Childhood Cancer which was declared in 2018. The aim is to increase the cure rate of children with cancer up to more than 60% by 2030. The fundraising system for APHOG is now being established.

Introduction: Dental caries is among the most common dental problems affecting humans. The prevalence and severity of dental caries is increasing in developing countries which may be attributed to changing lifestyle and dietary patterns that include binge eating habits and high sugar containing diet, popularity and easy availability of soft, sticky, high carbohydrate content food items among young adolescents. Objectives: (1). To study the magnitude of caries among 5 to 15year olds residing in Kalyan Puri. (2). To assess the associated dietary practices among study subjects. Methods: This was a community-based cross-sectional study in urban resettlement colony, Kalyan puri, East Delhi. An interview schedule was designed and pretested for dietary history and clinical examination was done using an oral probe, dental mirror and torch to assess the magnitude of caries. DMFT index was calculated for each child. Data analysis was performed using Statistical Package for the Social Sciences version 11.2. The qualitative variables were expressed in proportion and quantitative variables were summarized by mean and standard deviation. Result: Caries was present in 22.4% of subjects. The mean DMFT index was 0.48 ±0.991 with range 0 to 6. Study subjects who were consuming protective food items more than once a week were found to have comparatively less problems of teeth. Conclusion: This study gives the need for raising awareness regarding good oral hygiene, appropriate dietary practices and promotion of homemade, natural and indigenous products with good nutritional values over the use of processed food. How to cite this article:Bharti A, Prasuna JG, Mehra P, Rasania SK. Dental Caries and Dietary Habits: A Community-Based Cross-Sectional Study among Young Adolescents. Epidem Int 2020; 5(3): 10-14. DOI: https://doi.org/10.24321/2455.7048.202021

An optometrist plays a central role in the busy, routine practice of an ophthalmologist, often the point of first contact. More and more higher educational institutions are offering a plethora of technology-based paramedical training courses. Optometry is one such field that has, in parallel, benefitted by the growth of technology. Despite so many other options being available, optometry continues to enjoy popularity. We undertook this study to assess what ticks inside the minds of young adolescents, and makes them choose optometry, to define their career track. Using Google forms and census sampling, we were able to get responses from 40 BSc Optometry students, across all years of the course. We found females outnumber males, hugely. Among the several factors that influence the decision-making in favor of optometry, the top ones included positive course credentials, huge market opportunities, altruism, pleasant work-life balance, and being perceived as a doctor. Keywords: Careerchoice, Factors, Optometry.

There have been differences in temporal trends of asthma prevalence by geographic region and economic prosperity. The aim of this study was to assess temporal trends in asthma prevalence among young adolescents in Skopje, Republic of North Macedonia as a developing country with a low asthma prevalence.Data were obtained from three cross-sectional surveys (2002, 2006, and 2016) of adolescents (12-15 years) from randomly selected schools in Skopje. Trends in the prevalence of asthma and asthma-like symptoms were investigated descriptively and using multiple logistic regression to adjust for potential confounding factors.The prevalence of asthma increased, although the changes were not statistically significant (2002: 1.7%; 2006: 2.0%; 2016: 2.8%; p=0.075). Statistically significant (p0.05) reductions in wheeze prevalence over time (2002, 2006, 2016) were observed for current wheeze (8.8%, 7.2%, 5.5%), exercise-induced wheeze (14.2%, 7.9%, 1.9%), and night dry cough (16.5%, 13.5%, 9.6%). After adjustment for potential confounding factors, there was an increase in asthma likelihood by year compared to 2002 (2006: OR=1.22, 95%CI=0.67-2.22; 2016: OR=2.45, 95%CI=1.24-4.84). In the adjusted analyses, associations between year and the asthma-like symptoms confirmed the descriptive results, except for current wheeze, where statistical significance disappeared.Divergent trends in prevalence with a decrease in asthma-like symptoms and an increase in physician-diagnosed asthma in Skopje during a period of 14 years were established. Improved asthma labelling and effective preventative treatment of symptoms may explain some of these changes, although changes in environment and lifestyle could not be ruled out.

Diego, a young adolescent, is hospitalised in a psychiatric unit for anorexia. The diagnosis of anorexia, as well as medical practices, result in resistance from the young man, for whom being "anorexic" seems incompatible with a masculine and heterosexual vision of oneself. His passage through the psychiatric unit is then not without effect on his sexual development.

The aim of this study was to assess the awareness of caregivers, emergency medical technicians, and emergency medical doctors by investigating the storage media for avulsed teeth at the trauma site. This study was performed by reviewing medical records of 183 patients with the age under 17 years old, who visited Ajou University Hospital for dental trauma. Based on their medical records, storage media for avulsed permanent teeth were investigated by classifying them as dry, milk, saline, saliva and tap water. The storage media chosen by caregivers at the trauma site were classified as cases by parents and school nurse teachers. Storage media chosen by emergency medical technicians and emergency medical doctors were also investigated using the same classification criteria. The results show that both parents and school nurse teachers used milk the most as a storage medium for avulsed teeth. Dry storage was the second most chosen medium by parents, and saline by nurse teacher. As a storage media emergency medical technicians used saline the most, while emergency medical doctors used only saline when they failed to replant avulsed teeth. There is a need to improve the knowledge of caregivers, emergency medical technicians, and emergency medical doctors regarding the storage media for avulsed teeth.

Balanced levels of Psychological Well-Being (PWB) can represent protective factors for human functioning. PWB has not been investigated among young adolescents who practice binge drinking (BD), a popular pattern of alcohol intake, defined as the consumption of five or more alcoholic units in one session. The negative impact of BD on psychophysical health has been extensively studied, but there is scarcity of studies investigating the influence of psychological variables on BD in early adolescence. The main aim of this study was to fill the gap in the literature, focusing on PWB as a new possible target of preventive interventions. One thousand six hundred and eighty-seven Italian adolescents completed questionnaires assessing BD, cannabis use, lifestyle, allostatic overload, subclinical psychological distress, problem-solving, and PWB. Binge drinkers represented 9% of the sample. Among them, 71%, 26%, and 3% binge drank monthly, weekly, and daily, respectively. Stress (higher frequency of stressful life events), psychological distress (higher hostility), and PWB dimensions (higher scores on positive relations and lower on purpose in life) were associated with BD. These new findings on unbalanced levels of PWB could represent the potential target of longitudinal studies aimed to implement specific preventive interventions among young adolescents. Implications for research and prevention are discussed.

The purpose of the work is to investigate the screening frequency of anxiety and depressive disorders and their manifestations in young adolescents to determine risk factors and develop measures for their prevention. Anxiety testing was conducted for 313 students of educational institutions of the Khmelnitsky region aged 10-14 years: 156 (49.8 %) boys and 157 (50.2 %) girls. 258 people were tested for the spectrum of depressive disorders, of which 51.9 % (134) were boys and 48.1 % (124) girls. Spielberger State-Trait Anxiety Inventory (STAI) was used to study anxiety, and Children's Depression Inventory (CDI) by M. Kovacs, was used to diagnose depression. The probability was evaluated using Student's t-test with the construction of a 95 % confidence interval (CI) for the difference in means. Quantitative traits are given as M±σ. A high level of personal anxiety was determined in 20 (6.4 %), and situational anxiety in 17 (5.4 %) people. The average level of personal anxiety was determined in 38 (12.1 %), and situational anxiety – in 142 (45.3 %) people. A low level of personal anxiety was identified in 255 (81.5 %), and situational anxiety – in 154 (49.3 %) people. That is, most students of early adolescence had a low level of both personal and situational anxiety. Signs of depressive disorders were detected in 50.0 % of the examined children of early adolescence who completed the questionnaires, in particular, mild manifestations of depression were found in 70 (27.2 %) people, moderate in 46 (17.2 %) people, severe depression in 13 (5.0 %) people. The level of depressive symptoms in girls was higher (53.32±12.54 points) compared with boys (50.01±9.94 points), respectively (95 % CI, 0.5 – 6.0; p

Objective The current study explored whether the chances of having migraine are influenced by a youth’s friendship with a migraineur. Methods The study was centered on a community-based non-referral cohort of eighth graders from two middle schools in Taiwan. Among the 642 recruited adolescent students, 610 (95%) (mean age 14.1 years, male ratio 51.2%) nominated three good friends and completed a validated headache questionnaire for migraine diagnosis at the follow-up survey 1 year later. To explore social influences on incident migraine, we used longitudinal statistical models to examine whether the development of migraine in one adolescent during the 1-year observational period was associated with that in his/her friends. Results Overall, 1700 social ties were established in the social network based on the reported lists of good friends. Randomization test for the homophily effect demonstrated that the students with migraine tended to cluster together in the social network even when those with incident migraine were also considered ( p = 0.003). Besides, when friendship choices were mutual, the relative risk of an adolescent becoming a migraineur was 3.26 (95% CI: 1.25–8.47, p = 0.015) if his/her friend became a migraineur (induction) during the 1-year observational period. Conclusion To the best of our knowledge, this is the first study to demonstrate that migraine may spread through social networks in young adolescents. Both homophily and induction effects are possibly contributory.

Objectives We investigated the differences in cognitive and emotional empathic ability between adolescents and adults, and the differences of the brain activation during cognitive and emotional empathy tasks. Methods Adolescents (aged 13-15 years, n=14) and adults (aged 19-29 years, n=17) completed a range of empathic ability questionnaires and were scanned functional magnetic resonance imaging (fMRI) during both cognitive and emotional empathy task. Differences in empathic ability and brain activation between the groups were analyzed. Results Both cognitive and emotional empathic ability were significantly lower in the adolescent compared to the adult group. Comparing the adolescent to the adult group showed that brain activation was significantly greater in the right transverse temporal gyrus (BA 41), right insula (BA 13), right superior parietal lobule (BA 7), right precentral gyrus (BA 4), and right thalamus whilst performing emotional empathy tasks. No brain regions showed significantly greater activation in the adolescent compared to the adult group while performing cognitive empathy task. In the adolescent group, scores of the Fantasy Subscale in the Interpersonal Reactivity Index, which reflects cognitive empathic ability, negatively correlated with activity of right superior parietal lobule during emotional empathic situations (r=-0.739, p=0.006). Conclusion These results strongly suggest that adolescents possess lower cognitive and emotional empathic abilities than adults do and require compensatory hyperactivation of the brain regions associated with emotional empathy or embodiment in emotional empathic situation. Compensatory hyperactivation in the emotional empathy-related brain areas among adolescents are likely associated with their lower cognitive empathic ability.

This study explored the genetic testing experiences of adolescents and young adults (AYAs; aged 15-39 years) with, or at 50% risk of, an early onset cancer predisposition syndrome: Li-Fraumeni syndrome (LFS).We used interpretive description and conducted semi-structured interviews with 30 AYAs (mean age 25.5 years): 26 with LFS and four at 50% risk. Findings were developed using team-based, inductive thematic analysis.Participants reported genetic testing uptake to reduce uncertainty about their gene status and to access cancer risk management. Learning their gene status, however, introduced a new uncertainty about living with high multi-organ cancer risk. Participants preoccupied with surviving cancer during diagnostic testing underestimated the implications of LFS. Reliance on family at this life stage complicated decision-making for genetic testing, especially among adolescents.AYAs undergoing genetic testing for LFS have unique support needs based on their life stage and require developmentally appropriate psychosocial care.

Objective: To compare the efficacy of SSRI medication alone and SSRI+CBT combined. Methods: NCBI Pubmed, DARE, CSDR and NGC were searched October-November 2019. The population size, as well as the base and endpoint CGAS mean and standard deviation from the three studies included, are recorded. Statistical analysis was done in RStudio with the "meta" package. Results: For the SSRI only, the effect size was -1.82 with a 95% confidence interval between -2.28 and -1.37. For the SSRI and CBT combined, the effect size was -1.68 with a 95% confidence interval between -2.39 and -0.98. The effect size for both SSRI and SSRI + CBT didn't cross the null effect line, but the heterogeneity exceeds 50%. The result for the comparison of post SSRI vs. SSRI + CBT showed the effect size of -0.05 with a 95% confidence interval between -0.23 and 0.12. The size effect did cross the null effect line, but the heterogeneity was less than 50%. Conclusion: Both methods were shown to be effective. However, due to statistical inconsistencies, it couldn’t be concluded whether the combination of SSRI and CBT is better than treatment with SSRI alone.

Over a third of new HIV infections occur in adolescents aged 10–19 globally. Pre-exposure prophylaxis (PrEP) could be a powerful tool for prevention. Understanding more about the drivers of PrEP interest could inform implementation strategies among this age group. Moreover, family dynamics may play a uniquely critical role for this younger age group, thus it is important to gauge whether caregivers would support their children’s use of PrEP. We surveyed 2,089 adolescents (aged 10–16) and their caregivers in Malawi during 2017–2018. Data were collected on PrEP interest, factors that may facilitate PrEP use, and preferences for PrEP modality. We used multivariate logistic regression to estimate the association between the above characteristics and PrEP interest. We find that young adolescents are engaging in behaviors that would put them at substantial risk of acquiring HIV, would likely benefit from PrEP, are largely (82%) interested in using such, would prefer to get an injection over taking a daily pill, and are considerably discouraged by the prospect of side effects. Endorsement by caregivers was even greater (87%). Our findings demonstrate initial support for adolescent PrEP, and suggest parents may be a surprising advocate.

OBJECTIVE: To describe tuberculosis (TB) characteristics in the adolescent 10–19 years age group that is often underrepresented in surveillance and studies despite the high global TB burden estimated for this group.SETTING AND DESIGN: We use the case-based data reported to the European Surveillance System (TESSy) from European Union (EU)/European Economic Area (EEA) countries between 2007 and 2016 to describe notification rates, TB characteristics and treatment outcomes among adolescent TB cases. We also compare TB characteristics in young adolescents (10–14 years) and older adolescents (15–19 years).RESULTS: For the period 2007 to 2016, 705 826 TB cases were reported to TESSy by 29 EU/EEA countries, 38 054 (5.4%) of which were adolescents. The overall EU/EEA notification rate among adolescents was 6.9 per 100 000 population, 3.5 among young adolescents and 10.1 among older adolescents. The two adolescent groups had differences regarding sex distribution, site of disease, sputum smear microscopy positivity, laboratory confirmation and treatment outcome.CONCLUSION: Younger and older adolescents should be analysed as separate groups when studying and reporting TB, particularly to inform better targeting of TB prevention and care interventions in the future, in order to improve outcomes.

There is very little evidence whether recalling and answering questions about abuse or interpersonal violence has a positive or negative impact on participants of such research. This is an important ethical dilemma to ensure an appropriate risk-benefit ratio in research with young people is maintained. We assessed reported harms, benefits, and regrets of young adolescents who participated in a sensitive research project, and compared the harms and benefits in those who had and had not been victims and/or perpetrators of abuse or intimate partner violence. Participants were 3,264 adolescents aged 12 to 15 years in 41 public schools in the Western Cape, South Africa, who completed a survey about intimate partner violence, verbal, physical, and sexual abuse, as part of an HIV prevention cluster randomized controlled trial. The majority of participants reported research participation as beneficial (70.3%), while 27.7% reported harms and 14% regrets. Victims of abuse were more likely than non-victims to report benefits (71.9% vs. 67.1%; p = .02) and harms (31% vs. 20.9%; p < .01) and were less likely to report regret (13.1% vs. 16.7%; p = .02). Perpetrators of abuse were less likely than non-perpetrators to report benefits (67.4% vs. 72.8%; p = .01) and more likely to report harms (36.4% vs. 26.1%; p < .01) and regrets (17.4% vs. 13.3%; p = .01). Our findings suggested that research participation was more likely to have a positive rather than a negative emotional impact on young adolescents and that relatively few regretted participating. Victims and perpetrators of abuse were more likely to report benefits than harms, supporting the ethical appropriateness of ongoing research on abuse and violence. We recommend that further research is required to clarify and standardize terminology and instruments to quantify these kinds of evaluations, including measurement of the severity and intensity of reported benefits, harms and regrets, and the longer term impact of participation in sensitive research.

Aims: We examined the relationship between loneliness and health among young adolescents. We also investigated the validity of a single-item measure of loneliness by comparing this to a composite score. Methods: The current data come from a nationally representative sample of 11- to 15-year-old adolescents ( N=3305; F=52%) from Denmark collected in 2014 as part of the Health Behaviour in School-aged Children (HBSC) collaborative cross-national survey. Results: A series of binary logistic regressions showed that higher loneliness among adolescents, whether measured using the single- or multi-item measurement, was associated with poorer self-rated health, higher frequency of headache, stomach ache, backache, difficulties sleeping, greater sleep disturbance and more instances of feeling tired in the morning. Those associations were relatively consistent across sex and age groups. Conclusions: Loneliness is associated with poorer self-reported health and sleep problems among young adolescents. Those findings are similar across two measures of loneliness, suggesting robust findings. The development of interventions and health-education efforts to fight loneliness in adolescence is important.

The purpose of this systematic review was to identify adolescents' awareness on the human papillomavirus (HPV), the HPV vaccine, and the willingness to undergo the vaccination. A systematic review of studies concerning the adolescent's knowledge and education on the admission of the HPV vaccine was carried out, through the Medline/PubMed and the Google Scholar databases, covering information on adolescent attitudes towards HPV vaccination, as well as their perceptions regarding the vaccination and the need for more training, towards the public information about the HPV and the HPV vaccine. This study concludes that adolescents are poorly informed about the HPV and the preventive vaccination issues, underestimating the likelihood of the infection by the virus. The way to improve their knowledge about the HPV and the implications of the HPV infection is to provide information through the framework of compulsory schooling, primary health care, and the development of informative interactive interventions. The awareness for the need of training about the HPV and its implications should be broadened to address the major barrier to vaccination, which is regarded to be the lack of adequate information. The knowledge and the perceptible susceptibility to the HPV infection and HPV-related diseases among adolescents demonstrate the need for a well-designed training program to bridge the gap of information about the HPV virus and to accept the HPV vaccine.

Patellofemoral pain (PFP) is a common complaint among young sports active adolescents. This study evaluated the longitudinal changes in pronociceptive and antinociceptive mechanisms in young adolescents with PFP, their impact on prognosis, and responsiveness to treatment. Adolescents (N = 151, aged 10-14 years) diagnosed with PFP were compared with age-matched controls (N = 50) and subsequently tracked while participating in an intervention focussed on activity modification. They underwent quantitative sensory testing at baseline (preintervention), 4 weeks (during initial treatment), and 12 weeks (after treatment). Pressure pain thresholds (PPTs) were recorded on the knee, shin, and elbow. Temporal summation of pain (TSP) was assessed by the increase in pain intensity during 10 repeated cuff pressure pain stimulations on the leg. Conditioned pain modulation (CPM) was defined as change in cuff pain thresholds on one leg, during painful cuff conditioning on the contralateral leg. At baseline, adolescents with PFP had decreased PPTs at the knee, shin, and elbow (P < 0.001) as well as more facilitated TSP (P < 0.05) compared with controls. For CPM at baseline, controls displayed an increase in cuff pain thresholds during conditioning (P < 0.05), while those with PFP did not. More facilitated baseline TSP was associated with less improvements in pain intensity during the intervention (P < 0.01). Pressure pain thresholds increased at both follow-ups (P < 0.001), and the increased PPTs were associated with decreases in pain intensity (r = 0.316; P < 0.001). Overall, TSP remained facilitated at follow-ups, and there was no change in CPM. This is the first study to demonstrate a pronociceptive mechanism as a prognostic factor in young adolescents with PFP.

Alveolar soft part sarcoma (ASPS) is a distinct soft tissue sarcoma among adolescent and young individuals. It accounts for 1 % of all sarcomas. It is a rare malignancy of the mesenchymal tissue that possesses an uncertain histologic origin. The increased vascular nature of this lesion leads to the dissemination of tumour cells through the connective tissue along the haematogenous route. Here we present a case of a swelling involving the tongue of a 19-year-old male patient and emphasize on the importance of diagnostic aids and management of this rare and unique lesion.

Background The relationship between social media (SM) use and disordered eating (DE) has not been adequately explored in young adolescents. Methods Data from 996 Grade 7 and 8 adolescents (n = 534 girls; M age = 13.08) was investigated. DE cognitions (Eating Disorder Examination-Questionnaire [EDE-Q]), DE behaviors (Project Eating Among Teens), and SM use measures related to Facebook, Instagram, Snapchat, and Tumblr were completed. Results DE behaviors were reported by 51.7% of girls and 45.0% of boys, with strict exercise and meal skipping the most common. A total of 75.4% of girls and 69.9% of boys had at least one SM account where Instagram was the most common, used by 68.1% of girls and 61.7% of boys. Global EDE-Q scores were significantly higher for girls and boys with each type of SM account, except for Facebook and Instagram for girls. A greater number of SM accounts was associated with higher DE scores for both cognitions and behaviors. Girls with Snapchat and Tumblr accounts and boys with Snapchat, Facebook and Instagram were significantly more likely to have both DE behaviors and over-evaluation of shape and weight in the clinical range. Greater daily time spent using Instagram was associated with significantly higher Global EDE-Q scores and DE behaviors for girls, while this pattern was also found for Snapchat usage and DE behaviors for girls. Conclusions A clear pattern of association was found between SM usage and DE cognitions and behaviors with this exploratory study confirming that these relationships occur at younger-age than previously investigated.

Purpose To obtain data on Canadian youth, aged 11 to 15 years, presenting to paediatric emergency departments, with severe alcohol intoxication and to describe demographics, presentations to hospital, concurrent substance use, comorbidities, and short-term outcomes of admission to emergency departments. Methods Between March 2013 and February 2015, through the established methodology of the Canadian Paediatric Surveillance Program, Canadian paediatricians and paediatric subspecialists were surveyed monthly to identify cases of young adolescents presenting to paediatric emergency departments across Canada with severe alcohol intoxication. Those that identified cases were subsequently sent a detailed questionnaire. The detailed questionnaires were then screened to ensure the reported cases met the study’s inclusion criteria. Results A total of 39 cases (18 females and 21 males) were included in the final analysis. Overall, results indicate over 90% of presenting youth had consumed spirits, 39% had concurrent substance use and 46% experienced serious medical morbidity. Almost two-thirds of youth were admitted to hospital for a period ranging from 10 hours to 5 days; 12 youth required intubation. Follow-up referrals were provided to two-thirds of youth, with variable supports given. No statistically significant differences between sexes were noted for blood alcohol level or concurrent substance use. Conclusion Although rates of alcohol use in adolescents have been steadily decreasing, results from this surveillance study suggest that severe intoxication arising from the use of alcohol alone, and with concurrent substance use, results in significant immediate health consequences in young adolescents. Results from this study also highlight characteristics of patients, initial treatments and initial referrals across Canadian paediatric healthcare facilities, the results of which highlight variability and may aid in the guidance of a future longitudinal study, prevention strategies, and public health messaging.

Background Young adolescents with perinatally acquired human immunodeficiency virus (HIV) are at risk for poor care outcomes. We examined whether universal antiretroviral treatment (ART) eligibility policies (Treat All) improved rapid ART initiation after care enrollment among 10–14-year-olds in 7 sub-Saharan African countries. Methods Regression discontinuity analysis and data for 6912 patients aged 10–14-years were used to estimate changes in rapid ART initiation (within 30 days of care enrollment) after adoption of Treat All policies in 2 groups of countries: Uganda and Zambia (policy adopted in 2013) and Burundi, Democratic Republic of the Congo, Kenya, Malawi, and Rwanda (policy adopted in 2016). Results There were immediate increases in rapid ART initiation among young adolescents after national adoption of Treat All. Increases were greater in countries adopting the policy in 2016 than in those adopting it in 2013: 23.4 percentage points (pp) (95% confidence interval, 13.9–32.8) versus 11.2pp (2.5–19.9). However, the rate of increase in rapid ART initiation among 10–14-year-olds rose appreciably in countries with earlier treatment expansions, from 1.5pp per year before Treat All to 7.7pp per year afterward. Conclusions Universal ART eligibility has increased rapid treatment initiation among young adolescents enrolling in HIV care. Further research should assess their retention in care and viral suppression under Treat All.

Considerable support exists for both the phonological core deficit and the naming speed deficit models of dyslexia. The double deficit model proposed that many students with dyslexia might also be impaired in both underlying processes. Employing either performance thresholds (i.e., scores below the 16th or 25th percentile) or k-means clustering as classification methods, the current study investigated whether 154 young adolescents with dyslexia could be categorized into subtypes according to the presence or absence of phonological deficits alone, naming speed deficits alone, or a combination of the two and whether group composition changed depending on classification method. Results support the existence of both single and double deficit groups and confirm that those with both deficits are the most severely impaired across multiple measures. Contrary to previous research, most adolescents were classified as either naming speed only (about a third of the group) or double deficit when defining impairment using performance thresholds to classify groups. This may suggest that although early phonological deficits are amenable to remediation, identification of language symbols fails to become automatized in most individuals with dyslexia and may require more targeted intervention. Classification differences reported in the literature may depend on age and methods employed for classification.

Purpose:Using wearable monitoring devices is increasingly ubiquitous, including among young people. However, there is limited evidence of the validity of devices which are aimed at children and adolescents. The purpose of this study was to evaluate the validity of Fitbit Ace and Moki monitors in healthy young adolescents.Methods:This cross-sectional study included 17 young adolescents (ages 11–13 y) ambulating between 3 different walking conditions (incidental [∼6 min], controlled, and treadmill [each 3 min], while wearing wrist-worn devices [Fitbit Ace, Moki] on each wrist [left and right, respectively]). Data from the devices were compared with observer counts (criterion). Bland–Altman plots and mean absolute percentage errors were computed.Results:Analyses identified that the Fitbit Ace showed higher levels of bias across conditions compared with the Moki device: (mean difference [SD]; Fitbit Ace: 30.0 [38.0], 3.0 [13.0], and 13.0 [23.0] steps and Moki: 1.0 [19.0], 4.0 [16.0], and 6.0 [14.0] steps, incidental, controlled, and treadmill, respectively). Mean absolute percentage errors ranged from 3.1% to 9.5% for the Fitbit Ace and 3.0% to 4.0% for the Moki device.Conclusion:The Fitbit Ace and Moki devices might not provide acceptable validity under all walking conditions, but the Moki provides more accurate estimates of incidental walking and might therefore be a good choice for free-living research or school-based interventions.

BackgroundVery little is known about how self-reported gingival bleeding affects the oral health-related quality of life in adolescents compared with clinically evident bleeding. This study aimed to compare the impact of self-reported gingival bleeding and clinically evident gingival bleeding on the oral health-related quality of life in young adolescents.MethodsThis was a cross-sectional study involving 976 students (aged 10–14 years) in randomly selected primary schools in Ibadan. Data were obtained by oral examination and completion of the Child Oral Impact on Daily Performance Questionnaire. Data were analysed with SPSS version 24. The Mann Whitney U test was used to determine the association between gingival bleeding and the quality of life.ResultsThe mean age of the participants was 11.4±1.3 years. Almost half (48.3%) of the participants reported gingival bleeding during tooth cleaning while the gingiva of 534 (54.7%) participants bled on examination. Pupils with self-reported bleeding suffered a significantly greater impact on their overall quality of life than those without self-reported bleeding (mean ranks: 528.1 vs. 451.6, P