OBJECTIVE: Montelukast is used extensively in children and adolescents for allergic rhinitis and asthma. However, concerns have been raised regarding the increased risk of neuropsychiatric adverse events (NPAEs) associated with montelukast use. Therefore, our case-crossover study was conducted to observe whether there is an increased risk of NPAEs associated with montelukast use in children and adolescents.
METHODS: A population-based case-crossover study using the customised Health Insurance Review and Assessment (HIRA) dataset was conducted. Paediatric patients aged between 0 and 19 years diagnosed with allergic rhinitis and/or asthma with a history of at least one montelukast prescription between 1 January 2018 and 31 December 2021 were included. Exposure to montelukast was assessed during 3-, 7-, 14-, 28- and 56-day hazard periods prior to each patient\'s NPAE. Stratified analyses according to age group, gender and season for the risk of NPAEs associated with montelukast use in the previous 7 days and 14 days were performed, respectively. Conditional logistic regression analysis was used to calculate adjusted ORs (aORs) with their corresponding 95% CIs, adjusting for concomitant medications.
RESULTS: A total of 161 386 paediatric patients was identified. An increased risk of NPAEs associated with montelukast was found in all time window periods, including 3-day (aOR 1.28, 95% CI 1.24 to 1.32), 7-day (aOR 1.29, 95% CI 1.26 to 1.33), 14-day (aOR 1.34, 95% CI 1.31 to 1.37), 28-day (aOR 1.38, 95% CI 1.36 to 1.41) and 56-day (aOR 1.21, 95% CI 1.19 to 1.22) preceding hazard periods compared with use in the four control periods.
CONCLUSIONS: Children and adolescents with allergic rhinitis and/or asthma should be prescribed montelukast with caution considering clinical benefits.

UNASSIGNED: Although menstruation is a monthly biological phenomenon, it is shrouded in stigma and shame which directly impacts health, education, gender equality, decent work, and economic growth. However, there is scarce evidence on how personal agency, an individual\'s ability to access resources, may act as a protective factor to adequate menstrual health and hygiene practices. Therefore, we assess the association between attitudes toward menstruation and personal agency among very young adolescent girls.
UNASSIGNED: We use cross-sectional data from the Global Early Adolescent Study in São Paulo, Brazil, among 10- to 14-year-old girls who have experienced menarche (n = 325) and completed a home-based self-administered questionnaire in 2021. \"Attitudes toward menstruation\" was created based on five indicators on a Likert scale, with a higher score indicating more positive attitudes. The main covariate was personal agency, comprised of three scales and modeled as three continuous variables: voice, decision-making power, and freedom of movement. Data were analyzed using multivariable linear regression.
UNASSIGNED: Attitudes toward menstruation mean score was 12.5 (range 5-19). Older adolescents (12-14 years-old) had higher mean scores (more positive) than younger adolescents (10-11 years-old) on attitudes toward menstruation, whereas no other sociodemographic or menstrual health indicator (knowledge or access to products) were associated with attitudes toward menstruation. In the multiple regression model, older age and higher freedom of movement remained positively associated with attitudes toward menstruation (βadjust = 0.5; 95%CI 0.1 to 0.8).
UNASSIGNED: Positive attitudes toward menstruation are associated with higher freedom of movement among very young Brazilian adolescent girls. The promotion of personal agency should be recognized as key strategies to accelerate young girls\' positive approaches to their own menstruation and, consequently, well-being.
Menstrual Health and Hygiene Attitudes are associated with Personal AgencyOur results show that positive attitudes toward menstruation among very young adolescent girls are associated with personal agency, measured through freedom of movement. This information can inform strategies to accelerate young girls’ positive approaches to their own menstruation and, consequently, well-being.

OBJECTIVE: Emerging research evidence suggests positive relationships between higher screen time and eating disorders. However, few studies have examined the prospective associations between screen use and eating disorder symptoms in early adolescents and how problematic screen use may contribute to symptom development.
METHODS: We analyzed prospective cohort data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 10,246, 2016-2020, ages 9-14). Logistic regression analyses were used to estimate the longitudinal associations between baseline self-reported screen time and eating disorder symptoms in year two. Logistic regression analyses were also used to estimate cross-sectional associations between problematic screen use in year two (either problematic social media or mobile phone use) and eating disorder symptoms in year two. Eating disorder symptoms based on the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-5) included fear of weight gain, self-worth tied to weight, engaging in compensatory behaviors, binge eating, and distress with binge eating.
RESULTS: Each additional hour of total screen time and social media use was associated with higher odds of fear of weight gain, self-worth tied to weight, compensatory behaviors to prevent weight gain, binge eating, and distress with binge eating two years later (odds ratio [OR] 1.05-1.55). Both problematic social media and mobile phone use were associated with higher odds of all eating disorder symptoms (OR 1.26-1.82).
CONCLUSIONS: Findings suggest greater total screen time, social media use, and problematic screen use are associated with more eating disorder symptoms in early adolescence. Clinicians should consider assessing for problem screen use and, when high, screen for disordered eating.
METHODS: Level III: Evidence obtained from well-designed cohort or case-control analytic studies.

UNASSIGNED: Anaemia is one leading cause of morbidity among adolescent girls. Prevention, early detection, and treatment can break the intergeneration cycle of malnutrition.
UNASSIGNED: The aim of the study was to estimate the prevalence of anaemia and assess its sociodemographic determinants and understand its association with the dietary pattern of rural adolescent girls.
UNASSIGNED: A cross-sectional study was conducted among 350 adolescent girls studying in the school of Kalgatigi Taluk, Dharwad district. The school girls were interviewed using a predesigned structured questionnaire by interview method. A food frequency questionnaire was used to assess the dietary pattern. Haemoglobin levels were estimated using Sahli\'s method.
UNASSIGNED: Data were entered in Microsoft Excel and analysed using SPSS version 19 and the Chi-square test was applied to study the significance.
UNASSIGNED: Rural adolescent school girls between the age group of 13-16 years were included. The prevalence of anaemia among them was found to be 47.4% and was significantly associated with the educational status of the mother, their socioeconomic status (SES), and type of diet. Vegetarian girls had a higher prevalence of anaemia. The frequency of meat and egg consumption was significantly associated with anaemia. The prevalence of anaemia was higher in thin and severely thin girls based on WHO-BMI.
UNASSIGNED: Anaemia in rural adolescent girls is of high burden and public health importance with a prevalence of 47.4% and significant association with dietary habits, SES, and BMI.

BACKGROUND: Adolescents are a critical demographic facing unique health challenges who are further impacted in humanitarian settings. This article focuses on the urgent need for a structured health information system (HIS) to address the gaps in data availability and evidence-based interventions for adolescent health. The study aims to identify opportunities and challenges in utilizing the HIS to enhance adolescent health in the West Bank by gathering insights from healthcare providers.
METHODS: Semi-structured key informant interviews were conducted with participants involved in the HIS regarding adolescent health in the West Bank. They were selected by purposive sampling. Nineteen interviews were conducted between July and October 2022, and thematic analysis was carried out using MAXQDA software.
RESULTS: The opportunities identified were the small-scale victories the participants described in building the HIS for adolescent health. These included institutional and individual capacity building, digitalizing parts of the HIS, connection fragmentation of adolescent health activities, multi-sectoral collaboration, reorienting services based on health information, working with limited resources, enhancing community engagement to encourage ownership and active participation, and taking strategic actions for adolescents for information. The challenges were the high workload of staff, lack of health information specialists, limited resources, lack of a unified system in data collection, lack of data on essential indicators, data quality, data sharing, and data sources and use.
CONCLUSIONS: This study showed the potential of the HIS with capacity building, digitization, and collaborative initiatives; it also suffers from issues like staff shortages, non-standardized data collection, and insufficient data for essential indicators. To maximize the impact of the HIS, urgent attention to staff shortages through comprehensive training programs, standardization of data collection systems, and development of a unified core indicator list for adolescent health is recommended. Embracing these measures will allow the HIS to provide evidence-based adolescent health programs, even in resource-constrained and complex humanitarian settings.

This study aimed to identify the rates of cigarette sales to underage youth and the factors associated with these sales using a mystery shopping technique. Of the convenience stores selling cigarettes in Seoul, South Korea, 2600 were sampled in 2019 and 2020. Personal and environmental factors were independent variables. Cigarette sales to underage youth were the outcome variable, defined as cases where a seller sold cigarettes to a youth shopper. A multiple logistic regression analysis was performed. Rates of cigarette sales to underage youth were 17.9% in 2019 and 16.3% in 2020, significantly higher when the seller was younger and the store was located in a central area. Administrative actions are needed to enforce strong warnings and training guidelines for convenience store sellers. Differentiation in surveillance intensity based on the location of convenience stores in Seoul is also recommended.

BACKGROUND: The COVID-19 pandemic strained India\'s healthcare system and health workers unprecedentedly.
OBJECTIVE: The extent of the contribution by peer educators (PEs) from India\'s National Adolescent Health Programme-Rashtriya Kishor Swasthya Karyakram (RKSK) to COVID-19 response activities remains uncertain necessitating an imperative investigation. Within the overarching objective of the \'i-Saathiya\' study (\'i\' signifies implementation science and Saathiya represents PEs in Madhya Pradesh), a key focus was to understand the role of PEs recruited under RKSK during COVID-19 in two Indian states, namely Madhya Pradesh and Maharashtra. The study states differ in sociodemographic characteristics and peer education implementation models.
METHODS: In-depth interviews (IDIs) were conducted with stakeholders (n=110, Maharashtra: 57; Madhya Pradesh: 53) engaged in the implementation of RKSK\'s peer education programme at state, district, block and village levels. Focus group discussions (FGDs) (n=16 adolescents, Maharashtra: 8; Madhya Pradesh: 8) were conducted with adolescents, part of the peer group of PEs (n=120 adolescents, Maharashtra: 66; Madhya Pradesh: 54). IDIs and FGDs were audio-recorded, translated, transcribed verbatim and analysed thematically. Adopting inductive and deductive approaches, a data-driven open coding framework was developed for thematic analysis.
RESULTS: The PE recruited under RKSK took a central role that extended beyond their predefined responsibilities within the RKSK. They provided crucial support to healthcare workers in curbing the spread of COVID-19. Their diverse contributions, including COVID-19 pandemic response support, addressing community and adolescent needs, role in COVID-19 vaccination efforts, navigating access to the health system and facilitating health workers in the implementation of various national health programmes and campaigns during COVID-19.
CONCLUSIONS: The findings underscore the potential of PEs in bolstering the health system. Despite their unpreparedness for the context (COVID-19), PEs demonstrated tenacity and adaptability, extending their roles beyond their predefined responsibilities. Recognising PEs through awards and incentives, skill courses and additional grades, can enhance their visibility, sustaining impactful work within RKSK and beyond.

Labial fusion, though rare, can present during puberty, or even adolescence leading to challenges in diagnosis and management. This case report offers a detailed examination of the clinical manifestation, diagnostic process, and therapeutic approach in an adolescent girl with labial fusion. This report emphasizes the importance of early intervention to improve patient outcomes for this complex medical condition.

To analyze the distribution and factors associated with lack of knowledge about the human papillomavirus (HPV) vaccine among Brazilian adolescents.Cross-sectional study using the 2019 National School Health Survey among 17,805 Brazilian students of public and private schools, aged 13-17 years. The outcome variable was \"lack of knowledge about the HPV vaccine\" and the explanatory variables were sociodemographic, behaviors, knowledge, and health conditions. Logistic regression model was used to calculate Odds Ratio (OR) and 95% confidence intervals (95%CI). Spatial analysis techniques were used to determine the formation of clusters in the federated units with similar proportions of adolescents who were unaware of the vaccine. The lack of knowledge about the HPV vaccine was reported by 45.54% of Brazilian students. There was a higher chance of lack of knowledge having had sexual intercourse (OR 1.43; 95% CI 1.20-1.70); attending public school (OR 1.72; 95%CI 1.47-2.02) and located in the Northeast Region (OR 1.35; 95%CI 1.08-1.69). The lower chance of lack of knowledge were female gender (OR 0.41; 95% CI 0.35-0.48), higher maternal education (OR 0.62; 95% CI 0.50-0.77) self-rated health as Poor/very poor (OR 0.64; 95% CI 0.49-0.86) and receiving contraceptive counseling (OR 0.77; 95% CI 0.65-0.91). The proportion of lack of knowledge about the HPV vaccine was higher with the formation of High-High spatial clusters in the states of Maranhão, Piauí, and Pernambuco. Sociodemographic, health, and behavioral conditions and knowledge of students, as well as school characteristics, were associated with lack of knowledge about the HPV vaccine. A higher frequency of lack of knowledge about the HPV vaccine among adolescents was found in the states of the Northeastern Region.

OBJECTIVE: Absence rates remain high in UK schools, with negative implications for attainment, life chances and inequality. Reasons for non-attendance are complex but include psychosocial factors. Few UK-based studies have evaluated psychosocial interventions for school attendance outcomes or its moderators. This pre-post evaluation examined the potential influence of school-based one-to-one counselling on school attendance and possible moderators.
METHODS: Secondary analysis of routine data, collected by a national mental health provider in primary and secondary schools.
METHODS: 7405 pupils aged 4-19 years, with complete school attendance records at Time1 (pre-counselling term) and Time2 (the term when counselling ended).
METHODS: All participants received school-based one-to-one counselling with a trained counsellor between August 2016 and December 2019.
RESULTS: Percentage of school sessions attended (continuous) and persistent absence (binary; attending ≤90% of sessions) in a term. Potential moderators included sociodemographics, mental health and school engagement/enjoyment.
RESULTS: Median Time1 attendance was 96%. 23.6% of participants were persistently absent. The intervention was not associated with improved percentage attendance (0.028%, 95% CI -0.160-0.216%) but was associated with 18.5% reduced odds of persistent absence (OR=0.815, 95% CI 0.729-0.911). We identified five moderators of change in attendance (interaction terms p<0.05): age group (improvements for 4-9 s; worsening for 15-19 s), improvement for some ethnicities and lower parent/carer education. Mental health and school engagement/enjoyment co-varied with attendance in expected directions.
CONCLUSIONS: One-to-one counselling may improve school attendance among persistently absent pupils, particularly at younger ages. Improving mental health and pupil engagement/enjoyment are potential intervention targets. Our hypotheses require confirmation with controlled designs.