tag:theconversation.com,2011:/institutions/the-university-of-texas-medical-branch-1105/articlesThe University of Texas Medical Branch2019-06-28T14:30:02Ztag:theconversation.com,2011:article/1189802019-06-28T14:30:02Z2019-06-28T14:30:02ZLe sextage est lié une vie sexuelle plus active, à la consommation de drogues et à l'anxiété chez les ados<figure><img src="https://images.theconversation.com/files/281173/original/file-20190625-81758-1w6spuz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Les programmes d'éducation à la sexualité à l'école sont essentiels pour enseigner aux jeunes comment devenir des citoyens numériques responsables et assurer leur sécurité.</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>Vous jeter un oeil sur le téléphone intelligent de votre ado et voyez un message texte apparaître à l'écran… Vous constatez avec stupéfaction qu'il s'agit d'un sexto. Une série de questions vous viennent alors à l'esprit : </p>
<p>Est-ce normal? Est-ce que cela signifie que mon enfant a nécessairement des relations sexuelles?</p>
<p>Le sextage, soit l'échange de messages à caractère sexuel, de photographies ou de vidéos par l'intermédiaire de dispositifs technologiques, est relativement courant chez les adolescents. En fait, <a href="https://jamanetwork.com/journals/jamapediatrics/fullarticle/2673719">un jeune sur quatre reçoit des sextos et un jeune sur sept en envoie.</a></p>
<p>Certains chercheurs ont trouvé des liens entre les sextos et d'autres facteurs tels que <a href="https://pediatrics.aappublications.org/content/134/1/e21">l'activité sexuelle</a>, <a href="https://www.tandfonline.com/doi/abs/10.1080/15546128.2012.650959">la consommation de substances</a> (par exemple la consommation de drogues et d'alcool) et <a href="https://doi.org/10.1080/15546128.2012.650959">les problèmes de santé émotionnelle</a>. D'autres n'ont trouvé aucune preuve de ces associations.</p>
<p>Dans notre <a href="https://jamanetwork.com/journals/jamapediatrics/fullarticle/2735639?guestAccessKey=0d6a6a6da6-54f2-454c-a9ab-ef9e718d726f&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=061719">étude publiée dans la revue <em>JAMA Pediatrics</em></a>, nous avons cherché à résoudre cette incertitude. </p>
<p>À partir des résultats de 23 études publiées entre 2012 et 2018 auprès de 41 723 jeunes âgés de 12 à 17 ans, nous avons mené une série de méta-analyses pour examiner les liens entre le sextage et l'activité sexuelle, les partenaires sexuels multiples, la contraception, les comportements délinquants, les problèmes d'intériorisation (par exemple l'anxiété et la dépression), la consommation d'alcool et de drogues ainsi que le tabagisme. </p>
<h2>Sexe, alcool et santé mentale</h2>
<p>Nos résultats révèlent que les jeunes qui s'adonnent au sextage ont quatre fois plus de probabilités d'avoir déjà eu des relations sexuelles. Ils sont également cinq fois plus susceptibles d'avoir eu des partenaires sexuels multiples et deux fois moins enclins à utiliser la contraception.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/279406/original/file-20190613-32366-19l1318.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/279406/original/file-20190613-32366-19l1318.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/279406/original/file-20190613-32366-19l1318.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/279406/original/file-20190613-32366-19l1318.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/279406/original/file-20190613-32366-19l1318.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/279406/original/file-20190613-32366-19l1318.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/279406/original/file-20190613-32366-19l1318.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Une corrélation entre le sextage et la consommation d'alcool ne signifie pas que l'un cause l'autre.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
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<p>En examinant les liens entre le sextage, le comportement délinquant et la consommation d'alcool et d'autres drogues, nous avons constaté que les jeunes qui se sont livrés au sextage étaient aussi deux fois et demie plus nombreux à avoir eu des comportements délinquants comme le vol et les dommages matériels. </p>
<p>De plus, les probabilités qu'ils aient bu de l'alcool étaient quatre fois plus élevées et ils étaient environ trois fois plus susceptibles d'avoir consommé des drogues, comme la marijuana, et fumé des cigarettes.</p>
<p>Compte tenu de <a href="https://www.sciencedaily.com/releases/2019/03/190315110908.htm">l'augmentation des problèmes de santé mentale</a> au cours de la dernière décennie et des affirmations selon lesquelles <a href="https://www.theatlantic.com/magazine/archive/2017/09/has-the-smartphone-destroyed-a-generation/534198/">la technologie numérique entraîne une détérioration de la santé mentale chez les jeunes</a>, notre équipe a également examiné le lien entre les sextos et les problèmes de santé mentale. </p>
<p>Nous avons constaté que les jeunes qui se faisaient envoyer des sextos avaient environ deux fois plus de risques de présenter des symptômes de dépression et d'anxiété.</p>
<h2>Le contexte est important</h2>
<p>Les résultats de cette étude peuvent s'avérer alarmants pour certains. Cependant, certaines considérations sont d'une importance cruciale avant d'étiqueter les sextos comme un comportement dangereux ou « à risque » chez les jeunes.</p>
<p>Premièrement, les résultats sont des corrélations. Bien que les sextos soient liés au comportement sexuel et aux facteurs de santé mentale, les études de corrélations ne fournissent pas de preuves suggérant que ce type de messages soient la cause de comportements à risque ou d'une moins bonne santé mentale.</p>
<p>Deuxièmement, les risques liés au sextage peuvent varier en fonction de la situation dans laquelle il est effectué. Le contexte est important. Par exemple, des sondages menés auprès d'étudiants de premier cycle révèlent que les sextos qui sont envoyés dans le contexte d'une relation engagée ont <a href="https://doi.org/10.1016/j.chb.2017.06.018">plus d'impacts positifs et moins d'impacts négatifs</a> que les sextos envoyés dans le cadre de relations occasionnelles. </p>
<p>Le sextage peut aussi <a href="https://hrcak.srce.hr/index.php?show=clanak&id_clanak_jezik=282632">améliorer les aspects émotionnels et sexuels d'une relation</a> entre partenaires.</p>
<h2>Plus l'enfant est jeune, plus c'est risqué</h2>
<p>Au fur et à mesure que les adolescents vieillissent, <a href="https://doi.org/10.1363/3910007">l'exploration romantique et sexuelle devient un élément de plus en plus normatif et sain du développement</a>. Nous avons donc examiné si nos conclusions variaient selon l'âge des participants. Nous avons constaté que les liens entre les sextos et de nombreux comportements à risque étaient plus forts chez les adolescents plus jeunes que chez les adolescents plus âgés. </p>
<p>Ces résultats vont dans le sens des recherches qui montrent que <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2156059/">l'activité sexuelle est plus fortement liée aux comportements à risque chez les jeunes</a>.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/279407/original/file-20190613-32347-oomnuw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/279407/original/file-20190613-32347-oomnuw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/279407/original/file-20190613-32347-oomnuw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/279407/original/file-20190613-32347-oomnuw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/279407/original/file-20190613-32347-oomnuw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/279407/original/file-20190613-32347-oomnuw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/279407/original/file-20190613-32347-oomnuw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Parler ouvertement de sexe avec les jeunes est essentiel.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
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<p>En ce qui concerne le genre, nous avons constaté qu'en général, les résultats n'étaient pas différents selon que les jeunes qui sextaient étaient des filles ou des garçons. Cette observation est cohérente avec nos recherches précédentes, qui <a href="https://jamanetwork.com/journals/jamapediatrics/article-abstract/2688780">n'indiquent aucune différence selon le genre</a> dans la prévalence des différentes formes de sextage.</p>
<h2>L'éducation : la clé de la sécurité</h2>
<p>Le sexto, comme d'autres aspects du développement de l'adolescente et de l'adolescent, n'est pas exempt de risques. Mais, <a href="https://www.cdc.gov/mmwr/volumes/66/wr/pdfs/mm665152a1-H.PDF" title=" ">tout comme la sexualité</a>, <a href="https://jamanetwork.com/journals/jamapediatrics/fullarticle/2673719" title=" "">le sextage chez les adolescents est courant</a>. Pourtant, la sexualité reste souvent un sujet tabou entre les parents et leurs enfants. </p>
<p>En fait, <a href="https://doi.org/10.1111/j.1741-3729.2012.00740.x">une étude qui a mesuré l'intention des mères de parler de santé sexuelle à leurs enfants</a> a révélé que 71 % d'entre elles n'avaient pas parlé de sexualité à leurs adolescents et que 49 % n'avaient aucune intention de le faire. </p>
<p>Alors, comment pouvons-nous aider les jeunes à être en sécurité, en ligne et hors ligne ?</p>
<p>L'absence d'éducation sexuelle à la maison nécessite <a href="https://www.cbc.ca/news/canada/manitoba/nicole-chammartin-sex-education-opinion-1.4755517">des programmes complets d'éducation sexuelle dans les écoles</a>. Cela comprend l'enseignement du sextage aux adolescents.</p>
<p>Plutôt que de condamner l'acte de sexter chez les jeunes, une approche plus proactive pourrait se concentrer sur le fait de parler ouvertement de sexualité avec eux et de les éduquer sur la façon d'être <a href="https://theconversation.com/why-sexting-must-be-on-the-curriculum-96457">des citoyens numériques responsables</a> en mettant l'accent sur des interactions en ligne éthiques, respectueuses et sécuritaires.</p>
<p>*Si un parent ou un adolescent craint que des vidéos et des images soient distribuées sans son consentement, s'il reçoit des sextos non-sollicités ou est victime de sextorsion, il doit signaler immédiatement ses préoccupations à la police locale. Au Canada, on peut aussi consulter <a href="https://needhelpnow.ca/app/en/">needhelpnow.ca</a> et envoyer un rapport à <a href="https://www.cybertip.ca/app/en/report">Cyberaide.ca</a>. Aux États-Unis, on peut consulter <a href="https://www.stopbullying.gov/" title=" "">Stopbullying.org</a>.</p><img src="https://counter.theconversation.com/content/118980/count.gif" alt="La Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Camille Mori travaille au Determinants of Child Development Lab de l'Université de Calgary, en Alberta, et reçoit du financement du Conseil de recherches en sciences humaines (CRSH). </span></em></p><p class="fine-print"><em><span>Jeff Temple reçoit des fonds des National Institutes of Health, du National Institute of Justice et des Centers for Disease Control and Prevention. </span></em></p><p class="fine-print"><em><span>Sheri Madigan reçoit du financement du Conseil de recherches en sciences humaines, du Programme des chaires de recherche du Canada et de l'Alberta Children's Hospital Foundation.</span></em></p>Les jeunes qui s'adonnent au sextage sont quatre fois plus actifs sexuellement, cinq fois plus susceptibles d'avoir eu plusieurs partenaires et deux fois moins enclins à utiliser la contraception.Camille Mori, M.Sc. student in Clinical Psychology, University of CalgaryJeff Temple, Professor, Department of Obstetrics & Gynecology; Director, Behavioral Health and Research, The University of Texas Medical BranchSheri Madigan, Assistant Professor, Canada Research Chair in Determinants of Child Development, Owerko Centre at the Alberta Children’s Hospital Research Institute, University of CalgaryLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1168882019-06-17T15:12:09Z2019-06-17T15:12:09ZTeenage sexting linked to increased sexual behaviour, drug use and poor mental health<figure><img src="https://images.theconversation.com/files/279404/original/file-20190613-32335-mteyp7.jpg?ixlib=rb-1.1.0&rect=134%2C42%2C5473%2C3690&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Comprensive sexual education curricula in school are essential -- to teach youth how to be responsible digital citizens and to keep them safe.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>You glance at your teen’s smartphone and see a text message light up the screen. Was that a sext you just saw? Questions flood your mind. Is this what kids are doing nowadays? Does this mean my child is having sex too?</p>
<p>Sexting — the exchange of sexual messages, photographs or videos via technological devices — is a relatively common occurrence among adolescents, <a href="https://jamanetwork.com/journals/jamapediatrics/fullarticle/2673719">with one in four youth receiving sexts, and one in seven sending them</a>.</p>
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Read more:
<a href="https://theconversation.com/one-in-seven-teens-are-sexting-says-new-research-92170">One in seven teens are 'sexting,' says new research</a>
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<p>Some researchers have found links between sexting and factors such as <a href="https://pediatrics.aappublications.org/content/134/1/e21">sexual activity</a>, <a href="https://www.tandfonline.com/doi/abs/10.1080/15546128.2012.650959">substance use</a> (for example use of drugs and alcohol) and <a href="https://doi.org/10.1080/15546128.2012.650959">emotional health</a>. Others have found no evidence of these associations.</p>
<p>In our <a href="https://jamanetwork.com/journals/jamapediatrics/fullarticle/2735639?guestAccessKey=0d6a6da6-54f2-454c-a9ab-ef9e718d726f&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=061719">research published today in the journal <em>JAMA Pediatrics</em></a>, we sought to resolve this uncertainty. Drawing from the results of 23 studies published between 2012 and 2018, with 41,723 youth aged 12 to 17 years, we conducted a series of meta-analyses to examine the link between sexting and sexual activity, multiple sexual partners, contraception use, delinquent behaviour, internalizing problems (for example anxiety and depression), alcohol use, drug use and smoking. </p>
<h2>Sex, alcohol and mental health</h2>
<p>Our findings reveal that youth who are sexting are four times more likely to be having sex. They are also five times more likely to have had multiple sexual partners and half as likely to use contraception.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/279406/original/file-20190613-32366-19l1318.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/279406/original/file-20190613-32366-19l1318.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/279406/original/file-20190613-32366-19l1318.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/279406/original/file-20190613-32366-19l1318.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/279406/original/file-20190613-32366-19l1318.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/279406/original/file-20190613-32366-19l1318.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/279406/original/file-20190613-32366-19l1318.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">A correlation between sexting and drinking does not mean one causes the other.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
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<p>When looking at the links between sexting, delinquent behaviour and substance use, we found that youth who sexted were two and a half times more likely to have engaged in delinquent behaviours such as stealing and property damage. </p>
<p>Furthermore, they were almost four times more likely to have drunk alcohol, and were approximately three times more likely to have used drugs such as marijuana, and smoked cigarettes.</p>
<p>Given the <a href="https://www.sciencedaily.com/releases/2019/03/190315110908.htm">rise of mental health problems</a> over the past decade, and claims that <a href="https://www.theatlantic.com/magazine/archive/2017/09/has-the-smartphone-destroyed-a-generation/534198/">digital technology is resulting in deteriorating mental health among young people</a>, our team also examined the association between sexting and poor mental health. We found that youth who sexted were approximately twice as likely to have experienced symptoms of depression and anxiety.</p>
<h2>Sexting context matters</h2>
<p>The results of this study may prove alarming to some; however, certain considerations are crucially important to make before condemning sexting as a dangerous or “risky” behaviour among youth.</p>
<p>First, the findings are correlations. While sexting is linked to sexual behaviour and mental health factors, correlational studies do not provide evidence to suggest that sexting is in any way the cause of risky behaviour or poor mental health.</p>
<p>Second, the risks linked to sexting may vary based on the situation in which sexting is done. Context matters. For example, surveys done with undergraduate students reveal that sexting that occurs within the context of a committed relationship has <a href="https://doi.org/10.1016/j.chb.2017.06.018">more positive and fewer negative outcomes</a> than sexting that occurs in casual relationships. </p>
<p>Sexting can also <a href="https://hrcak.srce.hr/index.php?show=clanak&id_clanak_jezik=282632">enhance the emotional and sexual quality of a relationship</a> between partners.</p>
<h2>The younger, the riskier</h2>
<p>As adolescents age, <a href="https://doi.org/10.1363/3910007">romantic and sexual exploration become an increasingly normative and healthy part of development</a>. So we examined whether our findings varied depending on the age of participants. We found that links between sexting and many risk behaviours were stronger among younger compared to older adolescents. </p>
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Read more:
<a href="https://theconversation.com/12-ways-to-keep-your-kids-safe-from-sexual-encounters-online-97655">12 ways to keep your kids safe from sexual encounters online</a>
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<p>These results are in line with research showing that <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2156059/">sexual activity is more strongly linked to risk behaviours among younger youth</a>.</p>
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<img alt="" src="https://images.theconversation.com/files/279407/original/file-20190613-32347-oomnuw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/279407/original/file-20190613-32347-oomnuw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/279407/original/file-20190613-32347-oomnuw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/279407/original/file-20190613-32347-oomnuw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/279407/original/file-20190613-32347-oomnuw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/279407/original/file-20190613-32347-oomnuw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/279407/original/file-20190613-32347-oomnuw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Talking openly with youth about sex is essential.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
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<p>In terms of gender, we found that, in general, results did not differ based on whether the sexting youth was female or male. This finding is consistent with our previous research, which indicate <a href="https://jamanetwork.com/journals/jamapediatrics/article-abstract/2688780">no gender differences</a> in the prevalence of different forms of sexting.</p>
<h2>Educating teens is key to safety</h2>
<p>Sexting, like other aspects of adolescent and teen development, is not free from risks. But, <a href="https://www.cdc.gov/mmwr/volumes/66/wr/pdfs/mm665152a1-H.PDF">just like teen sex</a>, teen <a href="https://jamanetwork.com/journals/jamapediatrics/fullarticle/2673719">sexting is common</a>. Yet sex often remains an unbroached topic between parents and their children. </p>
<p>In fact, <a href="https://doi.org/10.1111/j.1741-3729.2012.00740.x">a study that assessed mothers’ intentions to talk to their children about sexual health</a> found that 71 per cent of mothers had not talked to their adolescents about sex, and that 49 per cent had no intention of doing so. </p>
<p>So how do we go about helping youth be safe, both online and offline?</p>
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Read more:
<a href="https://theconversation.com/why-sexting-must-be-on-the-curriculum-96457">Why sexting must be on the curriculum</a>
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<p>The absence of sex education within the home necessitates <a href="https://www.cbc.ca/news/canada/manitoba/nicole-chammartin-sex-education-opinion-1.4755517">comprehensive sexual education curricula in schools</a>. This includes teaching adolescents about sexting.</p>
<p>Rather than condemning the act of sexting among youth, a more proactive approach could focus on talking openly with youth about sex, and educating young people on how to be <a href="https://theconversation.com/why-sexting-must-be-on-the-curriculum-96457">responsible digital citizens</a> by emphasizing ethical, respectful and safe online interactions.</p>
<p><em>If a parent or teen is concerned about videos and images being distributed without their consent, or if they are being coerced into sexting or sextortion, they should report their concerns immediately to their local police. In Canada, they can also consult <a href="https://needhelpnow.ca/app/en/">needhelpnow.ca</a> and send a report to <a href="https://www.cybertip.ca/app/en/report">Cybertip.ca</a>. In the United States, they can consult <a href="https://www.stopbullying.gov/">Stopbullying.org</a>.</em></p><img src="https://counter.theconversation.com/content/116888/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Camille Mori works in the Determinants of Child Development Lab at the University of Calgary, Alberta, and receives funding from the Social Sciences and Humanities Research Council. </span></em></p><p class="fine-print"><em><span>Jeff Temple receives funding from the National Institutes of Health, National Institute of Justice, and Centers for Disease Control and Prevention. </span></em></p><p class="fine-print"><em><span>Sheri Madigan receives funding from Social Sciences and Humanities Research Council, the Canada Research Chairs program and the Alberta Children's Hospital Foundation.</span></em></p>Youth who are sexting are four times more likely to be having sex. They are five times more likely to have had multiple sexual partners and twice as likely not to be using contraception.Camille Mori, M.Sc. student in Clinical Psychology, University of CalgaryJeff Temple, Professor, Department of Obstetrics & Gynecology; Director, Behavioral Health and Research, The University of Texas Medical BranchSheri Madigan, Assistant Professor, Canada Research Chair in Determinants of Child Development, Owerko Centre at the Alberta Children’s Hospital Research Institute, University of CalgaryLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1057462018-11-22T13:25:22Z2018-11-22T13:25:22ZDomestic violence and social status: a Kenyan case study<figure><img src="https://images.theconversation.com/files/246884/original/file-20181122-182071-1yra8jo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Over 47% of women in Kenya have experienced physical or sexual violence by their partner</span> <span class="attribution"><span class="source">Chaiyapong/Shutterstock</span></span></figcaption></figure><p>The rate of domestic violence in sub-Saharan Africa is among the <a href="http://science.sciencemag.org/content/sci/340/6140/1527.full.pdf?casa_token=xGCBTJTGl8oAAAAA:BSQd3xKKK6i1lopepo7PFCwJSPiGoXjziHWVzJUMCJDaS4r1LZTZdBIo4q-e2NCGoHVghi8aP0I">highest</a> in the world. <a href="https://dhsprogram.com/pubs/pdf/fr308/fr308.pdf">Over 47%</a> of women in Kenya have experienced physical or sexual violence. This is higher than <a href="http://whqlibdoc.who.int/publications/2005/924159358X_eng.pdf">pooled estimates</a> from 81 countries which show that nearly 30% of women experience physical or sexual intimate partner violence during their lifetimes. </p>
<p>Experiencing violence leads to lasting physical, mental and emotional trauma for <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0136588">women</a>, and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3869039/">children</a> who witness it.</p>
<p>My colleagues and I wanted to better understand how violence against women could be prevented. An essential piece of the puzzle is identifying which men are more likely to perpetrate violence, and what factors drive them.</p>
<p>For <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/ajcp.12159">our study</a>, we wanted to know if perceived social status – how high up the “social ladder” men perceived themselves to be – affected domestic violence patterns. We hypothesised that men who perceived their social status as lower were more likely to perpetrate domestic violence, partly due to lower self-esteem. </p>
<p>We found that they were. This is consistent <a href="https://www.ncbi.nlm.nih.gov/pubmed/1581772">with research</a> in other parts of the world. Our research shows that the opinion men have about where they stand in society has mental, physical, and social implications. </p>
<p>This is because violence <a href="https://journals.sagepub.com/doi/pdf/10.1177/0022022199030001003?casa_token=Aa2UNbX-EVkAAAAA%3AqbG58WJPce9GQfv4fPNjMoHMTqBdWZ_mEN29F2ZRujqyFFPvvvNfi1UgWjLV7fdCaiu2qHOHoA">is often</a> perpetrated in an effort to “save face” – that is, to recover some sense of lost or threatened respect from other people and low self-esteem as a result. <a href="https://pdfs.semanticscholar.org/9034/b42ebaf99b0a1ccb32e1c4453e389ca6932a.pdf">Studies show</a> that men with lower self-esteem are more likely to perceive actions by their partner as threatening – even if their partner intends no harm or disrespect – and so their reactions are more likely to be violent or retaliatory. </p>
<p>This is by no means to suggest that only men with lower social status are violent towards women. Violence can be found at all levels of society. But, what it does show is that certain factors can erode a man’s sense of personal value – like income insecurity or a lack of social support during childhood – leading him towards violent reactions. </p>
<h2>The study</h2>
<p>We conducted interviews with over 500 men (aged 18 - 34 years) in Meru County, central Kenya, of whom 263 were in a relationship. </p>
<p>The men were shown a 10-rung ladder and told that the top of the ladder represented the most well-off in society –- those with the most money, education and best jobs. The rungs at the bottom of the ladder represented the least well-off in society –- those with the least money, education and worst or no jobs. </p>
<p>We asked men to place an “X” where they thought they were located on the social ladder. </p>
<p>The men were then asked about how often there was conflict with their partner over the past year. Conflict behaviour included: shoving a partner, punching or kicking a partner, injuring a partner to the extent that they needed to seek medical help, and using force to make a partner have sex. </p>
<p>We found that the lower men ranked themselves, the more violence they reported with their intimate partner. Men who ranked themselves low were also less likely to talk through the issue to resolve conflict the conflict. </p>
<p>Self-esteem appears in this study, as it has in <a href="https://pdfs.semanticscholar.org/9034/b42ebaf99b0a1ccb32e1c4453e389ca6932a.pdf">previous studies</a>, to reveal how social status affects conflict resolution between men and their romantic partners. Men with higher self-esteem appear to have more psychological and emotional resources to deal with conflict non-violently rather than resorting to violence.</p>
<p><a href="https://pdfs.semanticscholar.org/9034/b42ebaf99b0a1ccb32e1c4453e389ca6932a.pdf">For instance</a>, men with high self-esteem may attribute their partner’s irritation to an unrelated event, whereas men with low self-esteem are more likely to attribute their partner’s irritation to some perceived defect within themselves. They therefore may respond violently or in a way that demeans their partner. <a href="http://www.elaborer.org/cours/A12/lectures/Leary1995.pdf">There is strong</a> experimental support for this pattern in high-income countries. As men with lower subjective social status often have lower self-esteem, it follows that men with lower social standing may perpetrate more domestic violence due to lower self-esteem.</p>
<h2>Self-compassion</h2>
<p><a href="http://eprints.gla.ac.uk/64162/1/64162.pdf">One approach</a> to help deal with the impact of low self-esteem on mental health and social relationships has been the cultivation of <a href="http://self-compassion.org/wp-content/uploads/publications/Pauley.pdf">self-compassion</a>. </p>
<p>Teaching men to have compassion and acceptance for themselves may <a href="https://www.openground.com.au/Documents/mindful-self-compassion-program.pdf">improve</a> men’s mental health and <a href="https://ecommons.luc.edu/cgi/viewcontent.cgi?article=1661&context=luc_diss">increase</a> their ability to empathise with intimate partners. For instance, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3156028/?__hstc=3584879.d50a3c91e72c280a7921bf0d7ab734f9.1523750401948.1523750401949.1523750401950.1&__hssc=3584879.1.1523750401951&__hsfp=1773666937">loving kindness meditation</a> is a popular new approach to increasing compassion within Western social science research, and has not been explored in rural Kenya or sub-Saharan Africa.</p><img src="https://counter.theconversation.com/content/105746/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michael Goodman does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>A study in Kenya found that the lower men ranked themselves in society, the more violent they were with their intimate partners.Michael Goodman, Instructor, Social Epidemiology, The University of Texas Medical BranchLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1039232018-10-15T14:52:33Z2018-10-15T14:52:33ZSuicide behaviour in social circles increases risk for Kenyan men<figure><img src="https://images.theconversation.com/files/240398/original/file-20181012-119117-1ie1xwy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Suicide is increasingly recognised as a global health challenge.</span> <span class="attribution"><span class="source">Love the Wind/Shutterstock</span></span></figcaption></figure><p>Suicide is increasingly <a href="http://apps.who.int/iris/bitstream/handle/10665/131056/9789241564779_eng.pdf;jsessionid=1FDF22B5BA397898180800C77638BA6D?sequence=1">recognised</a> as a global health challenge by the World Health Organisation who call for society-wide efforts to prevent suicide. </p>
<p>In a <a href="https://www.ncbi.nlm.nih.gov/pubmed/29192523">recent study</a>, we set out to understand the drivers of suicide for young men in Meru county, in central Kenya. We wanted to know whether young men in the region were more at risk of contemplating suicide if they have more friends and family who have attempted, or committed, suicide. </p>
<p>Previous <a href="http://journals.sagepub.com/doi/abs/10.1177/0022146514568793">research</a> has found that incidents of suicide and emotional states <a href="https://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.160.8.1525">contribute</a> to suicidal thoughts passing among networks of friends and within families. Part of the familial link may be genetic, but <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/bjp.12134">evidence shows</a> that social pathways – like the transmission of considering suicide as a viable option and devaluing one’s own life as a result of a peer’s self destructiveness – also exist. </p>
<p>If we identify factors that predict why young men consider suicide as an option, we can potentially stop suicides before they happen. </p>
<h2>Contemplating suicide</h2>
<p>Using surveys, we randomly interviewed 514 young men (aged 18-34 years) in the Igembe sub-counties of Meru County. We used the <a href="http://okmis.com/forms/Charting/20160118183859_Modified_Scale_for_Suicidal_Ideation_20150126.pdf">Modified Scale of Suicide Ideation</a> – a scale that assesses the presence or absence of suicidal thoughts and how severe suicidal ideas are – and coded for only the most severe cases. </p>
<p>We found that, over two days, around 12% of men engaged in severe suicide ideation – they prepared a plan to end their lives, and considered their own death with concerning intensity or frequency. Though global lifetime <a href="https://www.tandfonline.com/doi/abs/10.1080/13811110500182018">estimates</a> of considering suicide range between 14%-33%, our survey specifically screened for more severe suicide ideation, as opposed to more common passing thoughts about ending one’s life.</p>
<p>Among young men who reported that none of their friends had completed suicide, the percentage who had contemplated suicide was 5%. This is much lower than the percentage of respondents who engaged in severe suicidal ideation if they had one friend who completed suicide (17%), and higher still if respondents knew two or more friends who completed suicide (32%). </p>
<p>Similarly, the prevalence of suicidal thoughts increases with the number of friends who attempt, but don’t complete, suicide. If a family member completed suicide during the respondent’s first 18 years of life, the risk for present suicidal thoughts increases by 20% in the respondent’s young adulthood. These patterns are consistent regardless of education, age and household wealth.</p>
<h2>Explanations</h2>
<p>Consistent with other studies, we found a relationship between self-esteem, loneliness and suicide that may explain this pattern. Men who <a href="http://faculty.psy.ohio-state.edu/crocker/lab/documents/CSEscale_general_version.pdf">reported</a> more suicide among friends and family, reported lower social self-esteem, a predictor of suicide behaviour. Men who <a href="http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.825.5782&rep=rep1&type=pdf">reported</a> lower self-esteem also reported more loneliness – described as the pain felt when they believed they didn’t belong socially and emotionally. </p>
<p>The image is therefore that men who have experienced suicide in their social groups think their social groups are less valuable and experience loneliness. <a href="https://link.springer.com/article/10.1007/s10902-018-0017-9">They then</a> experience less meaning in life and thoughts of ending their own life can begin to form. </p>
<p>Prior research also <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/bjp.12134">finds</a> that our thoughts about ourselves are influenced by the self destructive behaviours of our peers. We can internalise their emotions and behaviours as though these emotions and behaviours were our own through a process called projective identification. </p>
<p>Peer suicide doesn’t affect the majority and identifying social and psychological factors that lead to resistance needs more investigation, and <a href="https://academic.oup.com/bjsw/article/43/2/317/1671401">likely includes</a> making meaning from the tragedy. </p>
<h2>Implications</h2>
<p>The implications of this research are multi-fold. </p>
<p>As with many countries, <a href="https://www.ncbi.nlm.nih.gov/pubmed/20671901">Kenya lacks</a> enough mental health resources to meet the demand for services. Resources to prevent suicide in the future should target young men who are friends or children of those who have attempted or completed suicide in the past. This includes identifying and following-up with friends of suicide attempters who come to emergency health centres. </p>
<p>Efforts should focus on group support and gratitude interventions which encourage people to remember at least one thing they are thankful for each day by writing or drawing it down. Gratitude interventions <a href="https://www.sciencedirect.com/science/article/pii/S0092656613000597">can improve</a> one’s sense of meaning in life and reduce suicidal thoughts.</p>
<p>Faith, community, education and other leaders should be sensitised to the challenges faced by those who remain behind after a loved one’s suicide. </p>
<p>And finally, media campaigns should be promoted that improve awareness and reduce stigma related to mental health issues.</p><img src="https://counter.theconversation.com/content/103923/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michael Goodman receives funding from the University of Texas Medical Branch in Galveston, TX. He is affiliated with Sodzo International. </span></em></p>Young men in Kenya are more at risk of contemplating suicide if they have friends and family who attempted or have gone through with it.Michael Goodman, Instructor, Social Epidemiology, The University of Texas Medical BranchLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/964572018-05-16T22:34:13Z2018-05-16T22:34:13ZWhy sexting must be on the curriculum<figure><img src="https://images.theconversation.com/files/218923/original/file-20180515-100722-u1ffv1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Research from around the world shows that at least one in eight teens has had a sexually explicit image of themselves forwarded, without consent.</span> <span class="attribution"><span class="source">(Shutterstock))</span></span></figcaption></figure><p>Sex education remains a fiercely debated topic, both in the media and among politicians.</p>
<p>A recent controversial segment on <a href="http://video.foxnews.com/v/5741848984001/?#sp=show-clips">Fox News’ <em>The Ingraham Angle</em></a> discussed whether schools should teach students about “sexting” (sharing sexually explicit images or videos through electronic means). In Canada’s largest province, the leader of Ontario’s Progressive Conservative party recently vowed to <a href="https://www.theglobeandmail.com/canada/article-doug-ford-vows-to-overhaul-ontario-education-system-if-elected/">repeal the sex-education curriculum</a> if elected premier in next month’s election. </p>
<p>We cannot politicize the reality of sexual behaviours in youth. The reality is that <a href="https://www.cdc.gov/healthyyouth/sexualbehaviors/">almost half of youth in the United States have sex prior to leaving high school</a>. </p>
<p>Teen sexting is also common. A study of more than 110,000 teens suggests that <a href="http://www.dx.doi.org/10.1001/jamapediatrics.2017.5314">one in every seven are sending sexts</a>, and one in four are receiving sexts. This number is on the rise. For example, the average rate of teens sending sexts went from five per cent in 2009 to 20 per cent in 2014 — <a href="http://www.dx.doi.org/10.1001/jamapediatrics.2017.5314">a fourfold increase</a>.</p>
<p>And, even more alarmingly, <a href="https://theconversation.com/one-in-seven-teens-are-sexting-says-new-research-92170">the prevalence of non-consensual sexting is 12 per cent</a>. This means that at least one in eight teens are having a sexually explicit image of themselves forwarded, without consent. In many countries, this represents a <a href="http://www.justice.gc.ca/eng/rp-pr/other-autre/cndii-cdncii/p6.html">criminal offence</a>. </p>
<p>Many parents are concerned about digital safety but <a href="http://www.pewinternet.org/files/2016/01/PI_2016-01-07_Parents-Teens-Digital-Monitoring_FINAL.pdf">only 40 per cent are talking regularly to their children about what is appropriate content to view and share online</a>. That leaves six out of every 10 youth potentially vulnerable to victimization. And this is why we need to talk about it in schools. </p>
<p>The central benefit of educating about digital health, safety and security in schools is that it provides teens with a “two-gated” approach. If conversations about digital health and safety are not happening at the first gate, in the youth’s home, then youth can receive this information at the second gate, at school. </p>
<p>The two-gated approach guarantees that 10 out of 10 youth will receive the information they need to avoid digital dilemmas and risks. </p>
<h2>Talking about consensual sex</h2>
<p>While the digital age has introduced many benefits, one of its perils is the risk of teens being bullied or harassed through electronic mediums, a phenomenon known as <a href="http://www.rcmp-grc.gc.ca/cycp-cpcj/bull-inti/index-eng.htm">cyberbullying</a>. </p>
<p>Cyberbullying is a <a href="http://psycnet.apa.org/record/2014-04307-001">real challenge for today’s teens that often results in psychological consequences varying from stress to suicidal ideation</a>. </p>
<p>The <a href="http://www.cbc.ca/news/canada/british-columbia/amanda-todd-anniversary-harassment-1.4347163">suicide of Canadian teenager Amanda Todd </a>is one example. At the age of 13, Amanda Todd was convinced to expose herself to a man she had met online, who took a picture of her and proceeded to blackmail her with the image. A sexually explicit photo of her was posted and widely circulated online. In a video posted to YouTube prior to her death, Amanda attributed her anxiety and depression to her online victimization and humiliation. </p>
<p>While rare, these cases highlight the need to discuss digital health and safety with youth. This topic is all the more pressing considering the near universal access that children and teens have to smartphones, computers and the internet. </p>
<p>Throughout the world, <a href="https://www.getcybersafe.gc.ca/cnt/rsrcs/cmpgns/cmpgn-06/gd-prnts-en.aspx">a concept known as digital citizenship</a> has been introduced into many school curricula. This concept refers to the practice of being safe, legal and ethical in one’s online behaviours. </p>
<p>Educating youth to be good digital citizens and to understand cyberbullying and digital dilemmas involves talking about consensual and non-consensual sex and sexting. </p>
<h2>A proactive approach</h2>
<p>Of course, we can’t put all the responsibility on schools and educators. Discussions about digital safety and health should be happening at home as well. </p>
<p>Parents should talk to their children early and often about this topic, as well as about sex, sexuality, peer pressure and healthy relationships. </p>
<p>The digital world is changing rapidly, and so too is teenage development, so parents need to revise and revisit these discussions as often as possible.</p>
<p>But, as mentioned, only 40 per cent of parents are actually having these conversations on a regular basis. </p>
<p>Clearly, we need to do a better job of disseminating the many existing resources that encourage and provide parents with tips on talking with their children about online safety and citizenship. Perhaps this could be a priority of <a href="https://www.whitehouse.gov/bebest/">Melania Trump’s new #BeBest campaign.</a></p>
<p>But a benefit of receiving information from multiple sources, including school, is that it provides more information and more opportunities for discussion. </p>
<p>Some children may find that they are more comfortable talking about digital health and safety in a group context, such as in school.</p>
<p>The key is to talk about digital safety early. Children and youth can then be equipped with solutions on how to deal with unwanted situations when they arise. </p>
<p>It’s a proactive approach rather than a reactive one. And it can safeguard our children.</p>
<p>If trusted adults include both parents and educators, it means our youth have more opportunities to get the help they need to rectify, remedy or make a supportive plan for dealing with a challenging situation. </p>
<h2>Call it digital health</h2>
<p>The decision to keep or discard a sex-education curriculum should not be debated. We are beyond that. </p>
<p>Instead, our focus should be on our children’s best interests. And how we as parents and educators can create the best circumstances for our youth to thrive. </p>
<p>As they develop, sexuality will continue to be a pressing topic on the minds of teens. Despite many of our best efforts or wishes, it’s not something that we can program out of them. Nor can we create a school curriculum that excludes sexuality from their collective thinking. </p>
<p>In fact, as research has shown the ineffectiveness of abstinence-only education programs on rates of both <a href="https://doi.org/10.1371/journal.pone.0024658">teenage pregnancy</a> and <a href="https://www.bmj.com/content/335/7613/248.short">sexually transmitted infections</a>, there has been a push towards more comprehensive sex education. With the growing role of technology in the most intimate aspects of our lives, it is negligent not to effectively prepare our kids for this reality. </p>
<p>Our argument is that educating kids about sexuality mediated through the internet is essential to keeping them safe. </p>
<p>Sexual education in school is a logical and effective way to encourage these discussions. Call it by a different name — digital health or digital citizenship — but it should be included, as the potential risks are too great to ignore.</p>
<p>Let’s not let the political narrative blur the lines of who and what we are most concerned about — the safety and well-being of our children and adolescents.</p>
<p><em>If educators are interested in resources for discussing digital citizenship, Common Sense Media has a <a href="https://www.commonsense.org/education/digital-citizenship">digital citizenship program for K-12</a>. Parents can also consult <a href="https://www.getcybersafe.gc.ca/cnt/rsrcs/cmpgns/cmpgn-06/gd-prnts-en.aspx">Digital Citizenship: Guide for Parents</a> for further information.</em></p><img src="https://counter.theconversation.com/content/96457/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sheri Madigan receives funding from Social Sciences and Humanities Research Council, the Canada Research Chairs program, and the Alberta Children's Hospital Foundation.</span></em></p><p class="fine-print"><em><span>Camille Mori works in the Determinants of Child Development Lab at the University of Calgary, Alberta. </span></em></p><p class="fine-print"><em><span>Jeff Temple does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Sex-education curricula that openly discuss sexting, consent and other online behaviours have never been more important for teens – in Ontario and globally.Sheri Madigan, Assistant Professor, Canada Research Chair in Determinants of Child Development, Alberta Children’s Hospital Research Institute, University of CalgaryCamille Mori, M.Sc. student, clinical psychology program, University of CalgaryJeff Temple, Professor, Department of Obstetrics & Gynecology; Director, Behavioral Health and Research, The University of Texas Medical BranchLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/921702018-02-26T16:06:16Z2018-02-26T16:06:16ZOne in seven teens are ‘sexting,’ says new research<figure><img src="https://images.theconversation.com/files/207387/original/file-20180221-132680-11qmro2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Teen sexting has been on the rise over the last decade as smartphones have become more available; meanwhile teen sex has declined.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>Sexting is known as the sharing of sexually explicit images and videos through the internet or via electronic devices such as smartphones. </p>
<p>One in seven teens report that they are sending sexts, and one in four are receiving sexts, according to our study of over 110,000 teens from around the world published today, Monday Feb. 26, in <em><a href="http://jamanetwork.com/journals/jamapediatrics/fullarticle/10.1001/jamapediatrics.2017.5314">JAMA Pediatrics</a></em>.</p>
<p>Teen-to-teen sexting has generated considerable media attention, with news headlines mostly warning of <a href="http://www.cbc.ca/news/canada/british-columbia/fort-st-john-sexting-1.4500702">the dangers of sexting</a>. </p>
<p>In January 2018, police in Châteauguay, near Montreal, launched a campaign called “<a href="http://www.cbc.ca/news/canada/montreal/teen-sexting-ch%C3%A2teauguay-police-1.4502186">sexts are porn</a>” targeted at students aged 12 to 17. In the U.K., one police force recently <a href="https://news.sky.com/story/parents-face-police-action-for-their-childrens-sexting-11230325">warned parents they may be prosecuted</a> if their children send indecent images over mobile phones. </p>
<p>Naturally, this has many parents worried. Is consensual teen sexting a cause for concern? </p>
<h2>Girls and boys participate equally</h2>
<p>Sexting over the last decade has been on the rise, which is consistent with the rapid growth in the availability and ownership of smartphones. Teen sex, on the other hand, has been <a href="https://www.cdc.gov/mmwr/volumes/66/wr/pdfs/mm665152a1-H.PDF">on the decline</a> over the last decade. </p>
<p>Our team conducted a meta-analysis of the research literature, drawing from 39 research studies on teen sexting internationally between 2009 and 2016.</p>
<p>We found that approximately 15 per cent of teens are sending sexts. Meanwhile, around <a href="https://www.cdc.gov/mmwr/volumes/66/wr/pdfs/mm665152a1-H.PDF">41 per cent of teens are having sexual intercourse</a>, according to a 2018 report from the Centers for Disease Control and Prevention in the United States.</p>
<p>Considerable evidence suggests that teen sexting is related to <a href="http://pediatrics.aappublications.org/content/134/5/e1287.short">sexual behaviour</a>. Older teens are also sexting more often than younger teens. Taken together, it is not surprising that older teens are both more likely to sext and have sexual intercourse. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/207388/original/file-20180221-132650-xqg76n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/207388/original/file-20180221-132650-xqg76n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/207388/original/file-20180221-132650-xqg76n.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/207388/original/file-20180221-132650-xqg76n.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/207388/original/file-20180221-132650-xqg76n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/207388/original/file-20180221-132650-xqg76n.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/207388/original/file-20180221-132650-xqg76n.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Boys may see sexting as an opportunity to increase their social status.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Boys are often portrayed as the requesters, and girls as the senders, of nude images or videos. Findings from our study debunk this widely held assumption and show that boys and girls are equally likely to participate in sexting.</p>
<p>Our study found that the large majority of teens are using their personal smartphones versus their computers to sext. In 2015, approximately 92 per cent of teenagers aged 15 to 17 in <a href="http://www.pewinternet.org/2015/04/09/teens-social-media-technology-2015/pi_2015-04-09_teensandtech_06/">the U.S. owned a cell phone</a>. </p>
<h2>Risk-taking or ‘normal’ behaviour?</h2>
<p>With the ubiquity of smartphones and increasing digital usage across all age categories, parents should not be surprised that teens are engaging in sexting with other teens. </p>
<p>Researchers suggest that consensual teen sexting may be a normal component of <a href="http://www.bwjp.org/assets/documents/pdfs/webinars/primer-on-sexting.pdf">sexual behaviour and development</a> in the digital age. The increased prevalence of this sexual behaviour, in older youth in particular, corresponds to their increasing interest in sexual exploration and identity development.</p>
<p>Sexting has been linked to impulsive and <a href="http://pediatrics.aappublications.org/content/130/4/667.short">risk-taking behaviours</a> but, so far, the evidence for an association between sexting and <a href="https://www.researchgate.net/profile/David_Hallford/publication/259473730_Sexting_prevalence_and_correlates_A_systematic_literature_review/links/57418ebf08aea45ee8490fce.pdf">poor mental health such as depression or loneliness</a> is weak to non-existent. </p>
<p>The most consistent predictor of consensual teen sexting is actually whether or not they want to flirt, be <a href="http://www.bwjp.org/assets/documents/pdfs/webinars/primer-on-sexting.pdf">romantically involved with another teen</a>, or maintain intimacy with their partner.</p>
<h2>Sharing without consent</h2>
<p>Although girls and boys sext a similar amount, there are important differences in the perception of this behaviour among youth. </p>
<p><a href="http://www.tandfonline.com/doi/abs/10.1080/17482798.2014.923009">Compared to boys</a>, girls report feeling more pressure to sext, and also worry they will be judged harshly for sexting (e.g., slut shaming) or for not sexting (e.g., being called a “prude”). </p>
<p>Boys, on the other hand, may see sexting as an opportunity to <a href="http://www.jahonline.org/article/S1054-139X(13)00085-2/abstract">showcase their social status</a>. </p>
<p>This <a href="https://books.google.ca/books?id=R__hfWbE3DwC&lpg=PA151&ots=xiAY0IYCsz&dq=%E2%99%A3%09Livingstone%20%26%20Gorzig%20(2012)&lr&pg=PP1#v=onepage&q&f=false">double standard may create higher levels of distress for girls</a>.</p>
<p>The moment the youth presses “send,” they are trusting that the receiver will not share the images or videos without their consent. Sexting can become a problem when this trust is violated. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/207389/original/file-20180221-132663-1gqd5cf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/207389/original/file-20180221-132663-1gqd5cf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/207389/original/file-20180221-132663-1gqd5cf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/207389/original/file-20180221-132663-1gqd5cf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/207389/original/file-20180221-132663-1gqd5cf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/207389/original/file-20180221-132663-1gqd5cf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/207389/original/file-20180221-132663-1gqd5cf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Teens may not be asking questions such as, ‘Where are these images stored?’ and ‘If I change my mind, how do I get them back?’</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>In many countries, <a href="https://www.cybertip.ca/app/en/report-sharing_sexual_pictures">it is illegal for a person to distribute an intimate photo without the explicit consent of the individual in the photo</a>. Nonetheless, our research suggests that 12.5 per cent of teens are forwarding intimate photos without the consent of the sender. </p>
<h2>Coercion and ‘sextortion’</h2>
<p>Taken together, several challenges can potentially arise. First, many teens may feel as though sexting is an expectation. Although likely not a warranted expectation, the idea that “my friends are doing it, then maybe I should do it” could be a strong peer motivator. </p>
<p>A second problem that may arise is when teens are <a href="http://www.alaskahighwaynews.ca/fort-st-john/fort-st-john-rcmp-arrest-youth-in-sextortion-case-1.23177462">coerced into sexting or when they are “sextorted”</a> (when images or videos are used as a form of threat or blackmail).</p>
<p>Another problem is the idea of digital security. Teenage brains are still developing; their capacity to critically analyze the digital tools and apps they are using may not be enough to keep them safe.</p>
<p>Where are these images stored? Who, other than the intended recipient, has access to them? How long are they kept digitally? And, if I change my mind can I get them back? </p>
<p>These and many other questions are simply not at the forefront of the teenage mind — nor, arguably, are they always in an adult’s mind either, <a href="https://www.sciencedirect.com/science/article/pii/S0272735813001372">53 per cent of whom engage in sexting themselves</a> – especially when these thoughts are competing with sexual interest and intimacy.</p>
<h2>Parents should be proactive</h2>
<p>Parents can keep their teens aware and informed by having open discussions — about healthy dating relationships, peer pressure, digital security, sexuality and citizenship more broadly.</p>
<p>The general consensus is that parents and caregivers should be proactive, rather than protective and reactive, about talking to their teens about sexting. Preaching abstinence is not effective. As with the issue of safe sex, this should be an ongoing conversation with your child instead of a one off “talk.”</p>
<p>In these discussions, it is important to emphasize <a href="http://www.cyberwise.org/digital-citizenship">digital citizenship</a>. Broadly, digital citizenship encourages individuals to act in a way that is safe, legal and ethical — in their online and digital interactions and behaviours. </p>
<p>This is also an opportunity for parents and caregivers to emphasize that digital citizenship applies to adults as well. And such conversations can provide an opening for discussing other sensitive issues with teens, such as sexuality. </p>
<p>It’s also important to discuss strategies for dealing with peer pressure to engage in sexting. And to discuss the potential consequences of sending sexts. Parents should emphasize cause and effect for teens. Once the videos or images have been sent, the teen forfeits control of who sees it.</p>
<p>Sex and the digital world are two topics that can overwhelm parents and caregivers. Fortunately, there are some excellent resources on these issues to help guide conversations with your teens, including <a href="https://www.getcybersafe.gc.ca/cnt/rsrcs/cmpgns/cmpgn-06/gd-prnts-en.aspx">Digital Citizenship: Guide for Parents</a> and <a href="https://www.commonsensemedia.org/sites/default/files/uploads/landing_pages/sexting_handbook_ce_1020_1_.pdf">Common Sense Media’s Sexting Handbook</a>. </p>
<p><em>If a parent or teen is concerned about videos and images being distributed without their consent, or if they are being coerced into sexting or sextorted, they should report their concerns immediately to their local police. In Canada, they can also consult <a href="https://needhelpnow.ca/app/en/">needhelpnow.ca</a> and send a report to <a href="https://www.cybertip.ca/app/en/report">Cybertip.ca</a>. In the U.S., they can consult <a href="https://www.stopbullying.gov/">Stopbullying.org</a>.</em></p><img src="https://counter.theconversation.com/content/92170/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sheri Madigan receives funding from Social Sciences and Humanities Research Council, the Canada Research Chairs program, and the Alberta Children's Hospital Foundation.</span></em></p><p class="fine-print"><em><span>Jeff Temple receives funding from the National Institute of Health, National Institute of Justice, and the Centers for Disease Control and Prevention. </span></em></p>Teen sexting is on the rise. Boys and girls are equally likely to share sexually explicit imagery but girls report feeling more pressure to sext and more judgement about how they do it.Sheri Madigan, Assistant Professor, Canada Research Chair in Determinants of Child Development, Alberta Children’s Hospital Research Institute, University of CalgaryJeff Temple, Professor, Department of Obstetrics & Gynecology; Director, Behavioral Health and Research, The University of Texas Medical BranchLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/693272016-12-13T03:54:58Z2016-12-13T03:54:58ZWhy kids who have trouble behaving in preschool fall behind<figure><img src="https://images.theconversation.com/files/149715/original/image-20161212-26074-1tlwtbw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">What does it take for kids to be ready for school?</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/holtsman/3931735368/in/photolist-6ZraWQ-5iriPH-c4vDYA-6Qcv7w-eFtxyP-2WMgSU-68FbNw-9LnuRn-KfohR-g8u7g-gVknE-9nfaAn-9nidz9-dnooaQ-7PPHk-bFpDgx-8aVJx9-NVVB8-68BEp2-6QdjF1-eFBNkE-3aeYqH-68G1EG-6xajYr-5xHmNJ-2FwkyD-68FPtq-6p3b11-eFvCTP-CubFn-6xajHT-5em8tF-7q399g-NVkqN-NVk1m-9nidbW-pmogW-68BGdc-7i8PvZ-7qKhfB-KfoAR-8xRUKE-68Cc4V-4SoSPQ-eFvFKe-68Faa7-5gzBqn-71jsT7-c4vMiS-6p3aQb">Melanie</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span></figcaption></figure><p>The landscape of early schooling is drastically changing. More and more children are attending school at an earlier age. At the same time, early childhood and kindergarten programs are increasing focus on <a href="http://ero.sagepub.com/content/2/1/2332858415616358">academic</a> content. </p>
<p>But are these children ready for school?</p>
<p>Most <a href="https://www.infona.pl/resource/bwmeta1.element.elsevier-1f12239a-5447-3e9e-9c5e-6670b56e9d32">parents</a> and <a href="http://ero.sagepub.com/content/2/1/2332858415616358">teachers</a> will tell you that children’s abilities to “self-regulate” – that is, follow directions, pay attention, sit still and minimize disruptive behaviors – are among the most important skills necessary. </p>
<p>And with good reason: Such early behaviors <a href="https://www.researchgate.net/publication/261327622_Social_skills_and_problem_behaviors_as_mediators_of_the_relationship_between_behavioral_self-regulation_and_academic_achievement">predict academic success</a> throughout school and even later educational attainment. Some preschool-age children with self-regulation difficulties <a href="https://bangordailynews.com/2016/09/15/news/state/maine-officials-concerned-about-preschool-expulsions/?ref=relatedBox">are even expelled</a> from preschool.</p>
<p>We are researchers who evaluate what skills prepare children to succeed in school. The problem that our work has identified is that most children are still learning to manage their own behavior at the start of kindergarten. Many are simply not ready for the behavioral demands of kindergarten. And some are already two years behind their peers at kindergarten entry.</p>
<h2>Here’s how we found out</h2>
<p>To look at differences in how children develop self-regulation, we tested nearly 1,400 children from diverse backgrounds. Children were tested multiple times in preschool, from preschool to kindergarten, and preschool into first grade. </p>
<p>We used a game-like assessment called the <a href="http://blogs.edweek.org/edweek/early_years/2013/10/schoolyard_games_predict_academic_success_researcher_says.html">“Head-Toes-Knees-Shoulders”</a> task to measure children’s developing self-regulation skills. </p>
<p>Every time the experimenter said “touch your head,” the child had to remember to touch her toes instead, and when told to “touch your toes,” the child had to touch her head. </p>
<p>Sounds easy? Perhaps for the first part. The assessment became a lot harder as we added shoulders and knees. This task required children to engage their ability to remember the rules, do a different action than what the experimenter said, and keep focused throughout the task.</p>
<h2>Different levels of self-regulation</h2>
<p>We found that children had three different patterns of development: Some children entered preschool already demonstrating higher levels of self-regulation compared to their peers and quickly gained higher skill levels. For example, if most children start at “zero” on a scale of zero to 40, then the early developers started approximately 10 points ahead. </p>
<p>But most children started with lower self-regulation skills and gradually developed during preschool until they were ready for kindergarten. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/149717/original/image-20161212-26060-50ao1o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/149717/original/image-20161212-26060-50ao1o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=338&fit=crop&dpr=1 600w, https://images.theconversation.com/files/149717/original/image-20161212-26060-50ao1o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=338&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/149717/original/image-20161212-26060-50ao1o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=338&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/149717/original/image-20161212-26060-50ao1o.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/149717/original/image-20161212-26060-50ao1o.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/149717/original/image-20161212-26060-50ao1o.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Most children start preschool with low self-regulation skills.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/lewiselementary/8473380287/in/photolist-dULhKz-bfDoMn-dE5hgG-dDZqhi-JNeFwc-6p3aR7-MU8eT-6xairB-6p3cE3-buv3ti-zQXHHh-79avKF-dDZpSp-dDZgmM-bjp5ur-VNZo5-cev6tw-6p3cLN-5H1nG6-i8oaSZ-emMxm4-6SePR8-34cr6r-5hjRd3-6oY3rz-bTdMtn-3KhHX5-dDYVsk-6p3cTC-7ETqdB-dE5F9u-6p3bn5-7i8PwB-dDZ3GZ-8C5qaP-2CCYHz-neyMm8-7u6oHw-6dJ74g-5kkWNw-3KcCig-7qPbJj-8uTFTp-arSShD-6p3bEq-5H1nrg-dDYTxF-6oY2sp-6p3cVo-bWfLJx">Meriwether Lewis Elementary School</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span>
</figcaption>
</figure>
<p>The most troubling finding was that around 20 percent of children hardly showed any gains in self-regulation skills – such as remembering complex directions, raising their hand before speaking or taking turns with others – during their preschool years. </p>
<p>These children were attending preschool programs, usually four days a week, for one or two years, and yet they were lagging behind their peers in the self-regulation skills they would need in kindergarten. </p>
<p>The ones who had the most difficulty were more likely to be children from families where mothers had lower education levels, and children with lower levels of English vocabulary. They also tended to be male children.</p>
<p>For example, in our study, even though we had slightly fewer boys than girls (about 49 percent), when we looked into who the later developers were, up to 58 percent of them were boys. That is a noteworthy difference. </p>
<p>Other researchers who recently studied the same question as ours found <a href="http://ldx.sagepub.com/content/early/2016/01/11/0022219415619754.abstract">remarkably consistent</a> results. Specifically, <a href="http://cds.web.unc.edu/people/mentors/willoughby-michael/">researcher</a> <a href="http://ldx.sagepub.com/content/early/2016/01/11/0022219415619754.abstract">Michael Willoughby</a> concluded that at least 10 percent of children showed few or no gains in self-regulation across preschool. This had devastating consequences during their kindergarten years related to behavior and academic achievement. </p>
<h2>Why does this matter?</h2>
<p>Children who develop self-regulation later are generally the same children who lag behind their peers in the academic skills we value and target. </p>
<p>There is some evidence that the children who start kindergarten with lower self-regulation not only do not catch up by first or even second grade, but in some cases may be falling even further <a href="https://www.researchgate.net/publication/223830060_The_Impact_of_Kindergarten_Learning-Related_Skills_on_Academic_Trajectories_at_the_End_of_Elementary_School">behind</a>. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/149719/original/image-20161212-26074-11n8tct.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/149719/original/image-20161212-26074-11n8tct.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/149719/original/image-20161212-26074-11n8tct.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/149719/original/image-20161212-26074-11n8tct.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/149719/original/image-20161212-26074-11n8tct.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/149719/original/image-20161212-26074-11n8tct.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/149719/original/image-20161212-26074-11n8tct.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Children with lower ability to regulate their behaviors tend to fall behind in later grades as well.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/56155476@N08/6660073861/in/photolist-b9wBVF-ns3992-qMebL2-6pCyky-b9wBHa-b9woPx-oKwDst-cm4aWo-6pCs1m-8La5MM-nYfJYn-eg5hzD-7QrxNC-7FMHdG-eUGZ7h-8RWbxQ-87pDRt-2JwHu8-b9wfxp-6pCKfA-b9wzyB-b9wrUg-b9woDp-dtihpG-dQBCBA-6pyoyc-pEr4PD-b9wA7n-b9wFkx-fUfXdX-b9wejM-jcckSN-b9wbFz-pEtqf7-2bFCA-6AZxUv-jDxwsZ-b9wzna-qYMoLH-pEnuLx-axk7VN-b8vv3K-6AZBS8-p11MrG-6pynjc-dtifkW-dSim6o-b9waAB-6pCNLA-pWNbdR">Brad Flickinger</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>For example, a child with lower self-regulation in kindergarten is likely to have lower math skills throughout elementary school. What is worse, in early elementary grades that skill gap could further widen. </p>
<p>Our ongoing research evaluating literacy skills among children until second grade echoes these findings. Just as with math, later developers do not appear to catch up when it comes to letter and word recognition, awareness of word sounds and reading comprehension. In fact, the gaps grow wider across kindergarten and first grade. </p>
<h2>So what can we do?</h2>
<p>Does this mean that early childhood programs should eliminate their academic focus? </p>
<p>We are not arguing for this. Research shows that the early introduction of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3780775/">academic</a> material does help prepare children for school success.</p>
<p>Rather, what we are arguing for is what teachers have been observing for at least two decades – that programs that value children’s early social emotional development, and particularly their self-regulation skills, are critical. The development of these skills need individualized focus along with academic materials.</p>
<p>Teachers need to make sure children are <a href="http://www.nytimes.com/2016/10/17/well/family/which-came-first-the-behavior-problems-or-the-poor-sleep.html?_r=0">not overtired</a> or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4073202/">hungry</a> or that there is not some other physical need. Research shows the body and brain work together to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4682347/">self-regulate</a>. </p>
<p>Parents can set strong routines including bedtime, other rest times and consistent snack times. Such routines ensure children’s <a href="https://www.psychologytoday.com/blog/think-better/201111/how-structure-improves-your-childs-brain">brains</a> are ready to engage in tough academic work. </p>
<p>After that, children need practice. It is important to understand that paying attention, remembering directions and avoiding disruptive behaviors are all skills that can be practiced through <a href="https://www.naeyc.org/files/yc/file/201107/Self-Regulation_Florez_OnlineJuly2011.pdf">daily interactions</a>. <a href="http://www.parentingscience.com/teaching-self-control.html">Games</a> that require rules can be used for practicing these skills.</p>
<p>If children are to get the most out of early academic content, they need to be prepared for it. As it turns out, some of us need both a little bit more practice and lot more help in order to be ready to succeed.</p><img src="https://counter.theconversation.com/content/69327/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Children who aren’t ready for school tend to lag behind their peers in later grades. Parents and teachers can help.Janelle J. Montroy, Assistant Professor of Pediatrics, The University of Texas Medical BranchRyan Bowles, Associate Professor of Human Development and Family Studies, Michigan State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/343912014-11-19T15:56:38Z2014-11-19T15:56:38ZWhy was ‘Ebola-free’ survivor quarantined in India after viral traces in his semen?<figure><img src="https://images.theconversation.com/files/64983/original/image-20141119-31612-1ce4zeo.jpg?ixlib=rb-1.1.0&rect=14%2C1377%2C4960%2C3195&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">When other fluids free, traces can still be found in semen for 90 days.</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-222242668/stock-vector-ebola-epidemic-concept-of-spreading-among-people-vector-graphic-icon-this-graphic-illustrates.html?src=dt_last_search-3">Ebola by Shutterstock</a></span></figcaption></figure><p>A man in India <a href="http://in.reuters.com/article/2014/11/18/ebola-india-idINKCN0J21MY20141118">has been quarantined</a> after his semen sample tested positive for Ebola. This man had been in Liberia, was infected with Ebola, got horribly sick and survived. He had the same Ebola-free documentation that all survivors get on release from the hospital, which indicates their blood no longer harbours the virus. Unfortunately for him this wasn’t enough to get him through airport security in New Delhi.</p>
<p><a href="http://www.washingtonpost.com/world/india-quarantines-ebola-patient-from-liberia-who-has-traces-of-virus/2014/11/19/fba2c188-c5bf-4b24-be0d-aa9a61e67ecb_story.html">According to reports</a>, this recovered Ebola patient tested negative before flying into New Delhi airport on November 10 where he was immediately quarantined – despite the paperwork and previous negative tests. It was only later, after he’d been held that they tested his semen and found evidence of the virus. And because they found “traces of the virus” he will be held under quarantine until his semen tests negative. </p>
<h2>Ebola and semen</h2>
<p>It <a href="http://jid.oxfordjournals.org/content/179/Supplement_1/S28.full">is well known</a> and has been shown in a number <a href="http://jid.oxfordjournals.org/content/196/Supplement_2/S142.full">of studies</a> that semen and breast milk can contain ebolavirus after it has been cleared from the rest of the bodily fluids; <a href="http://jid.oxfordjournals.org/content/179/Supplement_1/S170.long">up to 90 days in semen</a>. </p>
<p>This is not surprising as these are <a href="http://www.nature.com/cmi/journal/v11/n5/full/cmi201438a.html">immune privileged sites</a> in which immune responses are suppressed. In addition, antibodies in blood <a href="http://www.sciencedirect.com/science/article/pii/S1357272512004050">don’t make it to the testes</a>.</p>
<p>Ebola is not the only hemorrhagic fever virus for which this is the case. <a href="http://www.ajtmh.org/content/19/4/670.long">Lassa virus</a> can be detected in semen after the patient recovers and there is also considerable anecdotal clinical evidence that Junin virus, the agent that causes <a href="http://medical-dictionary.thefreedictionary.com/Argentine+Hemorrhagic+Fever">Argentine Hemorrhagic Fever</a>, remains in semen after recovery.</p>
<p>However, finding “traces of virus” is not the same as finding infectious virus particles and at this point we don’t know what tests were used or what was found. And while the risk of sexual transmission is there – something I wrote about <a href="http://www.pathogenperspectives.com/2014/09/not-tonight-dear-i-had-ebola.html">in a recent blog</a> – it is extremely low. In fact <a href="http://jid.oxfordjournals.org/content/179/Supplement_1/S28.abstract">only one study</a> has found indirect evidence that one woman may have contracted Ebola from sex, but the researchers could not confirm that she actually had Ebola, or that she got it from sex. </p>
<p>However, because there is a risk, the US Centers for Disease Control recommends that male survivors of Ebola are specifically counselled on the <a href="http://www.cdc.gov/vhf/ebola/transmission/index.html?s_cid=cs_284">risks of transmission through sexual activity</a> at the time of discharge, and are warned to either abstain or use condoms for three months to protect their partners.</p>
<p>In addition, those who lived through the horror of a Liberian Ebola treatment centre are unlikely to be cavalier regarding its spread. The death and suffering they will have already seen must certainly take a toll. Quarantine is probably unnecessary. But “probably” clearly isn’t good enough for the Indian ministry of health, which has decided that the best way to handle this is to remove all chance for sexual transmission of Ebola via this survivor.</p>
<h2>Taking no chances</h2>
<p>If Ebola made its way into India it would be devastating, especially since many areas in India have the same kind of inadequate health care infrastructures and poor hygiene standards that led to the spiralling epidemic in West Africa. </p>
<p>Countries facing these types of situations have much more to worry about – and, although I may not think quarantine is necessary or even the right thing to do in this situation, I recognise that a health ministry with more than a billion lives at stake might be willing to take stronger measures to prevent the spread of a disease that is decimating parts of West Africa.</p>
<p>But we must keep this in perspective; it does not mean that we need to start quarantining survivors in developed countries. Countries with significant resources, high sanitation standards and good access to information about the virus should continue to keep Ebola at bay without adding to survivors’ burdens with unnecessary quarantines. </p>
<p>We’ve already seen what fear as a driving force has done in the US, where nurse <a href="http://www.theguardian.com/world/2014/nov/17/kaci-hickox-ebola-accuses-chris-christe-paul-lepage">Kaci Hickox</a> was forced to publicly defy an order from state authorities to remain isolated for 21 days after returning virus-free from helping in Sierra Leone. I really hope we don’t lose sight of this as we continue to deal with Ebola.</p><img src="https://counter.theconversation.com/content/34391/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Heather Lander does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>A man in India has been quarantined after his semen sample tested positive for Ebola. This man had been in Liberia, was infected with Ebola, got horribly sick and survived. He had the same Ebola-free documentation…Heather Lander, Science Writer , The University of Texas Medical BranchLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/321372014-09-25T04:41:43Z2014-09-25T04:41:43ZHow Ebola started, spread and spiralled out of control<figure><img src="https://images.theconversation.com/files/59969/original/y8rzctxw-1411610991.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">West African health-care workers are overworked and under-equipped to deal with the outbreak.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/69583224@N05/14857730723">European Commission DG ECHO/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span></figcaption></figure><p>Too slow. Too little, too late. Unprecedented. Out of control. These are just some of the descriptors for the biggest recorded epidemic of human infection by an ebolavirus. </p>
<p>The question by some is how this happened? As of this writing, 5,347 people <a href="http://virologydownunder.blogspot.com.au/2014/07/ebola-virus-disease-evd-2014-west.html">are suspected</a> or known to be infected (an undoubted underestimate) in Guinea, Sierra Leone, Liberia, Nigeria and Senegal. And 2,630 have died. </p>
<p>The previously stated death rate of 49% is also a serious underestimate. The World Health Organization has <a href="http://www.nejm.org/doi/full/10.1056/NEJMoa1411100">calculated</a> the fatality rate among confirmed cases with known outcomes to be above 70% overall and 64% for those who were hospitalised. </p>
<p>Latest worst-case modelling <a href="http://www.cdc.gov/mmwr/pdf/other/su63e0923.pdf">predicts</a> up to 1.4 million people might become infected in this outbreak; 70% of which is 980,000 souls. </p>
<h2>How did it happen?</h2>
<p>The outbreak was identified six months ago, three months after it is believed to have begun from a single animal-to-human transfer. </p>
<p>The world was soon after assured by those in senior roles that Ebola virus disease outbreaks were not hard to control and ebolaviruses were not easy to catch. This was meant to apply even to members of the <em>Zaire ebolavirus</em> species (an Ebola virus), one of which now ravages West Africa. </p>
<p>(Note, Ebola virus <a href="http://virologydownunder.blogspot.com.au/2014/08/behind-naming-of-ebola-virusesnot-yet.html">is the name</a> of the Zaire species, while ebolavirus refers to all species). </p>
<p>Were assurances just hubris or simply a failure to recognise this outbreak for what it was? </p>
<p>Every infectious disease outbreak has a “personality”; this one includes the introduction of a terrifying disease into a completely susceptible population, in a part of the world with no chance of stopping it alone. </p>
<p>West Africa has very few health-care workers, poor roads and sizable distances between villages, towns and cities. These factors in combination with traditions, especially those for preparing loved ones for burial, have conspired to produce a perfect storm of opportunity for Ebola virus transmission and spread. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/59968/original/4ngfyv24-1411610867.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/59968/original/4ngfyv24-1411610867.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/59968/original/4ngfyv24-1411610867.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/59968/original/4ngfyv24-1411610867.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/59968/original/4ngfyv24-1411610867.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/59968/original/4ngfyv24-1411610867.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/59968/original/4ngfyv24-1411610867.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Gravediggers use protective clothing when burying the deceased.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/69583224@N05/14592031507">European Commission DG ECHO/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
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<p>We often hear that ebolaviruses were not known to exist in Western Africa prior to this outbreak. But that is not strictly correct. Two scientific studies published in 1986, using samples collected in <a href="http://www.ncbi.nlm.nih.gov/pubmed/3015288">1973</a> and <a href="http://www.ncbi.nlm.nih.gov/pubmed/3092415">1981-2</a>, had already reported finding haemorrhagic fever viruses, including Ebola virus, in the forests of Liberia. </p>
<p>Another study, co-authored by Dr Sheik Umar Khan who subsequently succumbed to an Ebola virus infection in Sierra Leone, was <a href="http://wwwnc.cdc.gov/eid/article/20/7/13-1265_article">published</a> after the outbreak began. It found signs of Ebola virus in samples collected from 2006 to 2008. </p>
<p>With 20:20 hindsight, one can speculate that this information could have been used by local governments to educate their citizens and better train and prepare their front-line health-care workers; a higher proportion of whom have, throughout history, been infected during Ebola virus outbreaks. </p>
<p>Experts repeatedly tell us this virus can be easily contained with early intervention. Had this population been prepared, perhaps more <a href="http://en.wikipedia.org/wiki/Personal_protective_equipment">personal protective equipment</a> and bleach would have been ready to go, and the rapid transmission of the West African Ebola virus outbreak might have been contained.</p>
<h2>No airborne transmission</h2>
<p>Transmission of ebolaviruses between humans is by direct contact in which the broken skin or exposed mucous membrane (mouth, eyelids, genital tract) of susceptible humans is exposed to an infectious dose of Ebola virus-laden fluid (blood, vomit, faeces, sweat, saliva and semen) from a patient showing signs of the disease. </p>
<p>Semen can <a href="http://jid.oxfordjournals.org/content/196/Supplement_2/S142.full">remain infectious</a> weeks into the convalescence period. Propelling wet droplets onto a mucous membrane is also <a href="http://www.who.int/ith/ITH2009Chapter5.pdf?ua=1">a form of</a> direct contact. </p>
<p>But regardless of what one might read in <a href="http://www.goodreads.com/book/show/16213.The_Hot_Zone">The Hot Zone</a> (or the <a href="http://www.nytimes.com/2014/09/12/opinion/what-were-afraid-to-say-about-ebola.html?_r=0">New York Times</a>), there is no direct evidence that any ebolavirus species, strain or variant is transmitted via an airborne route. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/59970/original/d5r7j6wt-1411611371.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/59970/original/d5r7j6wt-1411611371.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=337&fit=crop&dpr=1 600w, https://images.theconversation.com/files/59970/original/d5r7j6wt-1411611371.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=337&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/59970/original/d5r7j6wt-1411611371.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=337&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/59970/original/d5r7j6wt-1411611371.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/59970/original/d5r7j6wt-1411611371.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/59970/original/d5r7j6wt-1411611371.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Personal protective clothing doesn’t necessarily look like lab containment ‘space suits’.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/69583224@N05/14700393759/in/photostream/">European Commission DG ECHO/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span>
</figcaption>
</figure>
<p>The <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3498927/">scientific evidence</a> suggests that while aerosols can be used in the lab, it is the wet droplets in these rather than the dried down airborne fraction that are most likely involved in ferrying virus. Even the researchers involved in the events of the dramatised book version caution us to keep in mind that “aerosol and droplet transmission” is not the same as “airborne transmission.” </p>
<p>This does not sit well with some who see ebolavirus lab workers in lab containment “space-suits” and erroneously compare that to the personal protective equipment worn by diagnostic scientists, Médecins Sans Frontières workers, doctors, nurses and gravediggers, and draw the conclusion that more is always better. </p>
<p>What’s missing from their concern that only an airborne Ebola virus can explain current health-care worker infections, is that simply including a more advanced mask (respirator) or a battery-powered air pump and hood does not cover all the potential sources of infection in or out of an Ebola virus disease treatment centre. </p>
<h2>Mounting a global response</h2>
<p>West African health-care workers are in short supply. They’re overworked, exhausted, under-equipped, insufficiently trained or can be fallible. </p>
<p>In the early days of the outbreak, personal protective equipment use was rare and risk of infection was high. In some instances, protective equipment is still not used to the extent that it should be. </p>
<p>But an Ebola treatment centre is not the only source of Ebola virus infection when in the midst of a raging epidemic in crowded cities. Health-care workers <a href="http://www.cbc.ca/news/canada/manitoba/3-winnipeg-scientists-exposed-to-ebola-coming-home-1.2749329">have been infected</a> in maternity wards. And when away from treating patients they have the same risk as the rest of the population of contracting an infection from others, such as in their hotels. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/59967/original/fysmztz4-1411610727.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/59967/original/fysmztz4-1411610727.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/59967/original/fysmztz4-1411610727.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/59967/original/fysmztz4-1411610727.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/59967/original/fysmztz4-1411610727.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/59967/original/fysmztz4-1411610727.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/59967/original/fysmztz4-1411610727.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A high proportion of health workers have been infected during the outbreak.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/usaid_images/15310371906">USAID U.S. Agency for International Development/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span>
</figcaption>
</figure>
<p>Another population taking a heavy toll are families. When an infected and sick member cannot get into an already full Ebola virus disease treatment centre, they return home, unrecorded, for care and another single case becomes many.</p>
<p>We are all part of a shrinking global village, and right now some of its homes are ablaze. We can and should expect each of our governments to do more than pay someone else to buy, fill and carry a few buckets to throw on the inferno, as the <a href="https://theconversation.com/gung-ho-on-terror-australia-is-missing-in-action-against-ebola-31896">Australian government has done</a>. </p>
<p>Instead we should follow and build upon the example set by the United States. Every neighbour in this village has a duty to mount an equally robust response. And from the ashes we must build a stronger, more communicative and sustainable alliance to watch for and respond to global health emergencies.</p><img src="https://counter.theconversation.com/content/32137/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Heather Lander previously received a US DOD T32 Training grant.</span></em></p><p class="fine-print"><em><span>Ian M. Mackay and Katherine Arden do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Too slow. Too little, too late. Unprecedented. Out of control. These are just some of the descriptors for the biggest recorded epidemic of human infection by an ebolavirus. The question by some is how…Ian M. Mackay, Associate Professor of Virology, The University of QueenslandHeather Lander, Science Writer, The University of Texas Medical BranchKatherine Arden, Postdoctoral researcher in Virology, The University of QueenslandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/192512013-10-16T18:11:01Z2013-10-16T18:11:01ZFirst Ebola antibody treatment to halt deadly virus in primates<figure><img src="https://images.theconversation.com/files/33151/original/p6rcw38s-1381934987.jpg?ixlib=rb-1.1.0&rect=1%2C0%2C798%2C535&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Primates - human and non-human - can be infected by Ebola.</span> <span class="attribution"><span class="source">Chris Huh</span></span></figcaption></figure><p>As viruses go, Ebola is one that strikes particular fear. It’s infectious and four out of the five identified strains can cause severe hemorrhagic fever, which in later stages leads to bleeding from the eyes, ears and nose as well as the mouth and rectum. One particular strain, Zaire ebolavirus, is one of the deadliest viruses we know and fatal in up to 90% of cases.</p>
<p>Ebola is transmitted through contact with infected blood and other bodily fluids and has caused sporadic but deadly <a href="http://on.wsj.com/1e4UtOG">human outbreaks in Africa</a>. There is no cure, vaccine or established drug treatment (one treatment called siRNAs has a high success rate if administered within minutes of infection) and in Africa, often in remote areas, the general approach is containment and palliative care. </p>
<p>But in a study, Canadian researchers found that a combination treatment of antibodies and virus-fighting proteins prevented death from Ebola-Zaire in some primates, even when administered three days after infection and when the early symptoms of the fever, which include fatigue and vomiting, begin to show.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/33150/original/66mfdgwj-1381934468.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/33150/original/66mfdgwj-1381934468.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=405&fit=crop&dpr=1 600w, https://images.theconversation.com/files/33150/original/66mfdgwj-1381934468.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=405&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/33150/original/66mfdgwj-1381934468.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=405&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/33150/original/66mfdgwj-1381934468.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=508&fit=crop&dpr=1 754w, https://images.theconversation.com/files/33150/original/66mfdgwj-1381934468.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=508&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/33150/original/66mfdgwj-1381934468.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=508&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">First Zaire-Ebola outbreak killed 280 people - 88% of cases.</span>
<span class="attribution"><span class="source">Lyle Conrad/Center for Disease Control</span></span>
</figcaption>
</figure>
<p>The study, <a href="http://bit.ly/1cXJQ2x">published in Science Translational Medicine</a>, builds on previous work in this field. Using <a href="http://www.defyrus.com/products_zmab.html">a drug made from</a> three mouse antibodies, the researchers said it protected two out of four non-human primates that were given the treatment two days after infection. But when combined with adenovirus-vectored inteferon (a protein prepped with viral material that helps trigger the immune system), three out of four cynomolgus monkeys survived three days after infection. </p>
<p>In rhesus macaques, however, all four survived after being given this combination three days after infection. A <a href="http://www.ncbi.nlm.nih.gov/pubmed/23616649">previous study</a> with a similar success rate was on guinea pigs.</p>
<p>The authors said the findings showed that antibodies could control how the Ebola virus replicated and, crucially, that combining it could also extend the window of time to treat the disease. </p>
<p>Gary Kobinger, one of the study authors, said it was the first time that a combination therapy had been done in non-human primates that showed it could be 100% effective.</p>
<p>“In the past antibodies alone were shown to work 100% only 24 hours after infection, but only 50% after 48 hours,” he said. “Now, with this combination, we’ve reached day three and into day four. For us as a team, it’s a bit of a holy grail to be able to get a 100% when you have clinical symptoms and infection has been detected.”</p>
<p>Ebola belongs to the filoviridae family of viruses, which quickly replicates and overwhelms the host’s immune system. The incubation period from first infection to death from the fever varies from between <a href="http://www.who.int/mediacentre/factsheets/fs103/en/">two and 21 days</a> and in more remote areas where outbreaks occur more time would be crucial. </p>
<p>Thomas W Geisber, an expert on Ebola and siRNAs at The University of Texas Medical Branch, said the research was “highly significant because it shows protection against Ebola in a robust model of human disease: non-human primates.” His only concern, he said, was to with the nature of the virus used in the study. </p>
<p>When Ebola-Zaire virus seed stocks are prepared in a laboratory for use in experiments, many are classed as 7U or 8U - this refers to the amount of virus contained in it in its natural wild (unmutated) form. But this can still vary.</p>
<p>“Two 7U stocks can be very different - for example one predominantly 7U stock with around 50% 7U and another 7U stock with around 98%,” Geisber said. “The only way to know for sure is to deep sequence them.” </p>
<p>Viruses with high populations of 7U cause a more rapid disease in macaques and are theoretically more difficult to protect against, he said. However, “past studies performed with viruses containing higher populations of 7U viruses <a href="http://bit.ly/1973uoH">using other MAbs</a> did not protect [non-human primates] against Ebola-Zaire, whereas studies using different antibodies containing <a href="http://stm.sciencemag.org/content/5/199/199ra113">high populations of 8U</a> did. It is hard to say whether the difference is because of the antibodies or the virus used. </p>
<p>"My gut feeling is that the difference is because virus stocks with high populations of 7U are more pathogenic in primates and harder to protect against.”</p>
<p>While Geisbert thought the use of siRNAs was more promising, treating Ebola could come down to a combination of “the most promising treatments -like HIV treatments - combined,” he said.</p>
<p>Kobinger said the study used a 7U virus that contained around 80% of the wild type population. The next step would be to work with <a href="http://stm.sciencemag.org/content/5/199/199ra113">another leading antibody team</a> to find an “even more potent cocktail” to extend the treatment window.</p>
<p>siRNAs were effective but “a proof of concept” that didn’t fit with real world conditions, he said. “[They are] best when injected everyday for seven days, but treatment has to be initiated within 30 minutes after infection to reach 100% … Even within a lab contamination, this might be unrealistic. In the real world we need to go past 24 hours.”</p>
<p>Ebola first emerged in Sudan and Zaire (now the Democratic Republic of the Congo) in the mid-1970s. Since then five strains have been identified: Zaire (1976), Sudan (1976), Reston (1989) Côte d’Ivoire (1994) and Bundibugyo (2007) - each named after where they were first discovered. Reston, <a href="http://www.the-scientist.com/?articles.view/articleNo/33277/title/Ebola-from-Pigs-to-Monkeys/">discovered in Virginia</a> in the US and later in pigs in the Philippines (and antibodies in a few pig farmers) isn’t known to cause haemorrhagic fever in humans. Ebola Côte d’Ivoire was discovered after a scientist <a href="http://www.stanford.edu/group/virus/filo/history.html">contracted the infection</a> from an autopsy on a dead chimpanzee.</p><img src="https://counter.theconversation.com/content/19251/count.gif" alt="The Conversation" width="1" height="1" />
As viruses go, Ebola is one that strikes particular fear. It’s infectious and four out of the five identified strains can cause severe hemorrhagic fever, which in later stages leads to bleeding from the…Jo Adetunji, EditorLicensed as Creative Commons – attribution, no derivatives.