In Kenya, the state and Love Matters share a commitment to SRHR for young people and both have similarly unpredictable enemies among religious authorities, some of whom — such as militant Islamist group al-Shabaab — are self-appointed and violent. More than once, such NGOs have abruptly been denied access to a school due to pressure from parents or teachers who are displeased with the material taught EIPR Indeed, as some studies show, mass media such as the internet and traditional media in the form of television, music, movies, magazines and so forth are highly influential in young people's sex-related knowledge, attitudes and behaviours L'Engle, Brown and Kenneavy ; Lou et al. However, the age at which disordered eating behaviours DEBs and associated cognitions initially develop has not been widely studied, and it is unclear at what age the sex differences in the prevalence of DEBs emerge. Sex educators are learning to engage with these commercial organisations and need to lobby private companies to acknowledge accurate, credible sources of sex education information. However, these instances are usually restricted to journalists reporting on drug-related or political issues. The present study aims to a characterise the point prevalence of DEBs at ages 14 and 16 in a large multinational community sample based on adolescent self-reports and parental reports [IMAGEN cohort; 16 ], and b explore the concordance between parent and youth ratings of DEBs.
Understanding the audience better would enable sex education providers to tailor their content and outreach activities even better. Similarly, Salbach-Andrae et al. Additionally, internet censorship by new gatekeepers has the potential to affect traffic patterns. How do young people reach these sites? There are also 'new' — as opposed to traditional — invisible gatekeepers, such as Facebook and Google in online spaces, which specifically restrict access to information about nudity, cleavage, adult content or sexually explicit content APC , 1 and impose strict rules. However, agreement between informants tends to be low [ 4 , 7 ]. For example, a picture of a dog with sunglasses and the text 'Doggy-style Are all men dogs? As an editorial rule, no graphic content or details about sex are published, even if that material is available elsewhere in China, either online or offline. Instead, in many parts of the world, sex education focuses on the risks and biomedical aspects of sexuality such as sexually transmitted infections STIs , contraception and the mechanics of conception. In our analysis, we found that referrals from Facebook are very engaged on Love Matters websites. GEE models assume that cases are not independent, assume a correlation between errors the structure of which are specified by a covariance matrix and do not assume heterogeneity of variance; thus, the GEE approach can be used to analyse non-normal within-subject data [ 22 ]. An approximately equal proportion of boys and girls participated at both time points. The most prominent restrictive example is China, where there is a high degree of internet censorship. Given the popularity of pornographic sites, it is an open question as to what extent people are looking for pornography and land on sex education pages instead. Although GEE models are typically taken to allow data to be missing completely at random, Satty et al. Organic searches, by people using search engines, are particularly important in Egypt and India 53 and 46 per cent of traffic, respectively ; Kenya has the largest share of social traffic among the Love Matters countries 57 per cent of traffic ; and 'other' channels only play a role in Mexico 19 per cent. Smolka Find articles by Michael N. Furthermore, direct and display traffic seem to play larger roles in China than in the other countries. In many countries traditional gatekeepers such as religious and educational authorities are still powerfully restricting access, content and materials used for sex education. The Kenyan government is interested in comprehensive sex education as part of a policy to improve SRHR, but faces public opposition to this idea due to differing sociocultural views, notably from religious groups as well as from teachers who hold the same conservative beliefs Agbemenu and Schlenk ; Mbugua Therefore, online sex education is of vital importance for young people. Censorship is more prominent in print and mostly focused on terrorism. Finally, studies show that web-based sexual health education increases awareness, knowledge and behaviour related to sexual and reproductive health issues. Our findings show the importance of understanding audiences, visible traditional and invisible online gatekeepers, and working with local and supranational commercial organisations for effective outreach and provision of sex education. Procedure Interview, questionnaire, genetic and neuroimaging data were obtained from adolescents at age 14 T1 , and interview and questionnaire data were obtained online two years later at age 16 T2. The GEE employed a binary logistic model with a logit link and an exchangeable working correlation matrix. In contrast, parents may be unaware and under-report behaviours characteristic of bulimia nervosa BN that are often associated wtih secrecy and shame, such as binge eating and purging [ 5 ].
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