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Oral Presentation and Defense

In this Discussion, you will present your capstone research, findings, and recommendations in a format of your choosing (e.g., audio, video, YouTube, vocaroo, PowerPoint presentation, infographic, screencast-o-matic, PowToons, Clyp, etc.).

Your capstone presentation must include the following:

  • general and specific problems you aimed to address
  • purpose of your research
  • general background of the problem(s)
  • findings yielded from your extensive literature review
  • any unexpected findings?
  • recommendations which may address the problem(s)
  • final thoughts

Work needs to illustrate the equivalent of an oral defense of your capstone research. If you are using audio or video, be sure to speak slowly and clearly, enunciating your words, and addressing all required talking points. Do not read a script!

After others have reviewed your posting, commented, and asked questions about your research, you will reply and defend your findings using scholarly-based evidence. Likewise, when you review the work of others, be sure to ask thought-provoking questions that may further the conversation.

Running head: ANNOTATED BIBLIOGRAPHY 1

ANNOTATED BIBLIOGRAPHY 3

Annotated Bibliography

Mitchelle Baker

A Capstone Presented in Partial Fulfillment

of the Requirements for the Degree

Master of Healthcare Administration

PURDUE UNIVERSITY GLOBAL

September 2019

Annotated Bibliography

Robinson, R. S., Kunnuji, M., Shawar, Y. R., & Shiffman, J. (2018). Prioritizing sexuality education in Mississippi and Nigeria: The importance of local actors, policy windows and creative strategy. Global Public Health, 13(12), 1807-1819. doi:10.1080/17441692.2018.1449000

This article asserts that Mississippi and Nigeria are both regarded as conservative regions. In that case, it would be difficult for both regions to prioritize sexuality education. However, in 2011, Mississippi passed a bill that required all schools to offer sexuality education to the students. The law also encouraged all the state ministries to focus on and prioritize sexuality education in the state. Various reasons influenced the decision to offer sexuality education in both Mississippi and Nigeria. One of the reasons is that both countries’ local organizations and individuals are highly committed towards the strategy of offering sexuality education. Such individuals and organizations also got support from external factors. As such the policy on sexuality education was perceived as a pathway to ending teenage pregnancy in Mississippi. It was also regarded as an effective solution towards HIV/AIDs menace in Nigeria. Furthermore, the proponents of these solutions had a strategic plan for the social problems affecting the two countries. However, the author of the article notes that offering sexuality education in difficult contexts always requires commitment from organizations and individuals. It also requires the identification of external resources to support the implementation and building costs.

Florescu, L., Temneanu, O. R., & Mindru, D. E. (2016). Social and Medical Implications of Teenage Motherhood. Revista de Cercetare si Interventie Sociala, 52.

Adolescence among girls is a certain age segment that suffers exposure to a lot of risks complications especially when the girl is pregnant. Such complications may occur during birth or post-natal period which may affect the health of the child and that of the young mother. Examples of complications faced by teenage mothers include low birth weight, premature birth and high risk of infant mortality.

The authors of this article note that teenage mothers are usually socially, physiologically and psychologically unprepared to have children. As such they cannot make informed decisions about the child’s health and also their health. Lack of social and family support forces teenage mothers to abandon their children. Most of the teenage mothers are also forced to abandon school despite having the right to continue school. As a result, there are financial and professional failures.

It is worth noting that teenage mothers cannot form sustainable couples with the fathers of their children. Consequently, there emerge some socio-psychological repercussions. This article suggests that reducing the effects of teenage pregnancy would require sex education, especially within the socio-educational family setting. Thus, applying the strategy of sex education would assist in reducing cases of teenage pregnancies in Mississippi.

Du Plessis, R. (2015). SEXUAL HEALTH NEEDS ASSESSMENT FOR TAMESIDE .

This article presents the sexual health needs assessment of Tameside borough. Mainly, the purpose of the article is to determine the sexual health needs assessment as well as service provision at Tameside. It also presents some interventions that would strengthen the Sexual Health Strategy implemented in the borough.

One of the objectives of this article is to reduce cases of abortions and unplanned pregnancies at Tame side. Notably, the intervention presented by the authors for this case is improving uptake of Long-Acting Reversible Contraceptives. In that sense, the article suggests that unplanned pregnancies would be lowered through increasing ellaOne access through pharmacy contract. It also suggests a thorough review of all pharmacy activities to ensure that there is equitable distribution of ellaOne throughout the borough. More pointedly, the authors of this article agree that improving access to LARCs serves as an effective strategy for reducing abortions and unplanned pregnancies. Similarly, Mississippi should also consider improving access to LARCS among adolescent girls to help reduce cases of unplanned pregnancies in the state.

Almeida, R., Lins, L., & Rocha, M. (2015). Ethical and bioethical dilemmas in adolescent health care. Retrieved 27 September 2019, from http://dx.doi.org/10.1590/1983- 80422015232071

This study aimed at explaining the ethical and bioethical issues affecting adolescent healthcare. The author of the article agrees that there exist conflicting situations between rules and ethical questions together with adolescent’s laws or codes. Autonomy is one of the key principles of bioethics that focuses on respecting the patient’s decision making on issues concerning their health. However, in certain circumstances, this principle is highly limited. For instance, physicians and health professionals must provide care and prevent harm to adolescent patients. Mainly, it is because when the risk of death is imminent, it may result in some paternalistic actions. In such a case, the ethical principle of beneficence supersedes that of autonomy. The health professional is supposed to respect the decision made by the patient since they must avoid putting the patient's life at risk. However, concerning patient autonomy, most of the health professionals have found themselves in a challenging situation. For instance, they are required to discern on issues related to self-care as well as the health of patients since they are the individuals responsible for patient life. However, many health professionals argue that adolescent patients are not responsible for their health. Therefore, they should pass the scrutiny of their legal representatives. Conversely, the reality is that the healthcare professional cannot guarantee that representatives are concerned with the benefit of minors. Also, about autonomy, studies have indicated that most of the teenage girls usually delay seeking medical help. Mainly, they fear that when they report such situations to the health professionals; it would be revealed to their relatives. As such, physicians are supposed to maintain confidential calls with these teenage girls because the patients fear exposure when they report health problems. However, since most of the teenage girls know that their information would be revealed; they tend to conceal or omit some information for proper treatment and diagnosis. As a result, this compromises their relationship with health professionals that is based on loyalty and confidentiality. Importantly, these are some of the potential ethical issues affecting teenage pregnancy in Mississippi.

Fouquier, K. (2017). Legal and Ethical Issues in the Provision of Adolescent Reproductive Health in the United States. Online Journal of Health Ethics, 13(1). http://dx.doi.org/10.18785/ojhe.1301.03

The author of this article agrees that when providing evidence-based and comprehensive reproductive health care to the adolescents; the care providers must comprehend all the ethical and legal issues surrounding confidentiality and informed consent. However, according to this article, such aspects are challenging to the care providers. For instance, informed consent is an active process between the healthcare provider and the patient. However, the differences in federal and state laws influence the provider’s ambiguity and uncertainty around management options and practice policies. This source is important because it offers information about some of the potential ethical and legal issues concerning confidentiality and informed consent for the teenage girls seeking reproductive health services.

Killebrew, A. E., Smith, M. L., Nevels, R. M., Weiss, N. H., & Gontkovsky, S. T. (2014). African-American Adolescent Females in the Southeastern United States: Associations Among Risk Factors for Teen Pregnancy. Journal of Child & Adolescent Substance Abuse, 23(2), 65-77. doi:10.1080/1067828x.2012.748591

This article examined the relationship between three external variables. Such variables include peer number of children, peer substance abuse use before sex, parental influence and the history of pregnancy in Mississippi. These variables were noted on the Youth Risk Behavior Surveillance survey and a demographic survey. The researchers used Bandura’s Social Learning theory interpretive model to comprehend the relationship. Notably, the participants in the research comprised 276 African American females aged 13 to 18 years. All these teenagers were enrolled in two public schools in Mississippi with 14% of them reporting previous pregnancies. When the researchers did some variance analysis; they discovered that teens having a history of pregnancy had higher chances of having more sexual partners. Also, teenagers with a history of pregnancy reported peer history of pregnancy as well as alcohol use before sex. More pointedly, their parents had also diminished expectancies about adolescent pregnancy. With such kind of information, these are some of the factors contributing to high rates of teenage pregnancies in Mississippi.

Bryant, Z., & Hasbini, T. (2016). Targeting unintended teen pregnancy in the US. International Journal of childbirth education, 31(1), 28.

The author of this article asserts that teenage pregnancy has become an issue of public concern in the United States. There is an increased rate of adolescent pregnancies in the USA compared to other developed countries such as Switzerland and Japan. However, one effective strategy of reducing teen pregnancy is through the formulation of effective policies. Noteworthy, some of the factors influencing teenage pregnancy in most of the states in the USA including Mississippi include lack of social support networks, lack of education as well as low income. Another significant factor influencing teenage pregnancy is the environment. As such, these factors should be highly considered when the policy on the reduction of teenage pregnancy is concerned. Addressing this problem would also involve a discussion of the available resources as well as social inequities. Importantly, the most effective strategy in developing policies to reduce teenage pregnancies in Mississippi would involve focusing directly on the inequalities in society rather than teenage pregnancies.

Mezey, G., Robinson, F., Gillard, S., Mantovani, N., Meyer, D., White, S., & Bonell, C. (2017). Tackling the problem of teenage pregnancy in looked‐after children: a peer mentoring approach. Child & Family Social Work, 22(1), 527-536.

This article explains that teenage pregnancy has some adverse social and health outcomes for individuals. Unfortunately, this may occur even after adjustment for prior disadvantage. As such, teenage pregnancy is considered a key public health issue in the whole world. Notably, the rate of teenage pregnancy in the UK is the highest in Europe. However, interventions have been formulated to help solve this problem. Some of these interventions include improving relationships and sex education in schools which have helped in reducing the rates of teenage pregnancies in the UK. Conversely, this decline is only perceived in the looked-after children. In the case of other children who are abandoned or who lack social support; the cases of teenage pregnancies are high. The strategy suggested in this article is the use of a system of peer mentoring. This system involves a young person who experienced a positive life post-care mentoring teenage girls in the schools. The strategy has been considered as an effective approach in reducing teenage pregnancy. Peer mentoring is highly effective since it assists the young people in making choices about their personal development, education as well as relationships. It also helps teenage girls to boost their confidence and self-esteem. That said, the government in Mississippi should consider introducing peer mentors in schools to advise teenage girls about their reproductive health.

Aventin, A., Lohan, M., O’Halloran, P., & Henderson, M. (2015). Design and development of a film-based intervention about teenage men and unintended pregnancy: applying the Medical Research Council framework in practice. Evaluation and program planning, 49, 19-30.

This article asserts that unintended teenage pregnancies are a result of complex interactions between familial, social, individual and cultural level factors. The article provides the School-based Relationship and Sexuality Education (RSE) is an effective strategy for reducing teenage pregnancy rates. Importantly, RSEs ensure holistic sexual health by providing teenagers with knowledge which helps them in making informed decisions when it comes to sexuality and relationships. Most of the Policymakers and researchers in the world have advocated for the establishment of scientifically evaluated RSE programs in schools. They argue that RSE intervention should also focus on addressing young men’s sexual needs. Mainly, it is because young men are often neglected when cases of teenage pregnancies are concerned.

National Conference of State Legislatures. (2015). Teen Pregnancy in Mississippi. Retrieved from http://www.ncsl.org/research/health/teen-pregnancy-in- Mississippi.aspx#Education%20and%20Economy

This article explains that in 2012, Mississippi was ranked third in terms of teen birth rate in the USA. In regard to this, more than 4700 teenage girls gave birth during that year. Mainly, this represents about 13 births per day. More pointedly, the public cost of adolescent pregnancies and childbirth in Mississippi as of 2010 was $ 137 million. Despite other states experiencing a decline in pregnancy rate; the USA remains the highest. More pointedly, childbearing and teen pregnancy affects the economic wellbeing of adolescent girls. It also affects the prospects of the children as well as the state. When a girl gets a child during the adolescent stage, their educational life and career goals are also affected. Further, these situations also have a considerable impact on the taxpayers.

Rubin, S. E., Coy, L. N., Yu, Q., & Muncie Jr, H. L. (2016). Louisiana and Mississippi family physicians' contraception counseling for adolescents with a focus on intrauterine contraception. Journal of pediatric and adolescent gynecology, 29(5), 458-463.

The adolescent pregnancy rate in the states of Mississippi and Louisiana are among the highest in the USA. One method that is used to reduce the rate of teenage pregnancy is the use of contraceptives. The main approach discussed in this article is the Mississippi and Louisiana family physician’s contraception counseling to the teenagers. More pointedly, the article is concerned about the use of the intrauterine contraceptive device. Notably, the design and outcome measures used in the article included carrying out an online survey of all the physician members in MS and LA Academy of FPs. The results from the survey indicated that 87.5% of the FPs discussed condoms and oral contraceptives while counseling teenagers. Only 34.6% of the FPs stated that they talked about newer and more effective methods of contraceptives such as IUD, ring, implants, and patch. Additionally, when the FPs were asked whether they could recommend the use of IUD on adolescent; many of the respondents were restrictive on that matter. There were only a few of them who agreed on considering using IUD on a teenage girl. From these results, there is a clear indication of some missed chances on the full scope of counseling on contraception by MS and LA FPs. In that case, when counseling the adolescents, FPs should consider discussing on newer and more effective methods of contraception. Also, MS and LA FPs should shun using restrictive eligibility criteria in regard to the application of IUDs on adolescent females.

Bogan, D. R., Aranmolate, R., & Mawson, A. R. (2019). Confronting the impact of teen pregnancy in Mississippi: the need for after-school programs. International journal of adolescent medicine and health .

The author of this article points out that the rates of teenage pregnancies in the USA have declined by 8% since 2014. However, rates of childbearing and teen pregnancy are abnormally high in Mississippi. Current evidence shows that after-school hours are the most significant times when teenagers engage in risky sexual behaviors. Mainly, this is the period between 3 and 6 pm. As such, this article proposes the introduction of after school programs. These programs would encompass a period of supervised activities that would help reduce the risks of STIs and teenage pregnancies. Notably, these programs would involve a multifaceted model of recreational and academic enhancement activities like youth development, service learning, and curriculum-based sex education.

Arrington, A. B., Ismail, O. H., Werle, N., Esters, J., Frederick, S., Ellis, K., & Kolbo, J. R. (2018). Sex-Related Education: Teacher Preparation and Implementation. National Teacher Education Journal, 11(1).

Negative academic and health outcomes have been linked to risky teenage sexual behaviors. Research shows that sex education programs adopted in schools are effective in curbing these behaviors. However, their effectiveness is dependent on the professional development of the individuals responsible for the evaluation and implementation of the SRE programs. In Mississippi, a sample of SRE instructors from both high and middle-level schools reported their training for implementation and adoption of laws associated with SRE. Mainly, the topics that instructors taught in the schools were found to correlate with the information they received during professional development. However, the SRE instructors stressed that they needed more professional development since they only had a few hours of training on SRE. The findings in this study also indicate that SRE instructors needed training on the specific curriculum and how to deliver sensitive and personal subjects to the teenagers. As such, the government of Mississippi should consider in-depth training for the SRE instructors to assist in reducing teenage pregnancies.

McConnell-Smith, S. L. (2015). School Administrator and Staff Member Perceptions of a Teenage Pregnancy Prevention Program.

The author of this article notes that Mississippi is among the states in the USA with the highest teenage pregnancy rates. Most of the cases are reported among teenage girls in high school. More pointedly, the article discusses some of the practices of the teenage pregnancy prevention Program in successfully lowering the rates of teenage pregnancies in Mississippi. It also analyzed the areas of improvement in the TTTP. The findings from this study indicated that TTTP has a positive influence on the students. For instance, it offered students with a structured curriculum on the abstinence approach which helped them avoid unwanted pregnancies. It also promoted small group discussions in classroom teaching which was associated with the prevention of adolescent pregnancy. One of the strengths of these programs is that it offered general support for communication. Also, the program was highly effective in the application of different instructional methods. However, areas of improvement in the program include the school staff, scheduling and parent buy-in. It is worth noting that teenage students would benefit highly from the TTTP program especially in preparing them to prevent cases of teenage pregnancy.

Colburn, J. (2019). Understanding Factors of Sexual Behaviors in Teenagers in Mississippi (Doctoral dissertation, The University of Mississippi).

This study was aimed at determining the link between sociodemographic factors and sexual habits. As such, a comparative analysis of survey data was done for both Mississippi and the USA. The article also reveals some findings of the factors influencing sex education programs and their relationship with teen’s conduct. In the article, there was the establishment of a relationship between race and alcohol usage as well as sexual initiation and gender. From the analysis of the curriculum, it is evident that there is an absence of a significant relationship between sex education and sexual behaviors. However, the findings indicated a significant relationship between sexual behaviors (birth control use, sexual initiation, and current sexual activity) and curriculum inclusive of birth control instruction. All said, there is a need for more data collection and research to support this study. Mainly, such aspects would assist in conducting an effective policy analysis of the sex education laws adopted in Mississippi.

Espiritu, E. A. (2015). Congratulations-Your Umbilical Cord Is Now State Property: A Comparative Analysis of Mississippi's Cord Blood Law and the Fight against Teen Pregnancy in the United States. New Eng. J. on Crim. & Civ. Confinement, 41, 183.

This article asserts that the government of Mississippi made some amendments to the Mississippi Child Protection Act of 2012. The provisions of the law state that, when a girl who is below 16 years gives birth to a child but fails to provide the name of the father; physicians are authorized to take blood samples from the umbilical cord and submit it to the law enforcement for DNA testing. This kind of testing would assist in nabbing the perpetrators responsible for statutory rape. Noteworthy, this law was enacted in 2013 given the problem of an increased rate of teenage pregnancies in the state. The DNA tests conducted would assist in the prosecution of the perpetrators who engage in sexual intercourse with teenage girls. However, critics feel that the act violates the privacy of both the father and the mother. Also, the language used in the law creates some gaps and unanswered questions. For instance, most people wonder how a law would expect a poor state to fund all the DNA tests. Also, people feel that this law lacks clarity. That said, it is, therefore, the duty of the Mississippi government to either strengthen the law through further amendments or scrap it off entirely and introduce other applicable laws.

Brandenburg, K. (2015). A Study of Public Opinion on Sex Education in Mississippi (Doctoral dissertation, The University of Mississippi).

Mississippi was ranked fourth in terms of the prevalence of teenage pregnancies in the USA as of 2011. This state introduced a law that mandated the teaching of sex education through either abstinence-plus method or abstinence-only in public schools. This article reviews and analyses the two methods as well as their implementation in the school's districts. Further, it analyses the leaders and parents’ opinions regarding sex education in the schools. Primarily, this was done through interviewing school administrators, leaders and parents. There was also a survey conducted on the parents in Mississippi to acquire their views about sex education and the factors that influenced such opinions. The results from this study indicate that most individuals in Mississippi did not feel knowledgeable about the sex education techniques adopted by the state. As such, many individuals and survey respondents stressed for a more comprehensive technique of sex education. In that sense, the state of Mississippi should review its current modes of sex education and introduce newer and more effective methods.

Maynard, R. A. (2018). The Costs of Adolescent Childbearing. Kids Having Kids, 285-337. DOI: 10.4324/9780429452635-10

This article explains that most of the women who give birth to children while in adolescent stage become dependent on federal assistance and have high chances of living in poverty soon. Also, their ability to get employment or advance school is lowered. As such, most of them are trapped in a dead-end and impoverished jobs. More pointedly, there are costs associated with teenage pregnancies and childbearing which are divided into personal and public costs. Some of the personal costs suffered include high school dropouts and decreased health outcomes. Also, teenage mothers only get $ 300,000 of their lifetime earnings. Some of the public costs include teenage mothers becoming increasingly dependent on government assistance. This also means that the state loses about $ 260,000 in tax revenue.It is crucial to note that teenage pregnancy and repeated teen childbearing also brings about increased medical cost. For instance, the average cost of pregnancy is $ 9,782 while public medical costs suffered by the state are about $ 695 annually.

Jeha, D., Usta, I., Ghulmiyyah, L., & Nassar, A. (2015). A review of the risks and consequences of adolescent pregnancy. Journal of neonatal-perinatal medicine, 8(1), 1-8.

This article discusses some consequences and risks of young maternal age on teenage mothers and their newborn children. The results from the study indicate that young maternal age is linked with a high risk of low birth weight, maternal anemia, emergency cesarean delivery, and infections. It is also associated with risks of postpartum depression and eclampsia. Many of the teenage mothers are in greater risks of developing autism and respiratory distress syndrome in the later stages of their life. Noteworthy, the author presents some of the factors that influence teenage pregnancies. They include the environment, culture as well as economic status. In that sense, Mississippi is a country with high populations of minority groups and low-income individuals. These are some of the factors that increase the risk of teenage pregnancies and childbearing. Therefore, the state should consider such factors when designing policies and programs to reduce the case of teenage pregnancy.

Campbell-Lewis, N., Bondurant, S. W., & Bush, F. M. (2016). Teen Pregnancy in Mississippi: A History and Analysis of Recent Legislative and Governmental Attempts to Address Different Aspects of this Issue in Mississippi. Journal of the Mississippi State Medical Association, 58(10), 318-321.

This article asserts that birth rates and teen pregnancy have been on the rise in the state of Mississippi. However, from 1991 to 2014, the rate of births reduced by 55%. Unfortunately, the birthrate in 2014 still maintained at position 48 out of the 50 states in the USA. To reduce teenage pregnancies; the government introduced Healthy Teens for a Better Mississippi together with other initiatives. It also amended some bills into laws to help enhance the prevention of teen pregnancy. Further, the government implemented legislation between 2011 and 2015 through extensive review and summary. However, the assessment of such efforts and the impact of these laws on teen pregnancy shows that there is a negligible effect on the reduction of adolescent pregnancies. As such, this calls for the government to introduce new measures and strengthen its policies and legislations to help reduce teen pregnancy in the state.

Lavin, C., & Cox, J. E. (2012). Teen pregnancy prevention. Current Opinion in Pediatrics, 1. doi:10.1097/mop.0b013e3283555bee

This article states that teen pregnancy has become a public concern for many years. Typically, the USA has experienced a decline in teen pregnancy over the last 20 years but the problem persists in some of its states. Mainly, there are differences in significant disparities and state-specific rates among the racial groups. An evaluation of the prevention interventions is crucial to assist in forming state and national policies. It is worth noting that various interventions have been formulated to reduce teen pregnancies. The most effective programs are grouped into three categories including school-linked, clinic-based and school-based interventions. Such interventions share similar features including educational aspects, individual counseling, contraceptive use, and confidential services. However, this article concludes that future initiatives for addressing teen pregnancy should be multifaceted and offer the most effective contraception to the youth engaging in sex. There is also a requirement of new family planning policies to address the special needs of various populations and promote healthy behavior.

References

Almeida, R., Lins, L., & Rocha, M. (2015). Ethical and bioethical dilemmas in adolescent health care. Retrieved 27 September 2019, from http://dx.doi.org/10.1590/1983- 80422015232071

Arrington, A. B., Ismail, O. H., Werle, N., Esters, J., Frederick, S., Ellis, K., & Kolbo, J. R. (2018). Sex-Related Education: Teacher Preparation and Implementation. National Teacher Education Journal, 11(1).

Aventin, A., Lohan, M., O’Halloran, P., & Henderson, M. (2015). Design and development of a film-based intervention about teenage men and unintended pregnancy: applying the Medical Research Council framework in practice. Evaluation and program planning, 49, 19-30.

Bogan, D. R., Aranmolate, R., & Mawson, A. R. (2019). Confronting the impact of teen pregnancy in Mississippi: the need for after-school programs.

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Running head: FINDINGS 1

FINDINGS 7

Teenage Pregnancy in Mississippi Findings

Mitchelle Baker

A Capstone Presented in Partial Fulfillment

of the Requirements for the Degree

Master of Healthcare Administration

PURDUE UNIVERSITY GLOBAL

October 2019

Introduction

It is worth noting that in 2015, Mississippi was ranked third in terms of the states with the highest teen birthrate in the USA. More pointedly, the teen birth rate in this country was almost twice that of the national average during that year. Mainly, this represents 34.8 births in the state per one thousand teens Vs. 22.0 births per 1000 adolescent girls in the whole of the USA. Never the less, most of the children born by the teenage mothers perform poorly in the schools. They also have lower birth weights and suffer a high risk of being neglected or abused. The good news is that Mississippi has perceived a decline in adolescent pregnancies since 2009. However, the rate of teen birth has continued to be one of the highest in the USA. Adolescent pregnancies and teen births attract some costs. For example, approximately four-fifths