Adolescent Population Research Articles

Fertility preservation in Malaysian pediatric cohort: a survey of healthcare providers' knowledge, practice, attitude, perceptions and barriers.

Impaired future fertility potential secondary to gonadotoxic therapies for childhood cancer is a shattering aftermath faced by childhood cancer survivors. Fertility preservation (FP) has emerged as a key to mitigate this unwelcomed sequelae. FP services catering to the needs of children and adolescents (C&A) population in developing countries are limited. Malaysia recently launched its pioneering pediatrics FP services. To evaluate healthcare providers' (HCPs) FP knowledge, practice behaviors, attitudes, perceptions, and barriers towards FP counseling/services (C/S) for the C&A cohort. A questionnaire-based study was conducted utilizing a questionnaire consisting of 51 items which was adapted from G.Quinn et al. The questionnaire was distributed both online and physically amongst HCPs in a tertiary center. Ethical committee approval was granted by the Research Ethical Committee, Universiti Kebangsaan Malaysia. A total of 102 HCPs completed the questionnaires. The majority of respondents were Malays (74.5%), females (80.4%), gynecology/pediatrics specialty (76.5%), and had children (88.2%). Nearly 72% of HCPs demonstrated good knowledge of FP. Almost 73% of HCPs consulted reproductive specialists (RES) on potential fertility issues and over 80% of HCPs referred patients who enquired on fertility issues to RES. Only 17% of HCPs practiced FP discussion, 12% reported no available person to discuss FP, and 10% of HCPs were unaware of who to discuss FP with. Patients' inability to afford FP (30.4%) tops the list of barriers to FP C/S, followed by limited available information on FP for patients (17.6%) and patients too ill to delay treatment (12.7%). Most HCPs (88.2%) demonstrated unfavorable attitudes towards FP C/S. In general, the majority of our HCP respondents demonstrated good current FP knowledge and practice behaviors. Mitigating several controversial issues in FP would improve HCPs' attitude towards FP. Main barriers to the uptake of FP C/S for C&A were patient and resource barriers. Addressing these issues by funding aid for FP procedures, increasing FP knowledge dispersion, as well as developing age-appropriate FP-related educational materials would improve FP service provision for C&A in the future. In conclusion, successful corrective action combined with strategic planning points to a promising future for Malaysia's FP services provision for C&A.

Factors associated with generalized anxiety disorder in adolescents with cultural diversity: secondary data analysis

BackgroundThe number of culturally diverse adolescents in South Korea has reached 290,000 and is increasing every year; however, they still represent only 2.5% of the total adolescent population in middle and high schools, making them a minority. Adolescents experiencing cultural diversity are psychologically vulnerable because they grow up in bicultural environments and experience prejudice. Given the nature of generalized anxiety disorder, which can be exacerbated by stress, these adolescents may face an increased risk of developing the disorder not only because of developmental stress but also because of the stress of cultural adaptation. To identify the prevalence of generalized anxiety disorder among adolescents with cultural diversity, we analyzed related factors. Based on the results, strategies have been proposed to reduce anxiety in adolescents with cultural diversity and generalized anxiety disorders.MethodsThis study used data from the 16th − 18th Korea Youth Risk Behavior Survey. Factors associated with generalized anxiety disorders were identified based on the social determinants of the health framework. Statistical analyses were conducted using IBM SPSS 25.0, and statistical methods were used for complex samples.ResultsAmong adolescents with cultural diversity, 12.8% exhibited generalized anxiety disorders. Among the structural factors, economic status, mother’s education level, and gender were significantly associated with the disorder, whereas among the psychosocial factors, suicidal ideation, depressive mood, loneliness, perceived stress level, and subjective health status were significant factors influencing it.ConclusionThe factors identified in our research can be used as a resource for the early identification of culturally diverse adolescents who are vulnerable to generalized anxiety disorders. To prevent generalized anxiety disorder among adolescents with cultural diversity, school or community nurses can implement interventions to reduce loneliness or stress management programs.

Prevalence of Abnormalities and Normal Variants in the Adolescent Knee on MRI in a Population-Based Cohort of 3800 Knees

Background: Many adolescents experience knee pain, and only some undergo detailed imaging. In this population, the prevalence of abnormalities and normal variants on magnetic resonance imaging (MRI) scans is unknown. Purpose: To investigate the prevalence of abnormalities and normal variants of the knee on MRI scans and their relationship with participant characteristics in the general young adolescent population. Study Design: Cross-sectional study; Level of evidence, 3. Methods: This study was part of an open population-based cohort study that focuses on health, growth, and development from fetal life until adulthood. Between 2017 and 2020, adolescents aged 12 to 15 years underwent MRI of both knees. These MRI scans were assessed in a standardized way for abnormalities and normal variants to determine their prevalence. Logistic regression was used to analyze the presence of abnormalities and normal variants in relation to sex, height, weight, body mass index–standard deviation (BMI-SD), and ethnicity. Results: A total of 1910 participants (median age, 13.5 years; interquartile range, 13.4-13.7 years; 52% girls) were included in this study. Of them, 370 (19.4%) participants had at least 1 abnormality or normal variant. Bone marrow edema around the knee was the most prevalent finding, affecting 140 (7.3%) participants. In 107 (5.6%) participants, nonossifying fibromas were found. A total of 43 (2.3%) participants had characteristics of Osgood-Schlatter disease, 16 (0.8%) showed characteristics of Sinding-Larsen-Johansson syndrome, and osteochondritis dissecans was found in 13 (0.7%) participants. Variants such as discoid menisci were found in 40 (2.1%) participants and a bipartite patella in 21 (1.1%) participants. There were multiple associations between abnormalities or variants and participant characteristics, including bone marrow edema being more often present in boys (odds ratio [OR], 2.44; 95% CI, 1.69-3.52) and those with a lower BMI-SD (OR, 0.85; 95% CI, 0.73-0.98). Osgood-Schlatter and osteochondritis dissecans were more often present in boys (OR, 4.21 [95% CI, 2.01-8.85] and OR, 13.18 [95% CI, 1.71-101.58], respectively). Discoid menisci were associated with a non-Western ethnicity (OR, 2.06; 95% CI, 1.07-3.96) and higher BMI-SD (OR, 2.34; 95% CI, 1.76-3.11). Conclusion: Abnormalities and normal variants on MRI scans of the knees are common in adolescents. Physicians who are involved in the treatment of adolescents with knee pain need to be aware of this prevalence so that these children will not be overtreated or misdiagnosed.

Management of Syndesmotic Ankle Injuries: Results of a Survey of Pediatric Orthopaedic Society of North America Members

BackgroundAlthough utilization of dynamic suture-button fixation for adult syndesmotic injuries has shown improved outcomes over static screw fixation, data in pediatric populations is limited. This study evaluated trends in management and identified factors influencing surgeon choice of implant for pediatric syndesmotic injuries. MethodsThe Pediatric Orthopaedic Society of North America (POSNA) members were surveyed regarding syndesmotic injury implant preferences between October 2021 and May 2022. Respondents that opted out, treated <1 syndesmotic ankle injury in the past year, or had conflicting financial obligations were excluded. Results were summarized and analyzed using logistic regression to assess for significance between years posttraining and technique preference. Odds ratios (OR) and 95% confidence intervals (CI) were calculated for significance (P-values<.05). ResultsAmong 103 respondents to the survey (with 102 complete responses), 25% were <5 years posttraining, 24% between 5 and 10 years, 21% between 11 and 15 years, and 28% ​> ​15 years posttraining. Twenty-four percent (24/102) preferred screw versus 76% (78/102) preferring suture-button implants for syndesmotic injuries. Members >15 years posttraining were 4.7 times more likely to prefer screw implants compared to members <5 years posttraining (OR ​= ​4.7; 95% CI, 1.14–19.34; P ​= ​.03). Since starting their clinical practice, 62 respondents (60%) reported an implant preference change, with avoidance of secondary surgery (46/62; 74%) and extrapolation from adult outcomes (39/62; 63%) cited as primary motivating factors. Of the 40 members with no preference change, comfort with the procedure was the primary cited reason (33/40; 83%). Among those choosing operative intervention, radiograph-based cases showed preference for the suture-button in 70%–79% of respondents for skeletally mature patients versus 71%–81% for skeletally immature patients. ConclusionsOur data shows that the shift over time from screw to suture-button implant fixation for pediatric and adolescent syndesmotic ankle injuries is largely due to interest in avoiding implant removal and extrapolation from superior outcomes seen with suture-button use in adults. Larger comparative studies of pediatric and adolescent patients treated with suture-button versus screw fixation are needed to establish standards of care for these challenging injuries. Key Concepts(1)Literature for operative syndesmotic injury management in adults has shown improved outcomes of dynamic suture-button fixation over static screw fixation, but data in pediatric and adolescent populations is limited.(2)A survey of 102 POSNA members shows that 76% prefer suture-button, 24% prefer screw fixation with members >15 years posttraining 4.7 times more likely to prefer screw fixation to members <5 years posttraining.(3)Among 62 respondents who switched implant preference during their clinical practice, avoidance of secondary surgery and extrapolation from outcomes in adults were the two most cited reasons.(4)Among 40 respondents who did not switch implant preference, comfort with the procedure was the most cited reason.(5)Comparative studies of suture-button versus screw implants for treatment of pediatric and adolescent syndesmotic ankle injuries are needed to establish an evidence-based standard of care management. Level of EvidenceLevel V: Expert Opinion

Interventions for the prevention of weight gain during festive and holiday periods in children and adults: A systematic review.

Some periods during the year, such as festive and summer holiday periods, have been associated with weight gain. We aimed to assess the effect of interventions for the prevention of body weight gain during festive and holiday periods in children and adults. A systematic search was conducted in six databases and supplementary sources until January 4, 2023. We included randomized controlled trials (RCTs), cluster-RCTs, and non-RCTs. Our primary outcome measure was the change in body weight in adults or the change in BMI z-score or BMI percentile in children and adolescents. From 4216 records, 12 primary studies (from 22 reports) met the inclusion criteria-10 from the United States, one from the United Kingdom, and one from Chile. Two studies had a low risk of bias, two moderate, seven high, and one critical risk of bias. The meta-analysis in children included four of seven studies during the summer holidays (six interventions) and showed a mean difference in BMI z-score favoring the intervention group (-0.06 [95% CI -0.10, -0.01], p = 0.01, I2= 0%, very low certainty evidence). The meta-analysis in adults included five studies during festive periods with a mean difference in weight favoring the intervention group (-0.99 kg [95% CI -2.15, 0.18], p = 0.10, I2= 89%, very low certainty evidence). This review has highlighted potential interventions to prevent the increase in body weight during holiday periods. More work is needed to improve the quality of the evidence and to extend it to countries outside of the United States and United Kingdom and to the adolescent population.

Stakeholder perspectives on managing the adolescent sleep crisis using a transdiagnostic self-management app for sleep disturbances: A qualitative follow-up study.

Sleep problems are diverse and pervasive among the adolescent population. Current sleep health interventions are ill-equipped to address the sleep crisis. We developed DOZE (Delivering Online Zzz's with Empirical Support), which is a self-management evidence-based app for sleep disturbances. In an initial study, we found that DOZE was perceived as an acceptable and effective support for teen sleep. In a qualitative follow-up study, we engaged with students and other stakeholders to understand their experiences with implementing, disseminating, and using DOZE. The study employed a combination of qualitative surveys and semi-structured interviews to students (n = 21) and stakeholders (teachers, social workers, and researchers; n = 5), respectively. Reflexive thematic analysis was used to identify themes related to experiences implementing and engaging with the app. Students reported increased sleep regularity and sleep duration after using DOZE. Facilitators included greater integration of the app with school curriculum, timing of implementation, and researcher involvement in supporting knowledge dissemination and engagement. Barriers included worries about phone use at night and normalized poor sleep patterns among adolescents. There is need to identify ways to support implementation and engagement in different communities. Researchers continue to engage with stakeholders to support timely access to sleep health interventions for adolescents.

Do Attitudes towards Gender Equality Influence the Internalization of Ambivalent Sexism in Adolescence?

Sexism during adolescence may hinder the attainment of gender equality and the eradication of violence against women. The aim of this research was to analyze the relationship between an individual's view on gender equality and the internalization of ambivalent sexism, as well as to study the impact of different types of egalitarian attitudes (sociocultural, relational, and personal) on the levels of hostile and benevolent sexism among the adolescent population. A quantitative approach with a cross-sectional design was employed in this research. The sample group consisted of 1840 students (50.1% female and 49.9% male) in Compulsory Secondary Education in Castilla-La Mancha, Spain. The results show that adolescents who endorse pro-gender-inequality attitudes exhibit greater levels of hostile and benevolent sexism than their counterparts. Conversely, adolescents adopting pro-equality attitudes leads to lower levels of ambivalent sexism. In both male and female adolescents, egalitarian attitudes at the sociocultural, relational, and individual levels have a negative impact on the internalization of sexism. It is therefore crucial for both schools and families to prioritize the instruction of egalitarian values from early childhood, as this will aid in advancing a fairer and more equal society whilst eradicating sexist biases and violence against women.

Low sensitivity of a self-report questionnaire for hand eczema in hairdressing apprentices.

The validity of the self-report questionnaire for hand eczema (HE) among Croatian hairdressers was not investigated previously, leading to uncertainty in the prevalence estimated from self-reported data. To (1) investigate the validity of the self-report questionnaire for HE in hairdressing apprentices and (2) examine the differences between apprentices who recognised their HE symptoms and those who did not. Clinical examination for HE signs on hands and wrists was performed by the Osnabrueck Hand Eczema Severity Index for 408 apprentices at four visits covering the entire schooling period. Self-report HE was based on the Nordic Occupational Skin Questionnaire. Low sensitivity (7%-37%) with high specificity (≥95%) was observed, with both measures improving from baseline to last visit. The severity of HE signs was the only factor associated with the correct identification of HE signs in analyses adjusted for previous HE signs, health-related quality of life, and atopic dermatitis (adjusted odds ratios of 1.58 with 95% confidence interval [1.06-2.35] and 1.74[1.38-2.19] at second and third follow-up visit, respectively). Self-report questionnaire for HE showed low sensitivity in hairdressing apprentices, especially at the beginning of training and in those with mild symptoms. Further validation studies following questionnaire modifications aimed at adolescent population are advised.

A Scoping Review of Vaping Among the Asian Adolescent Population.

Little is known about vaping and its associated factors among Asian adolescents worldwide. We did a scoping review of the international literature on vaping among Asian adolescents. The prevalence of Asian adolescent vaping varied by the country's e-cigarette policies: the highest prevalence in Indonesia 32.2% (ever vapers) and 11.8% (current vapers) in 2019 and the lowest in Japan with 2.1% to 3.5% (ever vapers) and 0.7% to 1.0% (current vapers) in 2017. In New Zealand, a Western country with strong tobacco control but liberal policies on vaping, the prevalence of ever vaping was 20.4%, regular vaping 4.2%, and weekly vaping 2.8% in 2019. The most common reasons for vaping in both contexts were curiosity and peer influence. The internet as a popular source of information on vaping was identified mostly in Asian studies. In Asian contexts, the most common reasons for more frequent vaping were the desire to quit smoking and the ability to vape indoors, whereas in Western countries, the top three reasons were nicotine concentration, nicotine dependence, and more daily vaping sessions. Regular monitoring and more targeted research to understand adolescents' vaping behaviors will need to be undertaken on this heterogeneous population to inform appropriate policies and regulations.

Mental health conditions of Colombian adolescent population: An approach to risk.

To determine the mental health conditions of adolescents in the city of Manizales, Colombia, and explore risk regarding gender-based differences. Quantitative, nonexperimental, descriptive research with associative scope. A total of 316 adolescents were assessed using five scales to evaluate mental health conditions: the Perceived Stress Scale, Patient Health Questionnaire-9, Generalized Anxiety Disorder Scale, Penn Alcohol Craving Scale and The Substance Dependence Severity Scale. Univariate and bivariate analysis was performed, Chi square and Odds Ratio were tested. The findings indicated that being female is a risk factor for high levels of perceived stress, depressive episodes and anxiety. Additionally, adolescents who are not attending school are at higher risk for dependence and abuse of psychoactive substances. Conversely, being female acts as a protective factor against dependence on psychoactive substances. The findings suggest a higher tendency among the participants towards experiencing depressive episodes. Regarding perceived stress, 71.5% of the participants fell into the low category, while 70.6% experienced a current episode of generalized anxiety.

When ethnic-racial discrimination from math teachers spills over and predicts the math adjustment of nondiscriminated adolescents: The mediating role of math classroom climate perceptions.

Ethnic-racial discrimination is a pernicious experience that affects discriminated adolescents' healthy human development, but the spillover consequences of discrimination on the nondiscriminated adolescent population are less clear. Adolescents who vicariously witness their classmates experience ethnic-racial discrimination from educators may question their educators' authority and classroom rules, and educators who perpetuate discrimination may engage in other practices that disadvantage the entire classroom. Thus, we posed three research questions: Did classmates' ethnic-racial discrimination from teachers predict adolescents' classroom adjustment outcomes (e.g., class grades, test scores, and engagement), did classroom climate mediate the link between classmates' ethnic-racial discrimination and adolescents' classroom adjustment outcomes, and did the results differ between early versus middle adolescents? To answer these research questions, the present study leveraged longitudinal data among 1,539 adolescents (Mage = 13.81, SDage = 1.49; 60% Black, 30% White, 9% other, 1% Asian; 49% female, 51% male) nested in 104 math classrooms, as math is a subject domain with pervasive ethnic-racial stereotypes about students' abilities and opportunities to succeed in class. Results illustrated that direct and vicarious ethnic-racial discrimination from math educators in the fall semester predicted worse math course grades, state-administered standardized test scores, and classroom engagement across the fall and spring semesters. Math classroom climate perceptions mediated the longitudinal relations between ethnic-racial discrimination and their math adjustment outcomes, and the role of ethnic-racial discrimination varied across different developmental stages of adolescence. Implications for the measurement of ethnic-racial discrimination in the classroom context and the social contagion linked to ethnic-racial disadvantage are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Comparison of Self-Care Practices and BMI between Celiac and Non-Celiac Adolescent Populations.

Celiac disease (CD) is a chronic gastrointestinal disorder that is most frequently found in Western countries, and the only treatment available today is a lifelong gluten-free diet (GFD). The main aim of the present study is to compare the self-care practices and body mass index (BMI) of adolescents with CD and without CD in different dimensions (physical, psychological, social, and management). The non-probabilistic sample included 236 participants (118 with CD) aged between 12 and 16 years old, who were part of the project "Role of the family in the perception of youth self-care". The data were obtained through the self-administration of the Practice and Management of Youth Self-care questionnaire, while the celiac population also completed the Adherence to a Gluten-Free Diet (GFD) questionnaire. The celiac population analyzed showed significant correlations between the Physical Practices and Management with adherence to a GFD, and between a GFD and Psychological Practices. Differences were observed between the celiac and the non-celiac populations in the dimensions of Physical Practices, Social Practices, and Management. With respect to BMI, age and CD showed a significant influence of a GFD on BMI (p < 0.001). In conclusion, the application of multi-dimensional questionnaires and their relationship with the adherence to a GFD provide valuable information to propose interventions directed to this population.

Perceptions of neighborhood disorder and gun carrying during adolescence: The indirect effect of exposure to violence

ObjectiveAs society strives to curb gun violence among adolescents, understanding the risk factors associated with gun carrying is of critical importance. The current study seeks to examine the relationship between perceived neighborhood disorder and adolescents' susceptibility to carrying a gun to school. More specifically, the aim of the current study was threefold: (1) to examine the direct relationship between perceived neighborhood disorder and exposure to violence, (2) to investigate the association between perceived neighborhood disorder and gun carrying, and (3) to test the mediating effect of exposure to violence on the relationship between perceived neighborhood disorder and gun carrying. MethodsData from waves I and II (1994–1996) of the National Longitudinal Study of Adolescent to Adult Health was analyzed (N = 11,887). Due to the binary nature of the mediating and dependent variables (i.e., exposure to violence and gun carrying) a series of logistic regression models were estimated. ResultsOur analyses revealed that perceived neighborhood disorder is positive and significantly associated with, both, exposure to violence and gun carrying. The relationship between perceived neighborhood disorder and gun carrying was fully mediated by exposure to violence. ConclusionsWhile neighborhood disorder is a risk factor for gun carrying among youth, exposure to violence explains the relationship between perceived neighborhood disorder and carrying a gun to school. To reduce the prevalence of gun carrying and gun violence among the adolescent population, mental health resources should be provided to those who reside in communities with high levels of disorder and violence.

Longitudinal Associations Between Cyberbullying Victimization and Cognitive and Affective Components of Subjective Well-Being in Adolescents: A Network Analysis

In recent years, there has been a notable increase in studies aimed at investigating the relationships between cyberbullying and subjective well-being (SWB) among adolescent populations. Nonetheless, the existing literature on this topic remains relatively sparse. Consequently, this study aims to explore the prospective associations of these constructs through the application of psychometric network analysis. Two cross-lagged network analyses were conducted (Wave 1 and Wave 2), alongside a longitudinal network analysis, encompassing 888 students aged 12 to 16 years (M = 12.61; SD = 1.79) from five secondary educational institutions. The results from both cross-lagged networks at both time points revealed significant associations among overall life satisfaction (OLS) and the various domains of life satisfaction, thereby reinforcing the central role of OLS within the network architecture of adolescent well-being. Regarding the affective component of SWB, “happy” emerged as the affect demonstrating the highest level of influence and impact at both time points. Additionally, a robust temporal consistency of the network structure was observed. In the longitudinal network analysis, the trajectories of the variables across time indicated that forms of cyberbullying, specifically “exclusion” and “harassment,” were prospectively and negatively related to “satisfaction with friends” and “satisfaction with body image.” The results of these findings are discussed in terms of their practical implications for the prevention and intervention of cyberbullying in adolescent population.

Is lipoprotein(a) measurement important for cardiovascular risk stratification in children and adolescents?

BackgroundElevated lipoprotein (Lp(a)) levels are associated with increased risk of atherosclerotic processes and cardiovascular events in adults. The amount of Lp(a) is mainly genetically determined. Therefore, it is important to identify individuals with elevated Lp(a) as early as possible, particularly if other cardiovascular risk factors are present. The purpose of the study was to investigate whether, in a population of children and adolescents already followed for the presence of one or more cardiovascular risk factors (elevated blood pressure (BP), and/or excess body weight, and/or dyslipidemia), the measurement of Lp(a) can be useful for better stratifying their risk profile.MethodsIn a sample of 195 children and adolescents, height, body weight, waist circumference and systolic (SBP) and diastolic (DBP) BP were measured. Body Mass Index (BMI) and SBP and DBP z-scores were calculated. Plasma Lp(a), total cholesterol, high-density lipoprotein (HDL), triglycerides, glucose, insulin, uric acid and creatinine were assessed. Low-density lipoprotein (LDL) cholesterol was calculated with the Friedewald formula. High Lp(a) was defined as ≥ 75 nmol/L and high LDL cholesterol as ≥ 3.37 mmol/L.ResultsOur sample of children and adolescents (54.4% males, mean age 11.5 years) had median LDL cholesterol and Lp(a) values equal to 2.54 (interquartile range, IQR: 2.07–3.06) mmol/L and 22 (IQR: 7.8–68.6) nmol/L respectively. 13.8% of children had LDL cholesterol ≥ 3.37 mmol/L and 22.6 Lp(a) values ≥ 75 nmol/L. Lp(a) values were higher in children of normal weight than in those with excess weight (p = 0.007), but the difference disappeared if normal weight children referred for dyslipidemia only were excluded from the analysis (p = 0.210). 69.4% of children had normal Lp(a) and LDL cholesterol values and only 6.2% showed both elevated Lp(a) and LDL cholesterol levels. However, 16.6% of the sample, despite having normal LDL cholesterol, had elevated Lp(a) values. Multivariable analyses showed a significant association of LDL cholesterol both with Lp(a) values, and with the presence of elevated Lp(a) levels. For each mmol/L increase in LDL cholesterol the risk of having an elevated Lp(a) value increased by 73%. There was an inverse correlation between BMI z-score and Lp(a). Neither BP z-scores, nor other biochemical parameters were associated with Lp(a).ConclusionsIn our population more than one out of five children had elevated Lp(a) values, and in about 17% of children elevated Lp(a) values were present in the absence of increased LDL cholesterol. Our results suggest that Lp(a) measurement can be useful to better define the cardiovascular risk profile in children and adolescents already followed for the presence of other cardiovascular risk factors such as elevated BP, excess body weight and high LDL cholesterol.

Juvenile Delinquency and Recidivism: An Overview

Recidivism in juveniles is a legal notion in criminal law. Juvenile refers to someone under theage of 18 the definition of an adult varies from nation to nation. In India, the Juvenile Justice Actmandates that juveniles convicted of misdemeanors be housed in institutions that offer therapeutic,educational, and vocational programs.The presence of a criminal milieu has influenced many young people to turn to criminal activity as ameans of self-expression. In this paper, we discuss two variables that contribute to juvenile recidivism.Firstly, in the adolescent population, a lack of parental oversight contributes to criminalmisbehaviour. Juvenile recidivism is fueled by peer pressure. Teenagers who are unemployed or earninglow wages are more likely to commit crimes. Secondly, mental health of juveniles is also a hot topicinternationally. Suicidal thoughts and behaviours are exacerbated by mental health issues. Depressiveillnesses, juvenile detention, and other societal issues combine to create a climate where youth rush toterminate their lives.In light of the 2012 Delhi rape case and after much debate, intensive conversation, and demonstrations,Indian Parliament enacted the Juvenile Justice (Care and Protection of Children) Act 2015. The authorhas explained that howjuveniles can now be disciplined using new methodsunder new legislation andadequately implementing existing ones.

Management of cubitus varus deformity by three-dimensional osteotomy: analysis of outcome

Background: Cubitus varus deformity, commonly resulting from malunited supracondylar fractures of the humerus, is prevalent in pediatric and adolescent populations. Traditional treatment methods often fall short in addressing the complex three-dimensional nature of this deformity. This study aims to evaluate the efficacy and outcomes of three-dimensional osteotomy in correcting cubitus varus deformity. Methods: This prospective interventional study was conducted at the Department of Orthopaedic Surgery, BSMMU, Shahbag, Dhaka, from March 2016 to September 2018. A total of 40 patients aged 8 to 20 years with cubitus varus deformity were enrolled. Participants underwent three-dimensional osteotomy, and outcomes were assessed using the Mayo Elbow Performance Score (MEPS) and functional recovery parameters. Results: The majority of patients (75%) achieved bone union within 8-10 weeks post-osteotomy. The MEPS results were promising, with 40% of patients scoring 'Excellent' and 45% scoring 'Good'. Functional outcomes were predominantly positive, with 95% of patients reporting satisfactory results. The complication rate was low, with 80% of patients experiencing no postoperative complications. Conclusions: Three-dimensional osteotomy is an effective and reliable surgical intervention for treating cubitus varus deformity, offering high rates of patient satisfaction, minimal complications, and improved functional outcomes. This technique presents a promising option for orthopedic surgeons in managing this complex deformity.

A Comparison of Two Methods of Dental Age Estimation in a Population of Saudi Children and Adolescents.

This study aimed to compare and evaluate the accuracy of the Demirjian (DE) and the London Atlas (LAE) dental age estimation methods in a Saudi population sample. This retrospective cross-sectional study used digital radiographs from electronic health records in three different dental institutes. In total, 357 male and 354 female (ages 5-15 years) digital orthopantomograms were selected for age estimation. The mean difference between the chronological age (CA) and age estimation method among males and females was 0.03 ± 0.34 and 0.00 ± 0.34, respectively, for LAE and 0.55 ± 0.84 and 0.76 ± 0.51, respectively, for DE. The mean difference between the LAE and DE methods among males and females was 0.52 ± 0.89 and -0.76 ± 0.57, respectively. No statistically significant difference between CA and LAE was found in either males (p = 0.079) or females (p = 0.872). A statistically significant difference was found between CA and DE in both genders (p < 0.001). A statistically significant difference was found between the LAE and DE groups (p < 0.001) in both genders. An overestimation of dental age was observed with DE compared with that in CA. LAE showed higher accuracy than CA, with no clinically significant difference. Although the difference between the LAE and DE methods was insignificant, the LAE method proved to be more accurate.

Location, location, location: predictors and risk factors associated with adolescents referred for firesetting at home and away from home

In New Zealand, adolescents contribute to almost half of property damage caused by fire. Data on firesetting location (at-home or away-from-home) of adolescents (aged 12–18 years), referred to a fire-awareness intervention programme (N = 2696), were analysed using chi-square and logistic regression. Characteristics of the ‘at-home’ group (93% male; mean age 13.5 years) included setting a fire alone; a history of misusing fire; a history of a psychiatric diagnosis; no history of offending; firesetting motivated by experimentation; and identifying as non-Māori/non-Pacific. Conversely, the ‘away-from-home’ group (88% male, M age = 13.8 years) were predicted by firesetting with peers; this being their first misuse of fire; negative feelings (fear, shame) after the fire; an offending history; firesetting motivated by peer pressure; and identifying as Māori 1 or Pacific. Finding distinct subgroups within the adolescent firesetting population enhances opportunities to appropriately target interventions.

Evaluation and Management of Glenohumeral Instability in Adolescent Patients: An Expert Consensus Statement.

Management of glenohumeral instability in the adolescent population can be both challenging and controversial. There are no current guidelines for optimal management of glenohumeral instability in this population (unidirectional or multidirectional), and the cutoff ages for transition to adult treatment are not known. To develop consensus-based guidelines for the management of glenohumeral instability in adolescents. Consensus statement. A 26-question, multiple-choice survey was developed after 2 rounds of iterations and was submitted to the orthopaedic surgeons of the Pediatric Research in Sports Medicine (PRiSM) Society. The survey comprised 3 sections-demographics, practice setting, and decision-making-and included cutoff ages and management in 5 specific case scenarios. Consensus-based guidelines were generated with 66% response agreement. An indication score was then applied to each response related to more aggressive management to determine if variables related to consensus (or lack thereof) could be identified. A total of 54 responses were returned. Of the respondents, 59% were from academic practice, 84% were pediatric orthopaedic fellowship trained, and 46% performed >25 shoulder instability cases per year. In the setting of first-time anterior shoulder dislocation, nonoperative treatment was preferred for boys aged <14 years and girls aged <13 years. Besides age, proximal humerus physeal status, injury mechanism, sport, and presence of bony injury affected treatment selection. The presence of a Bankart lesion was an indication for stabilization in first-time dislocations for contact athletes with a closing or closed physis, but not in patients with an open physis or noncontact injury mechanisms. For recurrent anterior shoulder dislocation, stabilization was preferred irrespective of physis status. Initial nonoperative treatment was preferred for multidirectional instability. In the setting of first-time anterior shoulder dislocation in patients with open physes, nonoperative treatment was preferred for boys <14 years and girls <13 years. Future multicenter prospective studies focusing on outcomes would help to validate current practice patterns, especially in scenarios for which no consensus was reached.