Adolescent Children Research Articles

Adolescent child custody loss and substance use treatment as predictors of young adult substance use trajectories among females with foster care and juvenile justice involvement

This study aimed to identify trajectories of substance use from adolescence to young adulthood among 166 females with dual child welfare and juvenile justice system involvement, and to explore the influence of adolescent child custody status and substance use treatment on substance use trajectories. Results identified four substance use trajectory groups (stable moderate substance use, decreasing substance use, increasing substance use, stable high substance use). Custody loss during adolescence predicted membership in the stable high substance use trajectory group (log odds estimate = 2.99, p = < 0.01). No significant associations were found with adolescent substance use treatment. The findings can inform policymakers, foster care professionals, and law enforcement officers to promote the delivery of timely and appropriate substance use services that respond to the unique needs of females across the child welfare and juvenile justice system populations.

The Relationship of Rejection Sensitivity to Depressive Symptoms in Adolescence: The Indirect Effect of Perceived Social Acceptance by Peers.

Rejection sensitivity (RS), the tendency to expect, perceive and overreact to rejection from others, has been linked to children's and adolescents' increased vulnerability to depressive symptoms, negatively affecting their perceptions of the quality of their relationship with their peers. The aim of this study is to examine (a) the indirect effect of perceived peer social acceptance in the relationship between RS and depressive symptoms in a sample of Greek adolescents, (b) the differential effect of the different components of rejection sensitivity (angry and anxious RS) on the model, and (c) possible gender differences. The sample of the study consists of 295 adolescents (139 boys, 156 girls, Mage = 14.20, SD = 1.60) residing in the greater Heraklion Prefecture area. Data collection was carried out using self-report questionnaires that measured demographic characteristics, self-perceptions about their peer relationships (self-perception profile for adolescents/SPPA), susceptibility to rejection (children's rejection sensitivity questionnaire/CRSQ), and depressive symptoms (children's depression inventory/CDI). Results showed that (a) RS was positively related to depressive symptoms and negatively related to adolescents' perceptions of their relationships, (b) relationship perceptions were negatively related to depressive symptoms, and gender differences were also found, (c) perceived social acceptance by peers was found to have an indirect effect in the relationship between RS and depressive symptoms, with girls showing a greater effect, and (d) differences were observed in the mediating model between the components of RS, with the mediating effect of perceptions being higher in the model with anxious RS, which appears to confirm previous theoretical postulations. The results of this study highlight the importance of adolescents' perceptions of their peer relationships in the occurrence of depressive symptoms during this developmental period, especially in youths with anxious rejection sensitivity.

Racial discrimination as a sociocultural barrier to leisure-based physical activity among West African immigrant children: proposing an adaptation model

ABSTRACT Racism is a determining factor for health disparities and has an impact on leisure-based physical activity, particularly for recent immigrants adapting to socio-environmental systems in a host country. The purpose of this study was to gain a deeper understanding of the impact of the sociocultural environment on active living among African adolescent children and further explore related pre- and post-migration experiences. Using purposive sampling, parents and children from Western-African families were interviewed. A constructivist grounded theory was used to create an adaptation model, which portrayed an idealized representation of internal, external, and transitional factors shaping physical activity engagement and opportunities of the children’s active living. The adaptation model demonstrated the role of structural external factors such as perceived discrimination on leisure participation, with an interconnection with intrinsic motivation and resiliency, while elucidating the moderating effect of transitional factors such as cultural adaptations between pre- and post-migration experiences.

Superior mesenteric artery syndrome (Wilkie’s syndrome) in children, as a late complication of neuropsychic diseases

Superior mesenteric artery syndrome (SMAS) in children is a rare cause of chronic duodenal obstruction (CDO), in which the inferior horizontal branch of the duodenum is compressed between the aorta and the acutely angled superior mesenteric artery. There are not many publications of clinical cases of SVBA in the literature, especially in the pediatric population. The main cause of the disease is weight loss due to various reasons, including anorexia nervosa, trauma, burns and other conditions. Currently, there is a frequent association of the syndrome with mental disorders. Literature data on the treatment of SVBA associated with various psychosomatic conditions vary; both conservative and surgical treatment methods are used. We present two clinical cases of SVBA in adolescent children, in which the cause of patient weight loss was concomitant mental disorders and previous surgical interventions. Both patients underwent laparoscopic side-to-side duodenojejunostomy with good long-term treatment results, confirmed during follow-up examination.

Adolescent General Efficacy Scale for Parents (AGES-p): Adaptation and Spanish Validation

It has been well documented in the literature that parental cognitions contribute in central ways to child development and adjustment. Nevertheless, there are no other questionnaires in the Spanish context that measure parents’ perceptions toward their adolescent children’s efficacy. This study aims to develop and validate a new scale to measure parents’ perceptions toward their adolescent children’s efficacy. A total of 594 Spanish parents and their children aged between 11 and 16 years completed the General Self-Efficacy Scale (GSE), the Adolescent General Efficacy Scale for Parents (AGES-p), and the Adolescent Future Expectations Scale for Parents (AFES-p). Non-probability convenience sampling was used. We kept similar proportions in our sample when selecting participating schools (75.90% State schools and 24.10% private schools). The psychometric properties of the AGES-p scale were examined using Exploratory and Confirmatory Factor Analysis. We obtained a unidimensional factor structure, which explains 66.77% of the variance. This means that most of the observed variance in item responses is explained by a single latent construct. The reliability (α = 0.926) and convergent validity of the scale were found to be high. It can be observed that there are positive and significant correlations between AGES-p and the questionnaires used: GSE (r = 0.268) and AFES-p (r = 0.508).The AGES-p has the potential for evaluating parents’ perception toward their children’s efficacy. This scale in the Spanish context provides a new measurement instrument to the field of family evaluation, applicable both to research and psychoeducational, clinical, and social interventions.

To determine the various causes of thrombocytopenia and its clinical correlation with bleeding in children and adolescents

Thrombocytopenia refers to a reduction in platelet count below 1,50,000/cumm. It is the most common cause of defective primary hemostasis that can lead to significant bleeding in children. It was a retrospective observational study conducted in a tertiary care hospital in Bhilai, chattisgarh between Augusts to December 2021. Data collection was done from Sept 2018-Sept 2019. The aim of present study was to determine the various causes of thrombocytopenia in children and adolescents and to correlate its severity with etiology and risk of bleeding. Total 112 patients were included from age group 1y-18 yrs. Out of total 112 patients 59 were males and 53 were females. 27 patients were 1-5 years of age, 30 patients were 6-12 years of age and55 were 13-18 years. The mean platelet count in my study was 68,340/cumm with a minimum of 4000/cumm. Bleeding was present in total 19 (16.9%) patients. The main bleeding manifestations were petechie or purpurae, epistaxis, ecchymosis, gastrointestinal bleed and others. Severity of thrombocytopenia correlates significantly with risk of bleeding (The p-value is 0.001**). The most common cause of thrombocytopenia in 69 patients with fever were infective and 43 patients without fever it was vitamin b12 deficiency. Severity of thrombocytopenia (p=0.0528) and bleeding (p=0.121) in patients with fever and without fever was not significant. Thrombocytopenia in pediatric and adolescent children is caused by both infective and non infective illness. It mainly presents with cutaneous bleeds and mucosal bleeds. Severity of thrombocytopenia is significantly correlated with bleeding.

Adapting the Planetary Health Diet Index for children and adolescents

BackgroundTools for measuring adherence to sustainable healthy diets among children and adolescents are lacking.ObjectiveTo advance methods for measuring adherence to sustainable healthy diets among children and adolescents by adapting an existing index, compare scores obtained using the original and adapted versions of the index in a sample of Chilean children, and describe the adapted index association with diet characteristics.MethodsThe Planetary Health Diet Index (PHDI) was adapted to better reflect children's and adolescents’ nutritional requirements. The adapted index (PHDI-C) comprises 16 components with a maximum score of 150 points. PHDI-C was piloted among a sample of 958 Chilean children (3–6 years) using dietary data collected in 2016 through single 24-h recalls. A decision tree and food disaggregation methodology were developed to guide the calculation of scores. Scores obtained using the original and adapted versions of the index were compared. Linear regression models adjusted by child’s gender and age were fitted to explore associations between total PHDI-C score, dietary recall characteristics and nutritional composition of children’s diets.ResultsPHDI accounted for 75.7% of children’s total caloric intake, whereas PHDI-C accounted for 99.6%. PHDI & PHCI-C scores were low among this sample of children; however, mean total score was lower when using PHDI compared to PHDI-C [40.7(12.1) vs 50.1(14.6)]. Children’s scores were very low for nuts & peanuts, legumes, dark green vegetables, whole cereals, tubers & potatoes, and added sugars components across both indices, but were higher for dairy products and eggs & white meats components when using the PHDI-C due to adjustments made to ensure nutritional adequacy. Mean total PHDI-C score was significantly lower on weekends and special occasions, and significantly higher when children reported having a special diet (e.g., vegetarian). Total PHDI-C score was negatively associated with total sugars, saturated fats, trans fats, and animal-based protein intake, and positively associated with total protein, plant-based protein, total carbohydrates, and total fibre intake.ConclusionsThis study provides a replicable method for measuring adherence to sustainable healthy diets among children and adolescents that can be used to monitor trends and measure the effectiveness of actions targeting improving children’s diets.

A systematic review reveals that African children of 15–17 years demonstrate low hepatitis B vaccine seroprotection rates

Childhood HBV immunization remains globally fundamental to the elimination of hepatitis B virus (HBV). However, monitoring proportions of HBV vaccine seroprotection and their determinants among African Pediatric recipients is crucial. This study sought to verify extent of immune protection accorded by the HBV vaccine in African children of up to 17 years of age by pooling the prevalence of seroprotection reported by primary studies conducted in the Northern, Western, and Southern African regions. We included 19 eligible articles out of the 197 initially downloaded, published from 1999 to 2021 from African Journals Online (AJOL), EMBASE, Scopus, and PubMed. The study protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO), University of York Centre for Reviews and Dissemination, under the registration number CRD42022361277. Significantly higher (p < 0.0001) proportion of HBV vaccine seroprotection (69.07%) was found among children under 15 years of age than children 15–17 years (32.368%), 95% CI [34.2454–39.0847%]. Whereas successful integration of the HBV vaccine on the extended programs on immunizations (EPI) has been a major achievement in the reduction of HBV infection in Africa, markedly reduced HBV vaccine seroprotection is persistently demonstrated among adolescent children 15–17 years of age. Future studies are required to clarify the need for booster dose vaccination in most at risk populations and age groups.

ANALYSIS OF MORAL VALUES IN THE JAWI SERIES AWAK AND ABU ACCORDING TO THE THEORY OF VALUES

This study analyses the pure values of the life of a kind of fruit, namely bananas, based on a series of Jawi reading Awak and Abu by Che Siah Che Man and Janudin Sardi. The book targets the youth and the beginning of an international view of the preparation that uses the language Malay (Jawi), English and Arabic. This analysis aims to see the inculcation of noble values in work to shape children's and adolescents' morals. This study found that the storyline, dialogue and situation touch on pure values, such as the values of love, family, friendship, hardworking, cleanliness, sacrifice, gratitude, cooperation and high prudence. Hopefully, this study will contribute to readers and educators, such as teachers and parents, on the importance of teaching good values to children and adolescents.

Extending the Knowledge Gap Hypothesis to Narrative Persuasion: Parents' Information-Seeking Intention and Learning About Adolescent Children's Covid-19 Vaccination.

The gap in knowledge and information-seeking between high and low socioeconomic status (SES) has been well documented. This study extends this knowledge gap hypothesis to narrative persuasion in the context of parents' knowledge and information-seeking intention concerning adolescents' COVID-19 vaccination. It specifically tests if the gap is moderated by a message type (narrative vs. non-narrative). An online quasi-experiment, with a 2 (participants' education level: high vs. low) × 3 (message type: narrative vs. non-narrative vs. no-message) between-subject design, showed a main effect of education level (i.e., parents with a higher [vs. lower] education level rated a higher intention to seek information and provided more correct answers on questions about adolescents' COVID-19 vaccination) and an interaction between the two factors. The interaction showed that the gap between high- and low-education groups in information-seeking intention disappeared among those who read the narrative or non-narrative, and the gap in knowledge disappeared among those who read the narrative. Study findings suggest the utility of narratives in narrowing the gap in knowledge and information-seeking to improve parents' decisions on child vaccination.

Single points of access to fill the "GAP" for unattached patients in primary care: What makes paediatric users more likely to require a medical appointment?

Unattachment to a regular primary care professional can affect children's and adolescents' well-being, considering their unique health needs. Having no alternative, many turn to emergency departments for non-urgent conditions. To help unattached patients access healthcare services while on waitlists, Quebec's government implemented single access points in each administrative region across the province. Our study aimed to describe the paediatric population using single access points and identify associations between their characteristics and need for a medical appointment. Clinical-administrative data of 1,323 paediatric access point users in the Montérégie region from November 2022 to March 2023 were utilized to conduct bivariate and multivariable regression analyses. Our study showed that young age, assessment trajectory, and specific reasons for calling were more likely to necessitate a medical appointment. While access points improve accessibility to doctors, questions remain regarding the relevance of medical consultations, inequities, and possible security issues resulting from the overall process.

Assessing the Impact of a Serious Game (MedSMARxT: Adventures in PharmaCity) in Improving Opioid Safety Awareness Among Adolescents and Parents: Quantitative Study.

The opioid crisis continues to worsen across the United States, affecting people of all demographics. Few evidence-based interventions exist for educating families, particularly those with adolescents, about opioid prescription safety. Serious games have demonstrated impacts in improving medication-related outcomes for various health conditions. The characterizing goal of this serious game is to improve opioid safety knowledge and awareness among adolescents and their families. This study evaluated the impact of a serious game, MedSMARxT: Adventures in PharmaCity, designed to foster opioid safety awareness among adolescents and their parents. A national sample of parents and their adolescent children was recruited through Qualtrics research panels, social media, listservs, and snowball sampling. Eligible participants were adolescents aged between 12 and 18 years and their parents. Study participants were required to reside in the United States; speak, read, and understand English; and have access to a computer with a webcam. Parent-child dyads completed pregame and postgame surveys and participated in gameplay for up to 30 minutes. Primary outcome scales have been previously evaluated by the study team. A total of 60 adolescent participants and 68 parent participants met full attention criteria for inclusion in this study. Statistical analysis confirmed that both adolescents' and parents' concept scores improved from baseline regarding opioid safety self-efficacy (adolescent: mean 0.35, SD 0.60; P<.001; parent: mean 0.28, SD 0.42; P<.001), perceived knowledge (adolescent: mean 1.08, SD 1.04; P<.001; parent: mean 0.56, SD 0.55; P<.001), behavioral intent (adolescent: mean 0.26, SD 0.39; P<.001; parent: mean 0.25, SD 0.32; P<.001), safe storage (adolescent: mean 0.12, SD 0.27; P<.001; parent: mean 0.03, SD 0.11; P=.03), disposal knowledge (adolescent: mean 0.10, SD 0.27; P=.006; parent: mean 0.07, SD 0.16; P<.001), and knowledge about misuse behavior (adolescent: mean 0.05, SD 0.14; P=.002; parent: mean 0.04, SD 0.10; P<.001). Participant groups, stratified by who completed and who did not complete gameplay, improved their knowledge and awareness, with no significant differences between subgroups. The use of this serious game to improve opioid prescription safety practices among parents and adolescents was supported by the study findings. MedSMARxT: Adventures in PharmaCity is an intervention with the capability of teaching parents and adolescents about safe opioid prescription practices. Further studies and game refinement are needed to demonstrate the effectiveness of a game-based intervention in clinical settings and community pharmacies.

Best practice for improving children's and adolescents’ sport skills with motor imagery

ABSTRACTOver the past 50 years, a large number of studies have been carried out on the use of motor imagery practice (also called mental practice) to train motor functions. Because of its proven effectiveness for motor learning in adults, many researchers have investigated whether this technique can also improve the motor (especially sport) performances of children and adolescents. Although there is evidence that mental practice positively affects motor learning in young athletes, questions remain about the best way of implementing this type of training when participants’ motor imagery and cognitive functions are not yet fully developed. We reviewed the literature on mental practice in typically developing children and adolescents. Based on our findings, we then drew up a list of recommendations and guidelines for practitioners and coaches to develop effective motor imagery interventions for young athletes. Unresolved issues, methodological limitations of empirical studies, and research perspectives in the field of motor imagery training are discussed.

A Descriptive Study to Assess the Level of Knowledge regarding Motivational behaviour among Urban Parents towards Their Adolescent children in Academic Performance

Parental involvement and genuine interest in an adolescent’s school life has a significant influence on this academic performance and ability to focus and efficiently manage homework. Brown and Lyengas (2008) noted that adolescents who look parental acceptance, behavioural supervision and psychological autonomy start out at a disadvantage by lacking vital skills needed to he academically successful. Adolescents gain and build upon values and academic goals based on those of parents.The purpose of this research was to analyse how presented involvement of presenting styles influencing adolescent’s academic performance, Objectives are to assess the level of knowledge regarding motivation behaviour among urban parents towards their adolescents children, to find out the association between the level of knowledge regarding motivational behaviour among urban parents towards their adolescent’s children with selected demographic variables.. A descriptive design was adopted to assess the level of knowledge regarding motivational behaviour among the urban parents towards their adolescent children in academic performance. The findings were that the level of motivational behaviour among parents revealed that 7% of women had adequate knowledge 90% of women had moderate knowledge 3% of women had inadequate knowledge.

Профілактика поведінкових факторів ризику серед дітей та підлітків у практиці сімейного лікаря і педіатра

The medical model of prevention among adolescents in the practice of a family physicians is focused on the medical and social consequences of behavioral risk factors and involves a multidisciplinary approach, interaction with the non-governmental sector, and the development of youth volunteerism. The introduction of new teaching methods, including the «project method», contributes to the formation of professional competence of future family physicians at the undergraduate level. The goal is to analyze the main problems of prevention of behavioral risk factors among adolescent children, the role of the family physician and pediatrician, the effectiveness of implementing the project method in teaching the discipline «general practice-family medicine» at the undergraduate level. Materials and methods. We have analyzed the main components of the family doctor’s preventive work among teenagers. The method of project activity of sixth-year students was implemented in the practical training of students. The basis of the application of project technology was the presence of a problem of medical and social factors affecting the health of a teenager, which requires integrated knowledge and a research search for its solution. Students created and implemented medical and social prevention projects among teenagers. The results. As a result of working on the project, the students found a specific solution to the problem and a specific result suitable for implementation. This approach creates conditions for creative development and self-realization of students, formation of all necessary professional and general life competencies. Conclusion: 1.A comprehensive approach to preventive measures among adolescents is an important component of maintaining the health of adolescents. 2. The problems of medical and social factors affecting adolescent health include not only the work of a family doctor and pediatrician or government regulation, but also interaction with the non-governmental sector and the development of youth volunteerism. 3. Participation in preventive measures among teenagers of sixth-year students through the implementation of the project method helps them master basic knowledge, ensures the formation of professional competences, communicative and social skills, skills, and creative abilities.

Desistance from physical abuse in a national study of Nepal: Protective informal social control and self-compassion

BackgroundResearch on the conditions under which perpetrators desist from child maltreatment has seen greater attention as part of the efforts to break the cycle of maltreatment. New theoretical insights suggest that informal actions (herein protective informal social control of child maltreatment) by network members which communicate warmth, empathy with victim distress, and promote the modeling of positive parenting practices are more likely to increase maltreatment desistance. Likewise, parents' desistance from maltreatment is theorized to impact on adolescents' (victim) cognition and self-compassion. ObjectiveThis study examined the relationship among protective informal social control of child maltreatment (protective ISC_CM) by social networks, physical abuse desistance, and adolescent self-compassion. Participants and settingA nationally representative sample of 1100 mothers and their adolescent children (aged 11–15) in Nepal was obtained. MethodsQuestionnaires were administered to mothers and their adolescent children independently. Hypotheses were tested using regression models with standard errors corrected for clustering within wards. ResultsMore than 1 in 7 mothers reported perpetrating physical abuse in the past year, and 1 in every 5 adolescents reported being victims of physical abuse. Odds of abuse desistance increase by roughly 10 % for each act of protective ISC_CM reported by the mother. Also, odds of abuse desistance associated with higher adolescent self-compassion, and acts of protective ISC_CM associated with higher levels of adolescent self-compassion. ConclusionThe findings suggest that interventions to boost desistance from maltreatment and break the cycle of abuse in Nepal, should focus on promoting protective informal social control actions.

The Impact of Montelukast’s Black Box Warning on Pediatric Mental Health Adverse Event Reports

OBJECTIVE In March 2020, the US Food and Drug Administration (FDA) required a black box warning for montelukast due to serious mental health side effects. We hypothesized the warning would lead to an overall decrease in reports of mental health symptoms and disorders related to montelukast in both ­pre-adolescent and adolescent groups. METHODS Adverse events of pre-adolescent and adolescent children taking montelukast sodium were reviewed from March 1, 2018 to March 3, 2020 and March 4, 2020 to February 28, 2022 using the FDA’s Adverse Events Reporting System. The objective was to determine if mental health adverse event reports were influenced by placement of a Boxed Warning. Adverse reactions were grouped into 8 categories deemed to be related to mental health guided by the research team’s interpretation of the FDA Sentinel Report. Chi-square tests were used to compare time periods and reports of the mental health categories. RESULTS Of the 1570 reports assessed, 1295 (82.5%) included ≥1 mental health concern. Nine hundred ninety-six (84.2%) of the 1183 reports involving pre-adolescents and 299 (77.3%) of the 387 reports involving adolescents included ≥1 mental health reaction. Statistically significant changes for pre-adolescents were found in reports related to depression (χ2 (1) = 4.30, p = 0.044), and sleep (χ2 (1) = 5.74, p = 0.019), which both decreased between the pre and post periods. The only statistically significant change across categories for adolescents was a reduction in aggression reports between time periods (χ2 (1) = 8.5, p = 0.004). CONCLUSIONS After placement of an FDA black box warning on montelukast, total number of reports ­including mental health adverse events decreased in pre-adolescents; however, several categories ­assessed increased for adolescents.

Trend Analysis of Maternal Mortality in Kenya: Post-Devolution Empirical Results.

Kenya has taken significant steps to improve Reproductive Maternal Neonatal Child Adolescent Health (RMNCAH) services, with a vision to prevent preventable deaths of women and newborns. This study seeks to fill a crucial gap in understanding the dynamics of maternal mortality in Kenya, post-devolution. The study spans all the 47 counties of the Republic of Kenya, using county as the unit of analysis. Maternal Mortality Ratio (MMR) data was extracted from the District Health Information Software (DHIS), which was created to evaluate the level of progress in coverage of RMHCAH service in Kenya. Changes in the MMR Indicator was modelled over time using Repeated measures one-way ANOVA in the 47 counties in Kenya. A descriptive study uncovered an average reduction in the MMR, which decreased from approximately 170 to 130 per 100,000 live births between 2012 and 2018. There was a steady decrease in MMR in Garisa, Mombasa, Busia, Elgeyo, Samburu and Uasin. Tables and figures were used to visualise findings. Our findings revealed that although there has been continuous improvement of relative equity over the last quarter-century in all the 47 counties in Kenya, uneven coverage remains within each county. This lack of equity differs from one county to another. There was a significant difference within each year and among the years, and pairwise comparison revealed a significant difference in the MMR between 2012 and all the years except 2016 and 2017.

Complications of testicular prosthetics: analysis of causes, surgical tactics, ways of prevention

Background. Testicular prosthetics, despite the apparent simplicity of the technique of performing the operation, often leads to complications. At the same time, the spread of data from different authors on the frequency and structure of complications is extremely large. At the same time, the factors indicated by the authors as the causes of complications often contradict each other, and, as a rule, are not analyzed, therefore, methods of prevention and therapeutic tactics are not clearly defined today.Aim. To analyze the frequency and structure of complications during testicular prosthetics in patients over 18 years of age and adolescent children, as well as to suggest optimal ways to prevent the identified complications.Materials and methods. The results of testicular prosthetics were analyzed in 292 patients aged 12–59 years in the period 2007–2022. Various complications were found in 27 patients (9.24 %), including in the adolescent group (12–17 years) – in 13 (8.33 %) patients out of 156, in adults – in 14 (10.29 %) out of 136. MIT implants were used in 116 cases (adults – 54, adolescents – 62) and Promedon implants – in 176 cases (adults – 80, adolescents – 96). Data processing was carried out in the Statistica 20.0 program. The p &lt;0.05 level was considered statistically significant.Results. The most common complications include implant extrusion (22.2 %) and surgical hemostasis disorders (29.6 %), they are also the most difficult to correct and often lead to the need to remove the implant. The use of antibacterial therapy by the course does not reduce the risk of complications, the absence of antibiotic prophylaxis increases the incidence of complications by 3.9 % in the adult group and by 2.28 % in the adolescent group. The most rational single perioperative antibiotic prophylaxis. The frequency of complications when using MIT implants is higher (n = 17) than Promedon (n = 10). The incidence of complications is significantly higher in the group of patients who underwent prosthetics for more than three years after primary orchectomy or in an initially hypoplasized scrotum.Conclusion. Complications of testicular prosthetics are 8.33–10.29 %. The structure is dominated by complications of hemostasis and implant extrusion, they are also the cause of the greatest number of repeated interventions and the reason for the removal of the implant. A number of factors influence the formation of complications – access, the scheme of antibacterial therapy/prevention, the implantable material, the period after the initial operation. The most rational is the use of a modern silicone implant for prosthetics 6–12 months after orchectomy with suprascrotal access with a single perioperative antibiotic prophylaxis. The risk of the most dangerous and frequent complications can be leveled by using preventive measures.

Assessing Access to Trauma-Informed Outpatient Mental Health Services for Adolescents: A Mystery Shopper Study.

The authors aimed to examine how access to trauma-informed mental health services in safety-net health centers varies by insurance type and race-ethnicity of the care seeker. In this mystery shopper study, three women (White, Latina, and Black voice actresses) called community mental health centers (CMHCs) and federally qualified health centers (FQHCs) (N=229) in Cook County, Illinois, posing as mothers requesting a mental health appointment for their traumatized adolescent child. Each health center was called twice-once in the spring and once in the summer of 2021-with alternating insurance types reported (Medicaid or private insurance). Ability to schedule an appointment, barriers to access, wait times, and availability of trauma-specific treatment were assessed. Callers could schedule an appointment in only 17% (N=78 of 451) of contacts. Reasons for appointment denial varied by organization type: the primary reasons for denial were capacity constraints (67%) at CMHCs and administrative requirements to switch to in-network primary care providers (62%) at FQHCs. Insurance and organization type did not predict successful appointment scheduling. Non-White callers were significantly less likely (incidence rate ratio=1.18) to be offered an appointment than the White caller (p=0.019). The average wait time was 12 days; CMHCs had significantly shorter wait times than FQHCs (p=0.019). Only 38% of schedulers reported that their health center offered trauma-informed therapy. Fewer than one in five contacts resulted in a mental health appointment, and an apparent bias against non-White callers raises concern that racial discrimination may occur during scheduling. For equitable access to care, antidiscrimination policies should be implemented.