Late Teens Research Articles

Childbearing Histories and Midlife Cognition: Accounting for Early Life Factors.

Childbearing histories-for example, parity and age at first birth-matter for the health outcomes of mid- and later-life women. There is growing evidence that childbearing may shape cognitive outcomes. However, previous research is not definitive due to its inability to account for selection. Selection is critical to address given that multiple factors, including socioeconomic background and cognition in adolescence, place women at risk for both specific childbearing experiences and poor cognitive functioning. We analyze the 1979 National Longitudinal Survey of Youth (NLSY79) (N=3,668), a longitudinal nationally representative dataset from the US that began collecting data during respondents' late teens and early 20s. We estimate the average treatment effects (ATEs) of childbearing histories on midlife memory and cognition using propensity-score matching techniques that incorporate an expansive set of early-life factors. In models adjusting for early life covariates, we find that any births, high parity, and early first birth are associated with worse self-reported memory, but not cognitive functioning scores. After addressing the influence of early life factors through matching techniques, the only robust differences relate to any births and early first births with self-reported memory. Selection into specific childbearing experiences partially drives the link between childbearing and cognition at mid-life, with cascading implications into later life. We suggest incorporating childbearing and early life factors into models to identify social determinants of memory and cognitive functioning.

Understanding of premenstrual dysphoric disorder and premenstrual syndrome among professionals in Japanese university health services: A survey with simulated cases

ObjectivesPremenstrual dysphoric disorder (PMDD) and severe premenstrual syndrome (PMS) exert profoundly adverse effects on quality of life. We surveyed psychiatrists and clinical psychologists in Japan to determine their understanding and practice of diagnosing PMDD/PMS. MethodsWe targeted psychiatrists and clinical psychologists working at health administration facilities of universities in Japan who treat female patients with depressive symptoms in their late teens and 20 s—when PMDD/PMS is likely to develop. We presented a fictitious clinical case of a 23-year-old female and investigated whether the participants considered PMDD/PMS as a potential diagnosis. We also investigated the practitioners’ basic understanding of PMDD/PMS. ResultsWe analyzed survey responses from 26 psychiatrists and 140 clinical psychologists. Comparatively few respondents considered PMDD/PMS a possible diagnosis or routinely inquired about a patient’s menstruation. When practitioners were provided with information linking observed symptoms to the menstrual cycle, most considered PMDD and PMS possible diagnoses. Recognizing and considering PMDD/PMS was related to the respondents’ attributes. ConclusionsClinicians should consider PMDD/PMS when treating women with depressive symptoms.

Mini screw Assisted Rapid Palatal Expansion (MARPE) Application and Impact Evaluation Review

Abstract: A maxillary transverse deficit is one of the most frequent craniofacial issues. Rapid palatal expansion (RPE) has historically been recommended for the treatment of children and early adolescents. However, due to the ossification of facial sutures, this procedure is inappropriate for late teens or adults. The surgical method known as surgically aided rapid palatal expansion (SARPE) was first recommended for this group of individuals; however, the presence of morbidity is related to the surgical process. Micro-implant-assisted rapid palatal expansion (MARPE) has been used to enable maxillary expansion in skeletally mature patients. Through a discussion of its history, indications, treatment effects, stability, and limits in the existing body of research, the purpose of this article is to explore the function that MARPE plays in clinical orthodontics.

6483 Diaphyseal Medullary Stenosis With Malignant Fibrous Histiocytoma: A Rare Skeletal Dysplasia/Sarcoma Syndrome

Abstract Disclosure: A. Grover: None. C.R. Ferreira: None. R.I. Gafni: None. S. Jumani: None. M.T. Collins: None. K.L. Roszko: None. I.R. Hartley: None. Introduction: Diaphyseal medullary stenosis with malignant fibrous histiocytoma (DMS-MFH) is a rare autosomal dominant syndrome associated with pathologic fractures, myopathy, premature hair graying, and aggressive osteosarcomas. DMS-MFH has been linked to genetic variants in the methylthioadenosine phosphorylase (MTAP) gene, which encodes an enzyme in the methionine salvage and polyamine synthesis pathway. This pathway is implicated in other skeletal fragility disorders, such as Snyder-Robinson syndrome, suggesting a still undefined role of this pathway in bone biology. We describe a kindred with DMS-MFH and identify diagnostic challenges. Case: A 53-year-old perimenopausal woman presented with four fragility fractures over one year. Relevant history included premature hair graying, esophageal strictures, and nephrolithiasis. The patient’s bone formation markers were slightly elevated; bone resorption markers were within reference range. Her only osteoporosis risk factor was perimenopausal status. Bone series showed a diffuse heterogeneous appearance of the long bones with a mixed lytic/sclerotic appearance. DEXA scan revealed osteopenia. Family history was significant for 2 sons with aggressive osteosarcomas diagnosed in their late teens; one died at age 20. The other son is currently 39-years-old with recurrent osteosarcomas in three different limbs. The family also has a multigenerational history of severe bone fragility, muscle weakness, and premature hair graying. The patient, her living son, and his father underwent genome sequencing that identified a variant in MTAP (c.885A>G; p.(R295=)) in the patient and son. This variant was previously reported in three other families with DMS-MFH and has been shown to alter splicing. Notably, commercial genetic testing did not report this as a relevant variant, and diagnosis required independent analysis of the raw sequence data. Based on these findings, the patient and her son were diagnosed with DMS-MFH. Given the bone fragility with elevated bone turnover markers we treated the patient with yearly zoledronic acid infusions with no subsequent fractures. Surveillance for osteosarcoma is also being performed with annual whole-body MRI. Conclusion: DMS-MFH has been reported in only five families to date. The sixth family described here has clinical characteristics similar to the other kindreds. Due to high risk of aggressive osteosarcoma, timely diagnosis is imperative to decrease morbidity and mortality. Commercial genome sequencing may miss this diagnosis, so targeted genetic testing should be pursued. As more cases are identified, characterization of affected families may enhance our understanding of the natural history of the disease and guide surveillance and treatment strategies. Presentation: 6/2/2024

Dense perivenular clustering of microaneurysms: A pointer of leukemic retinopathy?

A boy in his late teens with a history of low-grade fever evaluated for a hematological malignancy was screened for ocular involvement. The fundus examination revealed a hyperemic disc with engorged tortuous retinal veins, pseudo sheathing of the peripheral retinal vasculature with surrounding retinal hemorrhages, and retinal infiltrates suggestive of leukemic retinopathy. Wide-field fundus fluorescein angiography showed areas of capillary non-perfusion along with characteristic dense segregation of multiple perivenular microaneurysms with sparing of the arterioles. The patient was diagnosed with chronic myeloid leukemia and treated with imatinib mesylate. No active ophthalmic treatment was carried out because there was no evidence of treatable retinal complications such as macular edema or retinal neovascularization. Clearance of leukemic infiltrates, along with complete regression of the microaneurysms, were observed 6 weeks after the treatment.

Has Postponed Entry into Adult Roles Modified U.S. Age-Crime Curves? Age-Arrest Patterns of Teens, Emerging Adults and Adult Age Groups, 1980–2019

Social changes in industrialized societies have prolonged adolescence, postponing entry into adult roles. We use U.S. age-arrest data to investigate whether this delay has contributed to higher crime rates among emerging adults, altering population age-arrest curves. We compare parameters for multiple offenses from 1980 to 2019 to answer: (1) Have there been recent shifts toward older, less adolescent-spiked curves; (2) If so, do emerging adults today exhibit higher offending levels than historical counterparts; or (3) Do proximate age-groups drive these distributional alterations? We find peak age remains in the late teens, but today’s age-curves for minor offenses are more symmetrical compared to preceding adolescent-spiked iterations. Given contemporary emerging adults’ relatively low offending levels, more symmetrical age curves are the product of precipitous declines in teen arrest rates coupled with higher mid-life adult rates. Tracking future age-arrest trends is important, but data collection challenges related to the UCR-NIBRS transition may hinder those efforts.

Systematic literature review of acne vulgaris, its sophisticated treatment approaches, types, treatment and their side effects.

Background: Acne formation can be controlled effectively but it heals slowly and has numerous interactions with neuropeptides. Once gone another one pops up. Sometimes it can be filled with pus. Its size varies and can cause anxiety, depression, stress and social withdrawal. The mechanism is hyper secretion of sebaceous glands. Introduction: Acne vulgaris is a condition when hair follicles are accumulated with oil, dead cells and bacteria from skin. It can lead to formation of blackhead, whitehead, oily skin, pimples and scarring eventually. Patients have raised sebum level and thus skin is more prone to acne formation; triggered by propionibacterium, genetics, environment and food. Most commonly occurring on the face, upper limb and trunk between teen to middle age. Sebum contains wax esters, cholesterol, and triglyceride. Objectives: · To extensively explain the etiology of acne vulgaris, hormonal, bacterial causes and UV light. · To write comprehensive review on treatment of AV conventional, topical, retinoid and antibiotics based treatment. · Write a comprehensive review on its complications and its management. Methodology: In this research article we have explained systematic review, as well as we have described the systematic literature review of Acne Vulgaris, We did a literature search using electronic bibliographic databases and Journals : such as ELSEVIER ,British Medical Journals ,MEDLINE (Ovid SP and PubMed), EMBASE, The Cochrane Library (Cochrane Database of Systematic Reviews (CDSR), and Cochrane Central Register of Controlled Trials (CENTRAL), as well as annual meetings abstracts from inception till Oct 2024. The literature search has focused mainly on randomized clinical trials, Meta-analysis, phase II/III, and retrospective studies. Results and Conclusion: The review included 45 studies with a total of 12000 participants. Acne vulgaris affects 9% of the population worldwide, 85% are between 12-24 years. Characters such as age and sex may vary among different studies. Many papers demonstrate the effect of demographic factors. Reaching late teenage can decrease its prevalence, and eruption is higher in females compared to male. Topical retinoid and benzoyl per oxide were effective in reducing inflammatory and non-inflammatory lesions. For mild to moderate acne pharmacological treatment, chemical, antibiotic and photodynamic therapy are among most effective. Oral antibiotics while effective, have raised concerned about resistance. For moderate to severe, the most effective one is oral Isotretinoin and photodynamic treatment. Most of us already know too much about this topic. Its 8th commonest disease known globally. It has many treatments. It’s the cause of social withdrawal and depression. In this case it is important to know about the causes that shift non inflammatory to inflammatory ones. Dermatologists are trying their best in combination of multiple therapies to treat it successfully. Personalized treatment plans considering patient-specific factors, such as acne severity, patient preference and risk of adverse effects, are essential for optimal management.

Electronics Utilization by Consumers: Antecedents and Impact on Consumer Positivity

A sample of consumers, ranging in age from late teens to 65, is used to examine the impact of demographic antecedents on consumer electronic utilization variables (age, household income, undergraduate major, and ethnicity).Then, the impact of these electronic utilization variables on positive consumer characteristics is examined (cultural openness, deal proneness, value judgment, self-esteem, and shopping enjoyment).Strong support indicates the various impacts the antecedents have on consumer electronic utilization. Findings also suggest the influence of these electronic utilization variables on positive consumer characteristics. The non-findings are discussed, and future research is suggested to further examine the relationships included in this study’s research model.

Evaluation of neuroretina following i.v. or intra-CSF AAV9 gene replacement in mice with MPS IIIA, a childhood dementia.

Sanfilippo syndrome (mucopolysaccharidosis type IIIA; MPS IIIA) is a childhood dementia caused by inherited mutations in the sulfamidase gene. At present, there is no treatment and children with classical disease generally die in their late teens. Intravenous or intra-cerebrospinal fluid (CSF) injection of AAV9-gene replacement is being examined in human clinical trials; evaluation of the impact on brain disease is an intense focus; however, MPS IIIA patients also experience profound, progressive photoreceptor loss, leading to night blindness. To compare the relative efficacy of the two therapeutic approaches on retinal degeneration in MPS IIIA mice. Neonatal mice received i.v. or intra-CSF AAV9-sulfamidase or vehicle and after 20 weeks, biochemical and histological evaluation of neuroretina integrity was carried out. Both treatments improved central retinal thickness; however, in peripheral retina, outer nuclear layer thickness and photoreceptor cell length were only significantly improved by i.v. gene replacement. Further, normalization of endo-lysosomal compartment size and microglial morphology was only observed following intravenous gene delivery. Confirmatory studies are needed in adult mice; however, these data indicate that i.v. AAV9-sulfamidase infusion leads to superior outcomes in neuroretina, and cerebrospinal fluid-delivered AAV9 may need to be supplemented with another therapeutic approach for optimal patient quality of life.

A prospective comparative study of preoperative and postoperative clinicopathological correlation of fibroadenoma of breast: A study protocol

Fibroadenoma of the breast most often arises during the late teens and early reproductive years. It is the most prevalent tumor in women < 30 years. After the age of 40 to 45, fibroadenomas are rarely observed as new masses in women. Fibroadenomas are made up of both epithelial and stromal components. Fibroadenoma is the most frequent type of breast tumor. It is crucial to diagnose preoperatively, both clinically and pathologically, by using F.N.A.C. Postoperatively, Fibroadenoma is confirmed histopathology. However, malignant transformation is very rare in Fibroadenoma of the breast. Early identification, accurate analysis, and appropriate management are advantageous. The current study's goal is to examine preoperative and postoperative clinicopathological aspects of Fibroadenoma and to assess any differences between preoperative and postoperative diagnosis in patients admitted to Jawaharlal Nehru Medical College, Sawangi (M), Wardha, Maharashtra, India.

The Experience of Adolescents and Young Adults in Their Cancer Journeys in Japan: I Try to Move Forward With Feeling That I Would Be Okay With "My Cancer".

Purpose: A cancer diagnosis can greatly affect adolescents and young adults (AYAs), especially those in their late teens and early twenties, who might have their special needs. This study aimed to understand the experiences of the AYAs who were diagnosed between 15 and 24 years of age in Japan, thinking about the care guide supporting them, from the time of their cancer diagnosis through the rest of their lives. Methods: Data were collected using semi-structured interviews, which were audio recorded and transcribed verbatim. Qualitative analysis of the transcripts was used to categorize these into themes for comprehensive interpretation. Results: Twenty AYAs participated; they were diagnosed between the ages 15 and 23 and were 19-29 years old at the time of the interview. In total, 14 core categories were identified, consisting of three themes (1) There is a feeling of distance between the cancer and me, (2) I face "my cancer" in my way, and (3) I feel that I would be okay with "my cancer." Conclusions: AYAs had their way of dealing with cancer while experiencing a distant feeling between themselves and the presence of the disease during their cancer journey. Although the process was not simple, they tried to live their lives in their own way, believing that they would be okay. Nurses must respect and understand that AYAs have a process of facing their own cancer with time and watch over AYAs' experiences to appropriately support them to successfully proceed further.

Komunikasi Antarpribadi Orang Tua-Anak Dalam Mengurangi Prilaku Seksual Sebelum Menikah Pada Remaja Hindu

College student who are late teens aged 18-19 years, have sexual development and phases that make them inclined to enter into a heterosexual relationship or relationship such as dating. During this period of dating they have a tendency to engage in sexual behavior, this is a negative thing in Hinduism which prohibits interpersonal communication. Interpersonal communication has the potential to carry out an instrumental function as a tool to influence or persuade others. Parent-adolescent interpersonal communication is a form of parenting process that has an important influence on the formation of adolescents' attitudes regarding sexual relations before marriage. So in this study it is hypothesized that stronger and closer parent-child interpersonal communication can reduce sexual behavior before marriage among Hindu teenagers. This research aims to find the influence of interpersonal communication on sexual behavior before marriage in Hindu teenagers. Quantitative methods were used in this research, collecting data by distributing questionnaires to 53 Hindu teenagers at Bumigora University. The results of this study state that interpersonal communication has a significant negative effect on the attitudes of Hindu teenagers in having sexual relations before marriage. This means that the better the interpersonal communication between Hindu teenagers and their parents, the lower their sexual behavior before marriage.

Needs of transgender children and adolescents presenting to an urban gender health program

Youth who identify as transgender and gender diverse (TGD) are increasingly presenting to pediatric providers. Gender-affirming surgery is often delayed until after a patient reaches the age of majority; however, patients may desire surgery at a younger age. We explore the specific clinical needs of this vulnerable population, including surgical requests. We present a cross-sectional study of patient intake interviews at time of presentation to our gender health program from 2017 to 2020. We summarize patient demographics, medical histories, and gender-affirming care needs by gender identity and age of presentation. Of 92 patients analyzed, those included were 19 trans girls, 55 trans boys, and 18 non-binary individuals. The median age of our sample was 15 (range 5-17). The median age (IQR) while first questioning gender was 10 (7-12). Sexual orientation was variable with 28 (43%) not sure/unknown. The majority of patients present for primary care services (grade schoolers 75%, early teens 78%, and late teens 77%, p=0.97) and hormone management (grade schoolers 42%, early teens 62%, and late teens 77%, p=0.06). Late teens were more likely to present for surgical services (49%) compared to grade schoolers (25%) and early teens (11%), p=0.001. Prior psychiatric diagnoses were common in all age groups. Trans girls were interested in a variety of affirming procedures whereas trans boys and non-binary individuals primarily sought chest surgery (see summary figure). Pediatric gender affirming care needs are varied and multidisciplinary within our center. By age 16, about half of TGD individuals are seeking surgical services. On average, there was a 4-5 year delay from age at first questioning one's gender and presenting to our gender health program. Primary care physicians in particular may prepare to serve this complex population by familiarizing themselves with treatment needs, including developing a network of competent surgical referrals.

Varicella Vaccine: Recognizing the Gap Years of Inadequate Vaccine Immunity

Varicella vaccination programs introduced in 1995 significantly reduced morbidity and mortality of the disease in the United States. Initiated as a single-dose vaccine, studies evaluating efficacy identified periodic reports of outbreaks prompting the implementation of the 2-dose varicella vaccination in 2007. The single-vaccine dose period, 1995 to 2007, produced a gap of 2-dose coverage for many individuals, now in their late teens to late 30s. Those in the vaccine gap are likely unaware of possible compromised immunity and may be at risk. Primary care providers should screen patients in this gap population, administer a second vaccine dose as needed, as well as be alerted to recognize symptoms of breakthrough disease in this cohort.

Underweight in young Japanese women over time: a longitudinal retrospective study of the change in body mass index from ages 6 to 20 years

Background The high prevalence of underweight in young women has become a serious health problem in Japan. When and how young women reach a low body mass index (BMI) has not been clarified. Aim To clarify the characteristics of BMI standard deviation scores (BMI SDS) trajectory of young Japanese women with underweight. Subjects and methods A total of 601 Japanese female university students aged 20 years were classified into underweight and healthy weight groups. Their school health check-up data were available from the ages of 6 to 20 years. We evaluated the estimated mean values of BMI SDS at each age and differences in BMI SDS (ΔBMI SDS) from 6 years to each age using a mixed-effects model and compared between the two groups at each age. Results In the underweight group, the BMI SDS at every age (−1.67 to −0.91) and the ΔBMI SDS after 16 years of age (−0.76 to −0.38) were significantly lower than those in the healthy weight group (−0.41 to −0.13, −0.07 to 0.04), respectively. Conclusion Young Japanese women with underweight have at least two characteristics of BMI SDS trajectory: being constitutionally underweight and shifting their weight status from baseline towards underweight in their late teens.

Self-Compassion with Loneliness in Late Teens Who Are Migrating

Late adolescence is a time when individuals begin to prepare themselves to determine their future. For this reason, many teenagers choose to migrate for the sake of their desired future, but late teens often experience loneliness. To reduce feelings of loneliness, teenagers need to increase self compassion for themselves. This research aims to determine the relationship between self compassion and loneliness in late adolescents who are migrating. This study uses a quantitative approach. The number of samples in this study was 203 young people who were currently migrating, sampling using the quota sampling technique. The measuring instrument used in this research is the Self Compassion Scale (SCS). Loneliness scale version 3 (UCLA version 3). The data analysis technique used is the Pearson Product Moment correlation technique. The results of this study show a correlation coefficient of r = -0.510 with a significance value of 0.000 (p<0.01), which means there is a significant negative relationship between self compassion and loneliness in late adolescents who are migrating. This means that the higher the self compassion, the lower the level of loneliness experienced by teenagers who are migrating. Vice versa, the lower self compassion, the higher the level of loneliness experienced by teenagers who are migrating. The implication of this research is that late adolescents who are migrating are not immersed in feelings of loneliness and need to increase self compassion by carrying out activities according to their own desires or are popular which provide benefits for themselves and the people around them, to avoid feelings of loneliness.Masa remaja akhir merupakan masa dimana individu mulai mempersiapkan diri untuk menentukan masa depan. Oleh sebab itu banyak remaja memilih untuk merantau demi masa depan yang diinginkan, namun remaja akhir sering mengalami loneliness. Untuk mengurangi perasaan loneliness maka remaja perlu meningkatkan self compassion pada dirinya. Penelitian ini bertujuan untuk mengetahui hubungan antara self compassion dengan loneliness pada remaja akhir yang sedang merantau. Penelitian ini menggunakan pendekatan kuantitatif. Jumlah sampel dalam penelitian ini sebanyak 203 remaja akhir yang sedang merantau, pengambilan sampel pada menggunakan teknik quota sampling. Alat ukur yang digunakan pada penelitian ini yaitu skala Self-Compassion Scale (SCS). Skala Loneliness scale version 3 (UCLA versi 3). Teknik analisis data yang digunakan yaitu teknik korelasi Product Moment Pearson. Hasil penelitian ini menunjukan koefisien korelasi r = -0.510 dengan nilai signifikansi 0.000 (p<0.01) yang berarti terdapat hubungan negatif signifikan antara self compassion dengan loneliness pada remaja akhir yang sedang merantau. Artinya, semakin tinggi self compassion maka semakin rendah tingkat loneliness yang dimiliki remaja yang sedang merantau. Begitu pun sebaliknya, semakin rendah self compassion maka semakin tinggi tingkat loneliness yang dimiliki remaja yang sedang merantau. Implikasi dari penelitian ini, yaitu remaja akhir yang sedang merantau tidak terlarut dalam perasaan loneliness dan perlu meningkatkan self compassion dengan melakukan aktivitas sesuai dengan keinginan diri sendiri atau digemari yang memberikan manfaat bagi diri sendiri dan orang disekitar, sehingga terhindar dari perasaan loneliness.

Competence or Experience

Competence or Experience

Hubungan Kontrol Diri dengan Kenakalan Remaja di Sekolah

Adolescence is a period of developmental transition between childhood and adulthood which generally begins at the age of 12 or 13 years and ends at the age of (late teens or early twenties). During this transition period, it is possible that a period of crisis will arise, which is characterized by a tendency for naughty or deviant behavior to emerge. One of the factors that influences juvenile delinquency is self-control. This research aims to describe the picture of student juvenile delinquency at school, describe student self-control and examine the relationship between self-control and juvenile delinquency at school. This research is a quantitative descriptive correlational type of research. The population of this research is students of SMP Negeri 1 Kubung, totaling 339 students enrolled in the 2023/2024 academic year. Sampling was determined using a purposive sampling technique with a sample size of 35 students. Data collection used a self-control questionnaire and a questionnaire on juvenile delinquency at school with a Likert scale model. The data was processed using percentage analysis techniques and to test the relationship between the two variables using the Pearson correlation product moment formula. The results of this research show that: (1) juvenile delinquency of students at SMP Negeri 1 Kubung is in the high category with a percentage of 53.94%, self-control of students at SMP Negeri 1 Kubung is in the low category with a percentage of 57.67%, (2) self-control students at SMP Negeri 1 Kubung are in the low category with a percentage of 57.67%, (3) there is a significant negative relationship between self-control and juvenile delinquency of -464 with a significance level of 0.005. A significant negative relationship means that the higher the student's self-control, the lower the student's delinquency. On the other hand, the lower the student's self-control, the higher the student's delinquency. The implications of the results of this research can be used as a guideline in providing guidance and counseling services in schools, especially in information services, group guidance services, group counseling services and individual counseling services in preventing juvenile delinquency at school.

How Age, Sex and Transfusion Affects the Incidence of Endocrine and Bone Density Disorders in Major Thalassemic Patients.

Beta-thalassemia major patients frequently have endocrinopathies. We tried to determine relation between demographic and transfusion factor and endocrinopathies. Major beta-thalassemia patients (n=114 cases), 3-38 yr of age, entered this study. Female to male ratio was 51/63. Children (less than 20 yr) formed 57% of participants. Information about bone mineral density (BMD) and hormonal and biochemistry blood evaluation including fasting blood sugar (FBS), ferritin, triiodothyronine (T3), thyroxine (T4) and thyroid-stimulating hormone (TSH), luteinizing hormone (LH) and follicle-stimulating hormone (FSH), testosterone (males), and estradiol (females) entered data sheet. Sex and ferritin level showed no significant correlation with above disorders. Age significantly correlated to short stature, diabetes, low BMD at femur and neck (P, 0.031, 0.008, 0.009 and <0.001, respectively) . The risk of short stature had increased in 12 yr and older patients 7.71 times than younger patients (P= 0.008). The risk of diabetes had increased in 35 yr and older patients 26.25 times than younger patients (P= 0.03). The risk of Z-score ≤ -2 in femoral region has increased in 19 yr and older patients 5.84 times than younger patients (P= 0.002). The risk of Z-score ≤ -2 in spinal region has increased in 14 yr and older patients 17 times than younger patients (P= 0.007). The main factor related with endocrinopathies was age. The correlation between age and short stature, diabetes and low BMD was positive. Therefore, we recommend early monitoring of thalassemia patients (in their late childhood and early teenage) for these complications.

PENGARUH PELAKSANAAN CSR DAN INOVASI PRODUK TERHADAP KEPUTUSAN PEMBELIAN KONSUMEN PT. GARUDAFOOD PUTRA PUTRI JAYA TBK. DI KECAMATAN DRIYOREJO KABUPATEN GRESIK

In the era of digitalization, companies are expected to be able to analyze market changes by taking a consumer approach and the most popular is by carrying out Corporate Social Responsibility (CSR) activities which aim to strengthen relationships between the company, local communities and company consumers so that companies know consumer needs and implement them through product innovation. Garudafood Putra Putri Jaya Tbk. is a food company that has succeeded in implementing a good consumer approach from year to year. Currently, consumers, especially late teenage consumers, tend to be more careful in purchasing food products. The problem in this research is that many Garudafood in their late teens consumers feel dissatisfied with product innovation especially with unattractive packaging variations, this can influence the company in introducing its products to young consumers. The aim of this research is to determine the positive and significant influence between CSR and Product Innovation on Purchasing Decisions for Garudafood Putra Putri Jaya’s Products in Driyorejo Gresik District. This research uses a quantitative approach by collecting data using questionnaires, research techniques using Random Sampling (Probability Sampling), and the population is the community in Driyorejo Gresik District. The results obtained in this research are that there is a positive and significant influence between the independent variables (CSR and Product Innovation) and the dependent variable (Purchasing Decisions).