Young Adolescents Research Articles

Effects of Nail Biting (Onychophagy) on Upper Central Incisors in Children and Young Adolescents

Nail biting (NB) is a repetitive and uncontrolled parafunctional activity that can affect oral health by altering tooth shape and intraoral position. Nowadays, there is not enough scientific evidence about the impact of NB on teeth; therefore, this study aimed to evaluate the effects of NB on the length, width and inclination of upper central incisors. This retrospective study involved 76 patients, 40 males and 36 females, with a mean age of 10.6 ± 0.3 years. Digital scans of the maxillary arch of each patient were recorded. Next, the length, width and inclination of upper central incisors used and not used for NB were measured. Finally, data were analysed with a paired t-test. Statistical analysis showed statistically significant differences in the length and inclination of upper central incisors used for NB compared with those of upper central incisors not used for NB, while the width did not show a significant difference. There were relevant changes in upper central incisors subjected to NB, demonstrating that NB impairs the shape, morphology and inclination of teeth. Therefore, because of the potentially negative consequences of NB, it is recommended that NB not be underestimated.

Knowledge, attitude, and practices related to lead pollution among adolescents and caregivers of young children living near Used Lead Acid Battery (ULAB) recycling sites in Bangladesh: a cross-sectional study

BackgroundLead, a potent neurotoxin, causes irreversible damage to the nervous system, and low- and middle-income countries face huge health and economic productivity losses due to childhood lead exposure. In Bangladesh, informal Used Lead Acid Battery (ULAB) recycling sites are an important source of lead pollution. Little is known about lead awareness among communities exposed to ULAB recycling. Therefore, this study aims to assess knowledge, attitudes, and practices related to lead pollution among caregivers of young children and adolescents living adjacent to informal ULAB sites.MethodsA cross-sectional study was conducted among 732 mothers of young children and adolescents in 4 districts of Bangladesh (survey and observation). Simple and multiple linear regression was conducted to describe patterns and predictors of lead-related knowledge and practices.Results60% of respondents had heard the name ‘lead’ (“shisha”). The mean knowledge score was low (19 out of 44). Residents of high-risk districts, male respondents, and those with more than 5 years of schooling were significantly more likely to have higher knowledge scores than others. In terms of attitude, 52% of respondents perceived lead to be risky for human health but 43% thought lead pollution was controllable. Observation of households for lead exposure revealed that 63% of children and adolescents play or pass by ULAB sites, 29% ate non-food items, 41% of households had visible paint chips on the walls, 59% households used polished turmeric and 15% used lead-soldered cans to store foods. Among protective practices, 70% reported cleaning floors, 84% consumed iron-rich foods, and 48% consumed calcium-rich foods.ConclusionsThe population had a high potential for lead exposure. Their knowledge about lead was limited, and risk perception was moderate. To reduce lead exposure and increase knowledge and awareness among the at-risk population, it is crucial to take measures such as mass awareness campaigns through media and schools. It is important to strengthen the implementation of existing policies, such as policies on leaded gasoline, paints, and lead-acid batteries, that can address the sources of lead exposure for the community.

"You Need to be Able to Stand Up for What is Right": MTV Shuga Naija's Transformative Impact on Youth Attitudes Toward Sexual Violence in Nigeria.

In Nigeria, approximately 10% of women of reproductive age report experiencing sexual violence in the past year, with potentially enduring health and social consequences. The effects can be especially severe for younger women and adolescents. MTV Shuga Naija utilizes an entertainment-education TV serial drama to promote gender equality and challenge norms around sexual violence. Using a two-wave panel survey of Nigerian youth (574 females; 317 males) aged 15 to 24 years, this study explores the impact of MTV Shuga Naija on disclosing experiences of sexual violence, reducing stigma, and fostering dialogue. Baseline data were collected in person, while endline data were collected by telephone due to the COVID-19 pandemic. The survey, informed by the Theory of Planned Behavior (TPB), examined shifts in self-reported sexual harassment and attitudes toward victims of sexual violence. A doubly robust, difference-in-differences (DID) analysis compares changes in outcomes in treatment versus comparison areas, adjusting for observed and unobserved differences and using inverse probability weighting to enhance the precision of impact estimates. DID models show significant attitude shifts and increased disclosure of sexual violence among youth exposed to MTV Shuga Naija. Agreement with victim-blaming statements dropped significantly for both men and women in treatment versus comparison areas. However, contrary to hypotheses, respondents in comparison areas were more likely to discuss sexual violence with family, although the context and content of these discussions could not be examined. This study therefore confirms that MTV Shuga Naija's entertainment-education effectively improves attitudes and behaviors concerning sexual violence. Even so, victim-blaming norms and experiences of sexual violence remain prevalent. While the program has made progress in addressing this sensitive issue in Nigeria, further research is needed to improve family and community dialogues and to enhance support for victims.

Better relationships do not always feel better: Social relationships interact in predicting negative emotions in early adolescence.

How negatively young adolescents feel is central to their well-being. Intuitively, better social relationships should be linked to less negative emotions. This study tested this assumption, using a sample of over 80,000 young adolescents from 32 countries (ages 10-12). Inconsistent with the notion that better social relationships are always related to better emotional experiences, we found that links between negative emotions and adolescents' relationships with friends or teachers critically depend on their relationships with family. When young adolescents had relatively better relationships with family, better relationships with friends or teachers predicted less negative emotions. However, when adolescents had relatively poorer relationships with family, better relationships with friends or teachers predicted more negative emotions. Results were consistent across adolescents' gender, age, culture, or socioeconomic status. Findings suggest that the broader social context should be considered for understanding how specific relationships predict negative emotions in early adolescence. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Mental Health Interventions in Middle Schools: A 10-Year Review of Research.

Schools can play an important role in addressing growing concerns about adolescent mental health. Mental health of high school students has predominantly been the focus in literature with less emphasis on younger adolescents. This review identified articles published in the last decade that described evaluations of middle school-based mental health interventions and randomized participants to an intervention or control condition. Fourteen interventions met the inclusion criteria. About two-thirds of interventions were based on mindfulness or cognitive behavioral therapy. Many trials utilized racially diverse, low-income samples. All interventions were delivered to groups, and three contained a parent component. Five trials increased rigor by using an active control condition. Almost two-thirds of the interventions were effective (p < .10) in reducing at least one depression, anxiety, affect, or internalizing symptom outcome compared to a control group. This article provides information about intervention characteristics, efficacy, theoretical framework, and acceptability/feasibility.

Mapping educators’ insights of student problem-solving difficulties while implementing video-assisted self-regulated learning training in classrooms

Abstract Developing self-regulated learning (SRL) skills among young adolescents is crucial for lifelong learning, and teachers play a vital role in fostering these skills. Problem-solving is a key SRL skill; however, both learners and teachers encounter challenges during the problem-solving process and in evaluating its incorporated strategies. To tackle these challenges, this study examined students’ problem-solving difficulties using a generic video-assisted SRL training programme, based on teachers’ reports, and analysed these challenges across STEM and non-STEM domains. This study focusses on identifying and classifying the difficulties of 241 students within the problem-solving framework, as reported by teachers across various disciplines and grades (6–11). The analysis revealed that the most significant difficulties arose during the problem identification, followed by time planning and management, problem exploration, solution development and solution evaluation. Specifically, STEM teachers reported relatively fewer difficulties in problem exploration than in other steps, while non-STEM teachers reported fewer challenges in presenting and communicating solutions to peers. A dedicated map named the problem-solving sort out setbacks (PS-SOS) map was created to pinpoint challenges within the problem-solving process. The application of this mapping technique can further support the development of technology-based feedback systems, including digital assistants, which offer valuable assistance to students.

Descriptive Overview of Adolescent Health Indicators in Humanitarian Settings: A Cross-Country Analysis

Purpose: An adolescent health information system is a relevantly new concept, especially in humanitarian settings. This article aims to map the available adolescent health indicators collected in selected humanitarian settings, identify the available data sources, and determine the alignment between these indicators and the draft list of priority indicators for adolescent health measurement recommended by the Global Action for the Measurement of Adolescent Health Advisory Group. Methods: We selected five countries experiencing humanitarian crises- Myanmar, Nigeria, Palestine, Ukraine, and Yemen. We identified the adolescent health indicators collected in each country using document analysis and a purposive sampling approach. We reviewed the primary population-based surveys used to gather adolescent health data and noted the most recent year each survey was conducted. The identified indicators were then categorized by measurement domains and specific areas of adolescent health.Results: The Multiple Indicator Cluster Survey and Demographic Health Survey were conducted in all five countries selected, but three out of five countries have not administered either within the last five years. Yemen and Palestine only included married women in their sample sizes, and no one younger than 15 was interviewed. Indicators most commonly assess reproductive health, tobacco use, and adolescent fertility. Limited data was found on younger adolescents, males, water, sanitation, hygiene, disability, and nutrition indicators. Discussion: Adolescent health information in humanitarian crises requires more frequent surveys, including all adolescent age groups, and unique data collection methodologies. The current surveys used to measure adolescent health indicators have limited ability to be inclusive to all adolescents. It is important to establish a list of priority indicators deemed essential in humanitarian settings and relevant ways to collect them.

Understanding the process of adolescent assent for voluntary male medical circumcision in Zimbabwe: findings from a cross-sectional study

BackgroundVoluntary medical male circumcision (VMMC) is a method for combination HIV prevention for adolescents > 15 years in settings with generalized epidemics. In Zimbabwe, policy currently allows VMMC in adolescents > 15 years old, but there is consideration to lower the threshold to 13 years old. There is a need to understand current practices in assent/consent, and parents’ requirements for assent/consent to inform policy recommendations for the VMMC programme in lowering its age threshold.MethodsCross-sectional surveys were conducted in September 2022 using convenience sampling among three respondent groups: uncircumcised adolescents/young men (AYM) aged 13–16 years (n = 881), circumcised AYM aged 13–20 years (n = 247), and parents of uncircumcised adolescents aged 13–16 years (n = 443). Surveys asked about VMMC knowledge, experiences with mobilisers, circumcised AYM’s assent/consent experiences, and parents’ preferences for assent/consent processes.ResultsKnowledge of VMMC was significantly lower among younger adolescents aged 13–14 than their 15–16 year-old peers. 57% (142/247) of circumcised AYM had a one-to-one discussion with their provider before having the procedure, 32% (80/247) said they were not fully informed about VMMC prior to the procedure, and 54% (134/247) wanted more information about procedure-related pain. Over half (56%, 42/75) of circumcised AYM whose parents had not provided consent in-person for them to receive the procedure reported that their parents had never been contacted to verify consent.ConclusionsThere are gaps in the current assent/consent process for VMMC in Zimbabwe. Providers should be trained to give balanced information on risks and benefits of the procedure, including potential for pain. One-on-one discussions between providers and adolescents prior to the procedure, age-appropriate counselling, and tools for providers to ascertain adolescents’ understanding and ability to provide assent are essential processes, especially if the age threshold is lowered to include younger adolescents. it is also imperative to improve communication with parents, particularly to verify consent for their children has been given, per national guidelines.

When the second language becomes the first: family language policies in Polish return migrant families from English-speaking countries

ABSTRACT The study focuses on Polish families returning from migration to English-speaking countries and their family language policies in a language-shift situation. It aims to discover what language(s) parents and children associate their identities with and how they navigate through their development. The data for the project comes from content analysis of 4 interviews with selected families. The results show a discrepancy between parental ideologies and their adolescent children’s linguistic identities. While parents aim to maintain and develop the heritage language, Polish, abroad and on return, the children’s primary identity is associated with English, which causes their difficulties in reintegration into the Polish school environment on return. Additionally, the age of return matters: young adolescents (aged 10-15) continue to seek ties with English-speaking communities and plan to return to the country of their childhood while younger children (their siblings) who returned at the time of onset of Polish school time managed to adapt to the new situation. The study’s findings should be relevant to parents, teachers and psychologists who wish to aid the children in developing harmonious bilingualism.

Longitudinal associations of e-cigarette use with cigarette, marijuana, and other drug use initiation among US adolescents and young adults: Findings from the population assessment of tobacco and health study (Waves 1–6)

IntroductionResearch examining prospective links of e-cigarette use with cigarette, marijuana, and other substance use has been limited largely to 1–2-year follow-up periods and focused on younger adolescents. This study examined longitudinal associations of e-cigarette use with cigarette, marijuana, and other substance use initiation among U.S. adolescents and young adults (AYAs) across an eight-year period. MethodsAdolescent (ages 12–17) and young adult (ages 18–25) data from waves 1–6 of the nationally representative Population Assessment of Tobacco and Health study (2013–2021) were used. Discrete time survival models with time-varying weights were employed to examine the risk of cigarette, marijuana, and other drug use initiation over an eight-year follow-up period among AYAs with no lifetime use of e-cigarettes/other tobacco, lifetime but no past 30-day use of e-cigarettes/other tobacco, past 30-day e-cigarettes only, other tobacco use only, or past 30-day e-cigarette/other tobacco use. We compare our time-varying weighting approach to a traditional time-invariant/complete case weighting approach. ResultsAcross six follow-up waves, all three past 30-day nicotine/tobacco use groups, including e-cigarettes only, had greater risk for cigarette, marijuana, and other drug use initiation relative to those not using nicotine/tobacco. The three past 30-day nicotine/tobacco use groups did not differ from each other in risk for marijuana use initiation. Associations were smaller in magnitude for young adults compared to adolescents, but significant for both age groups. ConclusionsSubstance use initiation risks persist beyond 1–2 years for U.S. AYAs using e-cigarettes. Prevention strategies to reduce AYA e-cigarette use are needed to reduce cancer-related risk.

PELATIHAN PENGGUNAAN APLIKASI ME-HEALTH GO DALAM UPAYA PENGENDALIAN PERILAKU AGRESIF PADA SISWA REMAJA

Adolescence is a time of change in developmental and social domains which can be accompanied by behavioral problems such as aggressive behavior. Aggressiveness among adolescents can raise concerns about a teenager's mental health and is defined as a behavioral and emotional response that involves other people. Aggressive behavior can be a mental health problem for young adolescents and is defined as both behavioral and emotional in nature. Considering the importance of promoting mental health in adolescents, community service activities need to be carried out in teacher training using the me-health go application in an effort to aggressively control adolescent students at Jember High School. The training activity provided to teachers is in the form of an application called me-health go where the main focus of this application is prevention, early intervention, assessment and screening as well as additional mental health care through the application. The results of the community service activities carried out showed that of the 50 teachers who took part in training activities on using the me-health go application in an effort to control aggression among teenage students, 74% had good knowledge and 26% had sufficient knowledge. The results of the difference test using the Wilcoxon test showed that there was a difference in pretest and posttest knowledge with a p value of 0.000&gt;0.05. Me health go is an application that helps teachers monitor adolescent mental health

Psychometric Properties of a Wellness Behavior Rating Scale for Young Adolescents.

We examined the psychometric properties of the Physical Activity, Nutrition, and Technology (PANT) survey, developed by researchers to track weight management behaviors among youth. Data from 2,039 middle school students (M age = 12.4, SD = .5; 51.4% girls) were analyzed to explore and then confirm the factor structure of the PANT survey. We also examined the bivariate associations between the PANT survey, body mass index (BMI), and the Progressive Aerobic Cardiorespiratory Endurance Run (PACER). Results suggest that the PANT survey is comprised of two factors-Physical Activity and Healthy Choices-each with adequate internal consistency (α = .79 and 0.86, respectively). The Physical Activity subscale appears to be significantly associated with both z-BMI (r = -0.10, p < .001) and the PACER (r = 0.33, p < .001) in the anticipated directions, but the criterion validity of the Healthy Choices subscale is less clear. We discuss these findings and explore future directions for developing meaningful self-report wellness behavior scales for youth.

The need for structured career guidance in a resource-constrained South African school

Background: Career guidance and counselling in secondary schools are crucial for young adolescents as they embark on the initial stages of shaping their post-school studies and career goals. Initiating career guidance as early as Grade 9 is imperative to ensure alignment between chosen subjects and future career aspirations. The study was conducted with Grade 12 learners at a resource-constrained high school in Cape Town, Western Cape.Objectives: Utilising the Systems Theory Framework (STF), we sought to explore Grade 12 learners’ perceptions of the effectiveness of career guidance and counselling and its significance in shaping future career choices.Method: The study used a qualitative methodology. Semi-structured online interviews were used to gather the data, which were then analysed thematically. The study consisted of a sample size of 16 Grade 12 participants.Results: The findings indicated that learners found career guidance and counselling effective for deciding future occupations, with a preference for opportunities such as job shadowing and interactions with experts in the field of interest. However, limited access to vocational resources and a lack of structured classroom guidance led learners to conduct their own research.Conclusion: The study recommends that life orientation teachers actively engage with organisations and relevant stakeholders in providing career guidance and counselling to learners and ensure that pupils have sufficient access to career resources for effective career guidance.Contribution: These findings are a valuable resource for professionals and policymakers seeking to improve high school learners’ educational experiences, providing a framework for future scholars delving into the dynamic field of career counselling.

Amygdala volume and depression symptoms in young adolescents who use cannabis

IntroductionBoth cannabis use and depressive symptomology increase in prevalence throughout adolescence. Concurrently, the brain is undergoing neurodevelopment in important limbic regions, such as the amygdala. Prior research indicates the amygdala may also be related to cannabis use and depressive symptoms. We aimed to investigate the effects of adolescent cannabis use on amygdala volumes as well as the interaction of cannabis use and amygdala morphometry on depressive symptoms in youth. MethodTwo-hundred-twenty-four participants (ages 12–15), balanced by sex assigned at birth, were selected from a sub-sample of the Adolescent Brain Cognitive Development (ABCD) Study based on hair toxicology and self-report measures of cannabis use. Participants positive for cannabinoids in hair and/or self-reported cannabis use were demographically matched to youth with no self-reported or confirmed cannabis use. The guardians of these youth reported depression symptoms on the Child Behavioral Checklist. Linear mixed effect models were run investigating cannabis use group on amygdala volumes bilaterally, controlling for whole brain volume and random effects of scanner type. Additional analyses examined cannabis group status and bilateral amygdala volume on depression symptoms. ResultsCannabis use was not significantly associated with amygdala volume but was associated with increased depressive symptoms (p<0.01). Cannabis group interacted with amygdala volume, such that individuals with smaller volumes had increased depressive symptoms within the cannabis group (p’s<0.01–0.02). ConclusionAberrations in amygdala volume based on cannabis use were not found in early adolescence; however, more depressive symptoms were related to cannabis group. Youth who use cannabis and have smaller amygdala volumes were at increased risk for depressive symptomology, suggesting potential neurovulnerabilities to cannabis use.

Promoting Adolescent Safer Gambling Through Self-Referent Counterfactual Thinking and Knowledge of Probabilistic Outcome.

Research have continued to advocate for various safer gambling strategies (SGs) to curb initiation and sustenance of problem gambling through the conceptualization and development of SG tools. The present study aims to extend this advocacy by examining cognitive processes that promote adolescent responsible gambling (RG) in Nigeria. Young adolescents (N = 962, Mage =16.06, SD = 4.12) recruited from a high school population responded to measures of self-referent counterfactual thinking (S-RCFT), knowledge of probabilistic outcomes (KPO), and RG. Hayes PROCESS macro analysis result showed that S-RCFTs and KPO were positively associated with RG. More importantly, it was revealed that KPO amplified the S-RCFT-RG link and provided a plausible pathway to understanding the effect of S-RCFT on RG. This calls for SG advocacies to encourage adolescent gamblers to hold themselves responsible for responsible gambling, and to understand that gambling wins randomly occur. The limitations of the study and recommendations are highlighted.

Topical Treatment and Aesthetic Procedures in Management of Acne Vulgaris

Acne vulgaris is a common, chronic inflammatory skin disease affecting up to 80% of young adults and adolescents. The pathogenesis of acne is multifactorial and involves the pilosebaceous units of the skin. As a result of the disease process, skin lesions such as open and closed comedones, nodules, pustules, and papules appear on the skin. In recent years, acne has been increasingly observed in younger patients, which is associated with the earlier onset of puberty. Moreover, acne is increasingly diagnosed in individuals over 20 years of age, particularly in women, which is referred to as adult female acne (AFA). Effective and rapid implementation of treatment is crucial to prevent complications such as post-inflammatory hyperpigmentation and acne scars, as well as to mitigate the negative psychological impact of the disease on patients. The article discusses both topical treatment and aesthetic medicine procedures in the management of acne vulgaris. Topical treatments include the use of retinoids, antibiotics, benzoyl peroxide, clascoterone, dapsone, azelaic acid, and combination therapies. Aesthetic procedures such as chemical peels, microdermabrasion, photodynamic therapy, blue light therapy, and laser therapies can be beneficial as adjunctive treatments. The article also addresses the issue of acne as a comorbid condition in patients seeking aesthetic medicine treatments, even if it is not the primary reason for their visit.

The impact of juvenile onset rheumatic and musculoskeletal diseases on education, vocation and employment

The impact of juvenile onset rheumatic and musculoskeletal diseases on education, vocation and employment Professor Suzanne Verstappen discusses the impact and challenges associated with juvenile-onset rheumatic and musculoskeletal diseases when navigating education and employment. Juvenile onset rheumatic and musculoskeletal diseases (jRMDs), such as juvenile idiopathic arthritis (JIA), lupus and vasculitis, are chronic diseases with onset before the age of 16 years. These conditions can cause persistent joint pain, swelling of the joints and stiffness. Other symptoms include fatigue and functional disability. These symptoms may fluctuate, and sometimes, children and young adolescents with jRMDs have severe symptoms, whilst, on different days, they may feel better. Some children may experience the symptoms only for a couple of months or years, whilst others have symptoms for many years and continue to have symptoms during adulthood. Some types of jRMDs can cause serious complications, such as joint damage, growth problems and inflammation of the eyes. Although disease management has improved in the last decade with more effective drugs and multidisciplinary care, the symptoms, adverse events due to medication use and clinical visits may impact school attendance, career choices and future employment.

Evaluation of Sexual Transmitted Infections among Gender based Violence Cases: Retrospective Cross Sectional Study, Kigali-Rwanda

Background: STIs are infections that are passed from one person to another through sexual contact. The causes of STIs are bacteria, parasites, yeast, and viruses. There are more than 20 types of STIs, including Chlamydia, genital herpes, gonorrhea, HIV/AIDS, HPV, Syphilis and Trichomonas1 . According to WHO (2013), Amin and Garcia presented the evidence of the increased risk of STIs and HIV associated with GBV; and looks at potential pathways by which gender-based violence and STI and HIV are linked2 . GBV is defined by the UN in the CEDAW as any act that is likely to or results in physical, sexual or psychological harm or suffering to women including threats or acts of coercion, arbitrary deprivation of liberty, private or public, in the family or community2,15 . The aim of this study was to determine the prevalence of STIs among GBV cases attending Isange one stop center in Kibagabaga District Hospital.  Method: This study was retrospective conducted from January 2017 to September 2019 among GBV cases attending Isange one stop center in Kibagabaga District Hospital. Request forms describing the GBV case and indicating the demographic parameters and laboratory findings of the victim was evaluated. Data was analyzed using Microsoft Excel and SPSS version 16.0.  Result: In total 320 cases for GBV cases was reported from 2017 up to November, 2019 at Isange One Stop Center in Kibagabaga District Hospital. 100% of study population was female, majority of them 96.25% (308) were young female adolescent in the range of 10 to 19 years old. Considering laboratory findings, this study showed that Only 5% of all GBV cases within period of 3 years reported STIs negative, Majority GBV cases reported pregnancy at high level 72% and the overall Prevalence of STIs was 23% all GBV cases. 7.2% of these had HIV and 6.8% had Hepatitis B virus. The prevalence of trichomonas and Syphilis was 4% and 5% of all GBV cases respectively and this study showed no HPV and Gonorrhea cases has been reported.  Conclusion: Although the proven steps that have been taken by government of Rwanda to against GBV, but not understood as desired because GBV cases continue to increase periodical, so more Strength and focus are needed to reduce this rate GBV among young female adolescents. According to this study finding which suggested that GBV cases promote STIs and unwanted pregnancy.

Zinc as a Possible Critical Element to Prevent Harmful Effects of COVID-19 on Testicular Function: a Narrative Review.

Research into innovative non-pharmacological therapeutic routes via the utilization of natural elements like zinc (Zn) has been motivated by the discovery of new severe acute respiratory syndrome-related coronavirus 2 (SARS-COV2) variants and the ineffectiveness of certain vaccination treatments during COVID-19 pandemic. In addition, research on SARS-COV-2's viral cellular entry and infection mechanism has shown that it may seriously harm reproductive system cells and impair testicular function in young men and adolescents, which may lead to male infertility over time. In this context, we conducted a narrative review to give an overview of the data pertaining to Zn's critical role in testicular tissue, the therapeutic use of such micronutrients to enhance male fertility, as well as in the potential mitigation of COVID-19, with the ultimate goal of elucidating the hypothesis of the potential use of Zn supplements to prevent the possible harmful effects of SARS-COV2 infection on testis physiological function, and subsequently, on male fertility.

Trends in Continuation of Long-Acting Reversible Contraception Among Adolescents Receiving Medicaid

PurposeDespite increasing use of long-acting reversible contraception (LARC) among U.S. adolescents, there is limited literature on factors affecting intrauterine device (IUD) or subdermal implant use. This study aimed to describe statewide rates, and associated patient and provider factors of adolescent IUD or implant initiation and continuation. MethodsThis retrospective cohort study used N.C. Medicaid claims data. 10,408 adolescents were eligible (i.e., 13–19 years, female sex, continuous Medicaid enrollment, had an IUD or implant insertion or removal code from January 1, 2013, to October 1, 2015). Bivariate analyses assessed differences in adolescents using IUD versus implant. Kaplan-Meier curves were created to assess IUD or implant discontinuation through December 31, 2018. ResultsAdolescents initiated 8,592 implants and 3,369 IUDs (N = 11,961). There were significant differences in nearly all provider and patient factors for those who initiated implants versus IUDs. 16% of implants and 53% of IUDs were removed in the first year. Younger (i.e., age <18 years old), Hispanic, and Black adolescents had higher adjusted continuation of implants compared with older and White adolescents, respectively (both p < .001). Those whose IUD was inserted by an obstetrician/gynecologist provider had lower continuation of IUDs compared with non-obstetrician/gynecologist providers (p < .001). DiscussionWe found that age-related, racial, and ethnic disparities exist in both implant and IUD continuation. Practice changes to support positive adolescent experiences with implant and IUD insertion and removals are needed, including patient-centered health care provider training in contraception counseling, LARC initiation and removal training for adolescent-facing providers, and broader clinic capacity for LARC services.