The Adolescent Experience of Filling Prescriptions for the Treatment of Sexually Transmitted Infections.

PURPOSE: To describe adolescents' experience with treatment adherence when prescribed antibiotics for sexually transmitted infections (STIs) in emergency departments (ED). METHODS: Adolescents diagnosed with STIs in two EDs and prescribed outpatient treatment were interviewed to identify barriers and facilitators to treatment adherence. RESULTS: Of 26 participants, 46.2% filled their prescriptions, 38.5% returned to the ED for treatment, 7.7% received treatment elsewhere, and 7.7% received no treatment. All adolescents who filled their prescriptions notified caregivers of their diagnosis, compared with 50.0% who returned to the ED (P = 0.01). Adolescents identified cost, transportation, lack of insurance card, and lack of knowledge as perceived barriers to treatment adherence. Less than half of the participants were interested in school-based health clinics due to anonymity concerns. Most expressed interest in using mobile health (mHealth) to overcome adherence challenges. CONCLUSIONS: Adolescents identified multiple barriers to treatment adherence. Future work should explore the role of caregiver communication and incorporation of mHealth.

Genomic deletion of GIT2 induces a premature age-related thymic dysfunction and systemic immune system disruption.

Recent research has proposed that GIT2 (G protein-coupled receptor kinase interacting protein 2) acts as an integrator of the aging process through regulation of 'neurometabolic' integrity. One of the commonly accepted hallmarks of the aging process is thymic involution. At a relatively young age, 12 months old, GIT2-/- mice present a prematurely distorted thymic structure and dysfunction compared to age-matched 12 month-old wild-type control (C57BL/6) mice. Disruption of thymic structure in GIT2-/- (GIT2KO) mice was associated with a significant reduction in the expression of the cortical thymic marker, Troma-I (cytokeratin 8). Double positive (CD4+CD8+) and single positive CD4+ T cells were also markedly reduced in 12 month-old GIT2KO mice compared to age-matched control wild-type mice. Coincident with this premature thymic disruption in GIT2KO mice was the unique generation of a novel cervical 'organ', i.e. 'parathymic lobes'. These novel organs did not exhibit classical peripheral lymph node-like characteristics but expressed high levels of T cell progenitors that were reflexively reduced in GIT2KO thymi. Using signaling pathway analysis of GIT2KO thymus and parathymic lobe transcriptomic data we found that the molecular signaling functions lost in the dysfunctional GIT2KO thymus were selectively reinstated in the novel parathymic lobe - suggestive of a compensatory effect for the premature thymic disruption. Broader inspection of high-dimensionality transcriptomic data from GIT2KO lymph nodes, spleen, thymus and parathymic lobes revealed a systemic alteration of multiple proteins (Dbp, Tef, Per1, Per2, Fbxl3, Ddit4, Sin3a) involved in the multidimensional control of cell cycle clock regulation, cell senescence, cellular metabolism and DNA damage. Altered cell clock regulation across both immune and non-immune tissues therefore may be responsible for the premature 'aging' phenotype of GIT2KO mice.