Reducing Opioid Prescribing Rates in Emergency Medicine.

PubMed

Guarisco, Joseph; Salup, Adam

2018-01-01

Pain management is one of the most common reasons patients visit the emergency department. Understanding the contributions of emergency medicine-and specifically Ochsner Health System's emergency providers-to the opioid crisis is important. Benchmark prescribing data indicated that Ochsner Health System emergency medicine providers' opioid prescription rates were significantly higher than the national average in emergency medicine. Data relevant to visit and opioid prescription counts were extracted from the organization's electronic health record system. Opioid prescription rates were calculated for each provider. A data transparency project was initiated in which provider opioid prescription rates were unblinded and distributed among the provider group. Opioid prescription rates declined in aggregate for the emergency services from 22% to 14% during the 1-year project timeline. Some physicians demonstrated a 70% reduction in prescription rates. Importantly, patient satisfaction scores were not negatively impacted by declining opioid prescription rates. Provider performance transparency using unblinded and transparent data analytics can efficiently and significantly alter provider practice.

The influence of social adjustment on normative and risky health behaviors in emerging adults with spina bifida.

PubMed

Murray, Caitlin B; Lennon, Jaclyn M; Devine, Katie A; Holmbeck, Grayson N; Klages, Kimberly; Potthoff, Lauren M

2014-10-01

To understand the rates of normative and risky health behaviors and the influence of prior and current social adjustment on health risk behaviors in emerging adults with spina bifida (SB). These data are part of a larger longitudinal study of youth with SB; at ages 18-19, 50 emerging adults with SB and 60 typically developing (TD) youth participated. Social adjustment was measured at ages 12/13, 14/15, 16/17, and 18/19. Substance use and sexual activity were self-reported by emerging adults. The SB group reported similar frequencies (i.e., number of days in the previous month) of cigarette and marijuana use. Fewer individuals with SB reported initiation of both alcohol use (i.e., ever used) and sexual activity (i.e., ever had sex) compared to TD peers. The SB group also reported less frequent alcohol use and fewer sexual partners. Better social adjustment during early adolescence (ages 12/13) predicted more frequent alcohol use and a greater number of sexual partners for all youth. Social adjustment also mediated the effect of group status on health risk behaviors. Emerging adults with SB lag behind TD peers in terms of normative initiation of alcohol use and sexual activity. However, this population participates in some risky health behaviors at similar rates compared to their TD peers (e.g., smoking). Youths' health risk behaviors may be influenced by their level of social adjustment. A challenge for future interventions for this population will be finding methods of improving social functioning without increasing the rate of health risk behavior.

Parental Physical Force and Alcohol Use in Emerging Adults: Mediation by Psychological Problems.

PubMed

Pollard, Mary Ward; McKinney, Cliff

2016-07-01

Research has indicated that negative parenting practices, such as physical punishment, are associated with negative outcomes in children. These negative outcomes can present during childhood and during emerging adulthood. One negative consequence can be excessive alcohol use, a problematic outcome with its own myriad consequences. The goal of the current study was to examine the effects of parental physical force on emerging adult functioning, specifically alcohol and psychological problems. A sample of 488 young adults completed questionnaires on current perceptions related to alcohol-related problems, physical and psychological aggression by their parents experienced during the previous year, and current emotional and behavioral functioning. Results showed full mediation between paternal physical force and emerging adult alcohol problems by emerging adult psychological problems. Emerging adult psychological problems partially mediated the effect of maternal physical force on emerging adult alcohol problem. Gender did not moderate these effects. The results support existing literature suggesting that the use of parental physical force may lead to a chain reaction of problems, even during emerging adulthood. These results also reveal that emerging adults report currently receiving physical force from their parents, which brings to light a concerning lack of literature on the use of parental physical force on emerging adult children. These results advocate for positive parenting practives and efforts to teach them, even for emerging adult children. The results may also clinically suggest that paying attention to parental force in emerging adult clients could yield a better understanding of their current functioning, especially including excessive alcohol use.

Factors Influencing Dietary Fat Intake among Black Emerging Adults

ERIC Educational Resources Information Center

Horton, Shalonda E. B.; Timmerman, Gayle M.; Brown, Adama

2018-01-01

Objective: To determine what factors influenced dietary fat intake (DFI) among black emerging adults. Participants: Sample included 251 black emerging adults, ages 18-25 years, living in the US. Methods: This was a nonexperimental cross-sectional study based on self-report data. Results: The sample had high DFI. Factors related to DFI were gender…

High Utilizers of Emergency Health Services in a Population-Based Cohort of Homeless Adults

PubMed Central

Chambers, Catharine; Chiu, Shirley; Katic, Marko; Kiss, Alex; Redelmeier, Donald A.; Levinson, Wendy

2013-01-01

Objectives. We identified predictors of emergency department (ED) use among a population-based prospective cohort of homeless adults in Toronto, Ontario. Methods. We assessed ED visit rates using administrative data from the Institute for Clinical Evaluative Sciences (2005–2009). We then used logistic regression to identify predictors of ED use. Frequent users were defined as participants with rates in the top decile (≥ 4.7 visits per person-year). Results. Among 1165 homeless adults, 892 (77%) had at least 1 ED visit during the study. The average rate of ED visits was 2.0 visits per person-year, whereas frequent users averaged 12.1 visits per person-year. Frequent users accounted for 10% of the sample but contributed more than 60% of visits. Predictors of frequent use in adjusted analyses included birth in Canada, higher monthly income, lower health status, perceived unmet mental health needs, and perceived external health locus of control from powerful others; being accompanied by a partner or dependent children had a protective effect on frequent use. Conclusions. Among homeless adults with universal health insurance, a small subgroup accounted for the majority of visits to emergency services. Frequent use was driven by multiple predisposing, enabling, and need factors. PMID:24148033

Adolescent presentations to an adult hospital emergency department.

PubMed

Noori, Omar; Batra, Shweta; Shetty, Amith; Steinbeck, Katharine

2017-10-01

Age-related policies allow adolescents to access paediatric and adult EDs. Anecdotally, paediatric and adult EDs report challenges when caring for older and younger adolescents, respectively. Our aim was to describe the characteristics of an adolescent population attending an adult ED, co-located with a tertiary paediatric ED. The Westmead Hospital ED database was accessed for 14.5-17.9 years old presentations between January 2010 and December 2012. Patient diagnosis coding (SNOMED) was converted to ICD-10. De-identified data were transferred into Microsoft Excel with analysis performed using spss V22. There were 5718 presentations made to the Westmead Hospital, Sydney, Australia ED by 4450 patients, representing 3.3% (95% CI 3.2-3.4) of total visits from all patients 14.5 years and above. The mean age of the sample was 16.6 years (male 51.8%). Presentations triaged as level 4 or 5 represented 61.0% (95% CI 58.7-61.3) of visits. The proportion of patients who did not wait to receive care was 13.8% (95% CI 12.9-14.7), which was significantly higher than adult rates (P < 0.01). There were 279 unscheduled return visits (visits made <72 h of discharge) representing 4.9% (95% CI 4.4-5.8) of all presentations. Injury was the most common diagnosis (30.2%, 95% CI 28.8-31.6). Chronic physical illness and alcohol-related visits comprised 2.1% (95% CI 1.7-2.5) and 0.8% (95% CI 0.6-1.0) of adolescent presentations, respectively. Contrary to reported staff perceptions, adolescent chronic physical illness presentations were not a major burden. Alcohol was likely under-recorded as a contributing factor to presentations. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Understanding How Overweight and Obese Emerging Adults Make Lifestyle Choices.

PubMed

Cha, EunSeok; Crowe, James M; Braxter, Betty J; Jennings, Bonnie Mowinski

To better understand health-related decision making among overweight and obese emerging adults. A cross-sectional design was used in the parent study involving overweight and obese emerging adults, ages 18-29 years. The goal of the parent study was to screen participants' diabetes risk and identify characteristics of emerging adults with prediabetes (N=107). A sub-sample of respondents (n=34) from the parent study were invited to participate in focus group interviews depending on whether they had prediabetes (three groups) or they did not have prediabetes (four groups). Each focus group interview lasted 90-120 minutes following a semi-structured interview guide. Conventional content analysis was used in the data analysis. Because of the similarities between participants with and without prediabetes, the findings were synthesized and reported in the aggregate. Moreover, during the analysis, the authors decided that rational choice theory provided a useful organizing structure for presenting the data. Emerging adults' behavioral decisions were rational reactions to their personal competence, perception of health, environment, and availability of resources to handle problems. Calculation of trade-offs and estimations of resource availability were often used when making decisions. Emerging adults choose unhealthy behaviors due to inaccurate information and insufficient competence to practice healthy lifestyles rather than because of laziness or being irrational. Behavioral interventions for emerging adults need to help them develop skills to enhance health literacy and problem solving, thereby enhancing their awareness of available resources and decreasing the perceived cost of making healthy choices. Copyright © 2016 Elsevier Inc. All rights reserved.

Prevention of Recurrence of Major Depression among Emerging Adults by a Group Cognitive-Behavioral/Interpersonal Intervention

PubMed Central

Sheets, Erin S.; Craighead, Linda Wilcoxon; Brosse, Alisha L.; Hauser, Monika; Madsen, Joshua W.; Craighead, W. Edward

2012-01-01

Background Among the most serious sequelae to an initial episode of Major Depressive Disorder (MDD) during adolescence is the significant increase in the probability of recurrence. This study reports on an integrated CBT/IPT program, provided in a group format, that was developed to decrease the rate of MDD recurrence in emerging adults. Methods Participants were 89 young adults who were not depressed at study entry but had experienced MDD during adolescence. Participants were assigned to a CBT/IPT prevention program or to an assessment only control condition and were followed through the first 2 years of college. Results Risk for MDD recurrence was reduced more than 50% for the prevention program participants compared to assessment only controls. The intervention also conferred beneficial effects on academic performance for those students who completed the majority of the group sessions. Limitations The study included a self-selected sample of emerging adults who were aware of their history of depression. Due to the small sample size, it will be important to evaluate similar interventions in adequately-powered trials to determine if this is a replicable finding. Conclusions With 51% of the assessment only participants experiencing a MDD recurrence during the first 2 years of college, these findings support the need for programs designed to prevent MDD recurrence in young adults. The current program, based on IPT and CBT principles, appears to reduce the rate of MDD recurrence among previously depressed emerging adults. PMID:23021821

The effects of continuing care on emerging adult outcomes following residential addiction treatment.

PubMed

Bergman, Brandon G; Hoeppner, Bettina B; Nelson, Lindsay M; Slaymaker, Valerie; Kelly, John F

2015-08-01

Professional continuing care services enhance recovery rates among adults and adolescents, though less is known about emerging adults (18-25 years old). Despite benefit shown from emerging adults' participation in 12-step mutual-help organizations (MHOs), it is unclear whether participation offers benefit independent of professional continuing care services. Greater knowledge in this area would inform clinical referral and linkage efforts. Emerging adults (N=284; 74% male; 95% Caucasian) were assessed during the year after residential treatment on outpatient sessions per week, percent days in residential treatment and residing in a sober living environment, substance use disorder (SUD) medication use, active 12-step MHO involvement (e.g., having a sponsor, completing step work, contact with members outside meetings), and continuous abstinence (dichotomized yes/no). One generalized estimating equation (GEE) model tested the unique effect of each professional service on abstinence, and, in a separate GEE model, the unique effect of 12-step MHO involvement on abstinence over and above professional services, independent of individual covariates. Apart from SUD medication, all professional continuing care services were significantly associated with abstinence over and above individual factors. In the more comprehensive model, relative to zero 12-step MHO activities, odds of abstinence were 1.3 times greater if patients were involved in one activity, and 3.2 times greater if involved in five activities (lowest mean number of activities in the sample across all follow-ups). Both active involvement in 12-step MHOs and recovery-supportive, professional services that link patients with these community-based resources may enhance outcomes for emerging adults after residential treatment. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

An intensive assessment of alcohol use and emergency department utilization in homeless alcohol-dependent adults.

PubMed

Holtyn, August F; Jarvis, Brantley P; Subramaniam, Shrinidhi; Wong, Conrad J; Fingerhood, Michael; Bigelow, George E; Silverman, Kenneth

2017-09-01

Excessive alcohol use among the homeless may contribute to their high rates of emergency department use. Survey-based studies have provided some information on the relation between alcohol and emergency department use among the homeless. This study used an intensive schedule of random breath collections and self-report assessments to examine the relation between emergency department utilization and alcohol use in homeless alcohol-dependent adults. Data were from homeless alcohol-dependent adults (N=116) who were participating in a therapeutic workplace that provided job-skills training every weekday for 26 weeks. Breath-sample collections and assessments of self-reported alcohol use were scheduled each week, an average of twice per week per participant, at random times between 9:00 A.M. and 5:00 P.M. Participants received $35 for each breath sample collected. Self-reports of emergency department use were assessed throughout the study. Thirty-four percent of participants reported attending an emergency department and reported an average of 2.2 emergency department visits (range 1-10 visits). Alcohol intoxication was the most common reason for emergency department use. Participants who used the emergency department had significantly more alcohol-positive breath samples and more self-reported heavy alcohol use than participants who did not use the emergency department. This study provided a rare intensive assessment of alcohol and emergency department use in homeless alcohol-dependent adults over an extended period. Emergency department use was high and was significantly related to indices of alcohol use. Copyright © 2017 Elsevier B.V. All rights reserved.

Retention strategies in longitudinal studies with emerging adults.

PubMed

Hanna, Kathleen M; Scott, Linda L; Schmidt, Karen K

2014-01-01

The purpose of this report was to describe retention strategies that were useful and those that were not in a longitudinal study of emerging adults. A longitudinal study examining the transition to young adulthood among emerging adults with type 1 diabetes, which had success in retention, provided the context for describing retention strategies. A challenge in longitudinally designed studies is retention of participants because the loss decreases power for statistical analysis. Given that emerging adulthood is a period of instability, retention is particularly challenging among this population. However, longitudinal studies are the best way to understand developmental changes, and it is also important to increase our knowledge of health outcomes during emerging adulthood. Retention strategies used in the study are described, including promoting a positive relationship with participants, maintaining contact with participants, having a study staff with good interpersonal skills, using incentives, conveying respect for participants, and using user-friendly data collection. Useful strategies to promote a positive relationship included sending cards and newsletters to participants, maintaining consistency of contact person, and expressing appreciation for participant's time and effort. Useful strategies for maintaining contact with participants included obtaining contact information at every data collection point, maintaining birth dates and chart numbers in tracking databases, monitoring returned mail, and using Web search engines. Other useful strategies were providing incentives to participants, employing staff with good interpersonal skills, providing participants with choices when appropriate, and using user-friendly data collection. One strategy, using contests, was not found useful. Despite the challenges of conducting longitudinally designed studies with emerging adults, multiple retention strategies can be used that are useful to retention. It is feasible to

Are mothers' and fathers' parenting characteristics associated with emerging adults' academic engagement?

PubMed

Waterman, Emily A; Lefkowitz, Eva S

2017-06-01

Although parenting is clearly linked to academic engagement in adolescence, less is known about links between parenting and academic engagement in emerging adulthood. A diverse sample of college students ( N = 633; 53.1% female, 45.7% White/European American, 28.3% Asian American/Hawaiian/Pacific Islander, 26.4% Hispanic/Latino American, 21.6% Black/African American, and 2.8% Native American/American Indian) answered surveys about mothers' and fathers' parenting style, parent-offspring relationship quality, academic attitudes, academic behaviors, and academic performance. Emerging adults with more permissive mothers viewed grades as less important than emerging adults with less permissive mothers. Mothers' authoritarian parenting, mothers' permissive parenting, and relationship quality with father were differentially related to academic engagement depending on emerging adults' gender. Both mothers' and fathers' parenting characteristics may impact the academic engagement of emerging adults via past parenting behaviors and current quality of the parent-offspring relationship, despite decreased physical proximity of emerging adults and their parents.

FORUM: Instructional Communication and Millennial Students: Teaching Communication to Emerging Adults

ERIC Educational Resources Information Center

Tompkins, Paula S.

2016-01-01

The new developmental stage of emerging adulthood (age 18-25) offers a framework for thinking about younger millennials in our classrooms. Smith, Christoffersen, Davidson, and Herzog's (2011) profile of emerging adults, based on longitudinal study of over 3200 emerging adults and culminating in 230 in-depth interviews, parallels research of the…

The Influence of Social Adjustment on Normative and Risky Health Behaviors in Emerging Adults With Spina Bifida

PubMed Central

Murray, Caitlin B.; Lennon, Jaclyn M.; Devine, Katie A.; Holmbeck, Grayson N.; Klages, Kimberly; Potthoff, Lauren M.

2015-01-01

Objective To understand the rates of normative and risky health behaviors and the influence of prior and current social adjustment on health risk behaviors in emerging adults with spina bifida (SB). Method These data are part of a larger longitudinal study of youth with SB; at ages 18–19, 50 emerging adults with SB and 60 typically developing (TD) youth participated. Social adjustment was measured at ages 12/13, 14/15, 16/17, and 18/19. Substance use and sexual activity were self-reported by emerging adults. Results The SB group reported similar frequencies (i.e., number of days in the previous month) of cigarette and marijuana use. Fewer individuals with SB reported initiation of both alcohol use (i.e., ever used) and sexual activity (i.e., ever had sex) compared to TD peers. The SB group also reported less frequent alcohol use and fewer sexual partners. Better social adjustment during early adolescence (ages 12/13) predicted more frequent alcohol use and a greater number of sexual partners for all youth. Social adjustment also mediated the effect of group status on health risk behaviors. Conclusions Emerging adults with SB lag behind TD peers in terms of normative initiation of alcohol use and sexual activity. However, this population participates in some risky health behaviors at similar rates compared to their TD peers (e.g., smoking). Youths’ health risk behaviors may be influenced by their level of social adjustment. A challenge for future interventions for this population will be finding methods of improving social functioning without increasing the rate of health risk behavior. PMID:24490647

Assistive Technology and Older Adults in Disasters: Implications for Emergency Management.

PubMed

McSweeney-Feld, Mary Helen

2017-02-01

This article identifies concepts, trends, and policy gaps in the availability and service delivery of assistive technology utilized by older adults in disasters, as well as implications for emergency management planning and shelter administration. Definitions of types of assistive technology, as well as views of older adults using technology as at-risk individuals for emergency management service provision, are provided. An overview of peer-reviewed articles and gray literature is conducted, focusing on publications from 2001 to the present in the United States. Analytical frameworks used by emergency management organizations as well as regulations such as the Americans with Disabilities Act and recent court decisions on emergency shelter accessibility in disasters are reviewed. Research on the use of assistive technology by older adults during disasters is a neglected issue. The current and potential benefits of defining standards for provision and use of assistive technology for older adults during disasters has received limited recognition in emergency management planning. Older adults with disabilities utilize assistive technology to maintain their independence and dignity, and communities as well as emergency services managers need to become more aware of the needs and preferences of these older adults in their planning processes and drills as well as in service delivery during actual events. (Disaster Med Public Health Preparedness. 2017;11:135-139).

Coping-motivated Marijuana Use Correlates with DSM-5 Cannabis Use Disorder and Psychological Distress among Emerging Adults

PubMed Central

Moitra, Ethan; Christopher, Paul P.; Anderson, Bradley J.; Stein, Michael D.

2015-01-01

Compared to other age cohorts, emerging adults, ages 18–25 years old, have the highest rates of marijuana (MJ) use. We examined the relationship of using MJ to cope with negative emotions, relative to using MJ for enhancement or social purposes, to MJ-associated problems and psychological distress among emerging adults. Participants were 288 community-dwelling emerging adults who reported current MJ use as part of a ‘Health Behaviors’ study. Linear and logistic regressions were used to evaluate the adjusted association of coping-motivated MJ use with DSM-5 Cannabis Use Disorder, MJ-related problem severity, depressive symptoms, and perceived stress. After adjusting for other variables in the regression model, using MJ to cope was positively associated with having DSM-5 cannabis use disorder (OR = 1.85, 95%CI 1.31; 2.62, p < .01), MJ problem severity (b = .41, 95% CI .24; .57, p < .01), depression (b = .36, 95% CI .23; .49, p < .01), and perceived stress (b = .37, 95% CI .22; .51, p < .01). Using MJ for enhancement purposes or for social reasons was not associated significantly with any of the dependent variables. Using MJ to cope with negative emotions in emerging adults is associated with MJ-related problems and psychological distress. Assessment of MJ use motivation may be clinically important among emerging adults. PMID:25915689

Infection rate in adult patients with open fractures treated at the emergency hospital and at the ULBRA university hospital in Canoas, Rio Grande do Sul, Brazil.

PubMed

Guerra, Marcelo Teodoro Ezequiel; Gregio, Fernando Machado; Bernardi, Adriane; Castro, Cyntia Cordeiro de

2017-01-01

To identify the infection rate in adult patients with open fractures treated at two tertiary hospitals in the city of Canoas, Rio Grande do Sul, Brazil. This quantitative descriptive study was conducted at Hospital de Pronto Socorro de Canoas. Eligible participants were adults aged 18-60 years with open fractures who were admitted to the orthopedic trauma service from January to May 2014 and followed-up for one year. A total of 133 patients with open fractures were included; most were men (92.48%), with a mean age of 36 years. There was a predominance of Gustilo-Anderson type III fractures. The infection rate was 18.80%, being more frequent in Gustilo-Anderson type III fractures (72.00%). The most commonly observed bacteria were Staphylococcus aureus and Enterobacter aerogenes . The infection rate in open fractures of patients initially treated at the emergency department of HPSC was 18.8%. The infections occurred predominantly in Gustilo-Anderson type III fractures. The bacteria with the highest incidence in infections were Staphylococcus aureus and Enterobacter aerogenes .

Adult care providers' perspectives on the transition to adult care for emerging adults with Type 1 diabetes: a cross-sectional survey.

PubMed

Michaud, S; Dasgupta, K; Bell, L; Yale, J-F; Anjachak, N; Wafa, S; Nakhla, M

2018-03-25

To assess adult diabetes care providers' current transition practices, knowledge about transition care, and perceived barriers to implementation of best practices in transition care for emerging adults with Type 1 diabetes mellitus. We administered a 38-item web-based survey to adult diabetes care providers identified through the Québec Endocrinologist Medical Association and Diabetes Québec. Fifty-three physicians responded (35%). Fewer than half of all respondents (46%) were familiar with the American Diabetes Association's transition care position statement. Approximately one-third of respondents reported a gap of >6 months between paediatric and adult diabetes care. Most (83%) believed communication with the paediatric team was adequate; however, only 56% reported receiving a medical summary and 2% a psychosocial summary from the paediatric provider. Respondents believed that the paediatric team should improve emerging adults' preparation for transition care by developing their self-management skills and improve teaching about the differences between paediatric and adult-oriented care. Only 31% had a system for identifying emerging adults lost to follow-up in adult care. Perceived barriers included difficulty accessing psychosocial services, emerging adults' lack of motivation, and inadequate transition preparation. Most (87%) were interested in having additional resources, including a self-care management tool and a registry to track those lost to follow-up. Our findings highlight the need to better engage adult care providers into transition care practices. Despite adult physicians' interest in transition care, implementation of transition care recommendations and resources in clinical care remains limited. Enhanced efforts are needed to improve access to mental health services within the adult healthcare setting. © 2018 Diabetes UK.

Developmental Differences in Parenting Behavior: Comparing Adolescent, Emerging Adult, and Adult Mothers

ERIC Educational Resources Information Center

Lewin, Amy; Mitchell, Stephanie J.; Ronzio, Cynthia R.

2013-01-01

The nationally representative Early Childhood Longitudinal Study-Birth cohort data set was used to compare parenting behaviors of adolescent mothers (less than 19 years old), emerging adult mothers (19-25 years old), and adult mothers (greater than 25 years old) when their children were 2 years old. Regression models controlling for socioeconomic…

Self-Definition as Resistance: Understanding Identities among LGBTQ Emerging Adults

ERIC Educational Resources Information Center

Wagaman, M. Alex

2016-01-01

Scholars have questioned the relevance of existing identity categories and labels for lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth and emerging adults. Little is understood, however, about the ways in which LGBTQ emerging adults perceive their own identities and self-define the aspects of themselves that are most relevant to who…

Reducing recidivism and symptoms in emerging adults with serious mental health conditions and justice system involvement.

PubMed

Davis, Maryann; Sheidow, Ashli J; McCart, Michael R

2015-04-01

The peak years of offending in the general population and among those with serious mental health conditions (SMHC) are during emerging adulthood. There currently are no evidence-based interventions for reducing offending behavior among 18-21 year olds, with or without SMHC. This open trial examined outcomes from an adaptation of Multisystemic Therapy (MST), an effective juvenile recidivism reduction intervention, modified for use with emerging adults with SMHC and recent justice system involvement. MST for emerging adults (MST-EA) targets MH symptoms, recidivism, problem substance use, and young adult functional capacities. All study participants (n = 41) were aged 17-20 and had a MH diagnosis and recent arrest or incarceration. Implementation outcomes indicated that MST-EA was delivered with strong fidelity, client satisfaction was high, and the majority of participants successfully completed the intervention. Research retention rates also were high. Pre-post-analyses revealed significant reductions in participants' MH symptoms, justice system involvement, and associations with antisocial peers.

Reducing Recidivism and Symptoms in Emerging Adults with Serious Mental Health Conditions and Justice System Involvement

PubMed Central

Davis, Maryann; Sheidow, Ashli J.; McCart, Michael R.

2014-01-01

The peak years of offending in the general population and among those with serious mental health conditions (SMHC) are during emerging adulthood. There currently are no evidence-based interventions for reducing offending behavior among 18–21 year olds, with or without SMHC. This open trial examined outcomes from an adaptation of Multisystemic Therapy (MST), an effective juvenile recidivism reduction intervention, modified for use with emerging adults with SMHC and recent justice system involvement. MST for emerging adults (MST-EA) targets MH symptoms, recidivism, problem substance use, and young adult functional capacities. All study participants (n=41) were aged 17–20 and had a MH diagnosis and recent arrest or incarceration. Implementation outcomes indicated that MST-EA was delivered with strong fidelity, client satisfaction was high, and the majority of participants successfully completed the intervention. Research retention rates also were high. Pre-post analyses revealed significant reductions in participants’ MH symptoms, justice-system involvement, and associations with antisocial peers. PMID:25023764

Freedom to explore the self: How emerging adults use leisure to develop identity

PubMed Central

Layland, Eric K.; Hill, Brian J.; Nelson, Larry J.

2017-01-01

During a period of newly attained freedom preceding commitments expected in adulthood, emerging adults are faced with the major task of identity development. Leisure provides a context with relative freedom wherein emerging adults explore new experiences and access opportunities not always available in more constrained environments like work and school. In this case study of 40 emerging adults from 18 countries (Mage=23.14 years), qualitative interviews were used to investigate the role of leisure as a context for identity development. Results indicate five major themes for leisure-based identity development in emerging adulthood: discovering identity, forming identity, defining identity, positioning identity, and forgoing opportunities. These themes support leisure as an additional context wherein emerging adults may flourish on the pathway toward adulthood. Access to both novel and familiar leisure provide a context for emerging adults to actively direct their identity development through decisions made in leisure time. PMID:29276528

Freedom to explore the self: How emerging adults use leisure to develop identity.

PubMed

Layland, Eric K; Hill, Brian J; Nelson, Larry J

2018-01-01

During a period of newly attained freedom preceding commitments expected in adulthood, emerging adults are faced with the major task of identity development. Leisure provides a context with relative freedom wherein emerging adults explore new experiences and access opportunities not always available in more constrained environments like work and school. In this case study of 40 emerging adults from 18 countries ( M age =23.14 years), qualitative interviews were used to investigate the role of leisure as a context for identity development. Results indicate five major themes for leisure-based identity development in emerging adulthood: discovering identity, forming identity, defining identity, positioning identity, and forgoing opportunities. These themes support leisure as an additional context wherein emerging adults may flourish on the pathway toward adulthood. Access to both novel and familiar leisure provide a context for emerging adults to actively direct their identity development through decisions made in leisure time.

System factors to explain H1N1 state vaccination rates for adults in US emergency response to pandemic.

PubMed

Davila-Payan, Carlo; Swann, Julie; Wortley, Pascale M

2014-05-23

During the 2009-2010 H1N1 pandemic, vaccine in short supply was allocated to states pro rata by population, yet the vaccination rates of adults differed by state. States also differed in their campaign processes and decisions. Analyzing the campaign provides an opportunity to identify specific approaches that may result in higher vaccine uptake in a future event of this nature. To determine supply chain and system factors associated with higher state H1N1 vaccination coverage for adults in a system where vaccine was in short supply. Regression analysis of factors predicting state-specific H1N1 vaccination coverage in adults. Independent variables included state campaign information, demographics, preventive or health-seeking behavior, preparedness funding, providers, state characteristics, and H1N1-specific state data. The best model explained the variation in state-specific adult vaccination coverage with an adjusted R-squared of 0.76. We found that higher H1N1 coverage of adults is associated with program aspects including shorter lead-times (i.e., the number of days between when doses were allocated to a state and were shipped, including the time for states to order the doses) and less vaccine directed to specialist locations. Higher vaccination coverage is also positively associated with the maximum number of ship-to locations, past seasonal influenza vaccination coverage, the percentage of women with a Pap smear, the percentage of the population that is Hispanic, and negatively associated with a long duration of the epidemic peak. Long lead-times may be a function of system structure or of efficiency and may suggest monitoring or redesign of distribution processes. Sending vaccine to sites with broad access could be useful when covering a general population. Existing infrastructure may be reflected in the maximum number of ship-to locations, so strengthening routine influenza vaccination programs may help during emergency vaccinations also. Future research

Are There Gendered Pathways to Intimacy in Early Adolescents' and Emerging Adults' Friendships?

ERIC Educational Resources Information Center

Radmacher, Kimberley; Azmitia, Margarita

2006-01-01

Two studies addressed age- and gender-related patterns in early adolescents' and emerging adults' conceptions of intimacy in friendships. Forty-one early adolescents and 96 emerging adults in Study 1 and 174 emerging adults in Study 2 described a time when they felt especially close to a friend. Narratives were coded for intimate behaviors and…

Koru: Teaching Mindfulness to Emerging Adults

ERIC Educational Resources Information Center

Rogers, Holly B.

2013-01-01

Although there is much interest in teaching mindfulness to college students and other emerging adults, traditional methods of teaching mindfulness and meditation are not always effective for reaching this age group. Koru is a program, developed at Duke University, that has been specifically designed with the developmental characteristics of…

Examining gender differences for gambling engagement and gambling problems among emerging adults.

PubMed

Wong, Gloria; Zane, Nolan; Saw, Anne; Chan, Alan Ka Ki

2013-06-01

Gambling is fast becoming a public health problem in the United States, especially among emerging adults (18-25 year olds). Since 1995, rates have recently doubled with around 7-11 % of the emerging adult population having problems with gambling (Shaffer et al. in Am J Public Health 89(9):1369-1376, 1999; Cyders and Smith in Pers Individ Diff 45(6):503-508, 2008). Some states have lowered their gambling age to 18 years old; in turn, the gambling industry has recently oriented their market to target this younger population. However, little is known about the gender variation and the factors placing emerging adults at risk for getting engaged and developing problems with gambling. The purpose of the study was to determine the risk factors accounting for gender differences at the two levels of gambling involvement: engagement and problems. Mediation analyses revealed that impulsive coping and risk-taking were significant partial mediators for gender differences on engagement in gambling. Men took more risks and had lower levels of impulsive coping than women, and those who took more risks and had lower levels of impulsive coping were more likely to engage in gambling. Risk-taking and social anxiety were the significant mediators for gender differences in problems with gambling. Men took more risks and were more socially anxious than women, and greater risk-taking and more socially anxious individuals tended to have more problems with gambling. Implications for counseling preventions and intervention strategies are discussed.

Understanding how Overweight and Obese Emerging Adults Make Lifestyle Choices

PubMed Central

Cha, EunSeok; Crowe, James M.; Braxter, Betty J.; Jennings, Bonnie Mowinski

2016-01-01

Purpose To better understand health-related decision making among overweight and obese emerging adults. Design and Methods A cross-sectional design was used in the parent study involving overweight and obese emerging adults, ages 18–29 years. The goal of the parent study was to screen participants’ diabetes risk and identify characteristics of emerging adults with prediabetes (N = 107). A sub-sample of respondents (n = 34) from the parent study were invited to participate in focus group interviews depending on whether they had prediabetes (three groups) or they did not have prediabetes (four groups). Each focus group interview lasted 90–120 minutes following a semi-structured interview guide. Conventional content analysis was used in the data analysis. Because of the similarities between participants with and without prediabetes, the findings were synthesized and reported in the aggregate. Moreover, during the analysis, the authors decided that Rational Choice Theory provided a useful organizing structure for presenting the data. Results Emerging adults’ behavioral decisions were rational reactions to their personal competence, perception of health, environment, and availability of resources to handle problems. Trade-offs calculation and estimations of resource availability were often used when making decisions. Conclusions Emerging adults choose unhealthy behaviors due to inaccurate information and insufficient competence to practice healthy lifestyles rather than because of laziness or being irrational. PMID:27496826

Emerging adults' perspectives on their relationships with mothers with mental illness: implications for caregiving.

PubMed

Abraham, Kristen M; Stein, Catherine H

2012-10-01

Guided by a life course perspective, the current study examined whether emerging adults with and without mothers with affective disorders viewed their relationships with their mothers differently, and whether aspects of the emerging adult-mother relationship were associated with reports of caregiving for mothers. Reports from emerging adults with mothers with affective disorders (n = 46) were compared to reports from emerging adults with mothers without mental illness (n = 64). Results indicated that emerging adults with mothers with affective disorders reported significantly lower levels of affection, felt obligation, reciprocity, and future caregiving intentions, and significantly higher levels of role reversal in their relationships with their mothers. Reported current caregiving levels did not differ between emerging adults with and without mothers with affective disorders. Hierarchical multiple regression analyses generally indicated higher levels of felt obligation were associated with higher levels of caregiving, regardless of maternal mental health status. Results and future research directions are discussed from a life course perspective. © 2012 American Orthopsychiatric Association.

Social media use and anxiety in emerging adults.

PubMed

Vannucci, Anna; Flannery, Kaitlin M; Ohannessian, Christine McCauley

2017-01-01

Social media use is central to the lives of emerging adults, but the implications of social media use on psychological adjustment are not well understood. The current study aimed to examine the impact of time spent using social media on anxiety symptoms and severity in emerging adults. Using a web-based recruitment technique, we collected survey information on social media use and anxiety symptoms and related impairment in a nationally representative sample of 563 emerging adults from the U.S. (18-22 years-old; 50.2% female; 63.3% Non-Hispanic White). Participants self-reported the amount of time they spent using various social media sites on an average day, and responded to anxiety questionnaires RESULTS: Hierarchical regression revealed that more time spent using social media was significantly associated with greater symptoms of dispositional anxiety (B=0.74, 95% CI=0.59-0.90, p<0.001), but was unrelated to recent anxiety-related impairment (B=0.06, 95% CI=0.00-0.12, p=0.051), controlling for age, gender, race/ethnicity, and education level. Logistic regression also revealed that more daily social media use was significantly associated with a greater likelihood of participants scoring above the anxiety severity clinical cut-off indicating a probable anxiety disorder (AOR=1.032, 95% CI=1.004-1.062, p=0.028). Study limitations include the cross-sectional design and reliance on self-report questionnaires. Given the ubiquity of social media among emerging adults, who are also at high risk for anxiety disorders, the positive association between social media use and anxiety has important implications for clinicians. Gaining a more nuanced understanding of this relationship will help to inform novel approaches to anxiety treatment. Copyright © 2016 Elsevier B.V. All rights reserved.

Implications of parent-child relationships for emerging adults' subjective feelings about adulthood.

PubMed

Lindell, Anna K; Campione-Barr, Nicole; Killoren, Sarah E

2017-10-01

Little is known about the role of parents in promoting their children's successful transition to adulthood, particularly for college students who may maintain stronger ties to parents than other emerging adults. The present study therefore investigated longitudinal implications of parent-child relationship qualities during emerging adults' first year of college for their feelings about the upcoming transition to adulthood 3 years later, as well as implications of 3 types of parental control (behavioral control, psychological control, helicopter parenting) for these associations. Multilevel models indicated that emerging adults who reported less negativity in their relationships with mothers and fathers felt more like adults 3 years later compared with emerging adults with low-quality relationships, while high levels of psychological control and helicopter parenting had detrimental implications for their vocational identity development and perceived competence regarding their transition to adulthood. However, nuanced interactions between parent-child relationship quality and parental control indicated that behavioral control had positive implications for outcomes if it occurred within the context of high-quality relationships, or when utilized with sons. The present study highlights the complex role that parents may play during college students' transition to adulthood, and future work should continue to examine ways that clinicians can incorporate parents as a potential resource for promoting emerging adults' successful transition to adulthood and the workforce. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Emerging Adults With Type 1 Diabetes: A Comparison to Peers Without Diabetes

PubMed Central

Helgeson, Vicki S.; Reynolds, Kerry A.; Becker, Dorothy J.; Siminerio, Linda M.; Escobar, Oscar

2013-01-01

Objective This longitudinal study compared emerging adults with and without type 1 diabetes on life path decisions, health behaviors, and psychological well-being during the transition out of high school. Methods Administered questionnaires during the senior year of high school and 1 year later to 117 emerging adults with diabetes and 122 emerging adults without diabetes. Comparisons were conducted with respect to health status, sex, and school status. Results Those with and without diabetes chose similar life paths and engaged in similar levels of risky behaviors, but disturbed sleep increased for males with diabetes only. Having diabetes was not associated with depressive symptoms, loneliness, or bulimic symptoms, but was associated with lower life satisfaction and lower life purpose over time. Conclusions Emerging adults with and without diabetes fare similarly on most dimensions studied during the first year out of high school. PMID:23475831

Multidimensional attitudes of emergency medicine residents toward older adults.

PubMed

Hogan, Teresita M; Chan, Shu B; Hansoti, Bhakti

2014-07-01

The demands of our rapidly expanding older population strain many emergency departments (EDs), and older patients experience disproportionately high adverse health outcomes. Trainee attitude is key in improving care for older adults. There is negligible knowledge of baseline emergency medicine (EM) resident attitudes regarding elder patients. Awareness of baseline attitudes can serve to better structure training for improved care of older adults. The objective of the study is to identify baseline EM resident attitudes toward older adults using a validated attitude scale and multidimensional analysis. Six EM residencies participated in a voluntary anonymous survey delivered in summer and fall 2009. We used factor analysis using the principal components method and Varimax rotation, to analyze attitude interdependence, translating the 21 survey questions into 6 independent dimensions. We adapted this survey from a validated instrument by the addition of 7 EM-specific questions to measures attitudes relevant to emergency care of elders and the training of EM residents in the geriatric competencies. Scoring was performed on a 5-point Likert scale. We compared factor scores using student t and ANOVA. 173 EM residents participated showing an overall positive attitude toward older adults, with a factor score of 3.79 (3.0 being a neutral score). Attitudes trended to more negative in successive post-graduate year (PGY) levels. EM residents demonstrate an overall positive attitude towards the care of older adults. We noted a longitudinal hardening of attitude in social values, which are more negative in successive PGY-year levels.

Testing a Matching Hypothesis for Emerging Adults in Project MATCH: During-Treatment and One-Year Outcomes

PubMed Central

Davis, Jordan P.; Bergman, Brandon G.; Smith, Douglas C.; Kelly, John F.

2017-01-01

Objective: Compared with older adults, emerging adults (18-29 years old) entering treatment typically have less severe alcohol use consequences. Also, their unique clinical presentations (e.g., modest initial abstinence motivation) and developmental contexts (e.g., drinking-rich social networks) may make a straightforward implementation of treatments developed for adults less effective. Yet, this has seldom been examined empirically. This study was a secondary analysis of Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity) data examining (a) overall differences between emerging adults and older adults (≥30 years old) on outcomes during treatment and at 1-year follow-up, and (b) whether emerging adults had poorer outcomes on any of the three Project MATCH treatments in particular. Method: Participants were 267 emerging adults and 1,459 older adults randomly assigned to individually delivered cognitive-behavioral therapy (CBT), motivational enhancement therapy (MET), or 12-step facilitation (TSF). Multilevel growth curve models tested differences on percentage of days abstinent (PDA) and drinks per drinking day (DDD) by age group and treatment assignment. Results: During treatment, compared with older adults, emerging adults reported more DDD but similar PDA. Further, emerging adults assigned to TSF had less PDA and more DDD than emerging adults and older adults assigned to CBT or MET during treatment (i.e., emerging adults in TSF has poorer outcomes initially), but this matching effect was not evident at 1-year follow-up. Conclusions: This study is among the first to test age group differences across three psychosocial interventions shown to be efficacious treatments for alcohol use disorder. Although emerging adults generally did as well as their older counterparts, they may require a more developmentally sensitive approach to bolster TSF effects during treatment. PMID:27936374

Age differences in learning emerge from an insufficient representation of uncertainty in older adults

PubMed Central

Nassar, Matthew R.; Bruckner, Rasmus; Gold, Joshua I.; Li, Shu-Chen; Heekeren, Hauke R.; Eppinger, Ben

2016-01-01

Healthy aging can lead to impairments in learning that affect many laboratory and real-life tasks. These tasks often involve the acquisition of dynamic contingencies, which requires adjusting the rate of learning to environmental statistics. For example, learning rate should increase when expectations are uncertain (uncertainty), outcomes are surprising (surprise) or contingencies are more likely to change (hazard rate). In this study, we combine computational modelling with an age-comparative behavioural study to test whether age-related learning deficits emerge from a failure to optimize learning according to the three factors mentioned above. Our results suggest that learning deficits observed in healthy older adults are driven by a diminished capacity to represent and use uncertainty to guide learning. These findings provide insight into age-related cognitive changes and demonstrate how learning deficits can emerge from a failure to accurately assess how much should be learned. PMID:27282467

Parenting styles and emerging adult drug use in Cebu, the Philippines.

PubMed

Hock, Rebecca S; Hindin, Michelle J; Bass, Judith K; Surkan, Pamela J; Bradshaw, Catherine P; Mendelson, Tamar

Parenting style is a potent and malleable influence on emerging adult substance use. Most of the parenting-substance use literature has been conducted in Western populations and it is unknown whether findings are generalizable to other cultures and contexts. We extended the parenting-substance use literature to a cohort of emerging adults in the Philippines using the Cebu Longitudinal Health and Nutrition Survey. We assessed associations between mothers' and fathers' parenting styles (authoritative, permissive, authoritarian, and neglectful) reported by offspring at age 18 and odds of offspring-reported drug use three years later, adjusted for a range of offspring- and parent/household-level characteristics. Females were dropped from analyses due to low prevalence of drug users. We found that many emerging adults in Cebu reported having used drugs, particularly methamphetamine-a dangerous drug with high abuse potential. Authoritative (warm, firm) mothering was significantly associated with sons' reduced odds of drug use and neglectful fathering was related at a trend level with sons' increased odds of having tried drugs. Findings underscore the relation of parenting styles to emerging adults' drug use and add to the literature on cross-cultural variability in parenting styles.

Nonurgent Emergency Department Visits by Insured and Uninsured Adults.

PubMed

Searing, Lisabeth M; Cantlin, Kelly A

2016-01-01

To compare nonurgent emergency department (ED) visits by insured and uninsured adults in a Midwest community. Records for this secondary data analysis included 84,877 nonurgent visits to a Midwest ED from September 2004 to January 2012. Insured versus uninsured visits were analyzed using t tests for continuous variables and chi-squared tests for categorical variables. Standardized residuals were compared to determine if changes over time were statistically significant. Variables included demographic characteristics of patients, payment source, patients' access to primary care, acuity rating, time of visit, and the stated reason for the visit. Of all nonurgent visits, 77.9% were made by insured adults. Insured nonurgent visits were more often made by adults who were female, older, White, and had a primary care provider (PCP). Nonurgent visits on weekdays between the hours of 09:00 and 18:00 were more likely to be uninsured visits. Dental issues were the fourth most common issue for uninsured visits. Nonurgent ED visits occur when more appropriate options for prompt care are available in the community. Interventions should target both patients and PCPs. While patients should contact their PCP when in need of prompt care, PCPs should refer patients to facilities other than the ED when medically appropriate. © 2015 Wiley Periodicals, Inc.

Trends in Adult Cancer-Related Emergency Department Utilization: An Analysis of Data From the Nationwide Emergency Department Sample.

PubMed

Rivera, Donna R; Gallicchio, Lisa; Brown, Jeremy; Liu, Benmei; Kyriacou, Demetrios N; Shelburne, Nonniekaye

2017-10-12

The emergency department (ED) is used to manage cancer-related complications among the 15.5 million people living with cancer in the United States. However, ED utilization patterns by the population of US adults with cancer have not been previously evaluated or described in published literature. To estimate the proportion of US ED visits made by adults with a cancer diagnosis, understand the clinical presentation of adult patients with cancer in the ED, and examine factors related to inpatient admission within this population. Nationally representative data comprised of 7 survey cycles (January 2006-December 2012) from the Nationwide Emergency Department Sample were analyzed. Identification of adult (age ≥18 years) cancer-related visits was based on Clinical Classifications Software diagnoses documented during the ED visit. Weighted frequencies and proportions of ED visits among adult patients with cancer by demographic, geographic, and clinical characteristics were calculated. Weighted multivariable logistic regression was used to examine the associations between inpatient admission and key demographic and clinical variables for adult cancer-related ED visits. Adult cancer-related ED utilization patterns; identification of primary reason for ED visit; patient-related factors associated with inpatient admission from the ED. Among an estimated 696 million weighted adult ED visits from January 2006 to December 2012, 29.5 million (4.2%) were made by a patient with a cancer diagnosis. The most common cancers associated with an ED visit were breast, prostate, and lung cancer, and most common primary reasons for visit were pneumonia (4.5%), nonspecific chest pain (3.7%), and urinary tract infection (3.2%). Adult cancer-related ED visits resulted in inpatient admissions more frequently (59.7%) than non-cancer-related visits (16.3%) (P < .001). Septicemia (odds ratio [OR], 91.2; 95% CI, 81.2-102.3) and intestinal obstruction (OR, 10.94; 95% CI, 10.6-11.4) were

Emergency department discharge prescription interventions by emergency medicine pharmacists.

PubMed

Cesarz, Joseph L; Steffenhagen, Aaron L; Svenson, James; Hamedani, Azita G

2013-02-01

We determine the rate and details of interventions associated with emergency medicine pharmacist review of discharge prescriptions for patients discharged from the emergency department (ED). Additionally, we evaluate care providers' satisfaction with such services provided by emergency medicine pharmacists. This was a prospective observational study in the ED of an academic medical center that serves both adult and pediatric patients. Details of emergency medicine pharmacist interventions on discharge prescriptions were compiled with a standardized form. Interventions were categorized as error prevention or optimization of therapy. The staff of the ED was surveyed related to the influence and satisfaction of this new emergency medicine pharmacist-provided service. The 674 discharge prescriptions reviewed by emergency medicine pharmacists during the study period included 602 (89.3%) for adult patients and 72 (10.7%) for pediatric patients. Emergency medicine pharmacists intervened on 68 prescriptions, resulting in an intervention rate of 10.1% (95% confidence interval [CI] 8.0% to 12.7%). The intervention rate was 8.5% (95% CI 6.4% to 11.1%) for adult prescriptions and 23.6% for pediatric prescriptions (95% CI 14.7% to 35.3%) (difference 15.1%; 95% CI 5.1% to 25.2%). There were a similar number of interventions categorized as error prevention and optimization of medication therapy, 37 (54%) and 31 (46%), respectively. More than 95% of survey respondents believed that the new pharmacist services improved patient safety, optimized medication regimens, and improved patient satisfaction. Emergency medicine pharmacist review of discharge prescriptions for discharged ED patients has the potential to significantly improve patient care associated with suboptimal prescriptions and is highly valued by ED care providers. Copyright © 2012. Published by Mosby, Inc.

Multidimensional Attitudes of Emergency Medicine Residents Toward Older Adults

PubMed Central

Hogan, Teresita M.; Chan, Shu B.; Hansoti, Bhakti

2014-01-01

Introduction The demands of our rapidly expanding older population strain many emergency departments (EDs), and older patients experience disproportionately high adverse health outcomes. Trainee attitude is key in improving care for older adults. There is negligible knowledge of baseline emergency medicine (EM) resident attitudes regarding elder patients. Awareness of baseline attitudes can serve to better structure training for improved care of older adults. The objective of the study is to identify baseline EM resident attitudes toward older adults using a validated attitude scale and multidimensional analysis. Methods Six EM residencies participated in a voluntary anonymous survey delivered in summer and fall 2009. We used factor analysis using the principal components method and Varimax rotation, to analyze attitude interdependence, translating the 21 survey questions into 6 independent dimensions. We adapted this survey from a validated instrument by the addition of 7 EM-specific questions to measures attitudes relevant to emergency care of elders and the training of EM residents in the geriatric competencies. Scoring was performed on a 5-point Likert scale. We compared factor scores using student t and ANOVA. Results 173 EM residents participated showing an overall positive attitude toward older adults, with a factor score of 3.79 (3.0 being a neutral score). Attitudes trended to more negative in successive post-graduate year (PGY) levels. Conclusion EM residents demonstrate an overall positive attitude towards the care of older adults. We noted a longitudinal hardening of attitude in social values, which are more negative in successive PGY-year levels. PMID:25035760

Characteristics of emergency pages using a computer-based anesthesiology paging system in children and adults undergoing procedures at a tertiary care medical center.

PubMed

Weingarten, Toby N; Abenstein, John P; Dutton, Claire H; Kohn, Melinda A; Lee, Elizabeth A; Mullenbach, Tami E; Narr, Bradly J; Schroeder, Darrell R; Sprung, Juraj

2013-04-01

In our large academic supervisory practice, attending anesthesiologists concomitantly care for multiple patients. To manage communications within the procedural environment, we use a proprietary electronic computer-based anesthesiology visual paging system. This system can send an emergency page that instantly alerts the attending anesthesiologist and other available personnel that immediate help is needed. We analyzed the characteristics of intraoperative emergency pages in children and adults. We identified all emergency page activations between January 1, 2005 and July 31, 2010 in our main operating rooms. Electronic medical records were reviewed for rates and characteristics of pages such as primary etiology, performed interventions, and outcomes. During the study period, 258,135 anesthetics were performed (n = 32,103 children, younger than 18 years) and 370 emergency pages (n = 309 adults, n = 61 children) were recorded (1.4 per 1000 cases; 95% confidence interval, 1.3-1.6). Infants had the highest rates (9.4 per 1000; 95% confidence interval, 5.7-14.4) of emergency page activations (P < 0.001 compared with each other age group). In adults, the most frequent causes were hemodynamic (55%), and in children respiratory and airway (60.7%) events. Emergency pages were rare in patients older than 2 years. Infants were more likely than children 1 to 2 years of age to have emergency page activation, despite both groups being cared for by pediatric fellowship trained anesthesiologists.

Emerging technologies to support independent living of older adults at risk.

PubMed

Hanson, Gregory J; Takahashi, Paul Y; Pecina, Jennifer L

2013-01-01

The aging of the population is expected to place an unprecedented strain on health care systems over the next two decades and beyond. Emerging electronic monitoring technologies provide opportunities to learn about the aging process, age-related diseases, and contribute to new, cost effective care models that preserve independence at home for older adults at risk. The goals of this article are to familiarize the reader with emerging technologies and potential applications to older adults' at-risk, review the current literature about the clinical and economic outcomes of emerging technologies, and to outline future directions and challenges.

Sub-dissociative-dose intranasal ketamine for moderate to severe pain in adult emergency department patients.

PubMed

Yeaman, Fiona; Meek, Robert; Egerton-Warburton, Diana; Rosengarten, Pamela; Graudins, Andis

2014-06-01

There are currently no studies assessing effectiveness of sub-dissociative intranasal (IN) ketamine as the initial analgesic for adult patients in the ED. The study aims to examine the effectiveness of sub-dissociative IN ketamine as a primary analgesic agent for adult patients in the ED. This is a prospective, observational study of adult ED patients presenting with severe pain (≥6 on 11-point scale at triage). IN ketamine dose was 0.7 mg/kg, with secondary dose of 0.5 mg/kg at 15 min if pain did not improve. After 6 months, initial dose was increased to 1.0 mg/kg with the same optional secondary dose. The primary outcomes are change in VAS rating at 30 min; percentage of patients reporting clinically significant reduction in VAS (≥20 mm) at 30 min; dose resulting in clinically significant pain reduction. Of the 72 patients available for analysis, median age was 34.5 years and 64% were men. Median initial VAS rating was 76 mm (interquartile range [IQR]: 65-82). Median total dose of IN ketamine for all patients was 0.98 mg/kg (IQR: 0.75-1.15, range: 0.59-1.57). Median reduction in VAS rating at 30 min was 24 mm (IQR: 2-45). Forty (56%, 95% CI: 44.0-66.7) reported VAS reduction ≥20 mm, these patients having had a total median ketamine dose of 0.94 mg/kg (IQR: 0.72-1.04). IN ketamine, at a dose of about 1 mg/kg, was an effective analgesic agent in 56% of study patients. The place of IN ketamine in analgesic guidelines for adults requires further investigation. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Stress-related personal growth among emerging adults whose mothers have been diagnosed with mental illness.

PubMed

Abraham, Kristen M; Stein, Catherine H

2015-09-01

This study explored whether emerging adults' reports of their relationships with their mothers who have been diagnosed with mental illness and their attempts to make meaning of the experience of having a mother with mental illness were associated with stress-related personal growth. Fifty-two emerging adult children with mothers who have been diagnosed with mental illness responded to a self-report questionnaire containing measures of adult parent-child relationships, meaning making, and stress-related personal growth. Hierarchical multiple linear regression analysis of the cross-sectional data indicated that meaning making contributed to stress-related personal growth after accounting for emerging adult-mother relationship factors. Aspects of the emerging adult-mother relationship did not contribute to growth. Efforts to make meaning of having a mother with mental illness may facilitate growth among emerging adult children. Longitudinal investigations in larger samples are needed to better understand the relationship among interpersonal relationships, meaning making, and growth in this population. Interventions with adult children of people with mental illness should address their capacity for personal growth. (c) 2015 APA, all rights reserved).

Natural Mentoring Processes Deter Externalizing Problems Among Rural African American Emerging Adults: A Prospective Analysis

PubMed Central

Kogan, Steven M.; Brody, Gene H.; Chen, Yi-fu

2011-01-01

A 3-wave model linking natural mentoring relationships to externalizing behavior was tested with 345 rural African American emerging adults in their final year of high school. Structural equation models were executed linking multi-informant reports of mentor-emerging adult relationship quality with youths’ externalizing behavior 18 months later. Consistent with our primary hypotheses, emerging adults whose relationships with their natural mentors were characterized by instrumental and emotional support and affectively positive interactions reported lower levels of anger, rule-breaking behavior, and aggression. These effects emerged independent of the influences of family support and youth gender. Two intrapersonal processes, a future orientation and self-regulation, emerged as mediators of the influence of natural mentoring relationships. The influence of natural mentors was most pronounced for emerging adults experiencing high levels of life stress. PMID:21293917

Sentence Interpretation Strategies in Emergent Bilingual Children and Adults

ERIC Educational Resources Information Center

Reyes, Iliana; Hernandez, Arturo E.

2006-01-01

This study examined sentence processing in emergent bilingual children and young adults in both English (second language -- L2) and Spanish (first language -- L1). One hundred participants from five different age groups (5;4-7;11, 8;0-10;11, 11;2-13;11, 14;0-16;8 years, and college-age adults) participated in this study. An online sentence…

A Descriptive Study of Gambling Among Emerging Adult Males in French-Speaking Switzerland.

PubMed

Tomei, Alexander; Tichelli, Emmanuel; Ewering, Neil; Nunweiler-Hardegger, Sophie; Simon, Olivier

2015-09-01

The aims were twofold: to examine the gambling habits of emerging adult males in the French-speaking regions of Switzerland and to what extent these habits predict problem gambling within this population. We also evaluated problem gambling rates and provided data concerning variables such as gambling location, level of information about problem gambling and awareness of treatment centers. 606 Swiss male conscripts, aged 18-22 years, completed a self-report questionnaire. This was administered during their army recruitment day in 2012. Problem gambling was assessed through the Problem Gambling Severity Index (PGSI) (Ferris and Wynne 2001). 78.5% of the respondents were lifetime gamblers, 56.1% were past-year gamblers. Four out of ten past-year gamblers played in private spaces and in back rooms. The PGSI indicated that 10.8% of past-year gamblers presented with moderate gambling problems, whilst 1.4% appeared to be problem gamblers. The majority of respondents had never received information about problem gambling. Moreover, they were unaware of the existence of treatment centers for problem gambling in their region. PGSI scores were significantly predicted by the variety of games played. Problem gambling rates among young men appear to be higher than those of the general Swiss population. This confirms that emerging adult males are a particularly vulnerable population with regards to gambling addiction. The implications of this are considered for youth gambling-prevention programs.

Variables Affecting Emerging Adults' Self-Reported Risk and Reckless Behaviors

ERIC Educational Resources Information Center

Duangpatra, Krisna N. K.; Bradley, Graham L.; Glendon, A. Ian

2009-01-01

Young adults' behaviors are frequently characterized by risk-taking and recklessness. Few studies have examined the correlates of risk and reckless behaviors in emerging adults. Drawing on theories emphasising multifactorial effects of personality, social, and cognitive variables, this study explores psychosocial factors contributing to risk and…

Work-Family Planning Attitudes among Emerging Adults

ERIC Educational Resources Information Center

Basuil, Dynah A.; Casper, Wendy J.

2012-01-01

Using social learning theory as a framework, we explore two sets of antecedents to work and family role planning attitudes among emerging adults: their work-family balance self-efficacy and their perceptions of their parents' work-to-family conflict. A total of 187 college students completed a questionnaire concerning their work-family balance…

Parental and emerging adult psychopathology: Moderated mediation by gender and affect toward parents.

PubMed

Walker, Courtney S; McKinney, Cliff

2015-10-01

Current research indicates that children tend to view parents with psychopathology more negatively and children who hold negative perceptions of parents are at a greater risk for psychopathology. Yet, less research examines how parental psychopathology influences offspring psychopathology through affect toward parents. The current study tested a model that examined the associations among parental psychopathology, positive affect toward parents, and emerging adult psychopathology. Associations were expected to be partly indirect via positive affect toward parents and emerging adult gender was expected to moderate these associations. Results indicated gender-moderated mediation with significant effects found for males but not females. Results from the current study emphasize the importance of examining affect toward parents as a risk factor for emerging adult psychopathology. Additionally, results of the current study demonstrate the importance of examining the role of emerging adult gender as a potential moderator in these relationships. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

The Relationship Between Child Maltreatment and Substance Abuse Treatment Outcomes Among Emerging Adults and Adolescents

PubMed Central

Garner, Bryan R.; Hunter, Brooke D.; Smith, Douglas C.; Smith, Jane Ellen; Godley, Mark D.

2015-01-01

Emerging adulthood is the period of greatest risk for problematic substance use. The primary aim of the current study was to examine the relationship between a broad measure of child maltreatment and several key outcomes for a large clinical sample of emerging adults (n = 858) and adolescents (n = 2,697). The secondary aim was to examine the extent to which the relationship between child maltreatment and treatment outcomes differed between emerging adults and adolescents. Multilevel latent growth curve analyses revealed emerging adults and adolescents who experienced child maltreatment reported significantly greater reductions over time on several treatment outcomes (e.g., substance use, substance-related problems, and emotional problems). Overall, analyses did not support differential relationships between child maltreatment and changes over time in these substance use disorder treatment outcomes for emerging adults and adolescents. The one exception was that although emerging adults with child maltreatment did reduce their HIV risk over time, their improvements were not as great as were the improvements in HIV risk reported by adolescents who had experienced child maltreatment. PMID:25125233

The relationship between child maltreatment and substance abuse treatment outcomes among emerging adults and adolescents.

PubMed

Garner, Bryan R; Hunter, Brooke D; Smith, Douglas C; Smith, Jane Ellen; Godley, Mark D

2014-01-01

Emerging adulthood is the period of greatest risk for problematic substance use. The primary aim of the current study was to examine the relationship between a broad measure of child maltreatment and several key outcomes for a large clinical sample of emerging adults (n = 858) and adolescents (n = 2,697). The secondary aim was to examine the extent to which the relationship between child maltreatment and treatment outcomes differed between emerging adults and adolescents. Multilevel latent growth curve analyses revealed emerging adults and adolescents who experienced child maltreatment reported significantly greater reductions over time on several treatment outcomes (e.g., substance use, substance-related problems, and emotional problems). Overall, analyses did not support differential relationships between child maltreatment and changes over time in these substance use disorder treatment outcomes for emerging adults and adolescents. The one exception was that although emerging adults with child maltreatment did reduce their HIV risk over time, their improvements were not as great as were the improvements in HIV risk reported by adolescents who had experienced child maltreatment. © The Author(s) 2014.

Racial identity and depressive symptoms among Black emerging adults: the moderating effects of neighborhood racial composition.

PubMed

Hurd, Noelle M; Sellers, Robert M; Cogburn, Courtney D; Butler-Barnes, Sheretta T; Zimmerman, Marc A

2013-05-01

In the current study, we explored patterns of change in Black emerging adults' racial identity beliefs during the transition to adulthood, assessed neighborhood racial composition effects on Black emerging adults' racial identity beliefs, and tested the moderating effects of neighborhood racial composition on the associations between Black emerging adults' racial identity beliefs and depressive symptoms over time. Participants in the current study included 570 Black adolescents (52% female) who were transitioning into adulthood (senior year of high school through 5 years post- high school). We did not find average patterns of change in Black emerging adults' racial identity beliefs over time. Further, neighborhood racial composition did not predict participants' beginning status or growth in racial identity beliefs over time. We, however, found evidence that neighborhood racial composition may moderate the associations between Black emerging adults' racial identity beliefs and symptoms of depression over time. Findings from the current study underscore the importance of considering how the larger social context may interact with individuals' racial identity beliefs to influence Black emerging adults' psychological health.

Acculturative Stress, Perceived Discrimination, and Vulnerability to Suicide Attempts among Emerging Adults

PubMed Central

Gomez, Judelysse; Miranda, Regina; Polanco, Lillian

2018-01-01

Cultural factors are often neglected in studies of suicidal behavior among emerging adults. The present study examined acculturative stress and perceived discrimination as statistical predictors of a suicide attempt history among an ethnically diverse sample of 969 emerging adults, ages 18–25 (M = 18.8). Females made up 68% of the sample, and the racial/ethnic composition included Asian, Latino, Black, and White (U.S.-born and non-U.S.-born) individuals. There were no statistically significant racial/ethnic differences in endorsement of a suicide attempt history, with an overall rate of 8% in the sample. Asians participants reported higher acculturative stress than all other racial/ethnic groups, while both Asian and Black participants reported having experienced more discrimination in the previous year, compared to other groups. Logistic regression analyses suggested that familial acculturative stress was associated with 2 times higher odds of endorsing a past suicide attempt, overall. More specifically, it was associated with over 2 times higher odds among Asian participants, over 4 times higher odds among Black participants, and over 3 times higher odds among non-U.S.-born White participants, while social acculturative stress was associated with over 3 times higher odds of endorsing a past suicide attempt among Latino participants. Environmental acculturative stress was associated with decreased odds of endorsing a suicide attempt history, overall, but not when examined separately by racial/ethnic group. Perceived discrimination was associated with over 5 times higher odds of a suicide attempt, overall, and specifically was associated with over 3 times higher odds among Latino participants and over 10 times higher odds among White, U.S.-born participants. These findings suggest the importance of addressing culturally-related variables in treatment with emerging adults of racially/ethnically diverse backgrounds to reduce risk for suicidal behavior. PMID

Acculturative stress, perceived discrimination, and vulnerability to suicide attempts among emerging adults.

PubMed

Gomez, Judelysse; Miranda, Regina; Polanco, Lillian

2011-11-01

Cultural factors are often neglected in studies of suicidal behavior among emerging adults. The present study examined acculturative stress and perceived discrimination as statistical predictors of a suicide attempt history among an ethnically diverse sample of 969 emerging adults, ages 18-25 (M = 18.8). Females made up 68% of the sample, and the racial/ethnic composition included Asian, Latino, Black, and White (US-born and non-US-born) individuals. There were no statistically significant racial/ethnic differences in endorsement of a suicide attempt history, with an overall rate of 8% in the sample. Asian participants reported higher acculturative stress than all other racial/ethnic groups, while both Asian and Black participants reported having experienced more discrimination in the previous year, compared to other groups. Logistic regression analyses suggested that familial acculturative stress was associated with 2 times higher odds of endorsing a past suicide attempt, overall. More specifically, it was associated with over 2 times higher odds among Asian participants, over 4 times higher odds among Black participants, and over 3 times higher odds among non-US-born White participants, while social acculturative stress was associated with over 3 times higher odds of endorsing a past suicide attempt among Latino participants. Environmental acculturative stress was associated with decreased odds of endorsing a suicide attempt history, overall, but not when examined separately by racial/ethnic group. Perceived discrimination was associated with over 5 times higher odds of a suicide attempt, overall, and specifically was associated with over 3 times higher odds among Latino participants and over 10 times higher odds among White, US-born participants. These findings suggest the importance of addressing culturally-related variables in treatment with emerging adults of racially/ethnically diverse backgrounds to reduce risk for suicidal behavior.

Non-trauma surgical emergencies in adults: Spectrum, challenges and outcome of care

PubMed Central

Ibrahim, N.A.; Oludara, M.A.; Ajani, A.; Mustafa, I.; Balogun, R.; Idowu, O.; Osuoji, R.; Omodele, F.O.; Aderounmu, A.O.A.; Solagberu, B.A.

2015-01-01

Introduction Significant deaths of between 21% and 38% occur from non-trauma surgical conditions in the accident and emergency room. Access to emergency surgical care is limited in many developing countries including Nigeria. We aimed to study the spectrum of non-trauma surgical emergencies, identify challenges in management and evaluate outcomes. Methods A one year prospective cohort study of all non-trauma emergencies in adults seen at the surgical emergency room of LASUTH from 1st October, 2011 to 30th September, 2012 was conducted. Data was analyzed using SPSS version 15.0. Results Of a total of 7536 patients seen, there were 7122 adults. Those with non-trauma conditions were 2065 representing 29% of adult emergencies. Age ranged between 15 and 97 years and male to female ratio was 1.7:1. Acute abdomen (30%), urological problems (18%) and malignancies (10%) were the most common. Among 985 patients requiring admission only 464 (47%) were admitted while the remaining 53% were referred to other centers. Emergency surgical intervention was carried out in 222 patients representing 48% of admitted patients. There were 12 (24%) non-trauma deaths in the emergency room. They were due to acute abdomen and malignancies in half of the cases. Conclusion Facilities for patients needing emergency care were inadequate with more than half of those requiring admission referred. Attention should be paid to the provision of emergency surgical services to the teeming number of patients seen on yearly basis in the Teaching Hospital. PMID:26566434

The Role of Higher Education in Their Life: Emerging Adults on the Crossroad

ERIC Educational Resources Information Center

Chiang, Shu-Chen; Hawley, Josh

2013-01-01

This study describes the experience of younger, so called "emerging" adults, as they transition to full-time work, focusing specifically on the role of education in this process. When leaving their family-of-origin, emerging adults re-center themselves to settle down in permanent identity and different role commitments. Our findings show…

Parenting styles and emerging adult drug use in Cebu, the Philippines

PubMed Central

Hock, Rebecca S.; Hindin, Michelle J.; Bass, Judith K.; Surkan, Pamela J.; Bradshaw, Catherine P.; Mendelson, Tamar

2016-01-01

Parenting style is a potent and malleable influence on emerging adult substance use. Most of the parenting-substance use literature has been conducted in Western populations and it is unknown whether findings are generalizable to other cultures and contexts. We extended the parenting-substance use literature to a cohort of emerging adults in the Philippines using the Cebu Longitudinal Health and Nutrition Survey. We assessed associations between mothers’ and fathers’ parenting styles (authoritative, permissive, authoritarian, and neglectful) reported by offspring at age 18 and odds of offspring-reported drug use three years later, adjusted for a range of offspring- and parent/household-level characteristics. Females were dropped from analyses due to low prevalence of drug users. We found that many emerging adults in Cebu reported having used drugs, particularly methamphetamine—a dangerous drug with high abuse potential. Authoritative (warm, firm) mothering was significantly associated with sons’ reduced odds of drug use and neglectful fathering was related at a trend level with sons’ increased odds of having tried drugs. Findings underscore the relation of parenting styles to emerging adults’ drug use and add to the literature on cross-cultural variability in parenting styles. PMID:27330559

Effects of MON810 Bt field corn on adult emergence of Helicoverpa zea (Lepidoptera: Noctuidae).

PubMed

Horner, T A; Dively, G P; Herbert, D A

2003-06-01

A 3-yr study (1996-1998) was conducted to evaluate the effects of MON810 Bt corn on Helicoverpa zea (Boddie) emergence and to determine whether delayed larval development as a result of Bt intoxication results in higher levels of diapause induction and pupal mortality. In the 1997 study, there was no difference in prepupal mortality between corn types, although significantly more prepupae from Bt plots than from non-Bt plots died in emergence buckets before constructing pupal chambers in 1998. In all years, significantly fewer moths emerged from prepupae collected from Bt plots, suggesting that effects of the expressed Cry1Ab extended to the prepupal and pupal stages. Late plantings of corn showed the greatest reductions in moth emergence from Bt corn because environmental conditions were more conducive to trigger diapause at the time H. zea was developing in these plantings. This was supported by a significantly greater proportion of diapausing pupae remaining in the ground in the late plantings of both Bt and non-Bt corn. For April and early May plantings, larval feeding on Bt corn delayed the time to pupation, although there was no significant difference in moth emergence between corn types for those larvae that successfully pupated. Although Bt expression had less impact on the proportion of moths emerging, the actual number of moths emerging from Bt corn was significantly reduced because fewer larvae reached pupation. Delays in adult emergence, along with significant reductions in adult emergence from MON810 Bt corn, should reduce the rates of colonization in soybean and other late host crops but may also result in asynchrony of mating between individuals emerging from Bt and non-Bt corn. This, in turn, may contribute to the evolution of resistance to Bt corn.

National Characteristics of Emergency Medical Services Responses for Older Adults in the United States.

PubMed

Duong, Hieu V; Herrera, Lauren Nicholas; Moore, Justin Xavier; Donnelly, John; Jacobson, Karen E; Carlson, Jestin N; Mann, N Clay; Wang, Henry E

2018-01-01

Older adults, those aged 65 and older, frequently require emergency care. However, only limited national data describe the Emergency Medical Services (EMS) care provided to older adults. We sought to determine the characteristics of EMS care provided to older adults in the United States. We used data from the 2014 National Emergency Medical Services Information System (NEMSIS), encompassing EMS response data from 46 States and territories. We excluded EMS responses for children <18 years, interfacility transports, intercepts, non-emergency medical transports, and standby responses. We defined older adults as age ≥65 years. We compared patient demographics (age, sex, race, primary payer), response characteristics (dispatch time, location type, time intervals), and clinical course (clinical impression, injury, procedures, medications) between older and younger adult EMS emergency 9-1-1 responses. During the study period there were 20,212,245 EMS emergency responses. Among the 16,116,219 adult EMS responses, there were 6,569,064 (40.76%) older and 9,547,155 (59.24%) younger adults. Older EMS patients were more likely to be white and the EMS incident to be located in healthcare facilities (clinic, hospital, nursing home). Compared with younger patients, older EMS patients were more likely to present with syncope (5.68% vs. 3.40%; OR 1.71; CI: 1.71-1.72), cardiac arrest/rhythm disturbance (3.27% vs. 1.69%; OR 1.97; CI: 1.96-1.98), stroke (2.18% vs. 0.74%; OR 2.99; CI: 2.96-3.02) and shock (0.77% vs. 0.38%; OR 2.02; CI: 2.00-2.04). Common EMS interventions performed on older persons included intravenous access (32.02%), 12-lead ECG (14.37%), CPR (0.87%), and intubation (2.00%). The most common EMS drugs administered to older persons included epinephrine, atropine, furosemide, amiodarone, and albuterol or ipratropium. One of every three U.S. EMS emergency responses involves older adults. EMS personnel must be prepared to care for the older patient.

None of Us Will Get Out of Here Alive: The Intersection of Perceived Risk for HIV, Risk Behaviors and Survival Expectations among African American Emerging Adults.

PubMed

Edwards, Lorece V; Lindong, Ian; Brown, Lawrence; Hawkins, Anita S; Dennis, Sabriya; Fajobi, Olaoluwa; Rowel, Randolph; Braithwaite, Ronald; Sydnor, Kim D

2017-01-01

The Human Immunodeficiency Virus (HIV) significantly affects minority emerging adults, among whom the rate of new diagnoses is high and health disparities are more pronounced. Importantly, emerging adults today have limited knowledge of the earlier toll of the virus when it was identified as a killer. Among this population, perceptions of risk for HIV are low and sexual risk taking behaviors are high. The Get SMART Project is a behavioral intervention aimed to provide re-purposed HIV, alcohol, and substance abuse prevention education and HIV testing to African American emerging adults ages 18-24. The project was guided by the Health Belief Model, Community Promise, and Training for Institutional Procedures. Findings revealed that HIV testing is low. Marijuana and alcohol are drugs of choice. Emerging adults do not see themselves at risk for HIV, although they engaged in high-risk behaviors. Additionally, survival expectations influence behavior risk.

Malathion-induced oxidative stress in a parasitoid wasp: effect on adult emergence, longevity, fecundity, and oxidative and antioxidative response of Pimpla turionellae (Hymenoptera: Ichneumonidae).

PubMed

Büyükgüzel, Kemal

2006-08-01

Effects of an organophosphorus insecticide, malathion, on survivorship and lipid peroxidation of the greater wax moth, Galleria mellonella (L.), pupae were investigated by rearing the newly hatched larvae on an artificial diet containing 0.01, 0.1, 1, 10, and 100 ppm of the insecticide. As bioindicators of long-term physiological stress responses, the adult emergence rate, longevity, and fecundity associated with lipid peroxidation level and antioxidant enzyme activity in the endoparasitoid Pimpla turionellae (L.) (Hymenoptera: Ichneumonidae) were determined by rearing the parasitoid on a factitious host, G. mellonella pupae treated with malathion. At 100 ppm, malathion significantly decreased pupation rate of G. mellonella larvae and the rate of adult emergence of the parasitoid from these pupae. This concentration resulted in a significant increase in the lipid peroxidation product malondialdehyde (MDA) in both the host and the parasitoid. Malathion at 1 and 10 ppm significantly increased pupation rate and lipid peroxidation level of G. mellonella pupae. The adult emergence rate of P. turionellae was significantly decreased from 63.7 to 20% by these concentrations, whereas MDA content was increased by two- and three-fold, respectively, compared with the control (45.3 +/- 3.2 nmol/ g protein). The longevity of adults was significantly extended from 52.5 +/- 5.7 to 75.7 +/- 6.3 d when the parasitoids emerged from host pupae exposed with 0.1 ppm malathion. At low concentrations (0.01 and 0.1 ppm), malathion significantly increased the number of eggs laid per female per day. However, the lowest concentration (0.01 ppm) had no significant effect on hatchability, whereas 0.1 ppm of the insecticide resulted in significant decrease in egg hatch compared with the control. A significant increase in total superoxide dismutase (SOD) activity for low concentrations of malathion (0.01-1 ppm) was found compared with the control. There was a significant positive correlation of

North/South Differences Among Italian Emerging Adults Regarding Criteria Deemed Important for Adulthood and Life Satisfaction

PubMed Central

Piumatti, Giovanni; Garro, Maria; Pipitone, Laura; Di Vita, Angela Maria; Rabaglietti, Emanuela

2016-01-01

The main goal of this study was to compare Northern and Southern Italian emerging adult university students, regarding the importance attributed to criteria for adulthood and the levels of life and education satisfaction. Self-report questionnaires were filled by 475 Northern and Southern Italian University students (Age M = 22.91, 76% females, n = 359). Multivariate analysis of variance revealed that Southern emerging adults were more likely to place importance on family capacities, norm compliance, interdependence and role transitions as criteria for achieving adulthood than Northern emerging adults. Regarding gender differences, females were more likely to believe in the importance of norm compliance than males, while males were more likely to espouse the importance of legal transitions. Finally, emerging adults from the North reported higher levels of life satisfaction than their Southern counterparts. We interpreted these findings in light of socio-economical and gender socialization differences among Northern and Southern Italian emerging adults. PMID:27298636

Factors Contributing to the Uptake and Maintenance of Regular Exercise Behaviour in Emerging Adults

ERIC Educational Resources Information Center

Langdon, Jody; Johnson, Chad; Melton, Bridget

2017-01-01

Objective: To identify the influence of parental autonomy support, basic need satisfaction and motivation on emerging adults' physical activity level and exercise behaviours. Design: Cross-sectional survey. Setting: This study convenience-sampled approximately 435 college students identified as emerging adults--aged 18-25 years, who did not have a…

Validation and refinement of a rule to predict emergency intervention in adult trauma patients.

PubMed

Haukoos, Jason S; Byyny, Richard L; Erickson, Catherine; Paulson, Stephen; Hopkins, Emily; Sasson, Comilla; Bender, Brooke; Gravitz, Craig S; Vogel, Jody A; Colwell, Christopher B; Moore, Ernest E

2011-08-01

Trauma centers use "secondary triage" to determine the necessity of trauma surgeon involvement. A clinical decision rule, which includes penetrating injury, an initial systolic blood pressure less than 100 mm Hg, or an initial pulse rate greater than 100 beats/min, was developed to predict which trauma patients require emergency operative intervention or emergency procedural intervention (cricothyroidotomy or thoracotomy) in the emergency department. Our goal was to validate this rule in an adult trauma population and to compare it with the American College of Surgeons' major resuscitation criteria. We used Level I trauma center registry data from September 1, 1995, through November 30, 2008. Outcomes were confirmed with blinded abstractors. Sensitivity, specificity, and 95% confidence intervals (CIs) were calculated. Our patient sample included 20,872 individuals. The median Injury Severity Score was 9 (interquartile range 4 to 16), 15.3% of patients had penetrating injuries, 13.5% had a systolic blood pressure less than 100 mm Hg, and 32.5% had a pulse rate greater than 100 beats/min. Emergency operative intervention or procedural intervention was required in 1,099 patients (5.3%; 95% CI 5.0% to 5.6%). The sensitivities and specificities of the rule and the major resuscitation criteria for predicting emergency operative intervention or emergency procedural intervention were 95.6% (95% CI 94.3% to 96.8%) and 56.1% (95% CI 55.4% to 56.8%) and 85.5% (95% CI 83.3% to 87.5%) and 80.9% (95% CI 80.3% to 81.4%), respectively. This new rule was more sensitive for predicting the need for emergency operative intervention or emergency procedural intervention directly compared with the American College of Surgeons' major resuscitation criteria, which may improve the effectiveness and efficiency of trauma triage. Copyright © 2011 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

The impact of stepfamily relationship quality on emerging adult non-medical use of prescription drugs.

PubMed

Ward, Kaitlin P; Dennis, Cory B; Limb, Gordon E

2018-01-01

Emerging adults aged 18 to 25 are most at-risk for non-medical use of prescription drugs (NMUPD). While the literature dedicated to emerging-adult NMUPD has explored risk and protective factors at an individual level, much less is known regarding how interpersonal and familial factors relate to NMUPD. Because interpersonal bonds can have a significant impact on behavior, familial factors may be important predictors of NMUPD among emerging adults. Inasmuch as growing up in a stepfamily is increasingly common for children, this study aimed to determine whether perceived stepfamily quality within three stepfamily subsystems - child-biological parent, child-stepparent, and child-stepsibling - decreased the likelihood of NMUPD in emerging adulthood. Data came from the Stepfamily Experiences Project (STEP), a retrospective survey examining emerging adults' perceptions of their stepfamily life in 2013. A national quota sampling strategy was used, and the final sample consisted of 902 emerging adults (54.1% female). A structural equation model was constructed, with regression paths from each latent construct predicting the ordinal dependent variable, NMUPD. Increased retrospective biological parent relationship quality in childhood significantly decreased the likelihood of intensifying NMUPD in emerging adulthood (e.g. moving from the "None" category to the "Once a month or less" category). However, stepparent and stepsibling relationship quality did not influence NMUPD. Findings underscore the importance of the preservation of the child-biological parent relationship within a stepfamily context, and encourage further research on the impact familial systems and subsystems may have on NMUPD.

Predicting Future Suicide Attempts Among Adolescent and Emerging Adult Psychiatric Emergency Patients

PubMed Central

Horwitz, Adam G.; Czyz, Ewa K.; King, Cheryl A.

2014-01-01

Objective The purpose of this study was to longitudinally examine specific characteristics of suicidal ideation in combination with histories of suicide attempts and non-suicidal self-injury (NSSI) to best evaluate risk for a future attempt among high-risk adolescents and emerging adults. Method Participants in this retrospective medical record review study were 473 (53% female; 69% Caucasian) consecutive patients, ages 15–24 years (M = 19.4 years) who presented for psychiatric emergency (PE) services during a 9-month period. These patients’ medical records, including a clinician-administered Columbia-Suicide Severity Rating Scale, were coded at the index visit and at future visits occurring within the next 18 months. Logistic regression models were used to predict suicide attempts during this period. Results SES, suicidal ideation severity (i.e., intent, method), suicidal ideation intensity (i.e., frequency, controllability), a lifetime history of suicide attempt, and a lifetime history of NSSI were significant independent predictors of a future suicide attempt. Suicidal ideation added incremental validity to the prediction of future suicide attempts above and beyond the influence of a past suicide attempt, whereas a lifetime history of NSSI did not. Sex moderated the relationship between the duration of suicidal thoughts and future attempts (predictive for males, but not females). Conclusions Results suggest value in incorporating both past behaviors and current thoughts into suicide risk formulation. Furthermore, suicidal ideation duration warrants additional examination as a potential critical factor for screening assessments evaluating suicide risk among high-risk samples, particularly for males. PMID:24871489

Trends in fall-related injuries among older adults treated in emergency departments in the USA.

PubMed

Orces, Carlos H; Alamgir, Hasanat

2014-12-01

To examine national trends in fall-related injuries among older adults treated in emergency departments (ED) and project these injuries until the year 2030. The Web-based Injury Statistics Query and Reporting System was used to generate data on fall-related injuries treated in ED. Joinpoint regression analysis was used to examine the average annual change in injury rates over time. Fall-related injury and hospitalisation rates increased on average by 2% (95% CI 1.5% to 2.7%) and by 4% (95% CI 2.9% to 5.0%) per year, respectively. Assuming the increase in fall-related injury rates remains unchanged, the number of fall-related injuries may increase to 5.7 million by the year 2030. Fall-related injuries among older adults treated in ED increased in the USA during the study period. Moreover, a marked increase in the number of these injuries may occur over the next decades. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Validation of the Adult ADHD Investigator Symptom Rating Scale (AISRS)

ERIC Educational Resources Information Center

Spencer, Thomas J.; Adler, Lenard A.; Qiao, Meihua; Saylor, Keith E.; Brown, Thomas E.; Holdnack, James A.; Schuh, Kory J.; Trzepacz, Paula T.; Kelsey, Douglas K.

2010-01-01

Objective: Validation of the Adult ADHD Investigator Symptom Rating Scale (AISRS) that measures aspects of ADHD in adults. Method: Psychometric properties of the AISRS total and AISRS subscales are analyzed and compared to the Conners' Adult Attention-Deficit/Hyperactivity Disorder Rating Scale-Investigator Rated: Screening Version (CAARS-Inv:SV)…

Heart rate differentiates urgency and emergency in hypertensive crisis.

PubMed

Al Bannay, Rashed; Böhm, Michael; Husain, Aysha

2013-08-01

To study the clinical significance of presenting blood pressure parameters and heart rate in patients with hypertensive crisis. In patients admitted with hypertensive crisis between January 2011 and May 2011, demography, mode of presentation, co-morbidities, blood pressure readings, and heart rate at presentation were documented. Further clustering of hypertensive crisis into emergency or urgency was based on the presence or absence of target organ involvement. The relationship between blood pressure parameters, heart rate, and other variables was analyzed. 189 patients in sinus rhythm were enrolled in this pilot study. The rate of hypertensive urgency was 56 %, whereas the rate of hypertensive emergency was 44 %, respectively. Subjects with hypertensive emergency had a higher mean heart rate (93 ± 22.7 bpm) than those with urgency (81 ± 11.5 bpm) (P = 0.015). Women had higher heart rates (92 ± 18.5 bpm) than men (86 ± 17.6 bpm) (P = 0.014). Heart rates below 100 bpm had a specificity of 94 %, classifying patients as hypertensive urgency. Tachycardia had a powerful statistical association with hypertensive left ventricular failure (P < 0.0001). Other hemodynamic parameters, including systolic blood pressure, diastolic blood pressure, pulse pressure, and mean blood pressure relates neither to urgency nor to emergency. Diabetic patients with HBA1c levels of more than 53 mmol/mol had a heart rate of more than 100 bpm (P = 0.015) during hypertensive crisis. Normal heart rate is characteristic of hypertensive urgency. Tachycardia in this setting is an ominous sign and denotes hypertensive complications in particular left ventricular failure. Among diabetics, elevated heart rate is associated with poor glycemic control.

National Estimates of Emergency Department Visits for Antibiotic Adverse Events Among Adults-United States, 2011-2015.

PubMed

Geller, Andrew I; Lovegrove, Maribeth C; Shehab, Nadine; Hicks, Lauri A; Sapiano, Mathew R P; Budnitz, Daniel S

2018-04-20

Detailed, nationally representative data describing high-risk populations and circumstances involved in antibiotic adverse events (AEs) can inform approaches to prevention. Describe US burden, rates, and characteristics of emergency department (ED) visits by adults for antibiotic AEs. Nationally representative, public health surveillance of adverse drug events (National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance [NEISS-CADES]) and a nationally projected database of dispensed prescriptions (QuintilesIMS), 2011-2015. Antibiotic-treated adults (≥ 20 years) seeking ED care. Estimated annual numbers and rates of ED visits for antibiotic AEs among outpatients treated with systemically administered antibiotics. Based on 10,225 cases, US adults aged ≥ 20 years made an estimated 145,490 (95% confidence interval, 115,279-175,701) ED visits for antibiotic AEs each year in 2011-2015. Antibiotics were implicated in 13.7% (12.3-15.2%) of all estimated adult ED visits for adverse drug events. Most (56.6%; 54.8-58.4%) antibiotic AE visits involved adults aged < 50 years, and 71.8% (70.4-73.1%) involved females. Accounting for prescriptions dispensed from retail and long-term care pharmacies, adults aged 20-34 years had twice the estimated rate of ED visits for oral antibiotic AEs compared with those aged ≥ 65 years (9.7 [7.6-11.8] versus 4.6 [3.6-5.7] visits per 10,000 dispensed prescriptions, respectively). Allergic reactions accounted for three quarters (74.3%; 70.0-78.6%) of estimated ED visits for antibiotic AEs. The three most frequently implicated antibiotic classes in ED visits for antibiotic AEs were oral sulfonamides (23.2%; 20.6-25.8%), penicillins (20.8%; 19.3-22.4%), and quinolones (15.7%; 14.2-17.1%). Per-prescription rates declined with increasing age group. Antibiotics are a common cause of ED visits by adults for adverse drug events and represent an important safety issue. Quantifying risks of AEs from

Urban/Rural and Gender Differences among Canadian Emerging Adults

ERIC Educational Resources Information Center

Cheah, Charissa S. L.; Trinder, Krista M.; Gokavi, Tara N.

2010-01-01

Although cultural and subcultural differences during the transition to adulthood have been examined, important factors like rural/urban upbringing and gender differences among Canadian emerging adults have been neglected. The present study explored developmentally significant tasks including criteria for adulthood, beliefs about religiosity, and…

Physical health and wellbeing of emerging and young adults with mental illness: an integrative review of international literature.

PubMed

McCloughen, Andrea; Foster, Kim; Huws-Thomas, Michelle; Delgado, Cynthia

2012-06-01

Physical health in people with mental illness is often compromised. Chronic physical conditions and disease risk factors occur at higher rates than in the general population. Although substantial research exists regarding mental-physical comorbidities in middle to older-aged adults and mental illness consequential to childhood physical illness, research addressing physical health in young people/emerging adults of 16-24 years with primary mental illnesses is minimal. Health problems often track from youth to adulthood, indicating a need to better recognize and understand the overall health of young people with mental illness. This paper reports findings from an integrative review of published research investigating physical health of emerging/young adults with mental illness. A total of 18 research papers were systematically analysed. The review found that comorbid mental-physical illness/conditions were evident across a wide age span. Specific physical health problems, including pain, gastrointestinal, and respiratory disorders, were apparent in those 16 years to those in their mid-late 20s, and/or with first episode psychosis. Lifestyle risk factors for cardiometabolic disorders occurred with some frequency and originated prior to adulthood. These findings highlight the need for targeted health screening and illness prevention strategies for emerging/young adults with mental health problems and draws attention to the need for young people to be supported in their health-care behaviours. © 2012 The Authors. International Journal of Mental Health Nursing © 2012 Australian College of Mental Health Nurses Inc.

Accuracy of immunization histories provided by adults accompanying preschool children to a pediatric emergency department.

PubMed

Goldstein, K P; Kviz, F J; Daum, R S

1993-11-10

Because some have advocated the use of emergency departments to administer delayed childhood immunizations, we evaluated the accuracy of immunization histories obtained in this setting by comparison with medical records of inner-city health care facilities. Questionnaires were orally administered to adults accompanying children to the emergency department. Individual medical records were reviewed. Pediatric emergency department at Wyler Children's Hospital, University of Chicago and 68 inner-city primary care clinics. Children aged 3 to 65 months registering for medical care. Of the sample, 98% were African American; 75% were Medicaid recipients. Adults' knowledge of immunization histories, immunization cards, and medical records compared with American Academy of Pediatrics/Immunization Practices Advisory Committee recommendations. Of the accompanying adults, 64% stated that their child's general immunization status was "up-to-date"; 65% of these had clinic records confirming that status. Only 8% of specific regimens stated by these adults accurately matched those found in clinic records. Moreover, 45% of adults accompanying children at least 16 months and older provided inaccurate information regarding previous receipt of measles immunization. Information provided by accompanying adults (from recall or from immunization cards) is inadequate to determine accurately which preschoolers in the pediatric emergency department are delayed in immunizations.

Functions of autobiographical memory in Taiwanese and American emerging adults.

PubMed

Liao, Hsiao-Wen; Bluck, Susan; Alea, Nicole; Cheng, Ching-Ling

2016-01-01

The study addresses cultural and person-level factors contributing to emerging adult's use of memory to serve adaptive functions. The focus is on three functions: self-continuity, social-bonding and directing-behaviour. Taiwanese (N = 85, 52 women) and American (N = 95, 51 women) emerging adults completed the Thinking about Life Experiences scale, and measures of trait personality, self-concept clarity and future time perspective. Findings show that individuals from both cultures use memory to serve these three functions, but Taiwanese individuals use memory more frequently than Americans to maintain self-continuity. Culture also interacted with person-level factors: in Taiwan, but not America, memory is more frequently used to create self-continuity in individuals high in conscientiousness. Across cultures, having lower self-concept clarity was related to greater use of memory to create self-continuity. Findings are discussed in terms of how memory serves functions in context and specific aspects of the Taiwanese and American cultural context that may predict the functional use of memory in emerging adulthood.

Reckless Behaviour and Sexual Practices of Emerging Adult Women

ERIC Educational Resources Information Center

Mullis, Ronald L.; Byno, Lucy H.; Shriner, Michael; Mullis, Ann K.

2009-01-01

Relations between reckless behaviour and sexual practices of emerging adult women (ages 18-25) within a social cognitive theoretical perspective were examined. In addition, relations between self esteem, sexual attitudes and sexual behaviour were also examined. The Sexual Experience Inventory, Rosenberg Self-Esteem Scale, Hendrick Sexual Attitude…

Generation XXX: Pornography Acceptance and Use among Emerging Adults

ERIC Educational Resources Information Center

Carroll, Jason S.; Padilla-Walker, Laura M.; Nelson, Larry J.; Olson, Chad D.; McNamara Barry, Carolyn; Madsen, Stephanie D.

2008-01-01

This study examined correlates of pornography acceptance and use within a normative (nonclinical) population of emerging adults (individuals aged 18-26). Participants included 813 university students (500 women; M age = 20 years) recruited from six college sites across the United States. Participants completed online questionnaires regarding their…

Deaf Stigma: Links Between Stigma and Well-Being Among Deaf Emerging Adults.

PubMed

Mousley, Victoria L; Chaudoir, Stephenie R

2018-05-31

Although stigma has been linked to suboptimal psychological and physical health outcomes in marginalized communities such as persons of color, sexual minorities, and people living with HIV/AIDS, no known research has examined these effects among deaf individuals. In the present research, we examine the associations between anticipated, enacted, and internalized stigma and psychological well-being (i.e., depressive symptoms, anxiety) and physical well-being (i.e., quality of life, alcohol use) among a sample of 171 deaf emerging adults. Furthermore, we consider whether trait resilience and benefit-finding moderate these effects. Enacted stigma, but not anticipated or internalized stigma, was related to worse depressive symptoms, anxiety, and quality of life. However, none of these variables predicted alcohol use and neither resilience nor benefit-finding moderated these effects. These findings are consistent with other research among marginalized populations, though they are also the first to suggest that experiences of discrimination are related to suboptimal well-being among deaf emerging adults. The discussion considers how these findings may illuminate the potential causes of disparities in well-being between hearing and deaf emerging adults.

Trends in the Incidence of Hypertensive Emergencies in US Emergency Departments From 2006 to 2013.

PubMed

Janke, Alexander T; McNaughton, Candace D; Brody, Aaron M; Welch, Robert D; Levy, Phillip D

2016-12-05

The incidence of hypertensive emergency in US emergency departments (ED) is not well established. This study is a descriptive epidemiological analysis of nationally representative ED visit-level data from the Nationwide Emergency Department Sample for 2006-2013. Nationwide Emergency Department Sample is a publicly available database maintained by the Healthcare Cost and Utilization Project. An ED visit was considered to be a hypertensive emergency if it met all the following criteria: diagnosis of acute hypertension, at least 1 diagnosis indicating acute target organ damage, and qualifying disposition (admission to the hospital, death, or transfer to another facility). The incidence of adult ED visits for acute hypertension increased monotonically in the period from 2006 through 2013, from 170 340 (1820 per million adult ED visits overall) to 496 894 (4610 per million). Hypertensive emergency was rare overall, accounting for 63 406 visits (677 per million adult ED visits overall) in 2006 to 176 769 visits (1670 per million) in 2013. Among adult ED visits that had any diagnosis of hypertension, hypertensive emergency accounted for 3309 per million in 2006 and 6178 per million in 2013. The estimated number of visits for hypertensive emergency and the rate per million adult ED visits has more than doubled from 2006 to 2013. However, hypertensive emergencies are rare overall, occurring in about 2 in 1000 adult ED visits overall, and 6 in 1000 adult ED visits carrying any diagnosis of hypertension in 2013. This figure is far lower than what has been sometimes cited in previous literature. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Cultural values associated with substance use among Hispanic emerging adults in Southern California.

PubMed

Escobedo, Patricia; Allem, Jon-Patrick; Baezconde-Garbanati, Lourdes; Unger, Jennifer B

2018-02-01

Hispanic emerging adults are a priority population for substance use prevention, yet few studies have examined whether traditional Hispanic cultural values serve as risk or protective factors for substance use among emerging adults. This study examined the relationship between familism, respeto, fatalism, and substance use among Hispanic emerging adults. Participants (ages 18 to 25) completed surveys indicating identification with familism, respeto, and fatalism, past month use of tobacco, marijuana, hard drugs and binge drinking. Separate logistic regression models examined the association between cultural values and each substance use outcome, controlling for acculturation, age and gender. Among participants (n=1445, mean age=23, 60% female), 21% reported past month cigarette use, 18% reported past month alternative tobacco product (ATP) use, 25% reported past month marijuana use, 44% reported past month binge drinking, and 7% reported past month hard drug use. Higher fatalism scores were associated with increased ATP use. Higher familism scores were associated with binge drinking, while higher respeto scores were associated with decreased binge drinking, marijuana, and hard drug use. These findings suggest that substance use prevention and intervention programs should emphasize how substance use interferes with caring and honoring parents (respeto) and family cohesion and functioning (familism). Programs that highlight these cultural values and beliefs may be beneficial for Hispanic emerging adults and members of other collectivistic cultures. Copyright © 2017 Elsevier Ltd. All rights reserved.

High health satisfaction among emerging adults with diabetes: Factors predicting resilience.

PubMed

Corathers, Sarah D; Kichler, Jessica C; Fino, Nora F; Lang, Wei; Lawrence, Jean M; Raymond, Jennifer K; Yi-Frazier, Joyce P; Dabelea, Dana; Liese, Angela D; Saydah, Sharon H; Seid, Michael; Dolan, Lawrence M

2017-03-01

This study was conducted to identify factors contributing to health satisfaction outcomes among emerging adults (ages 18-25) with diabetes. SEARCH for Diabetes in Youth study participants whose diabetes was prevalent in 2001 and were ≥18 years of age when they completed a 2008-2009 follow-up survey (n = 340) were included. We developed a health resilience model (HRM) to identify potentially modifiable factors (anticipatory guidance, social support, physical activity, quality of life) associated with health outcomes (satisfaction with health care, overall personal health, self-report of hemoglobin A1c [HbA1c]). Proportional odds logistic regression models were used to examine relationships between modifiable factors and health outcomes while adjusting for predetermined characteristics; linear regression models were used for reported HbA1c. Comparison of participants who reported HbA1c versus nonreporters was conducted. A majority (70%) of participants rated satisfaction with health care ≥7 out of 10, and most (71%) rated overall health as good, very good, or excellent. Satisfaction with health care was independent of change in provider between the ages of 17 and 24. After controlling for predetermined characteristics, we found that the odds of increased satisfaction with health care and overall personal health were 1.3 and 1.2 greater, respectively, when participants discussed additional diabetes-related anticipatory guidance topics with a provider and 1.3 and 2.1, respectively, for each 10-unit change in quality of life score. Relationship between HbA1c level and modifiable factors was not significant; however, participants reporting HbA1c had higher ratings of health care and overall health versus nonreporters. HRM describes relationships between modifiable factors and patient-reported outcomes of satisfaction with health care and overall personal health among a cohort of ethnically and racially diverse emerging adults with longstanding diabetes, over half of

What adult electrocardiogram (ECG) diagnoses and/or findings do residents in emergency medicine need to know?

PubMed

Patocka, Catherine; Turner, Joel; Wiseman, Jeffrey

2015-11-01

There is no evidence-based description of electrocardiogram (ECG) interpretation competencies for emergency medicine (EM) trainees. The first step in defining these competencies is to develop a prioritized list of adult ECG findings relevant to EM contexts. The purpose of this study was to categorize the importance of various adult ECG diagnoses and/or findings for the EM trainee. We developed a list of potentially important adult ECG diagnoses/findings and conducted a Delphi opinion-soliciting process. Participants used a 4-point Likert scale to rate the importance of each diagnosis for EM trainees. Consensus was defined as a minimum of 75% agreement at the second round or later. In the absence of consensus, stability was defined as a shift of 20% or less after successive rounds. A purposive sampling of 22 emergency physicians participated in the Delphi process, and 16 (72%) completed the process. Of those, 15 were from 11 different EM training programs across Canada and one was an expert in EM electrocardiography. Overall, 78 diagnoses reached consensus, 42 achieved stability and one diagnosis achieved neither consensus nor stability. Out of 121 potentially important adult ECG diagnoses, 53 (44%) were considered "must know" diagnoses, 61 (50%) "should know" diagnoses, and 7 (6%) "nice to know" diagnoses. We have categorized adult ECG diagnoses within an EM training context, knowledge of which may allow clinical EM teachers to establish educational priorities. This categorization will also facilitate the development of an educational framework to establish EM trainee competency in ECG interpretation.

Energetics of emergence in the cicadas, Cyclochila australasiae and Abricta curvicosta (Homoptera: Cicadidae).

PubMed

Harvey, Prudence M; Thompson, Michael B

2006-09-01

The final moult in cicadas marks a major transition in lifestyle and is a behaviour that makes the cicada vulnerable to predation. Consequently, emergence times are short and, we predict, therefore the rate of energy consumption would be high. Hence, we measured the energetic cost of emergence in Cyclochila australasiae (green grocer) and Abricta curvicosta (floury baker) cicadas during the final moult from nymph to adult cicada. Maximum energy expended whilst emerging was compared between the sexes and species. Even though C. australasiae take longer to emerge than A. curvicosta, the mass-specific cost of emergence is not different between the two species (C. australasiae: 11.34+/-2.55 J g(-1); A. curvicosta: 12.91+/-1.90 J g(-1)). The mass-specific metabolic rates of fully emerged adults of both species are approximately twice those of the nymphs and the maximum metabolic rate during emergence is about 1.5 times higher than the resting metabolic rate of emerged adults. Emergence times, as indicated by rates of oxygen consumption, are longer than expected and probably reflect limitations in the oxygen capacity of the cicadas during moulting.

Firearm carrying and concurrent substance use behaviours in a community-based sample of emerging adults.

PubMed

Buschmann, Robert N; Prochaska, John D; Baillargeon, Jacques G; Temple, Jeff R

2017-12-01

This paper examines associations between high-risk gun carrying and substance use in emerging adults (ages 18-22). The coexistence of these high-risk behaviours in a general population of emerging adults can have disastrous consequences. Dating it Safe is an ongoing longitudinal (2010-2016) survey of emerging adults recruited from seven high schools in five south-east Texas-area school districts (current sample n=684). Multiple logistic regression modelling was used to examine the association between past-year use of legal and illegal substances and past-year firearm carrying for a reason other than sport or hunting. 6% of emerging adults carried firearms in the past year, with most (68%) carrying for protection. Use of cocaine, hallucinogens, methamphetamine, ecstasy and prescription medications in the past year, as well as episodic heavy drinking in the past month, was associated with increased risk of carrying a firearm (p<0.05 for all). After controlling for covariates, hallucinogens (OR 2.81, 95% CI 1.00 to 7.81), ecstasy (OR 3.66, 95% CI 1.32 to 10.14) and prescription medications (OR 2.85, 95% CI 1.22 to 6.68) remained associated with firearm carrying. Episodic heavy drinking was associated with firearm carrying, but only for those who had five or more episodes/month (OR 3.61, 95% CI 1.51 to 8.66). In this community-based sample of emerging adults, firearm carrying, mostly for protection, was associated with a variety of past-year substance use behaviours. These findings extend previous research and suggest directions for further exploration of the clustering of high-risk behaviours in emerging adults. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Childhood Poverty, Cumulative Risk Exposure, and Mental Health in Emerging Adults

PubMed Central

Evans, Gary W.; Cassells, Rochelle C.

2014-01-01

One out of four American children are born into poverty, but little is known about the long-term, mental health implications of early deprivation. The more time in poverty from birth-age-9, the worse mental health as emerging adults (n = 196, M = 17.30 years, 53% male). These results maintain independently of concurrent, adult income levels for self-reported externalizing symptoms and a standard learned helplessness behavioral protocol, but internalizing symptoms were unaffected by childhood poverty. We then demonstrate that part of the reason why early poverty exposure is harmful to mental health among emerging adults is because of elevated cumulative risk exposure assessed at age 13. The significant, prospective, longitudinal relations between early childhood poverty and externalizing symptoms plus learned helplessness behavior are mediated, in part, by exposure to a confluence of psychosocial (violence, family turmoil, child separation from family) and physical (noise, crowding, substandard housing) risk factors during adolescence. PMID:26609499

Reintervention Rate Following Emergency Surgery for Crohn Disease.

PubMed

Slavu, Iulian; Alecu, Lucian; Tulin, Adrian; Mihaila, Daniela; Braga, Vlad; Voiosu, Theodor; Tomescu, Luminiţa; Constantinoiu, Silviu

2018-01-01

Backround/Objective: To assess the impact of emergency surgery and postoperative recurrence in Crohn's disease (CD) and to evaluate the disease course while observing different factors that may influence it. Methods: Information on 37 consecutive patients which were diagnosed and operated in emergency for CD complications and the the relapse rate (regarded as a second surgery) were retrospectively evaluated. Results: The risk of relapse and second surgery was increased in males under 50 years and in those who benefited from an anastomosis during the first invervention while stomy seemed to reduce the rate of surgical relapse. The median duration until relapse was 2,3 years while a percentage of 33% required reintervention. Conclusions: The majority of patients with CD will undergo at least one surgical intervention during their lifetime and one third of them will relapse requiring a second intervention. Although medical treatment has seen great advancements, surgery requirements have remained unchanged as the mainstay treatment in emergent complications of CD. The age of the patients, smoking status and the postoperative medication influence the rate of postoperative recurrence. Celsius.

I Want Your Sext: Sexting and Sexual Risk in Emerging Adult Minority Men.

PubMed

Davis, Mikaela Jessica; Powell, Adeya; Gordon, Derrick; Kershaw, Trace

2016-04-01

Sexting, sending, or receiving sexually suggestive or explicit messages/photos/videos, have not been studied extensively. The aims of this study is to understand factors associated with sexting among minority (e.g., African- American, Hispanic) emerging adult males and the association between sexting and sexual risk. We recruited 119 emerging adult heterosexual males and assessed sexting and sexual risk behaviors. Fifty-four percent of participants sent a sext, and 70% received a sext. Participants were more likely to sext with casual partners than with steady partners. Multiple regression analyses showed that participants who sent sexts to steady partners had significantly more unprotected vaginal intercourse and oral sex. Participants who sent sexts to casual partners had significantly more partners, and participants who received sexts from casual partners had significantly more unprotected oral sex and sex while on substances. We found that sexting is a frequent and reciprocal behavior among emerging adults, and there were different patterns of significance for sexts with casual and steady partners.

A Song to Remember: Emerging Adults Recall Memorable Music

ERIC Educational Resources Information Center

Lippman, Julia R.; Greenwood, Dara N.

2012-01-01

The present study employs a mixed methods approach to understanding the psychological functions and contexts of music use. Seventy-six emerging adults selected a single piece of music that they considered personally significant and elaborated on the reasons for this significance in response to written prompts. A constant comparative analysis of…

Socioeconomic Disparities in Emerging Adult Weight and Weight Behaviors

ERIC Educational Resources Information Center

VanKim, Nicole A.; Laska, Melissa N.

2012-01-01

Objectives: To explore weight, weight behaviors, and tobacco and alcohol use among emerging adults by parental education and financial strain. Methods: Cross-sectional analyses of 2010 survey data from an urban Minnesota public 4-year university and 2-year community college (n=1201). Results: Low parental education was associated with lower…

Sibling Relationships in Emerging Adulthood and in Adolescence

ERIC Educational Resources Information Center

Scharf, Miri; Shulman, Shmuel; Avigad-Spitz, Limor

2005-01-01

In this study, 116 emerging adults and adolescents completed questionnaires and were interviewed about their relationship with a sibling. Respondents' siblings and their mothers also rated the quality of the sibling relationship. Emerging adults were found to spend less time and to be less involved in joint activities with their siblings than…

Self-rated driving and driving safety in older adults.

PubMed

Ross, Lesley A; Dodson, Joan E; Edwards, Jerri D; Ackerman, Michelle L; Ball, Karlene

2012-09-01

Many U.S. states rely on older adults to self-regulate their driving and determine when driving is no longer a safe option. However, the relationship of older adults' self-rated driving in terms of actual driving competency outcomes is unclear. The current study investigates self-rated driving in terms of (1) systematic differences between older adults with high (good/excellent) versus low (poor/fair/average) self-ratings, and (2) the predictive nature of self-rated driving to adverse driving outcomes in older adults (n=350; mean age 73.9, SD=5.25, range 65-91). Adverse driving outcomes included self-reported incidences of (1) being pulled over by the police, (2) receiving a citation, (3) receiving a recommendation to cease or limit driving, (4) crashes, and (5) state-reported crashes. Results found that older drivers with low self-ratings reported more medical conditions, less driving frequency, and had been given more suggestions to stop/limit their driving; there were no other significant differences between low and high self-raters. Logistic regression revealed older drivers were more likely to have a state-reported crash and receive a suggestion to stop or limit driving. Men were more likely to report all adverse driving outcomes except for receiving a suggestion to stop or limit driving. Regarding self-rated driving, older adults with high ratings were 66% less likely (OR=0.34, 95% CI=0.14-0.85) to have received suggestions to limit or stop driving after accounting for demographics, health and driving frequency. Self-ratings were not predictive of other driving outcomes (being pulled over by the police, receiving a citation, self-reported crashes, or state-reported crashes, ps>0.05). Most older drivers (85.14%) rated themselves as either good or excellent drivers regardless of their actual previous citation or crash rates. Self-rated driving is likely not related to actual driving proficiency as indicated by previous crash involvement in older adults

Physiological time model for predicting adult emergence of western corn rootworm (Coleoptera: Chrysomelidae) in the Texas High Plains.

PubMed

Stevenson, Douglass E; Michels, Gerald J; Bible, John B; Jackman, John A; Harris, Marvin K

2008-10-01

Field observations at three locations in the Texas High Plains were used to develop and validate a degree-day phenology model to predict the onset and proportional emergence of adult Diabrotica virgifera virgifera LeConte (Coleoptera: Chrysomelidae) adults. Climatic data from the Texas High Plains Potential Evapotranspiration network were used with records of cumulative proportional adult emergence to determine the functional lower developmental temperature, optimum starting date, and the sum of degree-days for phenological events from onset to 99% adult emergence. The model base temperature, 10 degrees C (50 degrees F), corresponds closely to known physiological lower limits for development. The model uses a modified Gompertz equation, y = 96.5 x exp (-(exp(6.0 - 0.00404 x (x - 4.0), where x is cumulative heat (degree-days), to predict y, cumulative proportional emergence expressed as a percentage. The model starts degree-day accumulation on the date of corn, Zea mays L., emergence, and predictions correspond closely to corn phenological stages from tasseling to black layer development. Validation shows the model predicts cumulative proportional adult emergence within a satisfactory interval of 4.5 d. The model is flexible enough to accommodate early planting, late emergence, and the effects of drought and heat stress. The model provides corn producers ample lead time to anticipate and implement adult control practices.

General Education Development (GED®) Credential Attainment, Externalizing Disorders, and Substance Use Disorders in Disconnected Emerging Adults

ERIC Educational Resources Information Center

Bergman, Andrea; Kong, Grace; Pope, Alice

2014-01-01

There are many benefits for emerging adults, both financial and personal, in obtaining a General Education Development (GED®) credential (Ou, 2008). However, little is known about the correlates of GED® credential attainment in "disconnected" emerging adults attending GED® programs. Our goal was to examine whether externalizing…

Racial Identity and Depressive Symptoms among Black Emerging Adults: The Moderating Effects of Neighborhood Racial Composition

ERIC Educational Resources Information Center

Hurd, Noelle M.; Sellers, Robert M.; Cogburn, Courtney D.; Butler-Barnes, Sheretta T.; Zimmerman, Marc A.

2013-01-01

In the current study, we explored patterns of change in Black emerging adults' racial identity beliefs during the transition to adulthood, assessed neighborhood racial composition effects on Black emerging adults' racial identity beliefs, and tested the moderating effects of neighborhood racial composition on the associations between Black…

Cardiovascular Disease Risk Factors among Emerging Adults in College

ERIC Educational Resources Information Center

Abshire, Demetrius Alexander

2014-01-01

The purpose of this dissertation was to examine factors associated with cardiovascular disease (CVD) risk among emerging adults in college aged 18-25 years. CVD risks that develop during this period often persist into adulthood making it an ideal time to target CVD prevention. The specific aims of this dissertation were to 1) explore perceptions…

A Reflection on an Emergent Spirituality and the Practice of Adult Education

ERIC Educational Resources Information Center

Lauzon, Allan C.

2007-01-01

The idea of spirituality is increasingly being used in the context of adult education. This paper will tentatively explore some of the implications of an emergent spirituality within the practice of adult education. It begins by situating our understanding of spirituality in an historical context. This is followed by a brief historical overview of…

Training Raters to Assess Adult ADHD: Reliability of Ratings

ERIC Educational Resources Information Center

Adler, Lenard A.; Spencer, Thomas; Faraone, Stephen V.; Reimherr, Fred W.; Kelsey, Douglas; Michelson, David; Biederman, Joseph

2005-01-01

The standardization of ADHD ratings in adults is important given their differing symptom presentation. The authors investigated the agreement and reliability of rater standardization in a large-scale trial of atomoxetine in adults with ADHD. Training of 91 raters for the investigator-administered ADHD Rating Scale (ADHDRS-IV-Inv) occurred prior to…

"You're Always First a Girl": Emerging Adult Women, Gender, and Sexuality in the Israeli Army

ERIC Educational Resources Information Center

Levin, Dana S.

2011-01-01

The Israeli army drafts both men and women, and most Israelis complete their military service during their emerging adulthood years. This study examined Israeli women's experiences as soldiers in the army. Twenty-three women (18 emerging adults, 5 young adults) were recruited using purposive sampling and interviewed about how they experienced…

[Awareness rate, treatment rate and control rate of dyslipidemia in Chinese adults, 2010].

PubMed

Li, Jian-hong; Wang, Li-min; Mi, Sheng-quan; Zhang, Mei; Li, Yi-chong; Jiang, Yong; Xu, Yu; Dai, Meng; Wang, Lin-hong

2012-08-01

To explore the awareness, treatment and control rates of dyslipidemia among Chinese adults aged over 18 in 2010, and to analyze the prevalent features. 97 409 subjects aged over 18 were recruited from 162 monitoring sites around 31 provinces in China mainland in 2010, applying multi-stage stratified cluster random sampling method. Information about subjects' history of dyslipidemia, treatment and control were collected by face-to-face interview; and each subject's fasting venous blood was drawn in the morning before having food, to test total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C). In total, 51 818 cases of dyslipidemia ever or now, including 2235 subjects who once suffered from dyslipidemia but had their blood lipid controlled to normal, were screened out. And the awareness, treatment and control rates were calculated by complex weighting. The awareness rate of dyslipidemia among Chinese adults was 10.93%, while the stratified rates were 6.00%, 16.75% and 18.74% in the groups of subjects aged 18 - 44, 45 - 59 and over 60 years old, respectively (χ² = 1293.02, P < 0.01); 10.32% and 11.71% among males and females, respectively (χ² = 18.67, P < 0.01); 16.59% and 8.17% in groups from urban and rural areas, respectively (χ² = 618.38, P < 0.01); and 12.22%, 11.75% and 8.26% in groups from eastern, central and western China, respectively (χ² = 117.04, P < 0.01). The treatment rate of dyslipidemia was 6.84% among Chinese adults, while the stratified rates were 3.55%, 10.73% and 12.05% in the groups of subjects aged 18 - 44, 45 - 59 and over 60 years old, respectively (χ² = 858.72, P < 0.01); 6.37% and 7.43% among males and females, respectively (χ² = 16.69, P < 0.01); 10.17% and 5.21% in groups from urban and rural areas, respectively (χ² = 327.51, P < 0.01); and 7.33%, 7.52% and 5.41% in groups from eastern, central and western China, respectively (χ² = 50.71, P < 0

Emergency department recidivism in adults older than 65 years treated for fractures.

PubMed

Southerland, Lauren T; Richardson, Daniel S; Caterino, Jeffrey M; Essenmacher, Alex C; Swor, Robert A

2014-09-01

Fractures in older adults are a commonly diagnosed injury in the emergency department (ED). We performed a retrospective medical record review to determine the rate of return to the same ED within 72 hours (returns) and the risk factors associated with returning. A retrospective medical record review of patients at least 65 years old discharged from a large, academic ED with a new diagnosis of upper extremity, lower extremity, or rib fractures was performed. Risk factors analyzed included demographic data, type of fracture, analgesic prescriptions, assistive devices provided, other concurrent injuries, and comorbidities (Charlson Comorbidity Index). Our primary outcome was return to the ED within 72 hours. Three hundred fifteen patients qualified. Most fractures were in the upper extremity (64% [95% confidence interval {CI}, 58%-69%]). Twenty patients (6.3% [95% CI, 3.9%-9.6%]) returned within 72 hours. Most returns (15/20, 75%) were for reasons associated with the fracture itself, such as cast problems and inadequate pain control. Only 3 (<1% of all patients) patients returned for cardiac etiologies. Patients with distal forearm fractures had higher return rates (10.7% vs 4.5%, P = .03), and most commonly returned for cast or splint problems. Age, sex, other injuries, assistive devices, and Charlson Comorbidity Index score (median, 1 [interquartile range, 1-2] for both groups) did not predict 72-hour returns. Older adults with distal forearm fractures may have more unscheduled health care usage in the first 3 days after fracture diagnosis than older adults with other fracture types. Overall, revisits for cardiac reasons or repeat falls were rare (<1%). Copyright © 2014 Elsevier Inc. All rights reserved.

Intertemporal Choice Behavior in Emerging Adults and Adults: Effects of Age Interact with Alcohol Use and Family History Status

PubMed Central

Smith, Christopher T.; Steel, Eleanor A.; Parrish, Michael H.; Kelm, Mary K.; Boettiger, Charlotte A.

2015-01-01

Adults with alcohol use disorders (AUDs) show marked immediate reward selection (or “Now”) bias in intertemporal choice tasks. This Now bias persists long into abstinence, suggesting an irreversible consequence of chronic alcohol abuse or a pre-existing AUD intermediate phenotype. However, some data show substantial Now bias among emerging adults (18–25), regardless of drinking behavior, suggesting age-dependent effects on Now bias. The objectives of the present study were to determine (1) whether Now bias is greater among emerging adults relative to adults, (2) whether any such age effect on Now bias is diminished in sub-clinical heavy alcohol users, and (3) whether having a problem drinking first degree relative is independently associated with elevated Now bias. To achieve these objectives, we used an intertemporal choice task to quantify Now bias in n = 237 healthy participants (ages 18–40; 50% female), and a wide range of non-zero alcohol use, based on the Alcohol Use Disorders Identification Test (AUDIT). We found that among non-heavy drinkers, Now bias inversely correlated with age; this relationship was not present among heavy drinkers. We found no significant relationship between AUDIT score and Now bias among emerging adults, but AUDIT scores and Now bias were positively correlated among 26–40 year olds. Additionally, non-heavy drinking adults who reported a problem drinking first degree relative showed greater Now bias compared to those not reporting familial problem drinking. While not definitive, these findings lend support for elevated Now bias in adulthood as an intermediate phenotype for AUDs. Moreover, non-additive effects of age and heavy drinking on Now bias suggest perturbations in largely common neural circuits in both groups. PMID:26635580

REDUCTIONS IN CANNABIS USE ARE ASSOCIATED WITH MOOD IMPROVEMENT IN FEMALE EMERGING ADULTS.

PubMed

Moitra, Ethan; Anderson, Bradley J; Stein, Michael D

2016-04-01

Cannabis use and the development of depression symptoms have been linked in prospective research. However, no research has examined how depression symptoms might change relative to reductions in cannabis use. One group at risk for comorbid cannabis-use disorders and clinical depression is female emerging adults (those aged 18-25 years old) as cannabis use peaks during this period, depression is the most common psychiatric disorder among emerging adults, and females are at increased risk for depression relative to males. This study examined the longitudinal association between reductions in cannabis use and existing depression symptoms. Secondary analyses from a cannabis intervention trial for 332 female emerging adults were conducted. Changes in depression symptoms (categorized as minimal, mild, and moderate or more severe depression) were assessed in relation to changes in cannabis use at 3- and 6-months postbaseline assessment. After controlling for alcohol use, the association between change in cannabis-use frequency and change in depression (measured by Beck Depression Inventory-II) was significantly stronger for those with mild depression (b = -0.26; 95% CI: -0.44, -0.08; P = .004), and for those with moderate or more severe depression (b = -0.50; 95% CI: -0.68, -0.33; P < .001) relative to those with minimal depression. These results indicate a relationship between reductions in cannabis use and reductions in depression symptoms among female emerging adults who report at least mild depression symptoms. This represents a clinically meaningful effect for clinicians treating patients with co-occurring cannabis use and depressive disorders. © 2015 Wiley Periodicals, Inc.

Cross-cultural differences and sexual risk behavior of emerging adults.

PubMed

Thomas, Tami L; Yarandi, Hossein N; Dalmida, Safiya George; Frados, Andrew; Klienert, Kathleen

2015-01-01

The authors examined population-specific risk factors that increase emerging adults' risk of acquiring sexually transmitted infections (STIs), including the human papillomavirus (HPV). A cross-sectional sample of 335 diverse, emerging adults ages 18 to 24 years was recruited from a health center at a large university in the Southeastern United States. The mean age was 20.6 ± 1.9 years, majority were females (74.0%), and 61.0% were Hispanic. Findings revealed inconsistent condom use, reasons for not using condoms, and a need for more culturally specific intervention strategies. Healthcare providers should identify culturally specific reasons for inconsistent condom use, examine cultural and geographic differences in sexual risk behaviors among groups and communities, and modify communication, educational programs, and interventions accordingly. By adopting a multicultural approach to the control of STIs, nurses can address specific cultural attitudes and behaviors that may influence exposure to STIs, including HPV. © The Author(s) 2014.

Young Adults' Perceived Purposes of Emerging Adulthood: Implications for Cohabitation.

PubMed

Rogers, Adam A; Willoughby, Brian J; Nelson, Larry J

2016-01-01

The authors investigated associations between young adults' perceived purposes of emerging adulthood and their attitudes toward and participation in cohabitation. In a sample of 775 never married individuals, ages 18-29 (69% female, 69% white) from the United States, young people's perceptions of this period of life were associated with their acceptance of cohabitation, their reasoning for accepting cohabitation, and the likelihood of cohabiting. Results showed that the perception that emerging adulthood is a time to prepare for future family roles was negatively associated with acceptance of cohabitation whereas the perception that emerging adulthood is a time to take risks was positively associated with acceptance of cohabitation. The perception that emerging adulthood is a time to prepare for future family roles was associated with an increased likelihood of having cohabited while the perception that emerging adulthood is a time of possibilities was associated with a decreased likelihood of having cohabited. Implications for future research are discussed.

The association between alcohol, marijuana use, and new and emerging tobacco products in a young adult population.

PubMed

Cohn, Amy; Villanti, Andrea; Richardson, Amanda; Rath, Jessica M; Williams, Valerie; Stanton, Cassandra; Mermelstein, Robin

2015-09-01

Young adults have the highest rates of alcohol, tobacco, and other drug use relative to any other age group. Few studies have examined the co-occurrence of substance use with new and emerging tobacco products in this vulnerable group, or the underlying personality factors that may explain these associations. To address this gap, this study examined the association of current alcohol and marijuana use with the use of cigarettes and emerging tobacco products in a nationally representative sample of young adults. Data were drawn from 18 to 24year olds in Wave 4 (January 2013; n=1609) of the Legacy Young Adult Cohort, a nationally-representative sample of men and women. Never, ever (lifetime), and past 30-day use of little cigars/cigarillos (LCCs), hookah, e-cigarettes, and cigarettes were assessed separately in current (everyday or some days) alcohol and marijuana users. Using weighted estimates, multivariable multinomial logistic regression models showed that current alcohol and marijuana use were associated with lifetime and past 30-day use of cigarettes, LCCs, e-cigarettes, and hookah, with different magnitudes of association found across each product. Post-hoc exploratory analyses showed that sensation-seeking traits moderated the relationship of alcohol (but not marijuana) use to current use of select tobacco products. Marijuana and alcohol use may enhance risk for emerging tobacco products use in young adulthood. Prevention and intervention programs may need to target poly-use of alcohol, marijuana, and tobacco rather than focusing on a single risk behavior during these critical years. Copyright © 2015 Elsevier Ltd. All rights reserved.

18 CFR 284.267 - Intrastate pipeline emergency transportation rates.

Code of Federal Regulations, 2010 CFR

2010-04-01

... POLICY ACT OF 1978 AND RELATED AUTHORITIES Emergency Natural Gas Sale, Transportation, and Exchange... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Intrastate pipeline emergency transportation rates. 284.267 Section 284.267 Conservation of Power and Water Resources FEDERAL...

Transition Readiness in Adolescents and Emerging Adults with Diabetes: The Role of Patient-Provider Communication

PubMed Central

Hilliard, Marisa; Sweenie, Rachel; Riekert, Kristin

2013-01-01

Transition from pediatric to adult care represents a high risk period for adolescents and emerging adults with diabetes. Fundamental differences between pediatric and adult care delivery models may contribute to increased risk for poor health outcomes. This review provides a brief overview of models of care in pediatric and adult settings and focuses on patient-provider communication content and quality as potential points of intervention to improve transition-related outcomes. This review also highlights disparities in transition and communication for adolescents and emerging adults from racial/ethnic minority groups and discusses recent changes in health care legislation that have significant implications for the transition process. Intervention opportunities include programs to enhance developmentally-appropriate patient-provider interactions and increased attention to promoting transition readiness skills. Improving patient-provider communication may hasten the development of vital self-advocacy skills needed in adult health care systems and, thus, help establish a lasting pattern of positive diabetes self-care. PMID:24014075

Distinguishing Features of Emerging Adulthood: The Role of Self-Classification as an Adult

ERIC Educational Resources Information Center

Nelson, Larry J.; Barry, Carolyn McNamara

2005-01-01

Research reveals that most 18- to 25-year-old individuals do not consider themselves to be adults. This time period between adolescence and adulthood has been newly defined as emerging adulthood. The purpose of this study was to (a) attempt to identify perceived adults and (b) explore whether differences in adulthood criteria, achievement of those…

Emergency Department Use in a Cohort of Older Homeless Adults: Results From the HOPE HOME Study.

PubMed

Raven, Maria C; Tieu, Lina; Lee, Christopher T; Ponath, Claudia; Guzman, David; Kushel, Margot

2017-01-01

The median age of single homeless adults is over 50, yet little is known about their emergency department (ED) use. We describe use of and factors associated with ED use in a sample of homeless adults 50 and older. We recruited 350 participants who were homeless and 50 or older in Oakland, California. We interviewed participants about residential history in the prior 6 months, health status, health-related behaviors, and health services use and assessed cognition and mobility. Our primary outcome was the number of ED visits in the prior 6 months based on medical record review. We used negative binomial regression to examine factors associated with ED use. In the 6 months prior to enrollment, 46.3% of participants spent the majority of their time unsheltered; 25.1% cycled through multiple institutions including shelters, hospitals, and jails; 16.3% primarily stayed with family or friends; and 12.3% had become homeless recently after spending much of the prior 6 months housed. Half (49.7%) of participants made at least one ED visit in the past 6 months; 6.6% of participants accounted for 49.9% of all visits. Most (71.8%) identified a regular non-ED source of healthcare; 7.3% of visits resulted in hospitalization. In multivariate models, study participants who used multiple institutions (incidence rate ratio [IRR] = 2.27; 95% confidence interval [CI] = 1.08 to 4.77) and who were unsheltered (IRR = 2.29; 95% CI = 1.17 to 4.48) had higher ED use rates than participants who had been housed for most of the prior 6 months. In addition, having health insurance/coverage (IRR = 2.6; CI = 1.5 to 4.4), a history of psychiatric hospitalization (IRR = 1.80; 95% CI = 1.09 to 2.99), and severe pain (IRR = 1.72; 95% CI = 1.07 to 2.76) were associated with higher ED visit rates. A sample of adults aged 50 and older who were homeless at study entry had higher rates of ED use in the prior 6 months than the general U.S. age-matched population. Within the sample

Adult Status Epilepticus: A Review of the Prehospital and Emergency Department Management

PubMed Central

Billington, Michael; Kandalaft, Osama R.; Aisiku, Imoigele P.

2016-01-01

Seizures are a common presentation in the prehospital and emergency department setting and status epilepticus represents an emergency neurologic condition. The classification and various types of seizures are numerous. The objectives of this narrative literature review focuses on adult patients with a presentation of status epilepticus in the prehospital and emergency department setting. In summary, benzodiazepines remain the primary first line therapeutic agent in the management of status epilepticus, however, there are new agents that may be appropriate for the management of status epilepticus as second- and third-line pharmacological agents. PMID:27563928

Self-rated Driving and Driving Safety in Older Adults

PubMed Central

Ross, Lesley A.; Dodson, Joan; Edwards, Jerri D.; Ackerman, Michelle L.; Ball, Karlene

2012-01-01

Many U.S. states rely on older adults to self-regulate their driving and determine when driving is no longer a safe option. However, the relationship of older adults’ self-rated driving in terms of actual driving competency outcomes is unclear. The current study investigates self-rated driving in terms of (1) systematic differences between older adults with high (good/excellent) versus low (poor/fair/average) self-ratings, and (2) the predictive nature of self-rated driving to adverse driving outcomes in older drivers (n=350; mean age 73.9, SD=5.25, range 65–91). Adverse driving outcomes included self-reported incidences of (1) being pulled over by the police, (2) receiving a citation, (3) receiving a recommendation to cease or limit driving, (4) crashes, and (5) state-reported crashes. Results found that older drivers with low self-ratings reported more medical conditions, less driving frequency, and had been given more suggestions to stop/limit their driving; there were no other significant differences between low and high self-raters. Logistic regression revealed older drivers were more likely to have a state-reported crash and receive a suggestion to stop or limit driving. Men were more likely to report all adverse driving outcomes except for receiving a suggestion to stop or limit driving. Regarding self-rated driving, older adults with high ratings were 66% less likely (OR=0.34, 95% CI=0.14–0.85) to have received suggestions to limit or stop driving after accounting for demographics, health and driving frequency. Self-ratings were not predictive of other driving outcomes (being pulled over by the police, receiving a citation, self-reported crashes, or state-reported crashes, ps>.05). Most older drivers (85.14%) rated themselves as either good or excellent drivers regardless of their actual previous citation or crash rates. Self-rated driving is likely not related to actual driving proficiency as indicated by previous crash involvement in older adults

Frailty in Older Adults Using Pre-hospital Care and the Emergency Department: A Narrative Review.

PubMed

Goldstein, Judah P; Andrew, Melissa K; Travers, Andrew

2012-03-01

Older adults use more health-care services per capita than younger age groups and the older adult population varies greatly in its needs. Evidence suggests that there is a critical distinction between relative frailty and fitness in older adults. Here, we review how frailty is described in the pre-hospital literature and in the broader emergency medicine literature. PubMed was used as the primary database, but was augmented by searches of CINAHL and EMBASE. Articles were included if they focused on patients 60 years and older and implemented a definition of frailty or risk screening tool in the Emergency Medical Services (EMS) or Emergency Department setting. IN THE BROAD CLINICAL LITERATURE, THREE TYPES OF MEASURES CAN BE IDENTIFIED: frailty index measures, frailty scales, and a phenotypic definition. Each offers advantages and disadvantages for the EMS stakeholder. We identified no EMS literature on frailty conceptualization or management, although some risk measures from emergency medicine use terms that overlap with the frailty literature. There is a paucity of research on frailty in the Emergency Medical Services literature. No research was identified that specifically addressed frailty conceptualization or management in EMS patients. There is a compelling need for further research in this area.

Personal and Ethnic Identity in Swedish Adolescents and Emerging Adults

ERIC Educational Resources Information Center

Ferrer-Wreder, Laura; Trost, Kari; Lorente, Carolyn Cass; Mansoory, Shahram

2012-01-01

The chapter describes empirical evidence about identity development in Swedish adolescents and emerging adults and highlights cultural and contextual influences that may be specific to coming of age in Sweden. Broad trends in identity options are evident in the lives of many youth living in Sweden. Although research on identity and diversity is in…

Academic Risks Associated with Emerging Adults Seeking the College Experience

ERIC Educational Resources Information Center

Strage, Amy; Sorkhabi, Nadia

2016-01-01

Sadly, data collected from universities across the nation continue to suggest that fully half of the "emerging adults" (Arnett, 2015) who make their way to college will not graduate. This vexing statistic is particularly troublesome because it reflects a tremendous cost--in dollars, in time, and in self-esteem. In this study, we report…

Risk perception and perceived self-efficacy of deaf and hard-of-hearing seniors and young adults in emergencies.

PubMed

Engelman, Alina; Ivey, Susan L; Tseng, Winston; Neuhauser, Linda

2017-01-01

The authors explored the factors influencing risk perception and perceived self-efficacy before and during an emergency for deaf and hard-of-hearing (Deaf/HH) seniors and young adults. The authors collected demographic survey data and conducted four focus groups with 38 Deaf/HH residents of the San Francisco Bay Area; two groups were with young adults (ages 18-35), including one group of college students and one group of young professionals, and two were with older adults (ages 50-90). Significant differences were found between Deaf/HH young adults and seniors in both the sources of self-efficacy and risk perception and their attitudes toward preparedness. All groups demonstrated high resilience. Deaf/HH young professionals expressed more concern about their risk in an emergency than Deaf/HH college students. Alternately, the risk perception of Deaf/HH older adults was often rooted in their past experiences (survival of past emergencies, inaccessibility of communications during drills). Policy implications include the need to dedicate more resources to increasing accessibility and relevance of emergency communications technology for Deaf/HH populations. This could help increase adaptability before, during, and after emergencies among all groups of Deaf/HH people, particularly among young Deaf/HH professionals.

Risk perception and perceived self-efficacy of deaf and hard-of-hearing seniors and young adults in emergencies.

PubMed

Engelman, Alina; Ivey, Susan L; Tseng, Winston; Neuhauser, Linda

The authors explored the factors influencing risk perception and perceived self-efficacy before and during an emergency for deaf and hard-of-hearing (Deaf/HH) seniors and young adults. The authors collected demographic survey data and conducted four focus groups with 38 Deaf/HH residents of the San Francisco Bay Area; two groups were with young adults (ages 18-35), including one group of college students and one group of young professionals, and two were with older adults (ages 50-90). Significant differences were found between Deaf/HH young adults and seniors in both the sources of self-efficacy and risk perception and their attitudes toward preparedness. All groups demonstrated high resilience. Deaf/HH young professionals expressed more concern about their risk in an emergency than Deaf/HH college students. Alternately, the risk perception of Deaf/HH older adults was often rooted in their past experiences (survival of past emergencies, inaccessibility of communications during drills). Policy implications include the need to dedicate more resources to increasing accessibility and relevance of emergency communications technology for Deaf/HH populations. This could help increase adaptability before, during, and after emergencies among all groups of Deaf/HH people, particularly among young Deaf/HH professionals.

Temporal discounting rates and their relation to exercise behavior in older adults.

PubMed

Tate, Linda M; Tsai, Pao-Feng; Landes, Reid D; Rettiganti, Mallikarjuna; Lefler, Leanne L

2015-12-01

As our nation's population ages, the rates of chronic illness and disability are expected to increase significantly. Despite the knowledge that exercise may prevent chronic disease and promote health among older adults, many still are inactive. Factors related to exercise behaviors have been explored in recent years. However, temporal discounting is a motivational concept that has not been explored in regard to exercise in older adults. Temporal discounting is a decision making process by which an individual chooses a smaller more immediate reward over a larger delayed reward. The aim of this study was to determine if temporal discounting rates vary between exercising and non-exercising older adults. This study used cross-sectional survey of 137 older adults living in the community. Older adults were recruited from 11 rural Arkansas churches. The Kirby delay-discounting Monetary Choice Questionnaire was used to collect discounting rates and then bivariate analysis was performed to compare temporal discounting rate between the exercisers and non-exercisers. Finally, multivariate analysis was used to compare discounting rate controlling for other covariates. The results indicated that exercising older adults display lower temporal discounting rates than non-exercising older adults. After controlling for education, exercisers still have lower temporal discounting rates than non-exercisers (p<0.001). These findings are important as several chronic health conditions relate to lack of exercise especially in older adults. This research suggests that if we can find appropriate incentives for discounting individuals, some type of immediate reward, then potentially we can design programs to engage and retain older adults in exercise. Copyright © 2015 Elsevier Inc. All rights reserved.

Differences in Healthcare Access, Use, and Experiences Within a Community Sample of Racially Diverse Lesbian, Gay, Bisexual, Transgender, and Questioning Emerging Adults.

PubMed

Macapagal, Kathryn; Bhatia, Ramona; Greene, George J

2016-12-01

Health services research involving lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) individuals has focused on differences in healthcare access, use, and experiences between cisgender, heterosexual adults and LGBTQ adults. Yet these factors may differ within the LGBTQ community and have not been well-studied among emerging adults (18-29 years), a group with unique barriers to healthcare. We sought to characterize healthcare challenges within a sample of LGBTQ emerging adults. From 2012 to 2013, 206 participants aged 18-27 (86% racial/ethnic minority, 10% transgender) completed questionnaires assessing healthcare access, use, and experiences during a longitudinal study. Descriptive statistics established patterns of healthcare access, use, and experiences, and nonparametric tests examined differences related to sociodemographic variables, HIV status, sexual orientation identity, and gender identity. Overall, 68% of participants reported relatively easy access to care. White and bisexual participants reported higher rates of insurance than racial/ethnic minority (P = 0.01) and gay or lesbian participants (P = 0.005), respectively. Although most participants did not report having negative experiences in healthcare settings related to their LGBTQ identity, transgender participants were more likely to delay care (P < 0.001) and report negative effects of disclosure to their provider (P < 0.001) compared with cisgender participants. Participants who identified as queer or were questioning their sexual orientation identity reported negative healthcare experiences more frequently than LGB-identified participants (P = 0.001). Although LGBTQ emerging adults experienced fewer barriers to care than observed in previous studies on LGBTQ adults, the results suggest that queer, questioning, and transgender individuals may face additional healthcare challenges compared with their LGB and cisgender counterparts.

Emergency Department Use by Centenarians: The 2008 Nationwide Emergency Department Sample

PubMed Central

Howell, Embry M.; McHugh, Megan Colleen

2013-01-01

Introduction Older adults have higher rates of emergency department use than do younger adults, and the number of centenarians is expected to increase. The objective of this study was to examine centenarians’ use of the emergency department in the United States, including diagnoses, charges, and disposition. Methods The 2008 Nationwide Emergency Department Sample, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality provided encounter-level data on emergency department visits and weights for producing nationwide estimates. From this data set, we collected patient characteristics including age, sex, primary diagnosis, and disposition. We used χ2 tests and t tests to test for significant differences among people aged 80 to 89, 90 to 99, and 100 years or older. Results Centenarians had a lower rate of emergency department use than those aged 90 to 99 (736 per 1,000 vs 950 per 1,000; P < .05). We found no significant difference in use between centenarians and those aged 80 to 89. The most common diagnoses for centenarians were superficial injuries (5.8% of visits), pneumonia (5.1%), and urinary tract infections (5.1%). Centenarians were more likely to visit the emergency department for fall-related injuries (21.5%) than those aged 80 to 89 (14.1%; P < .05) and 90 to 99 (18.7%; P < .05). Centenarians were more likely to die in the emergency department (2.0%) than were those aged 80 to 89 (0.6%; P < .05) and 90 to 99 (0.7%; P < .05). Conclusion Centenarians in emergency departments in the United States have different diagnoses, conditions, and outcomes than other older Americans. PMID:24286272

Speech Rate Entrainment in Children and Adults With and Without Autism Spectrum Disorder.

PubMed

Wynn, Camille J; Borrie, Stephanie A; Sellers, Tyra P

2018-05-03

Conversational entrainment, a phenomenon whereby people modify their behaviors to match their communication partner, has been evidenced as critical to successful conversation. It is plausible that deficits in entrainment contribute to the conversational breakdowns and social difficulties exhibited by people with autism spectrum disorder (ASD). This study examined speech rate entrainment in children and adult populations with and without ASD. Sixty participants including typically developing children, children with ASD, typically developed adults, and adults with ASD participated in a quasi-conversational paradigm with a pseudoconfederate. The confederate's speech rate was digitally manipulated to create slow and fast speech rate conditions. Typically developed adults entrained their speech rate in the quasi-conversational paradigm, using a faster rate during the fast speech rate conditions and a slower rate during the slow speech rate conditions. This entrainment pattern was not evident in adults with ASD or in children populations. Findings suggest that speech rate entrainment is a developmentally acquired skill and offers preliminary evidence of speech rate entrainment deficits in adults with ASD. Impairments in this area may contribute to the conversational breakdowns and social difficulties experienced by this population. Future work is needed to advance this area of inquiry.

Longitudinal Associations between Anhedonia and Internet-Related Addictive Behaviors in Emerging Adults

PubMed Central

Guillot, Casey R.; Bello, Mariel S.; Tsai, Jennifer Y.; Huh, Jimi; Leventhal, Adam M.; Sussman, Steve

2016-01-01

Internet addiction (including online gaming) has been associated with depression. However, most prior research relating internet addiction symptomatology to depressive symptoms has been cross-sectional, conducted with children and adolescents, and only examined depressive symptoms as a broad construct. The purpose of the current study was to examine potential longitudinal associations between anhedonia (i.e., difficulty experiencing pleasure, a key facet of depression) and internet-related addictive behaviors in 503 at-risk emerging adults (former attendees of alternative high schools). Participants completed surveys at baseline and approximately one year later (9–18 months later). Results indicated that trait anhedonia prospectively predicted greater levels of compulsive internet use and addiction to online activities as well as a greater likelihood of addiction to online/offline video games. These findings suggest that anhedonia may contribute to the development of internet-related addictive behaviors in the emerging adult population. Thus, interventions that target anhedonia in emerging adulthood (e.g., bupropion treatment or behavioral activation therapy) may help prevent or treat internet addiction. PMID:27182108

Adolescents' and Emerging Adults' Social Networking Online: Homophily or Diversity?

ERIC Educational Resources Information Center

Mazur, Elizabeth; Richards, Lacey

2011-01-01

More than half of all online American adolescents and emerging adults have created personal profiles for social networking on the Internet. Does homophily in their offline friendships extend online? Drawing mainly on research of face-to-face friendship, we collected data from the public spaces, called "walls," of 129 young Americans ages 16 to 19…

Incentivizing health care behaviors in emerging adults: a systematic review

PubMed Central

Yu, Catherine H; Guarna, Giuliana; Tsao, Pamela; Jesuthasan, Jude R; Lau, Adrian NC; Siddiqi, Ferhan S; Gilmour, Julie Anne; Ladha, Danyal; Halapy, Henry; Advani, Andrew

2016-01-01

Purpose For emerging adults with chronic medical diseases, the transition from pediatric to adult health care is often a time of great upheaval, commonly associated with unhealthy self-management choices, loss to follow-up, and adverse outcomes. We conducted a systematic review to examine the use of incentive strategies to promote positive health-related behaviors in young adults with chronic medical diseases. Methods The Medline, CINAHL, Embase, PsycInfo, and Cochrane databases were searched through June 2014. Studies of any design where an incentive was used to achieve a target behavior or outcome in a pediatric or emerging adult population (age <30 years) with chronic medical conditions including addictions, were included. Results A total of 26 studies comprising 10,880 patients met our inclusion criteria after screening 10,305 abstracts and 301 full-text articles. Of these studies, 20 examined the effects of behavioral incentives on cigarette smoking or substance abuse, including alcohol; four studies explored behavioral incentives in the setting of HIV or sexual health; and two articles studied individuals with other chronic medical conditions. Seventeen articles reported a statistically significant benefit of the behavioral incentive on one or more outcomes, although only half reported follow-up after the incentive period was terminated. Conclusion While the majority of studies reported positive outcomes, these studies focused on promoting the cessation of adverse behaviors rather than promoting positive behaviors. In addition, conclusions were limited by the high risk of bias present in the majority of studies, as well as lack of follow-up after the incentive period. Whether behavioral incentives facilitate the adoption of positive health choices in this population remains to be determined. PMID:27069356

Ethiopian Emerging Adult Immigrants in Israel: Coping with Discrimination and Racism

ERIC Educational Resources Information Center

Walsh, Sophie D.; Tuval-Mashiach, Rivka

2012-01-01

Experiences of discrimination and racism and individual coping strategies were examined among 22 emerging adult Ethiopian immigrants in Israel. In-depth interviews explored the way they perceive, understand, respond to, and cope with experiences of discrimination. Qualitative analysis identified an initial contrast between those interviewees who…

High rates of parkinsonism in adults with autism.

PubMed

Starkstein, Sergio; Gellar, Scott; Parlier, Morgan; Payne, Leslie; Piven, Joseph

2015-01-01

While it is now recognized that autism spectrum disorder (ASD) is typically a life-long condition, there exist only a handful of systematic studies on middle-aged and older adults with this condition. We first performed a structured examination of parkinsonian motor signs in a hypothesis-generating, pilot study (study I) of 19 adults with ASD over 49 years of age. Observing high rates of parkinsonism in those off atypical neuroleptics (2/12, 17 %) in comparison to published population rates for Parkinson's disease and parkinsonism, we examined a second sample of 37 adults with ASD, over 39 years of age, using a structured neurological assessment for parkinsonism. Twelve of the 37 subjects (32 %) met the diagnostic criteria for parkinsonism; however, of these, 29 subjects were on atypical neuroleptics, complicating interpretation of the findings. Two of eight (25 %) subjects not taking atypical neuroleptic medications met the criteria for parkinsonism. Combining subjects who were not currently taking atypical neuroleptic medications, across both studies, we conservatively classified 4/20 (20 %) with parkinsonism. We find a high frequency of parkinsonism among ASD individuals older than 39 years. If high rates of parkinsonism and potentially Parkinson's disease are confirmed in subsequent studies of ASD, this observation has important implications for understanding the neurobiology of autism and treatment of manifestations in older adults. Given the prevalence of autism in school-age children, the recognition of its life-long natural history, and the recognition of the aging of western societies, these findings also support the importance of further systematic study of other aspects of older adults with autism.

An Exploration of the Sexual Behaviors of Emerging Adult Men Attending a Historically Black College/University

PubMed Central

Younge, Sinead N.; Boyer, Cherrie B.; Geter, Angelica; Barker, Judith C.; Corneille, Maya

2015-01-01

The purpose of this study was to provide formative data on the sexual behaviors of emerging adult Black men who attended a historically Black college/university. A convenience sample of 19 participants completed a demographic questionnaire and a semi-structured interview. This study utilized a phenomenological qualitative approach to explore the role of the developmental stage that emerging adulthood has on sexual health. Some of the major themes that emerged included maturation, sexual decision-making, respectability, a future orientation, and masculinity. Despite sexual initiation beginning prior to entering college, participants discussed how the college environment presented them with new information, experiences, and attitudes. This study provides useful information for the future investigation of emerging adult Black men who attend HBCUs. PMID:26146649

The Introduction of Adult Appendicitis Score Reduced Negative Appendectomy Rate.

PubMed

Sammalkorpi, H E; Mentula, P; Savolainen, H; Leppäniemi, A

2017-09-01

Implementation of a clinical risk score into diagnostics of acute appendicitis may provide accurate diagnosis with selective use of imaging studies. The aim of this study was to prospectively validate recently described diagnostic scoring system, Adult Appendicitis Score, and evaluate its effects on negative appendectomy rate. Adult Appendicitis Score stratifies patients into three groups: high, intermediate, and low risk of appendicitis. The score was implemented in diagnostics of adult patients suspected of acute appendicitis in two university hospitals. We analyzed the effects of Adult Appendicitis Score on diagnostic accuracy, imaging studies, and treatment. The study population was compared with a reference population of 829 patients suspected of acute appendicitis originally enrolled for the study of construction of the Adult Appendicitis Score. This study enrolled 908 patients of whom 432 (48%) had appendicitis. The score stratified 49% of all appendicitis patients into high-risk group with specificity of 93.3%. In the low-risk group, prevalence of appendicitis was 7%. The histologically confirmed negative appendectomy rate decreased from 18.2% to 8.7%, p<0.001, compared to the original dataset. Adult Appendicitis Score is a reliable tool for stratification of patients into selective imaging, which results in low negative appendectomy rate.

"Condoms are the standard, right?": Exploratory study of the reasons for using condoms by Black American emerging adult women.

PubMed

Longmire-Avital, Buffie; Oberle, Virginia

2016-01-01

Condoms are considered a highly effective form of sexually transmitted infection prevention for heterosexual sex. Black American women (BAW) have been and are at elevated risk for heterosexual exposure to human immunodeficiency virus (HIV) because they have been and continue to be less likely to negotiate condom use with a partner that supports them financially. However, BAW who have made tremendous educational gains may still encounter challenges regarding the distribution of power that can affect condom use and negotiation. The purpose of this exploratory study was to examine the reasons that highly educated, emerging, adult BAW reported for using condoms. One hundred twenty-seven emerging adult BAW (ages 18-29 years) completed a mixed-methods online survey during the spring of 2013 (January-May). Approximately 80% of the women were in college or college graduates. They had a high rate of previous HIV testing (68.5%). Through the use of an interpretive paradigm and grounded theory, three themes emerged regarding the reasons that the participants in this sample used condoms as their primary form of protection: (1) the reliable "standard," (2) pregnancy prevention, and (3) cost effective and "easily accessible." Findings are discussed in terms of their public health significance for this seemingly lower-risk population.

Perspectives of Young Emerging Adults with Serious Mental Health Conditions on Vocational Peer Mentors

ERIC Educational Resources Information Center

Klodnick, Vanessa V.; Sabella, Kathryn; Brenner, Christopher J.; Krzos, Izabela M.; Ellison, Marsha L.; Kaiser, Susan M.; Davis, Maryann; Fagan, Marc A.

2015-01-01

For early emerging adults with serious mental health conditions, vocational services with peer mentors are a promising adaptation of adult system evidence-based practices. Peer mentors were added to the Individual Placement and Support model of supported employment for 17- to 20-year-olds receiving residential and psychiatric care. To explore the…

An Exploratory Investigation of the Role of Openness in Relationship Quality among Emerging Adult Chinese Couples

PubMed Central

Zhou, Yixin; Wang, Kexin; Chen, Shuang; Zhang, Jianxin; Zhou, Mingjie

2017-01-01

This study tested emerging adult couples’ openness and its fit effect on their romantic relationship quality using quadratic polynomial regression and response surface analysis. Participants were 260 emerging adult dyads. Both dyads’ openness and relationship quality were measured. The result showed that (1) female and male openness contribute differently to relationship quality; (2) couples with similar high openness could experience better relationship quality than those with similar low openness traits; and (3) when dyadic openness is dissimilar, it is better to be either relatively high or relatively low than to be moderate. These findings highlight the role of openness in emerging adults’ romantic relationships from a dyadic angle. PMID:28360875

Revisit rates and associated costs after an emergency department encounter: a multistate analysis.

PubMed

Duseja, Reena; Bardach, Naomi S; Lin, Grace A; Yazdany, Jinoos; Dean, Mitzi L; Clay, Theodore H; Boscardin, W John; Dudley, R Adams

2015-06-02

Return visits to the emergency department (ED) or hospital after an index ED visit strain the health system, but information about rates and determinants of revisits is limited. To describe revisit rates, variation in revisit rates by diagnosis and state, and associated costs. Observational study using the Healthcare Cost and Utilization Project databases. 6 U.S. states. Adults with ED visits between 2006 and 2010. Revisit rates and costs. Within 3 days of an index ED visit, 8.2% of patients had a revisit; 32% of those revisits occurred at a different institution. Revisit rates varied by diagnosis, with skin infections having the highest rate (23.1% [95% CI, 22.3% to 23.9%]). Revisit rates also varied by state. For skin infections, Florida had higher risk-adjusted revisit rates (24.8% [CI, 23.5% to 26.2%]) than Nebraska (10.6% [CI, 9.2% to 12.1%]). In Florida, the only state with complete cost data, total revisit costs for the 19.8% of patients with a revisit within 30 days were 118% of total index ED visit costs for all patients (including those with and without a revisit). Whether a revisit reflects inadequate access to primary care, a planned revisit, the patient's nonadherence to ED recommendations, or poor-quality care at the initial ED visit remains unknown. Revisits after an index ED encounter are more frequent than previously reported, in part because many occur outside the index institution. Among ED patients in Florida, more resources are spent on revisits than on index ED visits. Agency for Healthcare Research and Quality.

Individuation in relation to parents as a predictor of career goals and career optimism in emerging adults.

PubMed

Puklek Levpušček, Melita; Rauch, Victoria; Komidar, Luka

2018-04-01

The aim of this study was to examine the associations of Slovenian emerging adults' individuation characteristics (in relation to mother and father) with career goals and career optimism. We were interested in contributions of age, gender, certainty of study choice, and individuation dimensions when predicting intrinsic/extrinsic career goals and career optimism. The participants provided self-reports on the Individuation Test for Emerging Adults, the Career Goals Scale and the Career Futures Inventory. The results showed that age did not relate to emerging adults' career goals; however, older students reported lower career optimism than their younger counterparts. Furthermore, certainty of study choice was the most important predictor of career optimism, and, along with gender, of intrinsic career goals. Emerging adults who reported higher connectedness with both parents and self-reliance in relation to mother had higher intrinsic career goals, while self-reliance in relation to mother was positively associated with stronger optimism about an individual's future career. Fear of disappointing both parents significantly contributed to the prediction of extrinsic career goals and optimism, while parental intrusiveness did not add significantly to the prediction of the two measured career outcomes. The study confirmed the correlational effects of positive and negative aspects of individuation on career outcomes in emerging adulthood. © 2017 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Differences in Healthcare Access, Use, and Experiences Within a Community Sample of Racially Diverse Lesbian, Gay, Bisexual, Transgender, and Questioning Emerging Adults

PubMed Central

Bhatia, Ramona; Greene, George J.

2016-01-01

Abstract Purpose: Health services research involving lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ) individuals has focused on differences in healthcare access, use, and experiences between cisgender, heterosexual adults and LGBTQ adults. Yet these factors may differ within the LGBTQ community and have not been well-studied among emerging adults (18–29 years), a group with unique barriers to healthcare. We sought to characterize healthcare challenges within a sample of LGBTQ emerging adults. Methods: From 2012 to 2013, 206 participants aged 18–27 (86% racial/ethnic minority, 10% transgender) completed questionnaires assessing healthcare access, use, and experiences during a longitudinal study. Descriptive statistics established patterns of healthcare access, use, and experiences, and nonparametric tests examined differences related to sociodemographic variables, HIV status, sexual orientation identity, and gender identity. Results: Overall, 68% of participants reported relatively easy access to care. White and bisexual participants reported higher rates of insurance than racial/ethnic minority (P = 0.01) and gay or lesbian participants (P = 0.005), respectively. Although most participants did not report having negative experiences in healthcare settings related to their LGBTQ identity, transgender participants were more likely to delay care (P < 0.001) and report negative effects of disclosure to their provider (P < 0.001) compared with cisgender participants. Participants who identified as queer or were questioning their sexual orientation identity reported negative healthcare experiences more frequently than LGB-identified participants (P = 0.001). Conclusions: Although LGBTQ emerging adults experienced fewer barriers to care than observed in previous studies on LGBTQ adults, the results suggest that queer, questioning, and transgender individuals may face additional healthcare challenges compared with their LGB and

Young adults' support for adult-ratings for movies depicting smoking and for restrictions on tobacco magazine advertising.

PubMed

Choi, Kelvin; Fabian, Lindsey; Jansen, Jim; Lenk, Kathleen; Forster, Jean

2013-12-01

Smoking images in movies and tobacco advertisements in magazines are influential on adolescent smoking behaviors, and restrictions of these advertising strategies can reduce the prevalence of adolescent smoking. We assessed young adults' level of support for adult ratings for movies depicting smoking and for restrictions on tobacco magazine advertising. Young adults from the U.S. Midwest were surveyed between 2010-2011 (n=2622). We assessed their level of support for (a) adult-rating all movies depicting smoking, and (b) restrictions on tobacco magazine advertising. Multivariate regression models were used to investigate the characteristics associated with higher level of support for these policies. Overall, 34% of the participants favored adult ratings for movies with smoking images, and 68% favored restrictions on tobacco magazine advertising. Characteristics associated with higher level of support differed somewhat by policy. Further educating young adults about the influence of smoking images in movies on adolescent smoking may be necessary to gain more support for the policy. With the majority supporting restrictions on tobacco magazine advertising, it may be possible to tighten these restrictions to further protect adolescents. Future research is needed to identify how tobacco control advocates can frame these issues to gain further public support.

Sensitivity and specificity of the gain short-screener for predicting substance use disorders in a large national sample of emerging adults.

PubMed

Smith, Douglas C; Bennett, Kyle M; Dennis, Michael L; Funk, Rodney R

2017-05-01

Emerging Adults (ages 18-25) have the highest prevalence of substance use disorders and rarely receive treatment from the specialty care system. Thus, it is important to have screening instruments specifically developed for emerging adults for use in Screening, Brief Intervention and Referral to Treatment (SBIRT) models. Optimal cutoffs for the widely-used GAIN Short-Screener's (GAIN-SS) Substance Disorder Screener (SDScrY) are not established specifically for emerging adults. Therefore, this study examined the sensitivity and specificity of the SDScrY in predicting emerging adult (ages 18-25) substance use disorders. We analyzed data from emerging adults in a large clinical sample (n=9,808) who completed both the five-item SDScrY (α=0.85) and the full criteria set for DSM-IV Substance Use Disorders. We estimated the sensitivity, specificity and area under the curve to determine optimal cutoffs. Analyses revealed a high correlation between the SDScrY screener and its longer parent scale (r=0.95, p<0.001). Sensitivity (83%) and specificity (95%) were highest at a cutoff score of two (AUC=94%) on the SDScrY for any past year substance use disorder. Sensitivity (85%) was also high at a cutoff score of two on the SDScrY for any past year alcohol disorder. The five-item Substance Use Disorder Screener is a sensitive and specific screener for emerging adults, and could be used to identify emerging adults who may benefit from SBIRT interventions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Association between resting heart rate and arterial stiffness in Korean adults.

PubMed

Park, Byoung-Jin; Lee, Hye-Ree; Shim, Jae-Yong; Lee, Jung-Hyun; Jung, Dong-Hyuk; Lee, Yong-Jae

2010-04-01

Higher resting heart rate, a simple and useful indicator of autonomic balance and metabolic rate, has emerged as an independent predictor for atherosclerotic cardiovascular disease. To determine the association between resting heart rate and arterial stiffness measured by brachial-ankle pulse wave velocity (baPWV). We examined the association between resting heart rate and baPWV in 641 Korean adults (366 men, 275 women) in a health examination program. A high baPWV was defined as greater than 1450 cm/s (>75th percentile). The odds ratios for high baPWVs were calculated using multivariable logistic regression analysis after adjusting for confounding variables across heart rate quartiles (Q1or=69 beats/min). Age-adjusted baPWV mean values increased gradually with heart rate quartile (Q1=1281, Q2=1285, Q3=1354, Q4=1416 cm/s). The odds ratios (95% confidence intervals) for high baPWVs in each heart rate quartile were 1.00, 1.28 (0.57-2.86), 2.63 (1.20-5.79) and 3.66 (1.66-8.05), respectively, after adjusting for age, sex, smoking status, alcohol intake, exercise, body mass index, hypertension medication, diabetes medication, hyperlipidaemia medication, mean arterial blood pressure, fasting plasma glucose, total cholesterol, triglycerides, high-density lipoprotein cholesterol, white blood cell count, aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltransferase and uric acid. These findings indicate that a higher resting heart rate is independently associated with arterial stiffness. Accordingly, early detection of increased resting heart rate is important for preservation of arterial function and assessment of cardiovascular risk. Copyright 2010 Elsevier Masson SAS. All rights reserved.

Do I Really Need Someone in Order to become an Adult?: Romantic Relationships during Emerging Adulthood in Italy

ERIC Educational Resources Information Center

Lanz, Margherita; Tagliabue, Semira

2007-01-01

Italian emerging adults stay at home with their parents until they marry. Being involved in a romantic relationship may be considered one precursor of the success of the transition to adulthood. In this study, 92 dating and 84 nondating emerging adults were compared on when they left the parental home and their future plans. They were also…

Postnatal growth rates covary weakly with embryonic development rates and do not explain adult mortality probability among songbirds on four continents.

PubMed

Martin, Thomas E; Oteyza, Juan C; Mitchell, Adam E; Potticary, Ahva L; Lloyd, Penn

2015-03-01

Growth and development rates may result from genetic programming of intrinsic processes that yield correlated rates between life stages. These intrinsic rates are thought to affect adult mortality probability and longevity. However, if proximate extrinsic factors (e.g., temperature, food) influence development rates differently between stages and yield low covariance between stages, then development rates may not explain adult mortality probability. We examined these issues based on study of 90 songbird species on four continents to capture the diverse life-history strategies observed across geographic space. The length of the embryonic period explained little variation (ca. 13%) in nestling periods and growth rates among species. This low covariance suggests that the relative importance of intrinsic and extrinsic influences on growth and development rates differs between stages. Consequently, nestling period durations and nestling growth rates were not related to annual adult mortality probability among diverse songbird species within or among sites. The absence of a clear effect of faster growth on adult mortality when examined in an evolutionary framework across species may indicate that species that evolve faster growth also evolve physiological mechanisms for ameliorating costs on adult mortality. Instead, adult mortality rates of species in the wild may be determined more strongly by extrinsic environmental causes.

Postnatal growth rates covary weakly with embryonic development rates and do not explain adult mortality probability among songbirds on four continents

USGS Publications Warehouse

Martin, Thomas E.; Oteyza, Juan C.; Mitchell, Adam E.; Potticary, Ahva L.; Lloyd, P.

2016-01-01

Growth and development rates may result from genetic programming of intrinsic processes that yield correlated rates between life stages. These intrinsic rates are thought to affect adult mortality probability and longevity. However, if proximate extrinsic factors (e.g., temperature, food) influence development rates differently between stages and yield low covariance between stages, then development rates may not explain adult mortality probability. We examined these issues based on study of 90 songbird species on four continents to capture the diverse life-history strategies observed across geographic space. The length of the embryonic period explained little variation (ca. 13%) in nestling periods and growth rates among species. This low covariance suggests that the relative importance of intrinsic and extrinsic influences on growth and development rates differs between stages. Consequently, nestling period durations and nestling growth rates were not related to annual adult mortality probability among diverse songbird species within or among sites. The absence of a clear effect of faster growth on adult mortality when examined in an evolutionary framework across species may indicate that species that evolve faster growth also evolve physiological mechanisms for ameliorating costs on adult mortality. Instead, adult mortality rates of species in the wild may be determined more strongly by extrinsic environmental causes.

Nudging Our Way to a Healthier Population: The Effect of Calorie Labeling and Self-Control on Menu Choices of Emerging Adults.

PubMed

Rising, Camella J; Bol, Nadine

2017-08-01

Emerging adults are among those in the United States with concerning rates of overweight and obesity, putting them at risk for chronic diseases. One proposed intervention to address these issues across populations is to require that chain restaurants and similar establishments provide nutrition information, such as calorie labels, on menu items. This study therefore aims to examine the effect of menu calorie labeling and self-control on food and beverage choices of emerging adults. Results of a between-subjects experiment (n = 179) revealed that calorie labeling increased the likelihood of choosing lower calorie food and beverage options. Moreover, calorie labeling only led to selecting a lower calorie food option among those with high self-control, but not among those with low self-control. This moderating effect was not revealed for beverage choice. Public health practitioners and policymakers should consider intervention approaches that address other drivers of choice, such as self-control, in addition to nutrition information.

Alternating and Sequential Motion Rates in Older Adults

ERIC Educational Resources Information Center

Pierce, John E.; Cotton, Susan; Perry, Alison

2013-01-01

Background: Alternating motion rate (AMR) and sequential motion rate (SMR) are tests of articulatory diadochokinesis that are widely used in the evaluation of motor speech. However, there are no quality normative data available for adults aged 65 years and older. Aims: There were two aims: (1) to obtain a representative, normative dataset of…

Medicaid dental coverage alone may not lower rates of dental emergency department visits.

PubMed

Fingar, Kathryn R; Smith, Mark W; Davies, Sheryl; McDonald, Kathryn M; Stocks, Carol; Raven, Maria C

2015-08-01

Medicaid was expanded to millions of individuals under the Affordable Care Act, but many states do not provide dental coverage for adults under their Medicaid programs. In the absence of dental coverage, patients may resort to costly emergency department (ED) visits for dental conditions. Medicaid coverage of dental benefits could help ease the burden on the ED, but ED use for dental conditions might remain a problem in areas with a scarcity of dentists. We examined county-level rates of ED visits for nontraumatic dental conditions in twenty-nine states in 2010 in relation to dental provider density and Medicaid coverage of nonemergency dental services. Higher density of dental providers was associated with lower rates of dental ED visits by patients with Medicaid in rural counties but not in urban counties, where most dental ED visits occurred. County-level Medicaid-funded dental ED visit rates were lower in states where Medicaid covered nonemergency dental services than in other states, although this difference was not significant after other factors were adjusted for. Providing dental coverage alone might not reduce Medicaid-funded dental ED visits if patients do not have access to dental providers. Project HOPE—The People-to-People Health Foundation, Inc.

Serotonin Transporter Gene Polymorphisms and Early Parent-Infant Interactions Are Related to Adult Male Heart Rate Response to Female Crying

PubMed Central

Truzzi, Anna; Bornstein, Marc H.; Senese, Vincenzo P.; Shinohara, Kazuyuki; Setoh, Peipei; Esposito, Gianluca

2017-01-01

Adults' adaptive interactions with intimate partners enhance well-being. Here we hypothesized that adult males' physiological responses to opposite-sex conspecifics' distress result from an interaction between an environmental factor (early social interaction with caregivers) and a genetic factor (a polymorphism within the promoter region of the serotonin transporter gene, 5-HTTLPR). We assessed heart rate changes in 42 non-married male adults to distress vocalizations (female, infant, and bonobo cries). Males' early interaction with parents was assessed using the Parental Bonding Instrument. Buccal mucosa cell samples were collected to assess their 5-HTTLPR genotype. A significant interaction emerged between early experience and genetic predisposition. Males with a genetic predisposition for higher sensitivity to environmental factors showed atypical physiological responses to adult female cries according to their experienced early maternal parenting. Environmental experiences and genetic characteristics are associated with adult males' physiological responses to socially meaningfully stimuli. Understanding the mechanisms that modulate responses to opposite-sex conspecifics may improve personal well-being and social adaptiveness. PMID:28293197

Decreasing Emergency Department Walkout Rate and Boarding Hours by Improving Inpatient Length of Stay.

PubMed

Artenstein, Andrew W; Rathlev, Niels K; Neal, Douglas; Townsend, Vernette; Vemula, Michael; Goldlust, Sheila; Schmidt, Joseph; Visintainer, Paul

2017-10-01

Patient progress, the movement of patients through a hospital system from admission to discharge, is a foundational component of operational effectiveness in healthcare institutions. Optimal patient progress is a key to delivering safe, high-quality and high-value clinical care. The Baystate Patient Progress Initiative (BPPI), a cross-disciplinary, multifaceted quality and process improvement project, was launched on March 1, 2014, with the primary goal of optimizing patient progress for adult patients. The BPPI was implemented at our system's tertiary care, academic medical center, a high-volume, high-acuity hospital that serves as a regional referral center for western Massachusetts. The BPPI was structured as a 24-month initiative with an oversight group that ensured collaborative goal alignment and communication of operational teams. It was organized to address critical aspects of a patient's progress through his hospital stay and to create additional inpatient capacity. The specific goal of the BPPI was to decrease length of stay (LOS) on the inpatient adult Hospital Medicine service by optimizing an interdisciplinary plan of care and promoting earlier departure of discharged patients. Concurrently, we measured the effects on emergency department (ED) boarding hours per patient and walkout rates. The BPPI engaged over 300 employed clinicians and non-clinicians in the work. We created increased inpatient capacity by implementing daily interdisciplinary bedside rounds to proactively address patient progress; during the 24 months, this resulted in a sustained rate of discharge orders written before noon of more than 50% and a decrease in inpatient LOS of 0.30 days (coefficient: -0.014, 95% CI [-0.023, -0.005] P< 0.005). Despite the increase in ED patient volumes and severity of illness over the same time period, ED boarding hours per patient decreased by approximately 2.1 hours (coefficient: -0.09; 95% CI [-0.15, -0.02] P = 0.007). Concurrently, ED walkout rates

Adolescents' and young adults' perspectives on their emergency care.

PubMed

Hicks, Catherine F; Ward, Mary J; Platt, Shari L

2014-08-01

The aim of this study was to assess the perspectives of adolescents and young adults seen in the emergency department (ED) on the optimal age for transition from a pediatric ED (PED) to an adult ED (AED) as well as the appropriateness of their assigned ED site. Secondary aims were to determine ED physicians' understanding and assessment of their psychosocial needs, to determine whether subjects had a primary care provider (PCP), as well as to identify resources they felt would improve their ED experience. This study used in-person structured interviews on a convenience sample of ED patients aged 15 to 25 years. Data were analyzed with the SPSS for Windows (v15.0) using t tests and uncertainty coefficients. We interviewed 200 subjects; the mean age was 20.5 (SD, 3) years, 65% were female, and 54% were seen in the PED. The subjects reported a mean age of 18.5 years as optimal for transition to an AED (mode, 18; second peak, 21); only 5% chose an age older than 21 years. The AED subjects more likely felt that their site of care was appropriate (Likert scale, 1-3; 2.5 vs 2.2, P < 0.05). HEADSS (Home, Education/Employment, Activity, Drugs, Sexuality, Suicide) topics were rarely addressed in both ED sites. The PED subjects more often identified a PCP (87% vs 68%); there was no difference in notifying their PCP (27% vs 19%). The PED subjects more often desired magazines (83% vs 70%) and entertainment videos (61% vs 34%). Adolescents and young adults identify the age of 18 years as optimal for transition from a PED to an AED setting. Instituting a standardized HEADSS assessment protocol and offering age-appropriate resources may enhance the emergency experience for this population.

Relations of Behavioral Autonomy to Health Outcomes Among Emerging Adults With and Without Type 1 Diabetes

PubMed Central

Reynolds, Kerry A.; Becker, Dorothy; Escobar, Oscar; Siminerio, Linda

2014-01-01

Objective To examine the relation of behavioral autonomy to psychological, behavioral, and physical health among emerging adults with and without type 1 diabetes. Methods High school seniors with (n = 118) and without type 1 diabetes (n = 122) completed online questionnaires for three consecutive years. Behavioral autonomy, psychological health, risk behaviors, and diabetes outcomes were assessed. Regression analyses were conducted to predict Time 2 and 3 outcomes, controlling for Time 1 outcomes. Results There were no group differences in behavioral autonomy. Behavioral autonomy predicted better psychological health but only for emerging adults without diabetes. Behavioral autonomy was related to increased risk behavior for both groups. Behavioral autonomy was unrelated to self-care but predicted better glycemic control for females. Conclusions Behavioral autonomy may be beneficial for psychological health, but is related to increased risk behavior. The implications of behavioral autonomy for emerging adults with type 1 diabetes require careful consideration. PMID:25157070

Role transitions and substance use among Hispanic emerging adults: A longitudinal study using coarsened exact matching.

PubMed

Allem, Jon-Patrick; Sussman, Steve; Soto, Daniel W; Baezconde-Garbanati, Lourdes; Unger, Jennifer B

2016-07-01

Emerging adulthood (ages 18 to 25) is characterized by changes in relationships, education, work, and viewpoints on life. The prevalence of substance use also peaks during this period. Among emerging adults, Hispanics have a unique substance use profile, and have been described as a priority population for substance use prevention. Cross-sectional studies among Hispanics have shown that specific role transitions (e.g., starting or ending romantic relationships) were associated with substance use. Negative affect from uncertainty/stress that accompanies role transitions in emerging adulthood may lead to substance use as a maladaptive coping mechanism. Longitudinal studies are needed to gain a more complete understanding of these associations. Participants completed surveys for Project RED, a longitudinal study of substance use among Hispanics in Southern California. This study used Coarsened Exact Matching to overcome the methodological limitations of previous studies. Participants were matched on pretreatment variables including age, gender, substance use behavior in high school, and depressive symptoms. Past-month cigarette use, binge drinking, marijuana use, and hard drug use were the outcomes of interest. After matching, each outcome was regressed on each individual role transition in year one of emerging adulthood with this process repeated in year two of emerging adulthood. Role transitions in romance and work were positively associated with multiple categories of substance use. Prevention programs should teach emerging adults ways to cope with the stress from role transitions. Individual role transitions may be used to screen for subgroups of emerging adults at high risk for substance use. Copyright © 2015 Elsevier Ltd. All rights reserved.

Religion and health-promoting behaviors among emerging adults.

PubMed

Horton, Shalonda E B

2015-02-01

Studies suggest we capitalize upon religion's health benefits to prevent obesity. The purpose of this qualitative descriptive study was to determine how emerging adults used religion to manage their health. Two focus groups were conducted among White and African American participants. Content analysis of the data revealed categories about their attitudes regarding parental and religious influences, religion's influence on behavior, negative health effects of religion, barriers, obesity prevention, and health promotion programs. Society sends out "easy" solutions for unhealthy behaviors, but we should focus on healthy behavior benefits, remove barriers, and consider religion's part in health promotion (obesity prevention).

Financial Parenting, Financial Coping Behaviors, and Well-Being of Emerging Adults

ERIC Educational Resources Information Center

Serido, Joyce; Shim, Soyeon; Mishra, Anubha; Tang, Chuanyi

2010-01-01

The goal of this study was to consider the role of parents in the development of their children's financial independence by the time the children are old enough to enter college. Using data from 2,098 first-year university students, we examined two pathways to emerging adults' financial, psychological, and personal well-being, combining research…

Perceived Parental Relationships and Health-Risk Behaviors in College-Attending Emerging Adults

ERIC Educational Resources Information Center

Schwartz, Seth J.; Zamboanga, Byron L.; Ravert, Russell D.; Kim, Su Yeong; Weisskirch, Robert S.; Williams, Michelle K.; Bersamin, Melina; Finley, Gordon E.

2009-01-01

The present study investigated the association of perceived parenting with health-risk behaviors in an ethnically diverse sample of 1,728 college-attending emerging adults. Participants completed retrospective measures of perceived maternal and paternal nurturance, connection, psychological control, and disrespect and reported their frequency of…

Reentry of Emerging Adults: Adolescent Inmates' Transition Back into the Community

ERIC Educational Resources Information Center

Inderbitzin, Michelle

2009-01-01

This article is based on the sociological analysis of the experiences and perspectives of five young men making the transition out of one state's end-of-the-line maximum security juvenile correctional facility and attempting to reenter the community as emerging adults. As part of a larger ethnographic study of violent offenders in a cottage, these…

Sexting and Sexuality in Romantic Relationships among Latina/o Emerging Adults

ERIC Educational Resources Information Center

Castañeda, Donna Marie

2017-01-01

In a sample of 114 Latina/o emerging adults, ages 18 to 29, this study investigated the frequency of sexting, and gender differences in this behavior, and if sexting was related to a range of sexuality variables, including sexual satisfaction, sexual experience, sexual pleasure, and sexual permissiveness. Results show that a total of 63 (55.26%)…

Emerging Adults' Stress and Health: The Role of Parent Behaviors and Cognitions

ERIC Educational Resources Information Center

Donnelly, Reesa; Renk, Kimberly; McKinney, Cliff

2013-01-01

Although parent behaviors and cognitions are important for stress/health outcomes throughout development, little research examines whether cognitions mediate the relationship between parent behaviors and stress/health outcomes. As a result, the current study examined the reports of 160 emerging adults regarding their mothers' and fathers'…

Family Cultural Socialization Practices and Ethnic Identity in College-Going Emerging Adults

ERIC Educational Resources Information Center

Juang, Linda; Syed, Moin

2010-01-01

We examined how family cultural socialization related to the ethnic identity of Asian American, Latino, White, and Mixed-Ethnic emerging adults (N = 225). Greater family cultural socialization was related to greater ethnic identity exploration and commitment. Ethnic minority students reported higher levels of family cultural socialization and…

High Gastrointestinal Colonization Rate with Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in Hospitalized Patients: Emergence of Carbapenemase-Producing K. pneumoniae in Ethiopia

PubMed Central

Desta, Kassu; Woldeamanuel, Yimtubezinash; Azazh, Aklilu; Mohammod, Halima; Desalegn, Dawit; Shimelis, Damte; Gulilat, Dereje; Lamisso, Biruk; Makonnen, Eyasu; Worku, Alemayehu; Mannerqvist, Kerstin; Struwe, Johan; Aspevall, Olov; Aklillu, Eleni

2016-01-01

We investigated the gastrointestinal colonization rate and antibiotic resistance patterns of Extended-Spectrum Beta-Lactamase (ESBL)- producing Escherichia coli and Klebsiella pneumoniae in hospitalized patients admitted at Ethiopia’s largest tertiary hospital. Fecal samples/swabs from 267 patients were cultured on chrome agar. ESBL. Bacterial species identification, verification of ESBL production and antibiotic susceptibility testing were done using Vitek 2 system (bioMérieux, France). Phenotype characterization of ESBL-E.coli and ESBL- K.pneumoniae was done using Neo-Sensitabs™. ESBL positivity rate was much higher in K. pneumoniae (76%) than E. coli (45%). The overall gastrointestinal colonization rate of ESBL producing Enterobacteriaceae (ESBL-E) in hospitalized patients was 52% (95%CI; 46%–58%) of which, ESBL-E. coli and K.pneumoniae accounted for 68% and 32% respectively. Fecal ESBL-E carriage rate in neonates, children and adults was 74%, 59% and 46% respectively. Gastrointestinal colonization rate of ESBL-E.coli in neonates, children and adults was 11%, 42% and 42% respectively. Of all E. coli strains isolated from adults, children and neonates, 44%, 49% and 22% were ESBL positive (p = 0.28). The prevalence of ESBL-K.pneumoniae carriage in neonates, children and adults was 68%, 22% and 7% respectively. All K. pneumoniae isolated from neonates (100%) and 88% of K. pneumoniae isolated from children were ESBL positive, but only 50% of K.pneumoniae isolated from adults were ESBL positive (p = 0.001). Thirteen patients (5%) were carriers of both ESBL-E.coli and ESBL-KP. The overall carrier rate of ESBL producing isolates resistant to carbapenem was 2% (5/267), all detected in children; three with E.coli HL cephalosporinase (AmpC), resistant to ertapenem and two with K. pneumoniae Carbapenemase (KPC) resistant to meropenem, ertapenem and impenem. We report a high gastrointestinal colonization rate with ESBL-E and the emergence of carbapenems-resistant K

The Detroit Young Adult Asthma Project: Proposal for a Multicomponent Technology Intervention for African American Emerging Adults With Asthma.

PubMed

MacDonell, Karen; Naar, Sylvie; Gibson-Scipio, Wanda; Bruzzese, Jean-Marie; Wang, Bo; Brody, Aaron

2018-05-07

Racial and ethnic minority youth have poorer asthma status than white youth, even after controlling for socioeconomic variables. Proper use of asthma controller medications is critical in reducing asthma mortality and morbidity. The clinical consequences of poor asthma management include increased illness complications, excessive functional morbidity, and fatal asthma attacks. There are significant limitations in research on interventions to improve asthma management in racial minority populations, particularly minority adolescents and young adults, although illness management tends to deteriorate after adolescence during emerging adulthood, the unique developmental period beyond adolescence but before adulthood. The objective of the pilot study was to test the feasibility, acceptability, and signals of efficacy of an intervention targeting adherence to controller medication in African American youth (ages 18-29) with asthma. All elements of the protocol were piloted in a National Heart, Lung, and Blood Institute (NHLBI)-funded pilot study (1R34HL107664 MacDonell). Results suggested feasibility and acceptability of the protocol as well as proof of concept. We are now ready to test the intervention in a larger randomized clinical trial. The proposed study will include 192 African American emerging adults with moderate to severe persistent asthma and low controller medication adherence recruited from clinic, emergency department, and community settings. Half of the sample will be randomized to receive a multicomponent technology-based intervention targeting adherence to daily controller medication. The multicomponent technology-based intervention consists of 2 components: (1) 2 sessions of computer-delivered motivational interviewing targeting medication adherence and (2) individualized text messaging focused on medication adherence between the sessions. Text messages will be individualized based on ecological momentary assessment. The remaining participants will

Controlling Anxiety Mediates the Influence of Childhood Adversities on Risky Sexual Behaviors Among Emerging Adults.

PubMed

Wong, Janet Yuen-Ha; Choi, Edmond Pui-Hang; Chan, Claudia Kor-Yee; Fong, Daniel Yee-Tak

2017-10-01

Relatively little research has assessed the exposure-response relationship of childhood adversities on engaging in risky sexual behaviors. Also, no previous research has examined the interrelationship among childhood adversities, adult anxiety and depressive symptoms, and risky sexual behaviors. This study aimed to investigate their interrelationships. We used data from a multisite survey of emerging adults aged 18 to 29 studying at four universities in Hong Kong between September and December 2015. Structural equation modeling (SEM) was used to examine the pathways from childhood adversities to risky sexual behaviors. Participants who had higher childhood adversity scores reported more severe adult anxiety symptoms (β = 0.20, p = 0.002); and adult anxiety symptoms were associated with significantly more risky sexual behaviors (β = 0.46, p < 0.0001). The model with adult anxiety symptoms as the mediator between childhood adversities and risky sexual behaviors showed good fit (root mean square error of approximation [RMSEA] = 0.04, comparative fit index [CFI] = 0.96, Tucker-Lewis index [TLI] = 0.94 and standardized root mean square residual [SRMSR] = 0.04). However, adult depressive symptoms failed to mediate between childhood adversities and risky sexual behaviors. This study demonstrates the link between childhood adversities and risky sexual behaviors via adult anxiety but not adult depressive symptoms. It is essential to reduce anxious symptoms in dealing with emerging adults who have risky sexual behaviors to prevent sexually transmitted infections (STIs) and unintended pregnancy.

Adverse childhood experiences and substance use among Hispanic emerging adults in Southern California

PubMed Central

Allem, Jon-Patrick; Soto, Daniel W.; Baezconde-Garbanati, Lourdes; Unger, Jennifer B.

2015-01-01

Introduction Emerging adults who experienced stressful childhoods may engage in substance use as a maladaptive coping strategy. Given the collectivistic values Hispanics encounter growing up, adverse childhood experiences may play a prominent role in substance use decisions as these events violate the assumptions of group oriented cultural paradigms. Alternatively, adverse childhood events might not increase the risk of substance use because strong family ties could mitigate the potential maladaptive behaviors associated with these adverse experiences. This study examined whether adverse childhood experiences were associated with substance use among Hispanic emerging adults. Method Participants (n=1420, mean age=22, 41% male) completed surveys indicating whether they experienced any of 8 specific adverse experiences within their first 18 years of life, and past-month cigarette use, marijuana use, hard drug use, and binge drinking. Logistic regression models examined the associations between adverse childhood experiences and each category of substance use, controlling for age, gender, and depressive symptoms. Results The number of adverse childhood experiences was significantly associated with each category of substance use. A difference in the number of adverse childhood experiences, from 0 to 8, was associated with a 22% higher probability of cigarette smoking, a 24% higher probability of binge drinking, a 31% higher probability of marijuana use, and a 12% higher probability of hard drug use respectively. Conclusions These findings should be integrated into prevention/intervention programs in hopes of quelling the duration and severity of substance use behaviors among Hispanic emerging adults. PMID:26160522

Exploring the Everyday Life Information Needs, Practices, and Challenges of Emerging Adults with Intellectual Disabilities

ERIC Educational Resources Information Center

Hanson-Baldauf, Dana

2013-01-01

This dissertation research addresses a gap in the library and information science literature on everyday life information (ELI) needs and experiences of emerging adults with intellectual disabilities (I/DD). Emerging adulthood refers to the period between the late teen years and mid-twenties. Although this is a period of significant change for all…

Management of Adults With Acute Migraine in the Emergency Department: The American Headache Society Evidence Assessment of Parenteral Pharmacotherapies.

PubMed

Orr, Serena L; Friedman, Benjamin W; Christie, Suzanne; Minen, Mia T; Bamford, Cynthia; Kelley, Nancy E; Tepper, Deborah

2016-06-01

To provide evidence-based treatment recommendations for adults with acute migraine who require treatment with injectable medication in an emergency department (ED). We addressed two clinically relevant questions: (1) Which injectable medications should be considered first-line treatment for adults who present to an ED with acute migraine? (2) Do parenteral corticosteroids prevent recurrence of migraine in adults discharged from an ED? The American Headache Society convened an expert panel of authors who defined a search strategy and then performed a search of Medline, Embase, the Cochrane database and clinical trial registries from inception through 2015. Identified articles were rated using the American Academy of Neurology's risk of bias tool. For each medication, the expert panel determined likelihood of efficacy. Recommendations were created accounting for efficacy, adverse events, availability of alternate therapies, and principles of medication action. The search identified 68 unique randomized controlled trials utilizing 28 injectable medications. Of these, 19 were rated class 1 (low risk of bias), 21 were rated class 2 (higher risk of bias), and 28 were rated class 3 (highest risk of bias). Metoclopramide, prochlorperazine, and sumatriptan each had multiple class 1 studies supporting acute efficacy, as did dexamethasone for prevention of headache recurrence. All other medications had lower levels of evidence. Intravenous metoclopramide and prochlorperazine, and subcutaneous sumatriptan should be offered to eligible adults who present to an ED with acute migraine (Should offer-Level B). Dexamethasone should be offered to these patients to prevent recurrence of headache (Should offer-Level B). Because of lack of evidence demonstrating efficacy and concern about sub-acute or long-term sequelae, injectable morphine and hydromorphone are best avoided as first-line therapy (May avoid-Level C). © 2016 American Headache Society.

Product Related Adult Genitourinary Injuries Treated at Emergency Departments in the United States from 2002 to 2010

PubMed Central

Bagga, Herman S.; Tasian, Gregory E.; Fisher, Patrick B.; McCulloch, Charles E.; McAninch, Jack W.; Breyer, Benjamin N.

2013-01-01

Purpose We describe the epidemiological features of adult genitourinary injuries related to consumer products and determined the patient cohorts, products and situations associated with increased genitourinary injury risk. Materials and Methods The National Electronic Injury Surveillance System, a data set validated to provide a probability sample of injury related emergency department presentations in the United States, was analyzed to characterize genitourinary injuries from 2002 to 2010. We analyzed 3,545 observations to derive national estimates. Results An estimated 142,144 adults (95% CI 115,324–168,964) presented to American emergency departments with genitourinary injuries from 2002 to 2010. Of the injuries 69% occurred in men. A large majority of injuries involved the external genitalia. The most common categories of products involved were sporting items in 30.2% of cases, clothing articles in 9.4% and furniture in 9.2%. The highest prevalence of injury was at ages 18 to 28 years (37.5%), which was most often related to sports equipment, such as bicycles. Older cohorts (age greater than 65 years) more commonly sustained injuries during falls and often in the bathroom during use of a shower or tub. Of all patients 88% were evaluated and treated in the emergency department without inpatient admission, although the admission rate increased with increasing patient age. Conclusions Acute genitourinary injury is often associated with common consumer items and with identifiable high risk cohorts, products and situations. Consumers, practitioners and safety champions can use our epidemiological data to prioritize and develop strategies aimed at the prevention, limitation and informed treatment of such injuries. PMID:23127766

Relation between gastric emptying rate and energy intake in children compared with adults.

PubMed Central

Maes, B D; Ghoos, Y F; Geypens, B J; Hiele, M I; Rutgeerts, P J

1995-01-01

Measurement of gastric emptying rate of solids in children is difficult because the available methods are either invasive or induce a substantial radiation burden. In this study the newly developed 13C octanoic acid breath test was used to examine the gastric emptying rate of solids and milk in healthy children and to compare gastric emptying in children and adults. Fifteen healthy children and three groups of nine healthy adults were studied, using three different test meals labelled with 50 mg of 13C octanoic acid: a low caloric pancake (150 kcal), a high caloric pancake (250 kcal), and 210 ml of milk (134 kcal). Breath samples were taken before and at regular intervals after ingestion of the test meal, and analysed by isotope ratio mass spectrometry. The gastric emptying parameters were derived from the 13CO2 excretion curves by non-linear regression analysis. No significant difference was found between children and adults in the emptying rate of the low caloric solid test meal. In children as well as in adults, increasing the energy content of the solid meal resulted in a significantly slower emptying rate. The milk test meal, however, was emptied at a faster rate in adults and at slower rate in children compared with the low caloric solid test meal. Moreover, the emptying rate of milk in children was significantly slower than in adults. In conclusion, a similar gastric emptying rate of solids but a slower emptying of full cream milk was shown in children of school age compared with adults, using the non-radioactive 13C octanoic acid breath test. PMID:7883214

Associations among stress, gender, sources of social support, and health in emerging adults.

PubMed

Lee, Chih-Yuan Steven; Dik, Bryan J

2017-10-01

This study aimed to examine how sources of social support intersect with stress and health by testing two theoretical models. Three relationship-specific sources of social support (family, friends, and romantic partners) and two health indicators (self-rated physical health and depressive symptoms) were investigated. The sample consisted of 636 emerging adults attending college (age range: 18-25). Results suggest that only support from family was a stress-buffer, in that it buffered the adverse association between stress and depressive symptoms. Holding stress constant, only support from family was related to self-rated physical health and only support from friends or romantic partners was associated with depressive symptoms. There were no gender differences in the mean levels of self-rated physical health and depressive symptoms. However, gender moderations were found, in that the positive relationship between friends support and physical health was observed only in women, that the association between friends support and depressive symptoms was greater in men than in women, and that family support buffered the negative relationship between stress and physical health only in men. Findings of this study suggest that the associations among stress, social support, and health vary by the sources of support, the health outcome, and gender. Copyright © 2016 John Wiley & Sons, Ltd.

Exploring the Experiences of Female Emerging Adult Mentors: Building a Conceptual Model

ERIC Educational Resources Information Center

McGill, Julianne; Adler-Baeder, Francesca; Sollie, Donna L.; Kerpelman, Jennifer L.

2015-01-01

While mentoring programs are prevalent, limited research focused on the mentors' experiences exist, particularly during critical periods of development. Using a qualitative, grounded theory approach, this study explores the elements of the mentoring experience for a cohort of late adolescent/emerging adult women in a long-term program. Outcomes…

Exploring Dual Identification among Muslim-American Emerging Adults: A Mixed Methods Study

ERIC Educational Resources Information Center

Sirin, Selcuk R.; Bikmen, Nida; Mir, Madeeha; Fine, Michelle; Zaal, Mayida; Katsiaficas, Dalal

2008-01-01

This mixed methods study explored dual identification among Muslim-American emerging adults of immigrant origin. A closer look was taken at the relationship between American and Muslim identifications and how this relationship was influenced by experiences of discrimination, acculturative and religious practices, and whether it varied by gender.…

Future Life Goals of HIV-Positive Gay and Bisexual Male Emerging Adults

ERIC Educational Resources Information Center

Bruce, Douglas; Harper, Gary W.

2012-01-01

This qualitative study explores the future life goals reported by a sample of HIV-positive gay/bisexual male emerging adults. Semi-structured interviews were conducted with 54 participants ages 17-24 at four geographically and demographically diverse adolescent HIV medicine programs to explore the content of participants' goals, perceived…

Reliability and Validity of Self- and Other-Ratings of Symptoms of ADHD in Adults

ERIC Educational Resources Information Center

Van Voorhees, Elizabeth E.; Hardy, Kristina K.; Kollins, Scott H.

2011-01-01

Objective: Few studies have examined concordance between raters of ADHD symptoms in adults; there is less information on how well rating scales function in distinguishing adult ADHD from other disorders. This study examined these variables using the Conners Adult ADHD Rating Scales (CAARS). Method: The sample included 349 adults evaluated for…

The Reliability and Validity of Self- and Investigator Ratings of ADHD in Adults

ERIC Educational Resources Information Center

Adler, Lenard A.; Faraone, Stephen V.; Spencer, Thomas J.; Michelson, David; Reimherr, Frederick W.; Glatt, Stephen J.; Marchant, Barrie K.; Biederman, Joseph

2008-01-01

Objective: Little information is available comparing self- versus investigator ratings of symptoms in adult ADHD. The authors compared the reliability, validity, and utility in a sample of adults with ADHD and also as an index of clinical improvement during treatment of self- and investigator ratings of ADHD symptoms via the Conners Adult ADHD…

Relations of behavioral autonomy to health outcomes among emerging adults with and without type 1 diabetes.

PubMed

Helgeson, Vicki S; Reynolds, Kerry A; Becker, Dorothy; Escobar, Oscar; Siminerio, Linda

2014-01-01

To examine the relation of behavioral autonomy to psychological, behavioral, and physical health among emerging adults with and without type 1 diabetes. High school seniors with (n = 118) and without type 1 diabetes (n = 122) completed online questionnaires for three consecutive years. Behavioral autonomy, psychological health, risk behaviors, and diabetes outcomes were assessed. Regression analyses were conducted to predict Time 2 and 3 outcomes, controlling for Time 1 outcomes. There were no group differences in behavioral autonomy. Behavioral autonomy predicted better psychological health but only for emerging adults without diabetes. Behavioral autonomy was related to increased risk behavior for both groups. Behavioral autonomy was unrelated to self-care but predicted better glycemic control for females. Behavioral autonomy may be beneficial for psychological health, but is related to increased risk behavior. The implications of behavioral autonomy for emerging adults with type 1 diabetes require careful consideration. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

RSV in adult ED patients: Do emergency providers consider RSV as an admission diagnosis?

PubMed

Binder, William; Thorsen, Jill; Borczuk, Pierre

2017-08-01

Respiratory Syncytial Virus (RSV) has been recognized for over half a century as a cause of morbidity in infants and children. Over the past 20years, data has emerged linking RSV as a cause of illness in adults resulting in 177,000 annual hospitalizations and up to 14,000 deaths among older adults. Characterize clinical variables in a cohort of adult RSV patients. We hypothesize that emergency physicians do not routinely consider RSV in the differential diagnosis (DDx) of influenza like illness. Observational study of all adult inpatients, age≥19, with a positive RSV swab ordered within 48h of their hospital visit, including their emergency department (ED) visit, and who initially presented to a university affiliated urban 100,000 annual visit emergency department from 2007 to 2014. A data collection form was created, and a single trained clinical research assistant abstracted demographic, clinical variables. ED providers were given credit for RSV DDx if an RSV swab was ordered as part of the diagnostic ED workup. 295 consecutive inpatients (mean age=66.5years, range, 19-97, 53% male) were RSV positive during the 7-year study period. 207 cases (70%) were age≥60. 76 (26%) had fever, 86 (29%) had O2sat <92% and 145 (49%) had wheezing. 279 patients required admission, 30 needed ICU stay and overall mortality was 12 patients (4%). Age≥60 was associated with overall mortality (p=0.09). There were 106 (36%) immunocompromised patients (23% transplant, 40% cancer, 33% steroid use) in the cohort. A diagnosis of RSV was considered in the ED in 105 (36%) of patients. Being immunocompromised, having COPD/asthma, O2sat <92, or wheezing did not alert the ED provider to order an RSV test. Adults can harbor RSV as this can lead to significant mobility and mortality, especially in individuals who are over the age of 60. RSV is not being considered in the DDx diagnosis, and this was especially surprising in the transplant/immunocompromised subgroups. Given antiviral treatment

Adult Attachment Ratings (AAR): an item response theory analysis.

PubMed

Pilkonis, Paul A; Kim, Yookyung; Yu, Lan; Morse, Jennifer Q

2014-01-01

The Adult Attachment Ratings (AAR) include 3 scales for anxious, ambivalent attachment (excessive dependency, interpersonal ambivalence, and compulsive care-giving), 3 for avoidant attachment (rigid self-control, defensive separation, and emotional detachment), and 1 for secure attachment. The scales include items (ranging from 6-16 in their original form) scored by raters using a 3-point format (0 = absent, 1 = present, and 2 = strongly present) and summed to produce a total score. Item response theory (IRT) analyses were conducted with data from 414 participants recruited from psychiatric outpatient, medical, and community settings to identify the most informative items from each scale. The IRT results allowed us to shorten the scales to 5-item versions that are more precise and easier to rate because of their brevity. In general, the effective range of measurement for the scales was 0 to +2 SDs for each of the attachment constructs; that is, from average to high levels of attachment problems. Evidence for convergent and discriminant validity of the scales was investigated by comparing them with the Experiences of Close Relationships-Revised (ECR-R) scale and the Kobak Attachment Q-sort. The best consensus among self-reports on the ECR-R, informant ratings on the ECR-R, and expert judgments on the Q-sort and the AAR emerged for anxious, ambivalent attachment. Given the good psychometric characteristics of the scale for secure attachment, however, this measure alone might provide a simple alternative to more elaborate procedures for some measurement purposes. Conversion tables are provided for the 7 scales to facilitate transformation from raw scores to IRT-calibrated (theta) scores.

"Doesn't Everyone Want That? It's Just a Given": Swedish Emerging Adults' Expectations on Future Parenthood and Work/Family Priorities

ERIC Educational Resources Information Center

Frisén, Ann; Carlsson, Johanna; Wängqvist, Maria

2014-01-01

This study investigated Swedish emerging adults' expectations on future parenthood through interviews with 124 Swedish emerging adults who were not yet parents. Thematic analysis showed that most participants were sure they wanted to become parents, but not right now. First, they wanted a stable financial situation, a romantic relationship, and…

Social deprivation and the rate of emergency medical admission for older persons.

PubMed

Cournane, S; Conway, R; Byrne, D; O'Riordan, D; Coveney, S; Silke, B

2016-10-01

Deprivation Status increases the annual admission incidence of emergency medical admissions; the extent to which deprivation influences the admission of older persons is less well known. To examine whether deprivation within a hospital catchment area influences emergency medical admissions for the elderly population. The relationship between Deprivation Status, Dependency Ratio (population proportion of non-working age (<15 or ≥65 years) and age for all emergency admissions (82 368 episodes of 44 628 patients), over a 13-year period, were examined and ranked by quintile. Univariate and multi-variable risk estimates (incidence rate ratios) were calculated, using truncated Poisson regression. The Dependency Ratio and the Deprivation index independently predicted the annual incidence rate of medical emergencies; however, when calculated for older persons, the corresponding incidence rate ratios showed a falling trend with increasing Deprivation Status-Q2 0.51 (95% confidence interval [CI]: 0.50, 0.52), Q3 0.59 (95% CI: 0.58, 0.60), Q4 0.51 (95% CI: 0.50, 0.52) and Q5 0.37 (95% CI: 0.36, 0.38). Thus, with increasing Deprivation Status, the proportion of total admission from the ≥65-year cohort fell substantially. The admission incidence rate for emergency medical patients is strongly influenced by the catchment area Deprivation Status. However, because of its greater impact on the younger population, increasing deprivation alters the ratio of younger to older persons as a proportion of total emergency admissions. © The Author 2016. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Energy drink and other substance use among adolescent and young adult emergency department patients.

PubMed

Cotter, Bradford V; Jackson, Deidrya A E; Merchant, Roland C; Babu, Kavita M; Baird, Janette R; Nirenberg, Ted; Linakis, James G

2013-10-01

This study aimed to understand current patterns of energy drink use and compare the extent of usage of energy drinks and other commonly used and misused substances between adolescent (13-17-years-old) and young adult (18-25-years-old) emergency department (ED) patients. During a 6-week period between June and August 2010, all patients presenting to an adult or pediatric ED were asked to complete a computer-based, anonymous questionnaire regarding use of energy drinks and other substances. Wilcoxon rank-sum, 2-sample tests of binomial proportions, Pearson χ(2) testing, and regression models were used to compare energy drink and substance use by age groups. Past 30-day energy drink use was greater for young adults (57.9%) than adolescents (34.9%) (P < 0.03). Adolescents typically consumed a mean of 1.5 and young adults a mean of 2.6 energy drinks per day when using energy drinks and drank at most a mean of 2.4 and 2.6 drinks per day, respectively. Among adolescents, energy drink usage was more common than alcohol, "street" or illicit drugs, and tobacco usage, but less common than caffeine product usage. For young adults, energy drink usage was more common than "street" or illicit drugs, but less common than caffeine use, and similar to tobacco and alcohol usage. Young adult energy drink users were more likely than young adult non-energy drink users also to use tobacco and caffeine. Energy drink use is common among ED patients. Given the high prevalence of energy drink use observed, emergency physicians should consider the involvement of energy drinks in the presentations of young people.

Improving Completion Rates in Adult Education through Social Responsibility

ERIC Educational Resources Information Center

Wahlgren, Bjarne; Mariager-Anderson, Kristina

2017-01-01

Dropout is a serious problem within education. This article reports on an intervention project, titled "New Roles for the Teacher--Increased Completion Rates Through Social Responsibility," which sought to reduce nonattendance and drop-out rates in the Danish adult educational system by improving teachers' competences. This goal was…

Willingness to Engage in Consensual Nonmonogamy Among Emerging Adults: A Structural Equation Analysis of Sexual Identity, Casual Sex Attitudes, and Gender.

PubMed

Sizemore, Kayla M; Olmstead, Spencer B

2017-01-01

Research on consensual nonmonogamy (CNM) has increased over the past decade. However, willingness to engage in CNM is an understudied phenomenon within this body of literature. Little research has examined the correlates of this aspect of CNM or focused on individuals in the developmental period of emerging adulthood. This study used multigroup structural equation modeling (SEM) to test a conceptual model of emerging adults' (ages 18 to 29; N = 890) willingness to engage in CNM. Results indicated that emerging adult experimentation/possibilities, sexual identity exploration, and permissive attitudes toward casual sex were all related to willingness to engage in CNM. Results also showed that the pathway from emerging adult experimentation/possibilities to willingness to engage in CNM was differentially mediated across gender. Specifically, for women there was an indirect (and positive) pathway from experimentation/possibilities to willingness to engage in CNM through sexual identity exploration. For men there was an indirect (and positive) pathway from experimentation/possibilities to willingness to engage in CNM through permissive attitudes toward casual sex. Implications for future studies on CNM among emerging adults are discussed.

The Adults in the Making Program: Long-Term Protective Stabilizing Effects on Alcohol Use and Substance Use Problems for Rural African American Emerging Adults

ERIC Educational Resources Information Center

Brody, Gene H.; Yu, Tianyi; Chen, Yi-fu; Kogan, Steven M.; Smith, Karen

2012-01-01

Objective: This report addresses the long-term efficacy of the Adults in the Making (AIM) prevention program on deterring the escalation of alcohol use and development of substance use problems, particularly among rural African American emerging adults confronting high levels of contextual risk. Method: African American youths (M age, pretest =…

Associations between Online Friendship and Internet Addiction among Adolescents and Emerging Adults

ERIC Educational Resources Information Center

Smahel, David; Brown, B. Bradford; Blinka, Lukas

2012-01-01

The past decades have witnessed a dramatic increase in the number of youths using the Internet, especially for communicating with peers. Online activity can widen and strengthen the social networks of adolescents and emerging adults (Subrahmanyam & Smahel, 2011), but it also increases the risk of Internet addiction. Using a framework derived from…

Self-Presentation and Interaction in Blogs of Adolescents and Young Emerging Adults

ERIC Educational Resources Information Center

Mazur, Elizabeth; Kozarian, Lauri

2010-01-01

This article analyzed 124 blogs, chronological, journal-type entries published on public hosting Web sites, as new and popular places for adolescents and emerging adults aged 15 to 19 to play openly with their self-presentation, an important aspect of identity exploration. Findings indicate that most young persons write emotionally toned entries;…

Religiosity, Discrimination, and Community Engagement: Gendered Pathways of Muslim American Emerging Adults

ERIC Educational Resources Information Center

Sirin, Selcuk R.; Katsiaficas, Dalal

2011-01-01

The attacks on September 11, 2001, changed the lives of all Americans. For many immigrant Muslims in the United States this meant dealing with an elevated amount of discrimination. This study investigated how perceived discrimination influenced levels of community engagement among Muslim American emerging adults and whether it varied by gender.…

Neighborhood Contexts and Marijuana Use Among Urban Dwelling Emerging Adult Men.

PubMed

Taggart, Tamara; Brown, Andre L; Kershaw, Trace

2018-01-01

Neighborhoods are key socio-environmental contexts for marijuana use during emerging adulthood. This study examined the relationships between neighborhood context, traditional masculine norms (status, toughness, and anti-femininity), and marijuana use among 119 majority African American emerging adult men in a small urban community. Poisson regression models were used to determine the associations between neighborhood problems, social cohesion, and marijuana use. Moderator effects were examined to determine if masculinities modified these associations. Neighborhood problems and social cohesion were positively associated with marijuana use. Men who had a lower endorsement of some traditional masculine norms had greater marijuana use compared to men with a higher endorsement of these norms. These findings have implications for intervention strategies and policies.

Sleep problems: predictor or outcome of media use among emerging adults at university?

PubMed

Tavernier, Royette; Willoughby, Teena

2014-08-01

The pervasiveness of media use in our society has raised concerns about its potential impact on important lifestyle behaviours, including sleep. Although a number of studies have modelled poor sleep as a negative outcome of media use, a critical assessment of the literature indicates two important gaps: (i) studies have almost exclusively relied on concurrent data, and thus have not been able to assess the direction of effects; and (ii) studies have largely been conducted with children and adolescents. The purpose of the present 3-year longitudinal study, therefore, was to examine whether both sleep duration and sleep problems would be predictors or outcomes of two forms of media use (i.e. television and online social networking) among a sample of emerging adults. Participants were 942 (71.5% female) university students (M = 19.01 years, SD = 0.90) at Time 1. Survey measures, which were assessed for three consecutive years starting in the first year of university, included demographics, sleep duration, sleep problems, television and online social networking use. Results of a cross-lagged model indicated that the association between sleep problems and media use was statistically significant: sleep problems predicted longer time spent watching television and on social networking websites, but not vice versa. Contrary to our hypotheses, sleep duration was not associated with media use. Our findings indicate no negative effects of media use on sleep among emerging adults, but instead suggest that emerging adults appear to seek out media as a means of coping with their sleep problems. © 2014 European Sleep Research Society.

Adverse childhood experiences and substance use among Hispanic emerging adults in Southern California.

PubMed

Allem, Jon-Patrick; Soto, Daniel W; Baezconde-Garbanati, Lourdes; Unger, Jennifer B

2015-11-01

Emerging adults who experienced stressful childhoods may engage in substance use as a maladaptive coping strategy. Given the collectivistic values Hispanics encounter growing up, adverse childhood experiences may play a prominent role in substance use decisions as these events violate the assumptions of group oriented cultural paradigms. Alternatively, adverse childhood events might not increase the risk of substance use because strong family ties could mitigate the potential maladaptive behaviors associated with these adverse experiences. This study examined whether adverse childhood experiences were associated with substance use among Hispanic emerging adults. Participants (n = 1420, mean age = 22, 41% male) completed surveys indicating whether they experienced any of 8 specific adverse experiences within their first 18 years of life, and past-month cigarette use, marijuana use, hard drug use, and binge drinking. Logistic regression models examined the associations between adverse childhood experiences and each category of substance use, controlling for age, gender, and depressive symptoms. The number of adverse childhood experiences was significantly associated with each category of substance use. A difference in the number of adverse childhood experiences, from 0 to 8, was associated with a 22% higher probability of cigarette smoking, a 24% higher probability of binge drinking, a 31% higher probability of marijuana use, and a 12% higher probability of hard drug use respectively. These findings should be integrated into prevention/intervention programs in hopes of quelling the duration and severity of substance use behaviors among Hispanic emerging adults. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Interaction Between Punishment Sensitivity and Effortful Control for Emerging Adults' Substance Use Behaviors.

PubMed

Kahn, Rachel E; Chiu, Pearl H; Deater-Deckard, Kirby; Hochgraf, Anna K; King-Casas, Brooks; Kim-Spoon, Jungmeen

2018-01-08

Within the dual systems perspective, high reward sensitivity and low punishment sensitivity in conjunction with deficits in cognitive control may contribute to high levels of risk taking, such as substance use. The current study examined whether the individual components of effortful control (inhibitory control, attentional control, and activation control) serve as regulators and moderate the association between reward or punishment sensitivity and substance use behaviors. A total of 1,808 emerging adults from a university setting (Mean age = 19.48; 72% female) completed self-report measures of reward and punishment sensitivity, effortful control, and substance use. Findings indicated significant two-way interactions for punishment sensitivity and inhibitory control for alcohol and marijuana use. The form of these interactions revealed a significant negative association between punishment sensitivity and alcohol and marijuana use at low levels of inhibitory control. No significant interactions emerged for reward sensitivity or other components of effortful control. The current findings provide preliminary evidence suggesting the dual systems theorized to influence risk taking behavior interact to make joint contributions to health risk behaviors such as substance use in emerging adults.

The nature and meaning of insulin pump use in emerging adults with type 1 diabetes.

PubMed

Hood, Donna G; Duke, Gloria

2015-05-01

Objective. The purpose of this study is to investigate the meaning of living with an insulin pump for the management of type 1 diabetes during the period of emerging adulthood. Through a phenomenological narrative, this study contributes to the reflective understanding of the everyday life experiences of this population. Methods. A hermeneutic phenomenological design was used for this study of nine emerging adults (aged 19-24 years). Data were generated through face-to-face interviews and analyzed using the phenomenological approach of Max van Manen. Results. Four themes represent the essence of the day-to-day experiences of these emerging adults: seeking control, becoming responsible, staying connected, and accepting me. Conclusions. An in-depth understanding of the meaning of daily experiences with insulin pump technology has the potential to promote a developmentally appropriate approach to this age-group. The human understanding gained through this study is essential to the development of evidence-based practice guidelines and resources for this vulnerable population.

Stressful Life Events and Predictors of Post-traumatic Growth among High-Risk Early Emerging Adults.

PubMed

Arpawong, Thalida E; Rohrbach, Louise A; Milam, Joel E; Unger, Jennifer B; Land, Helen; Sun, Ping; Spruijt-Metz, Donna; Sussman, Steve

2016-01-01

Stressful life events (SLEs) may elicit positive psychosocial change among youth, referred to as Post-traumatic Growth (PTG). We assessed types of SLEs experienced, degree to which participants reported PTG, and variables predicting PTG across 24 months among a sample of high risk, ethnically diverse early emerging adults. Participants were recruited from alternative high schools ( n = 564; mean age=16.8; 65% Hispanic). Multi-level regression models were constructed to examine the impact of environmental (SLE quantity, severity) and personal factors (hedonic ability, perceived stress, developmental stage, future time orientation) on a composite score of PTG. The majority of participants reported positive changes resulted from their most life-altering SLE of the past two years. Predictors of PTG included fewer SLEs, less general stress, having a future time perspective, and greater identification with the developmental stage of Emerging Adulthood. Findings suggest intervention targets to foster positive adaptation among early emerging adults who experience frequent SLEs.

A cultural take on the links between religiosity, identity, and meaning in life in religious emerging adults.

PubMed

Negru-Subtirica, Oana; Tiganasu, Alexandra; Dezutter, Jessie; Luyckx, Koen

2017-03-01

Identity and meaning in life are core developmental assets in emerging adulthood. We analysed how religiosity is related to these intentional strivings in emerging adults enrolled in theological education, by depicting (1) identity strivings and meaning in life accounts in faith narratives (Study 1) and (2) links between personal identity and meaning in life profiles and religious beliefs, behaviours, and subjective experiences (Study 2). Both studies highlighted that a Foreclosed status, with high personal commitment and reduced exploration, was dominant in faith narratives and personal identity profiles. Also, in narratives meaning in life was reflected by a strong focus on presence of meaning through religious insights. Nonetheless, global meaning in life profiles indicated that many emerging adults were searching for a meaning in their lives, while reporting lower levels of presence of meaning. Identity Achievement and High Presence-High Search profiles were linked to the highest levels of subjective, behavioural, and cognitive religiosity. We highlighted the multidimensionality of identity and meaning in life strivings in emerging adults attending theological schools. We pointed out that even in a somewhat foreclosed cultural context (e.g., Romanian Christian Orthodox theological schools), religion represents a dynamic social and ideological context for self-development. Statement of contribution What is already known on this subject? Religious beliefs increase in emerging adults, doubled by decreases in religious behaviours, linked to an adherence to a more personal approach to religion. Religious youth are more committed to their faith and also explore identity and life meaning in relation to their religious strivings. Youth religious exemplars report close links between their religious faith and strivings for meaningful life goals. What does this study add? We investigated Christian Orthodox theology students, for whom religion is a normative dimension of

Evolving prehospital, emergency department, and "inpatient" management models for geriatric emergencies.

PubMed

Carpenter, Christopher R; Platts-Mills, Timothy F

2013-02-01

Alternative management methods are essential to ensure high-quality and efficient emergency care for the growing number of geriatric adults worldwide. Protocols to support early condition-specific treatment of older adults with acute severe illness and injury are needed. Improved emergency department care for older adults will require providers to address the influence of other factors on the patient's health. This article describes recent and ongoing efforts to enhance the quality of emergency care for older adults using alternative management approaches spanning the spectrum from prehospital care, through the emergency department, and into evolving inpatient or outpatient processes of care. Copyright © 2013 Elsevier Inc. All rights reserved.

Product related adult genitourinary injuries treated at emergency departments in the United States from 2002 to 2010.

PubMed

Bagga, Herman S; Tasian, Gregory E; Fisher, Patrick B; McCulloch, Charles E; McAninch, Jack W; Breyer, Benjamin N

2013-04-01

We describe the epidemiological features of adult genitourinary injuries related to consumer products and determined the patient cohorts, products and situations associated with increased genitourinary injury risk. The National Electronic Injury Surveillance System, a data set validated to provide a probability sample of injury related emergency department presentations in the United States, was analyzed to characterize genitourinary injuries from 2002 to 2010. We analyzed 3,545 observations to derive national estimates. An estimated 142,144 adults (95% CI 115,324-168,964) presented to American emergency departments with genitourinary injuries from 2002 to 2010. Of the injuries 69% occurred in men. A large majority of injuries involved the external genitalia. The most common categories of products involved were sporting items in 30.2% of cases, clothing articles in 9.4% and furniture in 9.2%. The highest prevalence of injury was at ages 18 to 28 years (37.5%), which was most often related to sports equipment, such as bicycles. Older cohorts (age greater than 65 years) more commonly sustained injuries during falls and often in the bathroom during use of a shower or tub. Of all patients 88% were evaluated and treated in the emergency department without inpatient admission, although the admission rate increased with increasing patient age. Acute genitourinary injury is often associated with common consumer items and with identifiable high risk cohorts, products and situations. Consumers, practitioners and safety champions can use our epidemiological data to prioritize and develop strategies aimed at the prevention, limitation and informed treatment of such injuries. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Online social communication patterns among emerging adult women with histories of childhood attention-deficit/hyperactivity disorder.

PubMed

Mikami, Amori Yee; Szwedo, David E; Ahmad, Shaikh I; Samuels, Andrea Stier; Hinshaw, Stephen P

2015-08-01

Little is known about adult women with attention-deficit/hyperactivity disorder (ADHD); however, available evidence suggests that they experience social impairment. Online social networking websites such as Facebook have become endemic outlets through which emerging adults communicate with peers. No study has examined the peer interactions of emerging adults with childhood histories of ADHD in this developmentally relevant online domain. Participants in the current study were an ethnically diverse sample of 228 women, 140 of whom met diagnostic criteria for ADHD in childhood and 88 who composed a matched comparison sample. These women were assessed at 3 time points spanning 10 years (mean age = 9.6 at Wave 1, 14.1 at Wave 2, 19.6 at Wave 3). After statistical control of demographic covariates and comorbidities, childhood ADHD diagnosis predicted, by emerging adulthood, a greater stated preference for online social communication and a greater tendency to have used online methods to interact with strangers. A childhood diagnosis of ADHD also predicted observations of fewer Facebook friends and less closeness and support from Facebook friends in emerging adulthood. These associations were mediated by a composite of face-to-face peer relationship impairment during childhood and adolescence. Intriguingly, women with persistent diagnoses of ADHD from childhood to emerging adulthood differed from women with consistent comparison status in their online social communication; women with intermittent diagnoses of ADHD had scores intermediate between the other 2 groups. Results are discussed within the context of understanding the social relationships of women with childhood histories of ADHD. (c) 2015 APA, all rights reserved).

Emerging technologies for pediatric and adult trauma care.

PubMed

Moulton, Steven L; Haley-Andrews, Stephanie; Mulligan, Jane

2010-06-01

Current Emergency Medical Service protocols rely on provider-directed care for evaluation, management and triage of injured patients from the field to a trauma center. New methods to quickly diagnose, support and coordinate the movement of trauma patients from the field to the most appropriate trauma center are in development. These methods will enhance trauma care and promote trauma system development. Recent advances in machine learning, statistical methods, device integration and wireless communication are giving rise to new methods for vital sign data analysis and a new generation of transport monitors. These monitors will collect and synchronize exponentially growing amounts of vital sign data with electronic patient care information. The application of advanced statistical methods to these complex clinical data sets has the potential to reveal many important physiological relationships and treatment effects. Several emerging technologies are converging to yield a new generation of smart sensors and tightly integrated transport monitors. These technologies will assist prehospital providers in quickly identifying and triaging the most severely injured children and adults to the most appropriate trauma centers. They will enable the development of real-time clinical support systems of increasing complexity, able to provide timelier, more cost-effective, autonomous care.

Sexual Behavior, Sexual Knowledge, and Sexual Attitudes of Emerging Adult Women: Implications for Working with Families

ERIC Educational Resources Information Center

Byno, Lucy H.; Mullis, Ronald L.; Mullis, Ann K.

2009-01-01

The purpose of this study was twofold: first, to examine the sexual behavior of emerging adult women in relation to their sexual knowledge, sexual attitudes, and perceptions of their parents' sexual attitudes; and second, to discuss the implications of this research in working with young adult women. Three hundred and sixty-four college-age women…

Emergency Department Use in a Cohort of Older Homeless Adults: Results from the HOPE HOME Study

PubMed Central

Raven, Maria C.; Tieu, Lina; Lee, Christopher T.; Ponath, Claudia; Guzman, David; Kushel, Margot

2018-01-01

Objective The median age of single homeless adults is over 50, yet little is known about their emergency department (ED) use. We describe use of and factors associated with ED use in a sample of homeless adults 50 and older. Methods We recruited 350 participants who were homeless and 50 or older in Oakland, CA. We interviewed participants about residential history in the prior six months, health status, health-related behaviors, and health services use, and assessed cognition and mobility. Our primary outcome was the number of ED visits in the prior six months based on medical record review. We used negative binomial regression to examine factors associated with ED use. Results In the six months prior to enrollment, 46.3% of participants spent the majority of their time unsheltered, 25.1% cycled through multiple institutions including shelters, hospitals and jails, 16.3% primarily stayed with family or friends, and 12.3% had become homeless recently after spending much of the prior six months housed. Half (49.7%) of participants made at least one ED visit in the past six months; 6.6% of participants accounted for 49.9% of all visits. Most (71.8%) identified a regular non-ED source of healthcare; 7.3% of visits resulted in hospitalization. In multivariate models, study participants who used multiple institutions (incidence rate ratio [IRR] = 2.27; 95% confidence interval [CI] = 1.08–4.77) and who were unsheltered (IRR = 2.29; 95% CI = 1.17–4.48) had higher ED use rates than participants who had been housed for most of the prior six months. In addition, having health insurance/coverage (IRR= 2.6; CI = 1.5–4.4), a history of psychiatric hospitalization (IRR = 1.80; 95% CI = 1.09–2.99), and severe pain (IRR = 1.72; 95% CI = 1.07–2.76) were associated with higher ED visit rates. Conclusions A sample of adults aged 50 and older who were homeless at study entry had higher rates of ED use in the prior six months than the general US age-matched population. Within

Determinants of poor self-rated health among adults in urban Mozambique.

PubMed

Cau, Boaventura M; Falcão, Joana; Arnaldo, Carlos

2016-08-24

Self-rated health is a measure expressing the general condition of health of individuals. Self-rated health studies are common in developed countries and in some developing regions. Despite increasing proportion of adult and older population in sub-Saharan Africa and poor population health indicators, there is a dearth of studies on self-rated health in the region. This study examines factors associated with poor self-rated health among adult individuals in Maputo metropolitan area in Mozambique. Data for this study come from a survey of 1768 individuals aged 18 years or more carried out in Maputo metropolitan area, Mozambique, in 2015. Employing multiple logistic regression, the study used a subsample of 677 female and male respondents aged 40 years or more to estimate the determinants of poor self-rated health. About 54 % of respondents aged 40 years or more believed that their health status was poor. Female respondents [Odds Ratios (OR) = 3.43, p <0.01], single (OR = 4.71, p < 0.05), widow (OR = 1.81, p < 0.05), separated or divorced (OR = 2.08, p < 0.05) and those believing that hypertension or heart problem was a major community health problem (OR = 1.56, p < 0.05) displayed higher odds of reporting poor health than their peers, net of other factors. Furthermore, individuals aged 40-49 years (OR = 0.45, p < 0.01), or 50-59 years (OR = 0.59, p < 0.05), those whose work involves intensive physical activity (OR = 0.60, p < 0.05) and those from households treating drinking water (OR = 0.49, p < 0.01) showed lower odds of reporting poor health, adjusting for other factors. Overall, the results point to the importance of age, gender, marital status, socioeconomic circumstances, individuals' health behaviors and perceived community health problems as key determinants of poor self-rated health among adults in Maputo metropolitan area. Given the growing number of adult and older people in sub

Trends and Characteristics of Emergency Department Visits for Fall-Related Injuries in Older Adults, 2003–2010

PubMed Central

Shankar, Kalpana N.; Liu, Shan W.; Ganz, David A.

2017-01-01

Introduction One third of older adults fall each year, and falls are costly to both the patient in terms of morbidity and mortality and to the health system. Given that falls are a preventable cause of injury, our objective was to understand the characteristics and trends of emergency department (ED) fall-related visits among older adults. We hypothesize that falls among older adults are increasing and examine potential factors associated with this rise, such as race, ethnicity, gender, insurance and geography. Methods We conducted a secondary analysis of data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) to determine fall trends over time by examining changes in ED visit rates for falls in the United States between 2003 and 2010, detailing differences by gender, sociodemographic characteristics and geographic region. Results Between 2003 and 2010, the visit rate for falls and fall-related injuries among people age ≥ 65 increased from 60.4 (95% confidence interval [CI][51.9–68.8]) to 68.8 (95% CI [57.8–79.8]) per 1,000 population (p=0.03 for annual trend). Among subgroups, visits by patients aged 75–84 years increased from 56.2 to 82.1 per 1,000 (P <.01), visits by women increased from 67.4 to 81.3 (p = 0.04), visits by non-Hispanic Whites increased from 63.1 to 73.4 (p < 0.01), and visits in the South increased from 54.4 to 71.1 (p=0.03). Conclusion ED visit rates for falls are increasing over time. There is a national movement to increase falls awareness and prevention. EDs are in a unique position to engage patients on future fall prevention and should consider ways they can also partake in such initiatives in a manner that is feasible and appropriate for the ED setting. PMID:28874929

Disparities in Treatment of Older Adults with Suicide Risk in the Emergency Department.

PubMed

Arias, Sarah A; Boudreaux, Edwin D; Segal, Daniel L; Miller, Ivan; Camargo, Carlos A; Betz, Marian E

2017-10-01

We described characteristics and treatment received for older (≥60 years) vs younger (<60 years) adult emergency department (ED) patients with suicide risk. Retrospective chart review. An ED with universal screening for suicide risk. Eligible charts included a random sample of adults (≥18 years) who screened positive for suicidal ideation (SI) in past 2 weeks and/or a suicide attempt (SA) within the past 6 months. Visit dates were from May 2014 to September 2016. A total of 800 charts were reviewed, with oversampling of older adults. Of the 200 older adults sampled, fewer older adults compared to younger adults (n = 600) had a chief complaint involving psychiatric behavior (53% vs 70%) or self-harm behavior (26% vs 36%). Although a higher number of older adults (93%) had documentation of current SI compared to younger adults (79%), fewer older adults (17%) reported SA in the past 2 weeks compared to younger adults (23%). Of those with a positive suicide screen who were discharged home, less than half of older adults received a mental health evaluation during their visit (42%, 95% CI 34-52) compared to 66% (95% CI 61-70) of younger adults who met the same criteria. Similarly, fewer older, than younger, adult patients with current SI/SA received referral resources (34%; 95% CI 26-43; vs 60%; 95% CI 55-65). Significantly fewer suicidal older adult patients who were discharged home received a mental health evaluation when compared to similar younger adults. These findings highlight an important area for improvement in the treatment of older adults at risk for suicide. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Self-rated wellbeing and physical activity associations in European older adults.

PubMed

Peralta, Miguel; Martins, João; Gómez Chávez, Francisco; Cortés Almanzar, Paola; Marques, Adilson

2018-05-08

Physical activity and self-rated wellbeing have important benefits to health. However, scientific knowledge regarding their relationship among older adults is scarce. Thus, the aim of this study was to examine the associations between physical activity frequency and several dimensions of self-rated wellbeing, in a representative sample of European older adults from 28 countries. This study is based on the European Social Survey round 6, 2012. It had a total sample size of 12,341 older adults (5100 men, 7241 women) with mean age 73.8 ± 6.6 years. Information was collected through a questionnaire, filled-in during an hour-long face-to-face interview. Physical activity was accessed using the question "On how many of the last 7 days you were physically active continuously for 20 minutes or longer?" and six dimensions of self-rated wellbeing were used. Physical activity in the last 7 days was linearly related with all dimension of the self-rated wellbeing and with wellbeing total score for both sexes (men, β = 0.09, 95% CI: 0.07 to 0.10, p < .001; women, β = 0.10, 95% CI: 0.09 to 0.11, p < .001). Physical activity promotion should be stressed as a meaningful strategy to improve people's wellbeing overall. This strategy has special importance when considering the older adult population.

Emerging adults' perceptions of messages about physical appearance.

PubMed

Gillen, Meghan M; Lefkowitz, Eva S

2009-06-01

Emerging adults receive messages about physical appearance from a range of sources, but few studies have examined the content of these messages. Undergraduates (N=154) who identified as African American, Latino American, and European American answered 4 open-ended questions about messages they perceived about physical appearance from family, peers, school, and media. Raters coded responses for content and affect. The most common messages perceived were the importance/non-importance of appearance, positive comments about appearance, and the link between attractiveness and success. The perception of these messages frequently differed by gender and source, but rarely by ethnicity. Women perceived more frequent and more negative messages than did men. Individuals perceived the media as transmitting more negative messages and the family more healthful and positive ones.

Adverse outcomes in older adults attending emergency departments: a systematic review and meta-analysis of the Identification of Seniors At Risk (ISAR) screening tool.

PubMed

Galvin, Rose; Gilleit, Yannick; Wallace, Emma; Cousins, Gráinne; Bolmer, Manon; Rainer, Timothy; Smith, Susan M; Fahey, Tom

2017-03-01

older adults are frequent users of emergency services and demonstrate high rates of adverse outcomes following emergency care. to perform a systematic review and meta-analysis of the Identification of Seniors At Risk (ISAR) screening tool, to determine its predictive value in identifying adults ≥65 years at risk of functional decline, unplanned emergency department (ED) readmission, emergency hospitalisation or death within 180 days after index ED visit/hospitalisation. a systematic literature search was conducted in PubMed, EMBASE, CINAHL, EBSCO and the Cochrane Library to identify validation and impact analysis studies of the ISAR tool. A pre-specified ISAR score of ≥2 (maximum score 6 points) was used to identify patients at high risk of adverse outcomes. A bivariate random effects model generated pooled estimates of sensitivity and specificity. Statistical heterogeneity was explored and methodological quality was assessed using validated criteria. thirty-two validation studies (n = 12,939) are included. At ≥2, the pooled sensitivity of the ISAR for predicting ED return, emergency hospitalisation and mortality at 6 months is 0.80 (95% confidence interval (CI) 0.70-0.87), 0.82 (95% CI 0.74-0.88) and 0.87 (95% CI 0.75-0.94), respectively, with a pooled specificity of 0.31 (95% CI 0.24-0.38), 0.32 (95% CI 0.24-0.41) and 0.35 (95% CI 0.26-0.44). Similar values are demonstrated at 30 and 90 days. Three heterogeneous impact analysis studies examined the clinical implementation of the ISAR and reported mixed findings across patient and process outcomes. the ISAR has modest predictive accuracy and may serve as a decision-making adjunct when determining which older adults can be safely discharged. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Examination of Emerging Adults' Emotional Autonomy and Parental Monitoring under Varying Living Arrangements

ERIC Educational Resources Information Center

Fozio-Thielk, Lisa

2016-01-01

The current trends of increasing community college enrollments and large numbers of emerging adults living with their parents suggest the need to examine patterns of adjustment and competence, in particular, emotional autonomy during college years. However, there has been little research focus on the role of extended parental monitoring on…

Time of day is not associated with increased rates of mortality in emergency surgery: An analysis of 49,196 surgical procedures.

PubMed

Gabriel, Rodney A; A'Court, Alison M; Schmidt, Ulrich H; Dutton, Richard P; Urman, Richard D

2018-05-01

There is a lack of large, multi-institutional studies analyzing the association of timing of emergency surgery with death occurring either intraoperatively or in the recovery room setting. The primary objective of this study was to determine if time of day for emergency surgeries was associated with mortality. Retrospective analysis. U.S. healthcare facilities. Adult patients undergoing emergency surgery and general anesthesia. No intervention. Utilizing the National Anesthesia Clinical Outcomes Registry database, all emergency non-cardiac, non-obstetric surgeries undergoing general anesthesia occurring between 2010 and 2015 in the United States were identified. We performed mixed effects logistic regression to determine the effect of time of day with mortality occurring during the intraoperative and immediate postoperative period. There were 46,196 cases that were eligible for this analysis, in which 24,247 and 21,949 occurred during day and after-hours shifts, respectively. The overall morality rate was 0.28%. Mortality rates were 0.17% and 0.41% in the day and after-hour shifts, respectively. There was no statistically significant association of time of day with mortality (odds ratio 1.31, 95% CI 0.90-1.92, p = 0.16). American Society of Anesthesiologists physical status classification, age, and operative body part were all associated with mortality. Although, theoretically, health care providers working after-hour shifts may be impacted by sleep deprivation and/or limited resources, we found that time of day was not associated with increased risk of mortality during the intraoperative and immediate postoperative period in emergency surgery. Copyright © 2018 Elsevier Inc. All rights reserved.

Emerging adults' use of alcohol and social networking sites during a large street festival: A real-time interview study.

PubMed

Whitehill, Jennifer M; Pumper, Megan A; Moreno, Megan A

2015-05-20

Emerging adults have high rates of heavy episodic drinking (binge drinking) and related risks including alcohol-impaired driving. To understand whether social networking sites (SNSs) used on mobile devices represent a viable platform for real-time interventions, this study measured emerging adults' use of two popular SNSs (Facebook and Twitter) during the Mifflin Street Block Party. This annual festival is held in Madison, Wisconsin and is known for high alcohol consumption. Event attendees ages 18-23 years were recruited by young adult research assistants (>21 years). Participants completed a brief in-person interview assessing drinking intensity, use of SNSs, and use of SNSs to plan transportation. Analyses included t-tests, chi-squared tests, and Fisher's exact tests. At the event, nearly all of the 200 participants (97 %) consumed alcohol and 18 % met criteria for heavy episodic drinking. Approximately one-third of participants had used Facebook or Twitter on the day of the event. Facebook use (23 %) was more prevalent than Twitter use (18 %), especially among heavy episodic drinkers. Use of either SNS was 41 % among females and 24 % among males (χ (2)=6.01; df=1; p=0.01). Plans to use a SNS to arrange transportation were relatively uncommon (4 %), but this was more frequent among heavy episodic drinkers (11 %) compared to non-heavy episodic drinkers (2 %) (Fisher's exact p=0.02). These results indicate that SNSs are used during alcohol consumption and warrant exploration as a way to facilitate connections to resources like safe ride services.

Can preferences in information processing aid in understanding suicide risk among emerging adults?

PubMed

Cramer, Robert J; Bryson, Claire N; Gardner, Brett O; Webber, Wesley B

2016-07-01

The present study evaluated emerging adult (n = 192 college students) preferences in information processing (PIP), defined by the need for affect (NFA) and need for cognition (NFC), as they may be associated with suicide risk. The following were direct indicators of elevated suicide risk: presence of lifetime exposure to suicide (i.e., lifetime yes/no), elevated depressive symptoms, and greater NFA avoidance. Two different interactions resulted in elevated suicide risk: high depressive symptoms and high NFA avoidance, and high NFC and high NFA. Present results concerning PIP hold the potential to inform suicide risk assessment and prevention efforts among young adults.

Identifying Effective Methods of Instruction for Adult Emergent Readers through Community-Based Research

ERIC Educational Resources Information Center

Blackmer, Rachel; Hayes-Harb, Rachel

2016-01-01

We present a community-based research project aimed at identifying effective methods and materials for teaching English literacy skills to adult English as a second language emergent readers. We conducted a quasi-experimental study whereby we evaluated the efficacy of two approaches, one based on current practices at the English Skills Learning…

Concepts of Infidelity among African American Emerging Adults: Implications for HIV/STI Prevention

ERIC Educational Resources Information Center

Eyre, Stephen L.; Flythe, Michelle; Hoffman, Valerie; Fraser, Ashley E.

2012-01-01

In this study, we used an exploratory methodology to determine what cultural models African American emerging adults use to understand infidelity/cheating. Cultural models are defined as "cognitive schema[s] that [are] intersubjectively shared by a social group" (D'Andrade, 1987, p. 112). We interviewed 144 participants ages 19-22 from three…

Online and Offline Social Networks: Use of Social Networking Sites by Emerging Adults

ERIC Educational Resources Information Center

Subrahmanyam, Kaveri; Reich, Stephanie M.; Waechter, Natalia; Espinoza, Guadalupe

2008-01-01

Social networking sites (e.g., MySpace and Facebook) are popular online communication forms among adolescents and emerging adults. Yet little is known about young people's activities on these sites and how their networks of "friends" relate to their other online (e.g., instant messaging) and offline networks. In this study, college students…

Examining Emerging-Adults' and Parents' Expectations about Autonomy during the Transition to College

ERIC Educational Resources Information Center

Kenyon, DenYelle Baete; Koerner, Susan Silverberg

2009-01-01

Our research goals were to document levels and examine the potential discrepancies of emerging-adults' and parents' expectations for autonomous behavior during the transition to college. Quantitative and qualitative data were collected from 204 incoming college freshmen (n = 150 females, n = 54 males) and 226 parents (n = 173 mothers, n = 53…

[IMSS in numbers: demand of services in the emergency room, 2004].

PubMed

2006-01-01

The emergency room is one of the most productive services in any medical institution, where the demand of health services is diverse and complex in nature. Around 15 % of all the medical attentions provided at IMSS were done at the emergency room. There was an important increase in the number of consultations provided from 1995 to 2004; the death rate in the service also increased but the incapacity rate decreased. Adult and elderly women were among the most frequent users of emergency services. The main problems seen were respiratory infections (19.4%), trauma and poisoning (18.8%) and diarrheas (8%). Cholelithiasis, migraine, urinary infections and diabetes were more frequent in women, while trauma, accidents and conjunctivitis were more frequent in men. In relation to mortality, around 21% of all deaths registered at IMSS occurred in the emergency room. Diabetes and cardiovascular diseases appeared among the main death causes, especially in the adult and elderly population. Mortality was higher in men than in women.

Gender roles and binge drinking among Latino emerging adults: a latent class regression analysis.

PubMed

Vaughan, Ellen L; Wong, Y Joel; Middendorf, Katharine G

2014-09-01

Gender roles are often cited as a culturally specific predictor of drinking among Latino populations. This study used latent class regression to test the relationships between gender roles and binge drinking in a sample of Latino emerging adults. Participants were Latino emerging adults who participated in Wave III of the National Longitudinal Study of Adolescent Health (N = 2,442). A subsample of these participants (n = 660) completed the Bem Sex Role Inventory--Short. We conducted latent class regression using 3 dimensions of gender roles (femininity, social masculinity, and personal masculinity) to predict binge drinking. Results indicated a 3-class solution. In Class 1, the protective personal masculinity class, personal masculinity (e.g., being a leader, defending one's own beliefs) was associated with a reduction in the odds of binge drinking. In Class 2, the nonsignificant class, gender roles were not related to binge drinking. In Class 3, the mixed masculinity class, personal masculinity was associated with a reduction in the odds of binge drinking, whereas social masculinity (e.g., forceful, dominant) was associated with an increase in the odds of binge drinking. Post hoc analyses found that females, those born outside the United States, and those with greater English language usage were at greater odds of being in Class 1 (vs. Class 2). Males, those born outside the United States, and those with greater Spanish language usage were at greater odds of being in Class 3 (vs. Class 2). Directions for future research and implications for practice with Latino emerging adults are discussed.

Autism spectrum disorder traits in typically developing emerging adults and associated parenting: A person-centered approach.

PubMed

McKinney, Cliff; Gadke, Daniel L; Malkin, Mallory L

2018-02-15

Research on parenting children with autism spectrum disorder (ASD) indicates these children receive parenting tailored to their condition. However, little is known about ASD in adulthood, especially in emerging adults at college, and how they are parented. The current study examined how emerging adults in a non-clinical typically-developing sample differed in their current perceptions of parenting as a function of ASD traits. Participants completed questionnaires about their current perceptions of parenting and self-reported ASD traits. Parenting characteristics assessed included parenting style, discipline, parent-child relationship quality, and parental distress. Results indicated that higher levels of self-reported ASD traits were associated with increasingly ineffective parenting characteristics including lower authoritative style, harsher discipline, poorer parent-child relationship quality (e.g., lower involvement), and higher parental distress. Researchers are encouraged to extend ASD research into adulthood by validating diagnostic methods with adults and investigating processes in adulthood that have been well-established in the childhood ASD literature.

Self-Reported Sleep Duration and Self-Rated Health in Young Adults

PubMed Central

Štefan, Lovro; Juranko, Dora; Prosoli, Rebeka; Barić, Renata; Sporiš, Goran

2017-01-01

Study Objectives: This study aimed to determine the associations between the self-reported sleep duration and self-rated health in young adults. Methods: In this cross-sectional study, participants were 689 young adults (mean age 20 ± 1.35 years, 49.8% female). Sleep duration and self-rated health, as the main outcome of interest, were measured as self-reported. As potential covariates, we included sex, age, smoking status, alcohol consumption, physical activity, sedentary behavior, psychological distress, and body mass index. Results: Approximately 30% of participants slept 7–8 hours, 17.4% were short sleepers (categories < 6 hours and 6–7 hours), and 53.9% were long sleepers (categories 8–10 hours and > 10 hours of sleep). In an unadjusted model, compared with the reference category (7–8 hours of sleep), those who slept < 6 hours (odds ratio 0.20; 95% confidence interval 0.08 to 0.48) and between 6–7 hours (odds ratio 0.43; 95% confidence interval 0.26 to 0.69) were less likely to have good self-rated health. In an adjusted model, short (< 7 hours) and long sleep (> 10 hours) were both associated with poor self-rated health. Conclusions: Our results suggest that both short (< 7 hours) and long (> 10 hours) sleepers have lower odds of having good self-rated health after adjusting for potential covariates. Health professionals should pay more attention to young adults, who have both short and long period of sleep, in order to prevent health problems and potential acute or chronic diseases. Citation: Štefan L, Juranko D, Prosoli R, Barić R, Sporiš G. Self-reported sleep duration and self-rated health in young adults. J Clin Sleep Med. 2017;13(7):899–904. PMID:28502281

Does Playing Sports Video Games Predict Increased Involvement in Real-Life Sports Over Several Years Among Older Adolescents and Emerging Adults?

PubMed

Adachi, Paul J C; Willoughby, Teena

2016-02-01

Given the extreme popularity of video games among older adolescents and emerging adults, the investigation of positive outcomes of video game play during these developmental periods is crucial. An important direction for research in this area is the investigation of a link between sports video game play and involvement in real-life sports among youth. Yet, this association has not been examined in the long-term among older adolescents and emerging adults, and thus represents an exciting new area for discovery. The primary goal of the current study, therefore, was to examine the long-term association between sports video game play and involvement in real-life sports clubs among older adolescents and emerging adults. In addition, we examined whether self-esteem was an underlying mechanism of this longitudinal association. We surveyed older adolescents and emerging adults (N = 1132; 70.6 % female; M age = 19.06 years, range of 17-25 years at the first assessment) annually over 3 years about their video game play, self-esteem, and involvement in real-life sports. We found a long-term predictive effect of sports video game play on increased involvement in real-life sports over the 3 years. Furthermore, we demonstrated that self-esteem was an underlying mechanism of this long-term association. Our findings make an important contribution to an emerging body of literature on the positive outcomes of video game play, as they suggest that sports video game play may be an effective tool to promote real-life sports participation and physical activity among older adolescents and emerging adults.

Perspectives on Adult Education, Human Resource Development, and the Emergence of Workforce Development

ERIC Educational Resources Information Center

Jacobs, Ronald L.

2006-01-01

This article presents a perspective on the relationship between adult education and human resource development of the past two decades and the subsequent emergence of workforce development. The lesson taken from the article should be more than simply a recounting of events related to these fields of study. Instead, the more general lesson may be…

Perspectives on Adult Education, Human Resource Development, and the Emergence of Workforce Development

ERIC Educational Resources Information Center

Jacobs, Ronald L.

2014-01-01

This article presents a perspective on the relationship between adult education and human resource development of the past two decades and the subsequent emergence of workforce development. The lesson taken from the article should be more than simply a recounting of events related to these fields of study. Instead, the more general lesson may be…

Older adults in jail: high rates and early onset of geriatric conditions.

PubMed

Greene, Meredith; Ahalt, Cyrus; Stijacic-Cenzer, Irena; Metzger, Lia; Williams, Brie

2018-02-17

The number of older adults in the criminal justice system is rapidly increasing. While this population is thought to experience an early onset of aging-related health conditions ("accelerated aging"), studies have not directly compared rates of geriatric conditions in this population to those found in the general population. The aims of this study were to compare the burden of geriatric conditions among older adults in jail to rates found in an age-matched nationally representative sample of community dwelling older adults. This cross sectional study compared 238 older jail inmates age 55 or older to 6871 older adults in the national Health and Retirement Study (HRS). We used an age-adjusted analysis, accounting for the difference in age distributions between the two groups, to compare sociodemographics, chronic conditions, and geriatric conditions (functional, sensory, and mobility impairment). A second age-adjusted analysis compared those in jail to HRS participants in the lowest quintile of wealth. All geriatric conditions were significantly more common in jail-based participants than in HRS participants overall and HRS participants in the lowest quintile of net worth. Jail-based participants (average age of 59) experienced four out of six geriatric conditions at rates similar to those found in HRS participants age 75 or older. Geriatric conditions are prevalent in older adults in jail at significantly younger ages than non-incarcerated older adults suggesting that geriatric assessment and geriatric-focused care are needed for older adults cycling through jail in their 50s and that correctional clinicians require knowledge about geriatric assessment and care.

Associations between patterns of emerging sexual behavior and young adult reproductive health.

PubMed

Haydon, Abigail A; Herring, Amy H; Halpern, Carolyn Tucker

2012-12-01

Identifying young adult outcomes associated with adolescent sexual behavior, including patterns of first oral, vaginal and anal sex, is critical to promoting healthy sexual development. Associations between patterns of emerging sexual behavior, defined using latent class analysis, and young adult sexual and reproductive health were examined among 9,441 respondents to Waves 1 (1994-1995), 3 (2001-2002) and 4 (2008) of the National Longitudinal Study of Adolescent Health. Logistic regression analyses examined associations between class membership and young adult outcomes, and tested for interactions by race and ethnicity. Compared with respondents who initiated vaginal sex first and reported other sexual behaviors within two years, those who initiated oral and vaginal sex during the same year had similar odds of having had an STD diagnosis ever or in the last year, of having had concurrent sexual partnerships in the last year and of having exchanged sex for money. However, respondents who postponed sexual activity had reduced odds of each outcome (odds ratios, 0.2-0.4); those who initiated vaginal sex and reported only one type of sexual behavior had reduced odds of reporting STD diagnoses and concurrent partnerships (0.4-0.6). Respondents who reported early initiation of sexual activity combined with anal sex experience during adolescence had elevated odds of having had concurrent partnerships (1.6). The data suggest racial and ethnic disparities even when patterns of emerging sexual behavior were the same. Patterns of early sexual behavior considered high-risk may not predict poor sexual and reproductive health in young adulthood. Copyright © 2012 by the Guttmacher Institute.

Career Pursuit Pathways among Emerging Adult Men and Women: Psychosocial Correlates and Precursors

ERIC Educational Resources Information Center

Shulman, Shmuel; Barr, Tamuz; Livneh, Yaara; Nurmi, Jari-Erik; Vasalampi, Kati; Pratt, Michael

2015-01-01

The present study examined career pursuit pathways in 100 Israeli emerging adults (54 men) who were followed from age 22 to 29. Employing a semi-structured interview at the age of 29, participants were asked about current work and educational status, work and educational goals and status changes in recent years, and to reflect on the meaning of…

Forecasting Hospitalization and Emergency Department Visit Rates for Chronic Obstructive Pulmonary Disease. A Time-Series Analysis.

PubMed

Gershon, Andrea; Thiruchelvam, Deva; Moineddin, Rahim; Zhao, Xiu Yan; Hwee, Jeremiah; To, Teresa

2017-06-01

Knowing trends in and forecasting hospitalization and emergency department visit rates for chronic obstructive pulmonary disease (COPD) can enable health care providers, hospitals, and health care decision makers to plan for the future. We conducted a time-series analysis using health care administrative data from the Province of Ontario, Canada, to determine previous trends in acute care hospitalization and emergency department visit rates for COPD and then to forecast future rates. Individuals aged 35 years and older with physician-diagnosed COPD were identified using four universal government health administrative databases and a validated case definition. Monthly COPD hospitalization and emergency department visit rates per 1,000 people with COPD were determined from 2003 to 2014 and then forecasted to 2024 using autoregressive integrated moving average models. Between 2003 and 2014, COPD prevalence increased from 8.9 to 11.1%. During that time, there were 274,951 hospitalizations and 290,482 emergency department visits for COPD. After accounting for seasonality, we found that monthly COPD hospitalization and emergency department visit rates per 1,000 individuals with COPD remained stable. COPD prevalence was forecasted to increase to 12.7% (95% confidence interval [CI], 11.4-14.1) by 2024, whereas monthly COPD hospitalization and emergency department visit rates per 1,000 people with COPD were forecasted to remain stable at 2.7 (95% CI, 1.6-4.4) and 3.7 (95% CI, 2.3-5.6), respectively. Forecasted age- and sex-stratified rates were also stable. COPD hospital and emergency department visit rates per 1,000 people with COPD have been stable for more than a decade and are projected to remain stable in the near future. Given increasing COPD prevalence, this means notably more COPD health service use in the future.

Evolving Prehospital, Emergency Department, and “Inpatient” Management Models for Geriatric Emergencies

PubMed Central

Carpenter, Christopher R.; Platts-Mills, Timothy F.

2013-01-01

Alternative management methods are essential to ensure high quality and efficient emergency care for the growing number of geriatric adults worldwide. Protocols for case-finding and rapid diagnosis to support early condition-specific treatment for older adults with acute severe illness and injury are needed. Improved emergency department care for older adults will require providers to look beyond the diagnosis to address the influence of other factors on the patient's health: isolation and depression; finances and transportation; and chronic medical conditions and polypharmacy. This review article describes recent and ongoing efforts to enhance the quality of emergency care for older adults using alternative management approaches spanning the spectrum from prehospital care, through the emergency department, and into evolving inpatient or outpatient processes of care. PMID:23177599

Constipation Prophylaxis Is Rare for Adults Prescribed Outpatient Opioid Therapy From U.S. Emergency Departments.

PubMed

Hunold, Katherine M; Smith, Samantha A; Platts-Mills, Timothy F

2015-09-01

Constipation is a common and potentially serious side effect of oral opioids. Accordingly, most clinical guidelines suggest routine use of laxatives to prevent opioid-induced constipation. The objective was to characterize emergency provider prescribing of laxatives to prevent constipation among adults initiating outpatient opioid treatment. National Hospital Ambulatory Medical Care Survey (NHAMCS) data from 2010 were analyzed. Among visits by individuals aged 18 years and older discharged from the emergency department (ED) with opioid prescriptions, the authors estimated the survey-weighted proportion of visits in which laxatives were also prescribed. A subgroup analysis was conducted for individuals aged 65 years and older, as the potential risks associated with opioid-induced constipation are greater among older individuals. To examine a group expected to be prescribed laxative medication and confirm that NHAMCS captures prescriptions for these medications, the authors estimated the proportion of visits by individuals discharged with prescriptions for laxatives among those who presented with constipation. Among visits in 2010 by adults aged 18 years and older discharged from the ED with opioid prescriptions, 0.9% (95% confidence interval [CI] = 0.7% to 1.3%, estimated total n = 191,203 out of 21,075,050) received prescriptions for laxatives. Among the subset of visits by adults aged 65 years and older, 1.0% (95% CI = 0.5% to 2.0%, estimated total n = 18,681 out of 1,904,411) received prescriptions for laxatives. In comparison, among visits by individuals aged 18 years and older with constipation as a reason for visit, 42% received prescriptions for laxatives. In this nationally representative sample, laxatives were not routinely prescribed to adults discharged from the ED with prescriptions for opioid pain medications. Routine prescribing of laxatives for ED visits may improve the safety and effectiveness of outpatient opioid pain management. © 2015 by the

Executive functioning independently predicts self-rated health and improvement in self-rated health over time among community-dwelling older adults.

PubMed

McHugh, Joanna Edel; Lawlor, Brian A

2016-01-01

Self-rated health, as distinct from objective measures of health, is a clinically informative metric among older adults. The purpose of our study was to examine the cognitive and psychosocial factors associated with self-rated health. 624 participants over the age of 60 were assessed at baseline, and of these, 510 were contacted for a follow-up two years later. Measures of executive function and self-rated health were assessed at baseline, and self-rated health was assessed at follow-up. We employed multiple linear regression analyses to investigate the relationship between executive functioning and self-rated health, while controlling for demographic, psychosocial and biological variables. Controlling for other relevant variables, executive functioning independently and solely predicted self-rated health, both at a cross-sectional level, and also over time. Loneliness was also found to cross-sectionally predict self-rated health, although this relationship was not present at a longitudinal level. Older adults' self-rated health may be related to their executive functioning and to their loneliness. Self-rated health appeared to improve over time, and the extent of this improvement was also related to executive functioning at baseline. Self-rated health may be a judgement made of one's functioning, especially executive functioning, which changes with age and therefore may be particularly salient in the reflections of older adults.

Rates and features of methamphetamine-related presentations to emergency departments: An integrative literature review.

PubMed

Jones, Rikki; Woods, Cindy; Usher, Kim

2018-07-01

To review the clinical impact methamphetamine has on emergency departments by assessing the available research on the rates and features of methamphetamine-related presentations. Globally, methamphetamine availability, distribution and use have rapidly increased. As a result, the number of methamphetamine-related presentations to emergency departments has also increased. In this context, it is timely to review the rate and features of methamphetamine-related presentations to understand the impact of methamphetamine on emergency departments and facilitate the allocation of services, staff and resources. An integrative literature review. This study presents an integrated literature review, following the systematic review process as outlined in the PRISMA flow chart. Several databases were searched using a combination of search terms. Articles were measured against inclusion and exclusion criteria, and the final ten articles were subjected to quality appraisal and outcomes reported. Methamphetamine accounted for 2.3% or less of all emergency departments presentations. The majority of methamphetamine users presenting to emergency departments were males, with a mean age 31-37. Methamphetamine-related presentations to emergency departments were more likely to present with trauma, psychosis, and be placed on 24-hr psychiatric hold. Methamphetamine-related presentations were more likely to present with agitation, aggression and homicidal behaviour and present to emergency departments out of hours and accompanied by police compared with other emergency departments substance-related presentations. Several important themes were highlighted in this review that has an impact on emergency departments services, resources and staff. Understanding the rate and patterns of methamphetamine-related presentations can help to provide evidence for policy development and staff education in emergency departments. Methamphetamine-related presenters are more aggressive and agitated and more

Prevalence of self-rated visual impairment among adults with diabetes.

PubMed

Saaddine, J B; Narayan, K M; Engelgau, M M; Aubert, R E; Klein, R; Beckles, G L

1999-08-01

This study estimated the prevalence of self-rated visual impairment among US adults with diabetes and identified correlates of such impairment. Self-reported data from the 1995 Behavioral Risk Factor Surveillance System survey of adults 18 years and older with diabetes were analyzed. Correlates of visual impairment were examined by multiple logistic regression analysis. The prevalence of self-rated visual impairment was 24.8% (95% confidence interval [CI] = 22.3%, 27.3%). Among insulin users, multivariable-adjusted odds ratios were 4.9 (95% CI = 2.6, 9.2) for those who had not completed high school and 1.8 (95% CI = 1.0, 2.8) for those who had completed high school compared with those with higher levels of education. Comparable estimates of odds ratios for nonusers of insulin were 2.2 (95% CI = 1.4, 3.4) and 1.3 (95% CI = 0.9, 2.0), respectively. Among nonusers, the adjusted odds for minority adults were 2.4 (95% CI = 1.0, 3.7) times the odds for non-Hispanic Whites. By these data, 1.6 million US adults with diabetes reported having some degree of visual impairment. Future research on the specific causes of visual impairment may help in estimating the avoidable public health burden.

EuroQol (EQ-5D) measure of quality of life predicts mortality, emergency department utilization, and hospital discharge rates in HIV-infected adults under care.

PubMed

Mathews, William C; May, Susanne

2007-01-25

Health-related quality of life (HR-QOL) is a relevant and quantifiable outcome of care. We implemented HR-QOL assessment at all primary care visits at UCSD Owen Clinic using EQ-5D. The study aim was to estimate the prognostic value of EQ-5D for survival, hospitalization, and emergency department (ED) utilization after controlling for CD4 and HIV plasma viral load (pVL). We conducted a retrospective analysis of HIV clinic based cohort (1996-2000). The EQ-5D includes single item measures of: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each item is coded using 3-levels (1 = no problems; 2 = some problems; 3 = severe problems). The instrument includes a global rating of current health using a visual analog scale (VAS) ranging from 0 (worst imaginable) to 100 (best imaginable). An additional single item measure of health change (better, much the same, worse) was included. A predicted VAS (pVAS) was estimated by regressing the 5 EQ-5D health states on VAS using reference cell coding of health states and random effects linear models. Survival models were fit using Cox modelling. Hospitalization and ED rate models were estimated using population-averaged Poisson models. 965 patients met eligibility criteria. 12% were female; 42% were non-white. Median time-at-risk was 1.2 years. Median CD4 was 233. Median log10(pVL) was 4.6. 47 deaths occurred. In two Cox models controlling for CD4 and pVL, the adjusted hazard ratios (aHR) for VAS and pVAS as time-varying covariates were 0.73 (95% CI: 0.63-0.83) and 0.66 (95% CI: 0.56-0.77) respectively, for every 10 point increase in (p)VAS rating. In Poisson regression models predicting ED visit rates and hospital discharge rates controlling for current CD4 and pVL, each of the EQ-5D health dimensions, VAS, and health change items were significantly (p < 0.05) associated with the outcomes. For ED visit rates, the adjusted incidence rate ratios (aIRR) were 0.86 (0.83-0.89) and 0.79 (0.75-0.82) for VAS

Longitudinal Predictors of Self-Rated Health and Mortality in Older Adults

PubMed Central

Short, Jerome L.

2014-01-01

Introduction Few studies have compared the effects of demographic, cognitive, and behavioral factors of health and mortality longitudinally. We examined predictors of self-rated health and mortality at 3 points, each 2 years apart, over 4 years. Methods We used data from the 2006 wave of the Health and Retirement Study and health and mortality indicators from 2006, 2008, and 2010. We analyzed data from 17,930 adults (aged 50–104 y) to examine predictors of self-rated health and data from a subgroup of 1,171 adults who died from 2006 through 2010 to examine predictors of mortality. Results Time 1 depression was the strongest predictor of self-rated health at all points, independent of age and education. Education, mild activities, body mass index, delayed word recall, and smoking were all associated with self-rated health at each point and predicted mortality. Delayed word recall mediated the relationships of mild activity with health and mortality. Bidirectional mediation was found for the effects of mild activity and depression on health. Conclusion Medical professionals should consider screening for depression and memory difficulties in addition to conducting medical assessments. These assessments could lead to more effective biopsychosocial interventions to help older adults manage risks for mortality. PMID:24901793

Quantifying the effect of changes in state-level adult smoking rates on youth smoking.

PubMed

Farrelly, Matthew C; Arnold, Kristin Y; Juster, Harlan R; Allen, Jane A

2014-01-01

Quantify the degree to which changes in state-level adult smoking prevalence subsequently influence youth smoking prevalence. Analysis of data from the Tobacco Use Supplement to the Current Population Survey (TUS-CPS) collected from 1995 to 2006 and the National Youth Tobacco Survey (NYTS) collected from 1999 to 2006. Adults 25 years or older who completed the TUS-CPS and youth in middle and high school who completed the NYTS. Current smoking among middle and high school students as a function of the change in state-level adult smoking, controlling for individual-level sociodemographic characteristics and state-level tobacco control policy variables. Among middle school students, declines in state-level adult smoking rates are associated with lower odds of current smoking (P < .05), and each doubling of the decline in adult smoking rates is associated with a 6.0% decrease in youth smoking. Among high school students, declines in state-level adult smoking rates are not associated with current smoking. Higher cigarette prices were associated with lower odds of smoking among middle and high school students. Greater population coverage by smoke-free air laws and greater funding for tobacco control programs were associated with lower odds of current smoking among high school students but not middle school students. Compliance with youth access laws was not associated with middle or high school smoking. By quantifying the effect of changes in state-level adult smoking rates on youth smoking, this study enhances the precision with which the tobacco control community can assess the return on investment for adult-focused tobacco control programs.

WSES guidelines for emergency repair of complicated abdominal wall hernias

PubMed Central

2013-01-01

Emergency repair of complicated abdominal hernias is associated with poor prognosis and a high rate of post-operative complications. A World Society of Emergency Surgery (WSES) Consensus Conference was held in Bergamo in July 2013, during the 2nd Congress of the World Society of Emergency Surgery with the goal of defining recommendations for emergency repair of abdominal wall hernias in adults. This document represents the executive summary of the consensus conference approved by a WSES expert panel. PMID:24289453

Comparison of immunization rates of adults ages 65 years and older managed within two nurse practitioner-owned clinics with national immunization rates.

PubMed

Wright, Wendy L; Morrell, Elise; Lee, Jennie; Cuellar, Norma Graciela; White, Patricia

2017-07-01

Adults ages ≥65 years are at increased risk for infectious diseases. Ensuring these individuals are fully vaccinated is imperative. The purpose of this study was to assess the immunization rates of adults ages ≥65 years managed by nurse practitioners (NPs) and compare the results with national immunization rates and Healthy People 2020 goals. A convenience sample of adults ages ≥65 years was obtained from two NP-managed clinics. The vaccine records of each subject were reviewed for documentation of having received five vaccines (tetanus, diphtheria, and pertussis; influenza; pneumococcal polysaccharide vaccine 23; pneumococcal conjugate vaccine 13; and herpes zoster vaccine). One hundred and fifty females (70.8%) and 62 males (29.2%) met inclusion criteria. NP-managed patients had higher immunization rates than the national averages across all five major vaccines. The herpes zoster vaccination rates exceeded the recommendations from Healthy People 2020 whereas pneumococcal and influenza rates were below. The stocking of vaccines within the NP-managed clinics, direct billing to Medicare for Part D vaccines, and previsit care planning likely contributed to the high vaccination rates. These high immunization rates in patients managed by NPs provide support for the important role that NPs play in the care of older adults. ©2017 American Association of Nurse Practitioners.

Estimating energy expenditure from heart rate in older adults: a case for calibration.

PubMed

Schrack, Jennifer A; Zipunnikov, Vadim; Goldsmith, Jeff; Bandeen-Roche, Karen; Crainiceanu, Ciprian M; Ferrucci, Luigi

2014-01-01

Accurate measurement of free-living energy expenditure is vital to understanding changes in energy metabolism with aging. The efficacy of heart rate as a surrogate for energy expenditure is rooted in the assumption of a linear function between heart rate and energy expenditure, but its validity and reliability in older adults remains unclear. To assess the validity and reliability of the linear function between heart rate and energy expenditure in older adults using different levels of calibration. Heart rate and energy expenditure were assessed across five levels of exertion in 290 adults participating in the Baltimore Longitudinal Study of Aging. Correlation and random effects regression analyses assessed the linearity of the relationship between heart rate and energy expenditure and cross-validation models assessed predictive performance. Heart rate and energy expenditure were highly correlated (r=0.98) and linear regardless of age or sex. Intra-person variability was low but inter-person variability was high, with substantial heterogeneity of the random intercept (s.d. =0.372) despite similar slopes. Cross-validation models indicated individual calibration data substantially improves accuracy predictions of energy expenditure from heart rate, reducing the potential for considerable measurement bias. Although using five calibration measures provided the greatest reduction in the standard deviation of prediction errors (1.08 kcals/min), substantial improvement was also noted with two (0.75 kcals/min). These findings indicate standard regression equations may be used to make population-level inferences when estimating energy expenditure from heart rate in older adults but caution should be exercised when making inferences at the individual level without proper calibration.

Motivating Adult Learners: Exploring the Emergence of Adult Business Students in an East Texas University

ERIC Educational Resources Information Center

Luke, Douglas; Justice, Madeline

2016-01-01

Adult enrollment in higher education institutions has grown significantly during the last decade, with students aged 25 and older attending 4-year institutions at higher rates than before. In the 21st century, few can improve their socioeconomic status or advance professionally without higher education. Colleges and universities must consider this…

Comparing chronic interpersonal and noninterpersonal stress domains as predictors of depression recurrence in emerging adults.

PubMed

Sheets, Erin S; Craighead, W Edward

2014-12-01

Understanding how persistent interpersonal difficulties distinctly affect the course of major depressive disorder (MDD) during emerging adulthood is critical, given that early experiences impact future coping resources and functioning. Research on stress and MDD has mostly concentrated on stressful life events, while chronic stress largely has not been explored. The present study examined interpersonal (intimate relationship, close friendships, social life, family relationships) and noninterpersonal (academic, work, financial, personal health, and family members' health) domains of chronic stress as time-varying predictors of depressive recurrence in emerging adults. Baseline assessments identified previously depressed emerging adults (N = 119), who subsequently completed 6-month, 12-month and 18-month follow-up interviews to determine chronic stress experiences and onset of new major depressive episodes. Survival analyses indicated that time-varying total chronic stress and chronic interpersonal stress predicted higher risk for depression recurrence; however, chronic noninterpersonal stress was not associated with recurrence. Intimate relationship stress, close friendship stress, family relationship stress, personal health, and family members' health independently predicted MDD recurrence, over and above well-established depression risk factors of dysfunctional cognitions and personality disorder symptoms. Evidence that interpersonal stress could have substantial impact on course of depression is consistent with theories of emerging adulthood, a time when young people are individuating from the family and experiencing significant social transition. Copyright © 2014 Elsevier Ltd. All rights reserved.

Basic Education for Adults: Pathways to College and Careers for Washington's Emerging Workforce. Washington's Community and Technical Colleges

ERIC Educational Resources Information Center

Washington State Board for Community and Technical Colleges, 2015

2015-01-01

This brief describes the Basic Education for Adults (BEdA) programs that bridge the gap between school and work, thereby creating pathways to college and careers for Washington's emerging workforce. BEdA programs teach foundational skills--reading, writing, math, technology and English language--so adults can move through college and into…

Concordance of Motion Sensor and Clinician-Rated Fall Risk Scores in Older Adults.

PubMed

Elledge, Julie

2017-12-01

As the older adult population in the United States continues to grow, developing reliable, valid, and practical methods for identifying fall risk is a high priority. Falls are prevalent in older adults and contribute significantly to morbidity and mortality rates and rising health costs. Identifying at-risk older adults and intervening in a timely manner can reduce falls. Conventional fall risk assessment tools require a health professional trained in the use of each tool for administration and interpretation. Motion sensor technology, which uses three-dimensional cameras to measure patient movements, is promising for assessing older adults' fall risk because it could eliminate or reduce the need for provider oversight. The purpose of this study was to assess the concordance of fall risk scores as measured by a motion sensor device, the OmniVR Virtual Rehabilitation System, with clinician-rated fall risk scores in older adult outpatients undergoing physical rehabilitation. Three standardized fall risk assessments were administered by the OmniVR and by a clinician. Validity of the OmniVR was assessed by measuring the concordance between the two assessment methods. Stability of the OmniVR fall risk ratings was assessed by measuring test-retest reliability. The OmniVR scores showed high concordance with the clinician-rated scores and high stability over time, demonstrating comparability with provider measurements.

Substrate effects on pupation and adult emergence of Hermetia illucens (Diptera: Stratiomyidae).

PubMed

Holmes, L A; Vanlaerhoven, S L; Tomberlin, J K

2013-04-01

Black soldier flies, Hermetia illucens (L.) (Diptera: Stratiomyidae), are of particular interest for their applications in waste management. Feeding on decaying organic waste, black soldier flies successfully reduce manure in confined animal feeding operations of poultry, swine, and cattle. To optimize waste conversion in confined animal feeding operations and landfill facilities, it is imperative to optimize black soldier fly development. Unfortunately, black soldier flies only convert waste during their larval feeding stages and therefore it is of interest to optimize the nonfeeding stages of development, specifically, the postfeeding and pupal stages. The time spent in these stages is thought to be determined by the pupation substrate encountered by the postfeeding larvae. The objective of this study was to determine the effect different pupation substrates have on postfeeding development time, pupation time, and adult emergence success. Five pupation substrates were compared: wood shavings, potting soil, topsoil, sand, and nothing. Postfeeding larvae took longer to reach pupation in the absence of a pupation substrate, although reaching pupation in the shortest time in potting soil and wood shavings. The time spent in the pupal stage was shortest in the absence of a pupation substrate. However, fewer adults emerged when a pupation substrate was not provided.

Effects of methoprene, a juvenile hormone analog, on survival of various developmental stages, adult emergence, reproduction and behavior of Asian citrus psyllid, Diaphorina citri Kuwayama.

PubMed

Brar, Gurpreet S; Meyer, Wendy; Stelinski, Lukasz L

2015-12-01

The Asian citrus citrus psyllid, Diaphorina citri Kuwayama, transmits a bacterium that causes huanglongbing in citrus. Frequent and repeated use of neurotoxic insecticides against D. citri has resulted in the development of insecticide resistance. We evaluated the effects of the juvenile hormone analog methoprene on egg hatch, nymphal development, adult emergence, reproduction and behavior of D. citri. Methoprene significantly reduced the viability of eggs that were between 0 and 4 days old. Egg hatch of 0-48-h-old and 49-96-h-old eggs was 8 and 9%, respectively, when treated with 320 µg mL(-1) of methoprene. Methoprene caused significant mortality of first-, third- and fifth-instar D. citri nymphs and reduced adult emergence as compared with controls. Methoprene caused less than 5% adult emergence when first- and third-instar stages were treated, respectively, and less than 40% adult emergence when fifth instars were treated. Reduced fertility of females was observed when they emerged from methoprene-treated fifth instars. Methoprene was effective in reducing egg hatch, suppressing nymphal development and decreasing adult emergence of D. citri under laboratory conditions. Treatment of fifth instars reduced the fertility of females. Methoprene might be a possible tool for integrated management of D. citri. © 2015 Society of Chemical Industry.

18 CFR 284.268 - Local distribution company emergency transportation rates.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Local distribution company emergency transportation rates. 284.268 Section 284.268 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY OTHER REGULATIONS UNDER THE NATURAL GAS POLICY...

Subjective Social Status and Positive Indicators of Well-Being among Emerging Adult College Students

ERIC Educational Resources Information Center

Zorotovich, Jennifer; Johnson, Elizabeth I.; Linn, Rebekah

2016-01-01

The current study extends research on social status and well-being among young people by examining whether subjective social status (SSS) is related to life satisfaction and happiness. Emerging adults (n = 383) between 18 and 29 provided data on demographic characteristics, SSS, life satisfaction, and happiness via an online survey. Regression…

The Dark Night: A Model of Spiritual Formation for Emerging Young Adults in College

ERIC Educational Resources Information Center

Rendon-Reyes, Juan

2017-01-01

An increasing number of baptized emerging adults consider themselves spiritual (spiritual seekers) and religiously un-affiliated. In 2003 the Pontifical Council for Culture, aware of the reality of the human spiritual quest, stated that helping people in their spiritual search by offering proven techniques and experiences of real prayer could open…

Factor Structure of the Kessler Psychological Distress Scale (K6) among Emerging Adults

ERIC Educational Resources Information Center

Bessaha, Melissa L.

2017-01-01

Objective: Confirmatory factor analysis was used to assess the factor structure of the 6-item version of the Kessler Psychological Distress Scale (K6). Methods: A subsample of emerging adults, aged 18-29 (n = 20,699), from the 2013 National Survey of Drug Use and Health were used in this study. Results: Each of the models (one-factor, two-factor…

Rating teams' non-technical skills in the emergency department: A qualitative study of nurses' experience.

PubMed

Porter, Joanne E; Cant, Robyn P; Cooper, Simon J

2018-05-01

Non-technical skills (NTS) teamwork training can enhance clinicians' understanding of roles and improve communication. We evaluated a quality improvement project rating teams' NTS performance to determine the value of formal rating and debriefing processes. In two Australian emergency departments the NTS of resuscitation teams were rated by senior nurses and medical staff. Key measures were leadership, teamwork, and task management using a valid instrument: Team Emergency Assessment Measure (TEAM™). Emergency nurses were asked to attend a focus group from which key themes around the quality improvement process were identified. Main themes were: 'Team composition' (allocation of resuscitation team roles), 'Resuscitation leadership' (including both nursing and medical leadership roles) and 'TEAM™ ratings promote reflective practice' (providing staff a platform to discuss team effectiveness). Objective ratings were seen as enabling staff to provide feedback to other team members. Reflection on practice and debriefing were thought to improve communication, help define roles and responsibilities, and clarify leadership roles. Use of a non-technical skills rating scheme such as TEAM™ after team-based clinical resuscitation events was seen by emergency department nurses as feasible and a useful process for examining and improving multi-disciplinary practice, while improving team performance. Copyright © 2018 Elsevier Ltd. All rights reserved.

The Relationship Between the Accumulated Number of Role Transitions and Hard Drug Use Among Hispanic Emerging Adults

PubMed Central

Allem, Jon-Patrick; Soto, Daniel; Baezconde-Garbanati, Lourdes; Unger, Jennifer

2014-01-01

Emerging adults (ages 18 to 25) who experience multiple role transitions in a short period of time may engage in hard drug use as a maladaptive coping strategy to avoid negative emotions from stress. Given the collectivistic values Hispanics encounter growing up, they may experience additional role transitions due to their group oriented cultural paradigm. This study examined whether those who experience many role transitions are at greater risk for hard drug use compared to those who experience few transitions among Hispanic emerging adults. Participants completed surveys indicating their hard drug use in emerging adulthood, role transitions in the past year of emerging adulthood, age, gender, and hard drug use in high school. Simulation analyses indicated that an increase in the number of role transitions, from 0 to 13, was associated with a 14% (95% CI, 4 to 29) higher probability of hard drug use. Specific role transitions were found to be associated with hard drug use, such as starting to date or experiencing a breakup. Intervention/prevention programs may benefit from acknowledging individual reactions to transitions in emerging adulthood, as these processes may be catalysts for personal growth where identities are consolidated, and decisions regarding hard drug use are formed. PMID:25715073

The Relationship Between the Accumulated Number of Role Transitions and Hard Drug Use among Hispanic Emerging Adults.

PubMed

Allem, Jon-Patrick; Soto, Daniel; Baezconde-Garbanati, Lourdes; Unger, Jennifer

2015-01-01

Emerging adults (ages 18 to 25) who experience multiple role transitions in a short period of time may engage in hard drug use as a maladaptive coping strategy to avoid negative emotions from stress. Given the collectivistic values Hispanics encounter growing up, they may experience additional role transitions due to their group-oriented cultural paradigm. This study examined whether those who experience many role transitions are at greater risk for hard drug use compared to those who experience few transitions among Hispanic emerging adults. Participants completed surveys indicating their hard drug use in emerging adulthood, role transitions in the past year of emerging adulthood, age, gender, and hard drug use in high school. Simulation analyses indicated that an increase in the number of role transitions, from 0 to 13, was associated with a 14% (95% CI, 4 to 29) higher probability of hard drug use. Specific role transitions were found to be associated with hard drug use, such as starting to date or experiencing a breakup. Intervention/prevention programs may benefit from acknowledging individual reactions to transitions in emerging adulthood, as these processes may be catalysts for personal growth where identities are consolidated and decisions regarding hard drug use are formed.

Examining the Moral Development of Emerging Adult Student-Athletes: The Connection to Engaged Leadership Practices

ERIC Educational Resources Information Center

Bowers, Kristie M.

2017-01-01

With university mission statements focused on preparing emerging adult students for globally inclusive professional careers, moral and leadership development has become a central focus of many colleges and universities (Bass, 1991; Binghamton University, 2016; Zimmerman-Oster & Burkhardt, 1999). Colleges and universities utilize interactions…

Feasibility Testing of an Emergency Department Screening Tool To Identify Older Adults Appropriate for Palliative Care Consultation.

PubMed

Ouchi, Kei; Block, Susan D; Schonberg, Mara A; Jamieson, Emily S; Aaronson, Emily L; Pallin, Daniel J; Tulsky, James A; Schuur, Jeremiah D

2017-01-01

Seriously ill older adults in the emergency department (ED) may benefit from palliative care referral, yet little is known about how to identify these patients. To assess the performance and determine the acceptability of a content-validated palliative care screening tool. We surveyed Emergency Medicine (EM) attending physicians at the end of their shifts using the screening tool and asked them to retrospectively apply it to all patients ≥65 years whom they had cared for. We conducted the survey for three consecutive weeks in October 2015. EM attending physicians at an urban, university-affiliated ED. Patient characteristics, acceptability rating, and time per patient screened. We approached 38 attending physicians to apply the screening tool for 69 eligible shifts. Physicians agreed to participate during 55 shifts (80%) and screened 207 patients. On 14 shifts (20%), physicians declined to participate. Mean age of the screened patients was 75 years, 51% were male, and 45% had at least one life-limiting illness. Overall, 67 patients (32%) screened positive for palliative care needs. Seventy percent of physicians (n = 33) found the screening tool acceptable to use and the average time of completion was 1.8 minutes per patient screened. A rapid screen of older adults for palliative care needs was acceptable to a majority of EM physicians and identified a significant number of patients who may benefit from palliative care referral. Further research is needed to improve acceptability and determine the appropriate care pathway for patients with palliative care needs.

Risky business: Is there an association between casual sex and mental health among emerging adults?

PubMed

Bersamin, Melina M; Zamboanga, Byron L; Schwartz, Seth J; Donnellan, M Brent; Hudson, Monika; Weisskirch, Robert S; Kim, Su Yeong; Agocha, V Bede; Whitbourne, Susan Krauss; Caraway, S Jean

2014-01-01

A multiethnic sample of single, heterosexual, emerging-adult college students (N = 3,907) ages 18 to 25, from 30 institutions across the United States, participated in a study about identity, culture, psychological well-being, and risky behaviors. Given ongoing debates about the connection between casual sex and psychological adjustment, in the current study we assessed the cross-sectional association of participation in casual sex with psychological well-being and distress. A greater proportion of men (18.6%) compared to women (7.4%) reported having had casual sex in the month prior to assessment. Structural equation modeling indicated that casual sex was negatively associated with well-being (ß = .20, p < .001) and positively associated with psychological distress (ß = .16, p < .001). Gender did not moderate these associations. For emerging-adult college students, engaging in casual sex may elevate risk for negative psychological outcomes.

The Effects of Tooth Brushing on Whole Salivary Flow Rate in Older Adults

PubMed Central

Trottier, K.; Garrick, R.; Mascarenhas, T.; Jang, Y.

2018-01-01

Objectives (1) To determine whether manual (MTB), or electric, tooth brushing (ETB) modulates whole salivary flow rate in older adults who are free of systemic disease. (2) To determine the duration of the brushing-related modulation of salivary flow rate. (3) To compare salivary flow rate modulation associated with MTB and ETB. Method Twenty-one adults aged 60 years and older participated in two experimental sessions during which they used a manual, or electric, toothbrush to brush their teeth, tongue, and palate. Whole salivary flow rates were determined using the draining method before, during, and after brushing. Differences in salivary flow rates across time periods, and between conditions, were examined using paired samples t-tests applying a Holm-Bonferroni sequential procedure (pcorr < 0.0045). The relationship between tooth brushing and age with respect to maximum salivary flow rate increase was examined using Pearson's correlation coefficient (p < 0.05). Results/Conclusion Whole salivary flow rates increased during, and for up to 5 minutes following, tooth brushing in adults aged 60 years and older who were free of systemic disease. The salivary effects of MTB and ETB were not significantly different. A moderate, positive correlation was observed between tooth-brushing-related maximum salivary flow rate increase and age. PMID:29682540

Mediating and moderating processes in the relationship between multicultural ideology and attitudes towards immigrants in emerging adults.

PubMed

Musso, Pasquale; Inguglia, Cristiano; Lo Coco, Alida; Albiero, Paolo; Berry, John W

2017-12-01

Few studies examine intercultural relations in emerging adulthood. Framed from the perspective of the Mutual Intercultural Relations in Plural Societies (MIRIPS) project, the current paper examined the mediating role of tolerance and perceived consequences of immigration in the relationship between multicultural ideology and attitudes towards immigrants. Additionally, the moderating role of context was analysed. A two-group structural equation modelling was performed on data collected from 305 Italian emerging adults living both in northern and in southern Italy with different socio-political climates towards immigrants. In both groups, tolerance and perceived consequences of immigration mediated the relationship between multicultural ideology and attitudes towards immigrants. Also, this indirect relationship was significantly higher for the northern than southern Italians. These findings provide provisional evidence of mediating and moderating processes in the relationship between multicultural ideology and attitudes towards immigrants and suggest important implications for practitioners interested in promoting intercultural relations among emerging adults. © 2016 International Union of Psychological Science.

Associations Between Patterns of Emerging Sexual Behavior and Young Adult Reproductive Health

PubMed Central

Haydon, Abigail A.; Herring, Amy H.; Halpern, Carolyn Tucker

2012-01-01

CONTEXT Identifying young adult outcomes associated with adolescent sexual behavior, including patterns of first oral, vaginal and anal sex, is critical to promoting healthy sexual development. METHODS Associations between patterns of emerging sexual behavior, defined using latent class analysis, and young adult sexual and reproductive health were examined among 9,441 respondents to Waves 1 (1994–1995), 3 (2001–2002) and 4 (2008) of the National Longitudinal Study of Adolescent Health. Logistic regression analyses examined associations between class membership and young adult outcomes, and tested for interactions by race and ethnicity. RESULTS Compared with respondents who initiated vaginal sex first and reported other sexual behaviors within two years, those who initiated oral and vaginal sex during the same year had similar odds of having had an STD diagnosis ever or in the last year, of having had concurrent sexual partnerships in the last year and of having exchanged sex for money. However, respondents who postponed sexual activity had reduced odds of each outcome (odds ratios, 0.2–0.4); those who initiated vaginal sex and reported only one type of sexual behavior had reduced odds of reporting STD diagnoses and concurrent partnerships (0.4–0.6). Respondents who reported early initiation of sexual activity combined with anal sex experience during adolescence had elevated odds of having had concurrent partnerships (1.6). The data suggest racial and ethnic disparities even when patterns of emerging sexual behavior were the same. CONCLUSIONS Patterns of early sexual behavior considered high-risk may not predict poor sexual and reproductive health in young adulthood. PMID:23231329

Cortical thinness and volume differences associated with marijuana abuse in emerging adults.

PubMed

Mashhoon, Y; Sava, S; Sneider, J T; Nickerson, L D; Silveri, M M

2015-10-01

The prevalence of marijuana (MJ) use among youth and its legalization for medical or recreational use has intensified public health endeavors of understanding MJ effects on brain structure and function. Studies indicate that MJ use is related to impaired cognitive performance, and altered functional brain activation and chemistry in adolescents and adults, but MJ effects on brain morphology in emerging adults are less understood. Fifteen MJ users (age 21.8±3.6, 2 females) and 15 non-user (NU) participants (age 22.3±3.5, 2 females) were included, demographically matched on age, education and alcohol use. High-resolution structural MR images were acquired at 3Tesla. Cortical thickness (CT) and volumetric analyses were performed using Freesurfer. A priori regions of interest (ROI) included orbitofrontal and cingulate cortices, amygdala, hippocampus and thalamus. Whole brain CT analysis did not result in significant group differences in a priori ROIs but revealed MJ users had significantly less CT (i.e., thinness) in right fusiform gyrus (rFG) compared to NU (p<0.05). Thalamic volume was significantly smaller in MJ users compared to NU (right, p=0.05; left, p=0.01) and associated with greater non-planning (p<0.01) and overall impulsivity (p=0.04). There were no other group differences. RFG cortical thinness and smaller thalamic volume in emerging adults is associated with MJ abuse. Furthermore, smaller thalamic volume associated with greater impulsivity contributes to growing evidence that the thalamus is neurobiologically perturbed by MJ use. Collectively, altered thalamic and rFG structural integrity may interfere with their known roles in regulating visuoperceptual and object information processing. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Willingness of Emerging Adults to Engage in Consensual Non-Monogamy: A Mixed-Methods Analysis.

PubMed

Sizemore, Kayla M; Olmstead, Spencer B

2018-07-01

Over the past decade, research on consensual non-monogamy (CNM) has increased. However, willingness to engage in CNM is an understudied phenomenon within this field. Because qualitative methods are rarely used to study this phenomenon, little is known about why individuals may or may not be willing to engage in CNM. Further, research on CNM has devoted little attention to the period of emerging adulthood. The current study used a mixed-methods approach to examine a sample of emerging adults' (ages 18-29; N = 549) willingness to engage in CNM. Results from a qualitative content analysis revealed three distinct groups (Unwilling, Willing, and Open-Minded), and several subthemes emerged within each group that help explain why emerging adults are willing to engage in CNM. Quantitative analyses examined the relationship between group membership and demographic characteristics, finding that a greater proportion of women and heterosexual participants were Unwilling. Results also indicated that a greater proportion of men were Willing, and a greater proportion of sexual minorities were Open-Minded. Group mean differences were examined using quantitative measures of CNM attitudes and willingness. The Unwilling group reported more negative attitudes towards CNM compared to the Open-Minded and Willing groups. Additionally, the Open-Minded group reported more negative attitudes compared to the Willing group. On the willingness to engage in CNM Scale, the Unwilling group had lower mean scores compared to the Willing and Open-Minded groups. The Willing group had higher mean scores compared to the Open-Minded group. Implications for CNM research and methodology are discussed.

Longitudinal Changes in Emerging Adults' Attachment Preferences for Their Mother, Father, Friends, and Romantic Partner: Focusing on the Start and End of Romantic Relationships

ERIC Educational Resources Information Center

Umemura, Tomo; Lacinová, Lenka; Macek, Petr; Kunnen, E. Saskia

2017-01-01

Only a few studies have longitudinally explored to whom emerging adults prefer to turn to seek closeness, comfort, and security (called "attachment preferences"), and previous studies on attachment preferences in emerging adults have focused only on the beginning of romantic relationships but not on the end of relationships. Czech…

Perceived Discrimination and Suicide Ideation: Moderating Roles of Anxiety Symptoms and Ethnic Identity among Asian American, African American, and Hispanic Emerging Adults.

PubMed

Cheref, Soumia; Talavera, David; Walker, Rheeda L

2018-05-03

Suicide is a leading cause of death for vulnerable ethnic minority emerging adults in the United States (Web-based injury statistics query and reporting system [WISQARS], 2015). Perceived discrimination (Journal of Youth and Adolescence, 40, 2011, 1465) and anxiety symptoms (Asian American Journal of Psychology, 1, 2010, 18) are two predictors that are theoretically and conceptually related, but have yet to be examined in a simultaneous model for suicide ideation. Existing theory and research suggest that these variables activate similar pathways (American Behavioral Scientist, 51, 2007, 551). This study sought to address this gap in the literature by examining the simultaneous relationship between perceived discrimination and anxiety symptoms as predictors of suicide ideation. The moderating effect of anxiety symptoms on the relationship between perceived discrimination and suicide ideation was examined in a multiethnic sample of emerging adults. Results indicated that anxiety symptoms moderated the perceived discrimination-suicide ideation relationship for Hispanic emerging adults, but not for their Asian American and African American counterparts. Furthermore, ethnic identity has been shown to mitigate suicide risk in the face of other stressors (Cultural Diversity and Ethnic Minority Psychology, 14, 2008, 75). Ethnic identity emerged as a protective factor for Hispanic emerging adults by further interacting with perceived discrimination and anxiety symptoms to negatively predict suicide ideation. The implications of these findings are discussed. © 2018 The American Association of Suicidology.

Declining death rates from hyperglycemic crisis among adults with diabetes, U.S., 1985-2002.

PubMed

Wang, Jing; Williams, Desmond E; Narayan, K M Venkat; Geiss, Linda S

2006-09-01

To examine trends in death rates for hyperglycemic crisis (diabetic ketoacidosis or hyperglycemic hyperosmolar state) among adults with diabetes in the U.S. from 1985 to 2002. Deaths with hyperglycemic crisis as the underlying cause were identified from national mortality data. Death rates were calculated using estimates of adults with diabetes from the National Health Interview Survey as the denominator and age adjusted to the 2000 U.S. population. The trends from 1985 to 2002 were tested using joinpoint regression analysis. Deaths due to hyperglycemic crisis dropped from 2,989 in 1985 to 2,459 in 2002. During the time period, age-adjusted death rates decreased from 42.4 to 23.8 per 100,000 adults with diabetes (4.4% decrease per year, P for trend <0.01). Death rates declined in all age-groups, with the greatest decrease occurring among individuals aged > or =65 years. Age-adjusted death rates fell for all race-sex subgroups, with black men experiencing the smallest decline. About one-fifth of deaths occurred at home or on arrival at the hospital, and the death rates for hyperglycemic crisis occurring at these places declined only modestly over time (2.1% decrease per year, P for trend = 0.049). Overall death rates due to hyperglycemic crisis among adults with diabetes have declined in the U.S. However, scope for further improvement remains, especially to further reduce death rates among black men and to prevent deaths occurring at home.

L-arginine levels are diminished in adult acute vaso-occlusive sickle cell crisis in the emergency department.

PubMed

Lopez, Bernard L; Kreshak, Allyson A; Morris, Claudia R; Davis-Moon, Linda; Ballas, Samir K; Ma, Xin-Liang

2003-02-01

Paediatric studies have demonstrated that l-arginine (l-arg), the precursor to nitric oxide, is diminished in vaso-occlusive crisis (VOC). This study aimed to determine whether l-arginine levels are altered in adult VOC in the emergency department. Plasma l-arg and nitric oxide metabolite (NOx) levels were obtained in adult VOC patients presenting to the emergency department. Fifty patients had significantly low plasma l-arg (29.78 micromol/l +/- 11.21, P < 0.05 vs steady-state control = 41.16 micromol/l +/- 5.04) and significantly low plasma NOx (12.33 micromol/l +/- 10.28, P < 0.05 vs steady-state control = 25.2 +/- 2.6 micro mol/l). Neither l-arg nor NOx levels could predict VOC clinical course.

Characteristics of Resting Metabolic Rate in Critically Ill, Mechanically Ventilated Adults With Cystic Fibrosis.

PubMed

Frankenfield, David C; Ashcraft, Christine M; Drasher, Tammy L; Reid, Elizabeth K; Vender, Robert L

2017-05-01

Critically ill patients with cystic fibrosis may be especially sensitive to the negative consequences of overfeeding and underfeeding, yet there is almost no information available about the energy needs of these patients. The purpose of this study was to characterize the metabolic rate of critically ill adult patients with cystic fibrosis requiring mechanical ventilation. This was an observational study in which the resting metabolic rate, oxygen consumption, and carbon dioxide production of adult patients with cystic fibrosis requiring critical care, sedation, and mechanical ventilation were measured with indirect calorimetry. This group was compared with a cohort of adult critical care patients without cystic fibrosis. Twelve patients with cystic fibrosis were identified and measured. These were compared with a control group of 25 critically ill patients. Both groups were underweight (body mass index, 17.4 ± 4.0 kg/m 2 in cystic fibrosis and 18.4 ± 2.3 kg/m 2 in control). Adjusting for differences in age, sex, height, and weight, there was no difference in resting metabolic rate between the cystic fibrosis and control groups (1702 ± 193 vs 1642 ± 194 kcal/d, P = .388). Measured resting metabolic rate matched predicted values 58% of the time in cystic fibrosis and 60% of the time in control. The resting metabolic rate of sedated adult patients with cystic fibrosis being assisted with mechanical ventilation is not different from that of adult critical care patients without cystic fibrosis. In both these underweight groups, accurate prediction of resting metabolic rate is difficult to obtain.

Reading Electronic and Printed Books with and without Adult Instruction: Effects on Emergent Reading

ERIC Educational Resources Information Center

Segal-Drori, Ora; Korat, Ofra; Shamir, Adina; Klein, Pnina S.

2010-01-01

The effects of electronic book (e-book) and printed book reading on children's emergent reading with and without adult instruction were investigated. One hundred twenty-eight 5- to 6-year-old kindergarten children from low SES families were randomly assigned to one of four groups (32 children each): (1) independently reading the e-book (EB); (2)…

Emerging Adults in Sweden: Identity Formation in the Light of Love, Work, and Family

ERIC Educational Resources Information Center

Frisen, Ann; Wangqvist, Maria

2011-01-01

In this study, the identity formation of emerging adults in Sweden was investigated in order to discover how identity issues concerning love, work and family are handled. The study group comprised 136 24- to 26-year-olds. The results revealed differences between men and women with regard to their position in the identity formation process. While…

Self-Reported Sleep Duration and Self-Rated Health in Young Adults.

PubMed

Štefan, Lovro; Juranko, Dora; Prosoli, Rebeka; Barić, Renata; Sporiš, Goran

2017-07-15

This study aimed to determine the associations between the self-reported sleep duration and self-rated health in young adults. In this cross-sectional study, participants were 689 young adults (mean age 20 ± 1.35 years, 49.8% female). Sleep duration and self-rated health, as the main outcome of interest, were measured as self-reported. As potential covariates, we included sex, age, smoking status, alcohol consumption, physical activity, sedentary behavior, psychological distress, and body mass index. Approximately 30% of participants slept 7-8 hours, 17.4% were short sleepers (categories < 6 hours and 6-7 hours), and 53.9% were long sleepers (categories 8-10 hours and > 10 hours of sleep). In an unadjusted model, compared with the reference category (7-8 hours of sleep), those who slept < 6 hours (odds ratio 0.20; 95% confidence interval 0.08 to 0.48) and between 6-7 hours (odds ratio 0.43; 95% confidence interval 0.26 to 0.69) were less likely to have good self-rated health. In an adjusted model, short (< 7 hours) and long sleep (> 10 hours) were both associated with poor self-rated health. Our results suggest that both short (< 7 hours) and long (> 10 hours) sleepers have lower odds of having good self-rated health after adjusting for potential covariates. Health professionals should pay more attention to young adults, who have both short and long period of sleep, in order to prevent health problems and potential acute or chronic diseases. © 2017 American Academy of Sleep Medicine

Diltiazem vs. Metoprolol in the Management of Atrial Fibrillation or Flutter with Rapid Ventricular Rate in the Emergency Department.

PubMed

Fromm, Christian; Suau, Salvador J; Cohen, Victor; Likourezos, Antonios; Jellinek-Cohen, Samantha; Rose, Jonathan; Marshall, John

2015-08-01

Diltiazem (calcium channel blocker) and metoprolol (beta-blocker) are both commonly used to treat atrial fibrillation/flutter (AFF) in the emergency department (ED). However, there is considerable regional variability in emergency physician practice patterns and debate among physicians as to which agent is more effective. To date, only one small prospective, randomized trial has compared the effectiveness of diltiazem and metoprolol for rate control of AFF in the ED and concluded no difference in effectiveness between the two agents. Our aim was to compare the effectiveness of diltiazem with metoprolol for rate control of AFF in the ED. A convenience sample of adult patients presenting with rapid atrial fibrillation or flutter was randomly assigned to receive either diltiazem or metoprolol. The study team monitored each subject's systolic and diastolic blood pressures and heart rates for 30 min. In the first 5 min, 50.0% of the diltiazem group and 10.7% of the metoprolol group reached the target heart rate (HR) of <100 beats per minute (bpm) (p < 0.005). By 30 min, 95.8% of the diltiazem group and 46.4% of the metoprolol group reached the target HR < 100 bpm (p < 0.0001). Mean decrease in HR for the diltiazem group was more rapid and substantial than that of the metoprolol group. From a safety perspective, there was no difference between the groups with respect to hypotension (systolic blood pressure < 90 mm Hg) and bradycardia (HR < 60 bpm). Diltiazem was more effective in achieving rate control in ED patients with AFF and did so with no increased incidence of adverse effects. Copyright © 2015 Elsevier Inc. All rights reserved.

Palliative Care Needs of Seriously Ill, Older Adults Presenting to the Emergency Department

PubMed Central

Grudzen, Corita R.; Richardson, Lynne D.; Morrison, Matthew; Cho, Elizabeth; Morrison, R. Sean

2010-01-01

Objectives To identify the palliative care needs of seriously ill, older adults in the emergency department (ED) Methods The authors conducted a cross-sectional structured survey. A convenience sample of 50 functionally impaired adults 65 years or older with coexisting cancer, congestive heart failure, end-stage liver or renal disease, stroke, oxygen-dependent pulmonary disease, or dementia was recruited from an urban academic tertiary care ED. Face-to-face interviews were conducted using the Needs Near the End-of-Life Screening Tool (NEST), McGill Quality of Life Index (MQOL), and Edmonton Symptom Assessment Survey (ESAS) to assess 1) range and severity of symptoms, 2) goals of care, 3) psychological well-being, 4) health care utilization, 5) spirituality, 6) social connectedness, 7) financial burden, 8) the patient-clinician relationship, and 9) overall quality of life. Results Mean age was 74.3 (SD ± 6.5) years and cancer was the most common diagnosis. Mean quality of life on the MQOL was 3.6 (SD ± 2.9). Over half of the patients exceeded intra-test severity-of-needs cutoffs in four categories of the NEST: physical symptoms (47/50, 94%), finances (36/50, 72%), mental health (31/50, 62%), and access to care (29/50, 58%). The majority of patients reported moderate to severe fatigue, pain, dyspnea, and depression on the ESAS. Conclusions Seriously ill, older adults in an urban ED have substantial palliative care needs. Future work should focus on the role of emergency medicine and the new specialty of palliative care in addressing these needs. PMID:21175525

Identifying Geographic Disparities in Diabetes Prevalence Among Adults and Children Using Emergency Claims Data

PubMed Central

Lee, David C; Gallagher, Mary Pat; Gopalan, Anjali; Osorio, Marcela; Vinson, Andrew J; Wall, Stephen P; Ravenell, Joseph E; Sevick, Mary Ann; Elbel, Brian

2018-01-01

Abstract Geographic surveillance can identify hotspots of disease and reveal associations between health and the environment. Our study used emergency department surveillance to investigate geographic disparities in type 1 and type 2 diabetes prevalence among adults and children. Using all-payer emergency claims data from 2009 to 2013, we identified unique New York City residents with diabetes and geocoded their location using home addresses. Geospatial analysis was performed to estimate diabetes prevalence by New York City Census tract. We also used multivariable regression to identify neighborhood-level factors associated with higher diabetes prevalence. We estimated type 1 and type 2 diabetes prevalence at 0.23% and 10.5%, respectively, among adults and 0.20% and 0.11%, respectively, among children in New York City. Pediatric type 1 diabetes was associated with higher income (P = 0.001), whereas adult type 2 diabetes was associated with lower income (P < 0.001). Areas with a higher proportion of nearby restaurants categorized as fast food had a higher prevalence of all types of diabetes (P < 0.001) except for pediatric type 2 diabetes. Type 2 diabetes among children was only higher in neighborhoods with higher proportions of African American residents (P < 0.001). Our findings identify geographic disparities in diabetes prevalence that may require special attention to address the specific needs of adults and children living in these areas. Our results suggest that the food environment may be associated with higher type 1 diabetes prevalence. However, our analysis did not find a robust association with the food environment and pediatric type 2 diabetes, which was predominantly focused in African American neighborhoods. PMID:29719877

Modeling substance use in emerging adult gay, bisexual, and other YMSM across time: The P18 cohort study

PubMed Central

Halkitis, Perry N.; Siconolfi, Daniel E.; Stults, Christopher B.; Barton, Staci; Bub, Kristen; Kapadia, Farzana

2014-01-01

Objective To examine patterns of substance use over time in a new generation of emerging adult gay, bisexual, and other young men who have sex with men (YMSM). Methods Data were drawn from the first four waves of on ongoing prospective cohort study of YMSM who were ages 18 to19 at baseline and were assessed each 6 months for substance use via calendar based methods. Latent growth curve modeling was utilized to assess changes over time for four drug use categories: alcohol, marijuana, inhalant nitrates, and other drugs (e.g., cocaine, ecstasy) and between groups (race/ethnicity, perceived familial socioeconomic status; SES). Results Use of all substances increased steadily across the follow-up period. White YMSM demonstrated higher levels of alcohol use at the 18-mo follow-up visit compared to other racial/ethnic groups, while rates of change across groups were similar. Marijuana use at 18 months was highest for Hispanics who also indicated the highest rate of change. Finally, YMSM who reported higher perceived SES reported the lowest use and lowest rates of change for other drug use. Controlling for perceived SES, differences in patterns of drug use by race/ethnicity were evident but differences were not as large. Conclusions Increases in substance use in the emerging adulthood of YMSM indicate the need for structural and behavioral interventions tailored to address substance use in these young men before chronic patterns of use develop. Differences in patterns of drug use across racial/ethnic and SES groups suggest that interventions need to consider person-level differences. PMID:25456332

Modeling substance use in emerging adult gay, bisexual, and other YMSM across time: the P18 cohort study.

PubMed

Halkitis, Perry N; Siconolfi, Daniel E; Stults, Christopher B; Barton, Staci; Bub, Kristen; Kapadia, Farzana

2014-12-01

To examine patterns of substance use over time in a new generation of emerging adult gay, bisexual, and other young men who have sex with men (YMSM). Data were drawn from the first four waves of on ongoing prospective cohort study of YMSM who were ages 18 to 19 at baseline and were assessed each 6 months for substance use via calendar based methods. Latent growth curve modeling was utilized to assess changes over time for four drug use categories: alcohol, marijuana, inhalant nitrates, and other drugs (e.g., cocaine, ecstasy) and between groups (race/ethnicity, perceived familial socioeconomic status; SES). Use of all substances increased steadily across the follow-up period. White YMSM demonstrated higher levels of alcohol use at the 18-mo follow-up visit compared to other racial/ethnic groups, while rates of change across groups were similar. Marijuana use at 18 months was highest for Hispanics who also indicated the highest rate of change. Finally, YMSM who reported higher perceived SES reported the lowest use and lowest rates of change for other drug use. Controlling for perceived SES, differences in patterns of drug use by race/ethnicity were evident but differences were not as large. Increases in substance use in the emerging adulthood of YMSM indicate the need for structural and behavioral interventions tailored to address substance use in these young men before chronic patterns of use develop. Differences in patterns of drug use across racial/ethnic and SES groups suggest that interventions need to consider person-level differences. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

The influence of pornography on sexual scripts and hooking up among emerging adults in college.

PubMed

Braithwaite, Scott R; Coulson, Gwen; Keddington, Krista; Fincham, Frank D

2015-01-01

The explosive growth in access to the Internet has led to a commensurate increase in the availability, anonymity, and affordability of pornography. An emerging body of research has shown associations between pornography and certain behaviors and attitudes; yet, how pornography actually influences these outcomes has not been documented. In two studies (Study 1 N = 969; Study 2 N = 992) we examined the hypothesis that pornography influences potentially risky sexual behavior (hooking up) among emerging adults via sexual scripts. Our results demonstrate that more frequent viewing of pornography is associated with a higher incidence of hooking up and a higher number of unique hook up partners. We replicated these effects both cross-sectionally and longitudinally while accounting for the stability of hook ups over the course of an academic semester. We also demonstrated that more frequent viewing of pornography is associated with having had more previous sexual partners of all types, more one occasion sexual partners ("one night stands"), and plans to have a higher number of sexual partners in the future. Finally, we provided evidence that more permissive sexual scripts mediated the association between more frequent pornography viewing and hooking up. We discuss these findings with an eye toward mitigating potential personal and public health risks among emerging adults.

Affective Norms for Italian Words in Older Adults: Age Differences in Ratings of Valence, Arousal and Dominance

PubMed Central

Fairfield, Beth; Ambrosini, Ettore; Mammarella, Nicola; Montefinese, Maria

2017-01-01

In line with the dimensional theory of emotional space, we developed affective norms for words rated in terms of valence, arousal and dominance in a group of older adults to complete the adaptation of the Affective Norms for English Words (ANEW) for Italian and to aid research on aging. Here, as in the original Italian ANEW database, participants evaluated valence, arousal, and dominance by means of the Self-Assessment Manikin (SAM) in a paper-and-pencil procedure. We observed high split-half reliabilities within the older sample and high correlations with the affective ratings of previous research, especially for valence, suggesting that there is large agreement among older adults within and across-languages. More importantly, we found high correlations between younger and older adults, showing that our data are generalizable across different ages. However, despite this across-ages accord, we obtained age-related differences on three affective dimensions for a great number of words. In particular, older adults rated as more arousing and more unpleasant a number of words that younger adults rated as moderately unpleasant and arousing in our previous affective norms. Moreover, older participants rated negative stimuli as more arousing and positive stimuli as less arousing than younger participants, thus leading to a less-curved distribution of ratings in the valence by arousal space. We also found more extreme ratings for older adults for the relationship between dominance and arousal: older adults gave lower dominance and higher arousal ratings for words rated by younger adults with middle dominance and arousal values. Together, these results suggest that our affective norms are reliable and can be confidently used to select words matched for the affective dimensions of valence, arousal and dominance across younger and older participants for future research in aging. PMID:28046070

Emergency Department Visits Involving Nonmedical Use of Central Nervous System Stimulants among Adults Aged 18 to 34 ...

MedlinePlus

... Emergency Department Visits Involving Nonmedical Use of Central Nervous System Stimulants among Adults Aged 18 to 34 Increased between 2005 and 2011 Central nervous system (CNS) stimulants include prescription drugs, like those used ...

Being Close and Being Social: Peer Ratings of Distinct Aspects of Young Adult Social Competence

PubMed Central

Larson, Justine J.; Whitton, Sarah W.; Hauser, Stuart T.; Allen, Joseph P.

2012-01-01

The present study had three main objectives: (1) to develop and validate scales of young adult social competence in two domains, close relationships and social groups, using peer ratings of California Q-sort (Block, 1974; Kremen & Block, 2002) items; (2) to test the hypothesis that social competence is associated with young adult well-being and ego development; (3) to test the hypothesis that close relationship competence aligns more closely than social group competence with young adult functioning. Psychometric data on peer ratings of social competence are presented. For 133 young adults, peer ratings of social competence were correlated in expected directions with indices of functioning (e.g., self-worth, education, psychological distress, criminal behavior, and ego development). Associations were generally stronger for competence in close relationships than in social groups. PMID:17764391

Non-Traumatic Dental Condition-Related Emergency Department Visits and Associated Costs for Children and Adults with Autism Spectrum Disorders

PubMed Central

Nakao, Sy; Scott, JoAnna M.; Masterson, Erin E.; Chi, Donald L.

2014-01-01

We analyzed 2010 U.S. National Emergency Department Sample data and ran regression models to test the hypotheses that individuals with ASD are more likely to have non-traumatic dental condition (NTDC)-related emergency department (ED) visits and to incur greater costs for these visits than those without ASD. There were nearly 2.3 million NTDC-related ED visits in 2010. Less than 1.0% (children) and 2.1% (adults) of all ED visits were for NTDC. There was no significant difference in NTDC-related ED visits or costs for children by ASD status. Adults with ASD had significantly lower odds of NTDC-related ED visits (OR=0.39; 95% CI: 0.29, 0.52; P<0.001) but incurred significantly greater mean costs for NTDC-related ED visits (P<0.006) than did adults without ASD. PMID:25374135

Adult survival and population growth rate in Colorado big brown bats (Eptesicus fuscus)

USGS Publications Warehouse

O'Shea, T.J.; Ellison, L.E.; Stanley, T.R.

2011-01-01

We studied adult survival and population growth at multiple maternity colonies of big brown bats (Eptesicus fuscus) in Fort Collins, Colorado. We investigated hypotheses about survival using information-theoretic methods and mark-recapture analyses based on passive detection of adult females tagged with passive integrated transponders. We constructed a 3-stage life-history matrix model to estimate population growth rate (??) and assessed the relative importance of adult survival and other life-history parameters to population growth through elasticity and sensitivity analysis. Annual adult survival at 5 maternity colonies monitored from 2001 to 2005 was estimated at 0.79 (95% confidence interval [95% CI] = 0.77-0.82). Adult survival varied by year and roost, with low survival during an extreme drought year, a finding with negative implications for bat populations because of the likelihood of increasing drought in western North America due to global climate change. Adult survival during winter was higher than in summer, and mean life expectancies calculated from survival estimates were lower than maximum longevity records. We modeled adult survival with recruitment parameter estimates from the same population. The study population was growing (?? = 1.096; 95% CI = 1.057-1.135). Adult survival was the most important demographic parameter for population growth. Growth clearly had the highest elasticity to adult survival, followed by juvenile survival and adult fecundity (approximately equivalent in rank). Elasticity was lowest for fecundity of yearlings. The relative importances of the various life-history parameters for population growth rate are similar to those of large mammals. ?? 2011 American Society of Mammalogists.

Deprivation index and dependency ratio are key determinants of emergency medical admission rates.

PubMed

Conway, Richard; Byrne, Declan; O'Riordan, Deirdre; Cournane, Seán; Coveney, Seamus; Silke, Bernard

2015-11-01

Patients from deprived backgrounds have a higher in-patient mortality following an emergency medical admission; there has been debate as to the extent to which deprivation and population structure influences hospital admission rate. All emergency medical admissions to an Irish hospital over a 12-year period (2002-2013) categorized by quintile of Deprivation Index and Dependency Ratio (proportion of population <15 or ≥ 65 years) from small area population statistics (SAPS), were evaluated against hospital admission rates. Univariate and multivariable risk estimates (Odds Ratios (OR) or Incidence Rate Ratios (IRR)) were calculated, using logistic or zero truncated Poisson regression as appropriate. 66,861 admissions in 36,214 patients occured during the study period. The Deprivation Index quintile independently predicted the admission rate/1000 population, Q1 9.4 (95%CI 9.2 to 9.7), Q2 16.8 (95%CI 16.6 to 17.0), Q3 33.8 (95%CI 33.5 to 34.1), Q4 29.6 (95%CI 29.3 to 29.8) and Q5 45.4 (95%CI 44.5 to 46.2). Similarly the population Dependency Ratio was an independent predictor of the admission rate with adjusted predicted rates of Q1 20.8 (95%CI 20.5 to 21.1), Q2 19.2 (95%CI 19.0 to 19.4), Q3 27.6 (95%CI 27.3 to 27.9), Q4 43.9 (95%CI 43.5 to 44.4) and Q5 34.4 (95%CI 34.1 to 34.7). A high concurrent Deprivation Index and Dependency Ratio were associated with very high admission rates. Deprivation Index and population Dependency Ratio are key determinants of the rate of emergency medical admissions. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Community-Level Characteristics Associated With Variation in Rates of Homelessness Among Families and Single Adults

PubMed Central

Fargo, Jamison D.; Munley, Ellen A.; Byrne, Thomas H.; Montgomery, Ann Elizabeth; Culhane, Dennis P.

2013-01-01

Objectives. We modeled rates of family and single-adult homelessness in the United States in metropolitan and nonmetropolitan regions and as a function of community-level demographic, behavioral, health, economic, and safety net characteristics. Methods. We entered community-level characteristics and US Department of Housing and Urban Development point-in-time counts for a single night in January 2009 into separate mixed-effects statistical analyses that modeled homelessness rates for 4 subpopulations: families and single adults in metropolitan and nonmetropolitan regions. Results. Community-level factors accounted for 25% to 50% of the variance in homelessness rates across models. In metropolitan regions, alcohol consumption, social support, and several economic indicators were uniquely associated with family homelessness, and drug use and homicide were uniquely associated with single-adult homelessness. In nonmetropolitan regions, life expectancy, religious adherence, unemployment, and rent burden were uniquely associated with family homelessness, and health care access, crime, several economic indicators, and receipt of Supplemental Security Income were uniquely associated with single-adult homelessness. Conclusions. Considering homeless families and single adults separately enabled more precise modeling of associations between homelessness rates and community-level characteristics, indicating targets for interventions to reduce homelessness among these subpopulations. PMID:24148057

Community-level characteristics associated with variation in rates of homelessness among families and single adults.

PubMed

Fargo, Jamison D; Munley, Ellen A; Byrne, Thomas H; Montgomery, Ann Elizabeth; Culhane, Dennis P

2013-12-01

We modeled rates of family and single-adult homelessness in the United States in metropolitan and nonmetropolitan regions and as a function of community-level demographic, behavioral, health, economic, and safety net characteristics. We entered community-level characteristics and US Department of Housing and Urban Development point-in-time counts for a single night in January 2009 into separate mixed-effects statistical analyses that modeled homelessness rates for 4 subpopulations: families and single adults in metropolitan and nonmetropolitan regions. Community-level factors accounted for 25% to 50% of the variance in homelessness rates across models. In metropolitan regions, alcohol consumption, social support, and several economic indicators were uniquely associated with family homelessness, and drug use and homicide were uniquely associated with single-adult homelessness. In nonmetropolitan regions, life expectancy, religious adherence, unemployment, and rent burden were uniquely associated with family homelessness, and health care access, crime, several economic indicators, and receipt of Supplemental Security Income were uniquely associated with single-adult homelessness. Considering homeless families and single adults separately enabled more precise modeling of associations between homelessness rates and community-level characteristics, indicating targets for interventions to reduce homelessness among these subpopulations.

Emergency intraosseous access in a helicopter emergency medical service: a retrospective study.

PubMed

Sunde, Geir A; Heradstveit, Bård E; Vikenes, Bjarne H; Heltne, Jon K

2010-10-07

Intraosseous access (IO) is a method for providing vascular access in out-of-hospital resuscitation of critically ill and injured patients when traditional intravenous access is difficult or impossible. Different intraosseous techniques have been used by our Helicopter Emergency Medical Services (HEMS) since 2003. Few articles document IO use by HEMS physicians. The aim of this study was to evaluate the use of intraosseous access in pre-hospital emergency situations handled by our HEMS. We reviewed all medical records from the period May 2003 to April 2010, and compared three different techniques: Bone Injection Gun (B.I.G® - Waismed), manual bone marrow aspiration needle (Inter V - Medical Device Technologies) and EZ-IO® (Vidacare), used on both adults and paediatric patients. During this seven-year period, 78 insertion attempts were made on 70 patients. Overall success rates were 50% using the manual needle, 55% using the Bone Injection Gun, and 96% using the EZ-IO®. Rates of success on first attempt were significantly higher using the EZ-IO® compared to the manual needle/Bone Injection Gun (p < 0.01/p < 0.001). Fifteen failures were due to insertion-related problems (19.2%), with four technical problems (5.1%) and three extravasations (3.8%) being the most frequent causes. Intraosseous access was primarily used in connection with 53 patients in cardiac arrest (75.7%), including traumatic arrest, drowning and SIDS. Other diagnoses were seven patients with multi-trauma (10.0%), five with seizures/epilepsy (7.1%), three with respiratory failure (4.3%) and two others (2.9%). Nearly one third of all insertions (n = 22) were made in patients younger than two years. No cases of osteomyelitis or other serious complications were documented on the follow-up. Newer intraosseous techniques may enable faster and more reliable vascular access, and this can lower the threshold for intraosseous access on both adult and paediatric patients in critical situations. We believe

Emergency intraosseous access in a helicopter emergency medical service: a retrospective study

PubMed Central

2010-01-01

Background Intraosseous access (IO) is a method for providing vascular access in out-of-hospital resuscitation of critically ill and injured patients when traditional intravenous access is difficult or impossible. Different intraosseous techniques have been used by our Helicopter Emergency Medical Services (HEMS) since 2003. Few articles document IO use by HEMS physicians. The aim of this study was to evaluate the use of intraosseous access in pre-hospital emergency situations handled by our HEMS. Methods We reviewed all medical records from the period May 2003 to April 2010, and compared three different techniques: Bone Injection Gun (B.I.G® - Waismed), manual bone marrow aspiration needle (Inter V - Medical Device Technologies) and EZ-IO® (Vidacare), used on both adults and paediatric patients. Results During this seven-year period, 78 insertion attempts were made on 70 patients. Overall success rates were 50% using the manual needle, 55% using the Bone Injection Gun, and 96% using the EZ-IO®. Rates of success on first attempt were significantly higher using the EZ-IO® compared to the manual needle/Bone Injection Gun (p < 0.01/p < 0.001). Fifteen failures were due to insertion-related problems (19.2%), with four technical problems (5.1%) and three extravasations (3.8%) being the most frequent causes. Intraosseous access was primarily used in connection with 53 patients in cardiac arrest (75.7%), including traumatic arrest, drowning and SIDS. Other diagnoses were seven patients with multi-trauma (10.0%), five with seizures/epilepsy (7.1%), three with respiratory failure (4.3%) and two others (2.9%). Nearly one third of all insertions (n = 22) were made in patients younger than two years. No cases of osteomyelitis or other serious complications were documented on the follow-up. Conclusions Newer intraosseous techniques may enable faster and more reliable vascular access, and this can lower the threshold for intraosseous access on both adult and paediatric

Gender Differences in the Self-Defining Activities and Identity Experiences of Adolescents and Emerging Adults

ERIC Educational Resources Information Center

Sharp, Erin Hiley; Coatsworth, J. Douglas; Darling, Nancy; Cumsille, Patricio; Ranieri, Sonia

2007-01-01

Activity participation provides a unique context for adolescents and emerging adults to explore interests, talents, and skills and for identity work to occur. Research has found consistent gender differences in the types of activities in which males and females participate. The current study drew on Eudaimonistic identity theory to examine the…

Rates and risk factors associated with hospitalization for pneumonia with ICU admission among adults.

PubMed

Storms, Aaron D; Chen, Jufu; Jackson, Lisa A; Nordin, James D; Naleway, Allison L; Glanz, Jason M; Jacobsen, Steven J; Weintraub, Eric S; Klein, Nicola P; Gargiullo, Paul M; Fry, Alicia M

2017-12-16

Pneumonia poses a significant burden to the U.S. health-care system. However, there are few data focusing on severe pneumonia, particularly cases of pneumonia associated with specialized care in intensive care units (ICU). We used administrative and electronic medical record data from six integrated health care systems to estimate rates of pneumonia hospitalizations with ICU admissions among adults during 2006 through 2010. Pneumonia hospitalization was defined as either a primary discharge diagnosis of pneumonia or a primary discharge diagnosis of sepsis or respiratory failure with a secondary diagnosis of pneumonia in administrative data. ICU admissions were collected from internal electronic medical records from each system. Comorbidities were identified by ICD-9-CM codes coded during the current pneumonia hospitalization, as well as during medical visits that occurred during the year prior to the date of admission. We identified 119,537 adult hospitalizations meeting our definition for pneumonia. Approximately 19% of adult pneumonia hospitalizations had an ICU admission. The rate of pneumonia hospitalizations requiring ICU admission during the study period was 76 per 100,000 population/year; rates increased for each age-group with the highest rates among adults aged ≥85 years. Having a co-morbidity approximately doubled the risk of ICU admission in all age-groups. Our study indicates a significant burden of pneumonia hospitalizations with an ICU admission among adults in our cohort during 2006 through 2010, especially older age-groups and persons with underlying medical conditions. These findings reinforce current strategies aimed to prevent pneumonia among adults.

Annual survival rates of adult and immature eastern population tundra swans

USGS Publications Warehouse

Nichols, J.D.; Bart, J.; Limpert, R.J.; Sladen, William J. L.; Hines, J.E.

1992-01-01

Tundra swans (Cygnus columbianus ) of the eastern population were neckbanded in Maryland, North Carolina, and Alaska from 1966 through 1990. These swans were resighted and recaptured during autumn, winter, and spring, 1966-1990. Although the original motivation for this study involved swan movements, we wanted to use the resulting data to test hypotheses about sources of variation in swan survival rates. Recaptures of legbanded and neckbanded swans permitted us to estimate neckband loss rates, which were found to vary with age and sex of swans, and number of years since initial application. Estimates of annual neckband retention rate ranged from about 0.50 for adult male swans greater than or equal to 2 years after initial neckbanding to > 0.96 for immature swans and adult females the first year following neckbanding. This variation in neckband loss rates prevented the simple correction of survival estimates to account for such loss. Consequently, we developed a series of multinomial models parameterized with survival, sighting, and neckband retention probabilities for use with the recapture and resighting data.

Emerging Adulthood: Age-Related Tasks and Underlying Self Processes

ERIC Educational Resources Information Center

Shulman, Shmuel; Feldman, Benni; Blatt, Sidney; Cohen, Omri; Mahler, Amalya

2005-01-01

Seventy-two Israeli emerging adults were interviewed for descriptions of themselves and accounts of their personal, social, and professional dreams, current life status, romantic relationships, and relationships with their parents. Interviews were transcribed and rated on scales assessing self-processes, attainment of professional and romantic…

Effect of Various Sugary Beverages on Salivary pH, Flow Rate, and Oral Clearance Rate amongst Adults.

PubMed

Hans, Rinki; Thomas, Susan; Garla, Bharat; Dagli, Rushabh J; Hans, Manoj Kumar

2016-01-01

Introduction. Diet is a major aetiological factor for dental caries and enamel erosion. This study was undertaken with the aim of assessing the effect of selected locally available beverages on salivary pH, flow rate, and oral clearance rate amongst adults. Materials and Method. This clinical trial comprised 120 subjects. Test beverages undertaken were pepsi, fruit drink, coffee, and sweetened milk. Statistical analysis was carried out using SPSS version 17. Descriptive statistics, one-way ANOVA, and post hoc Tukey's test were applied in the statistical tests. Results. It was found that salivary pH decreased for all the beverages immediately after consumption and the salivary flow rate increased after their consumption. The oral clearance rate of sweetened milk was found to be the least at 6.5 minutes and that of pepsi was found to be 13 minutes. However, the oral clearance rates of fruit drink and coffee were found to be equal at 15 minutes. Conclusion. Although it was found out that liquids cleared rapidly from the oral cavity, they had a significant cariogenic and erosive potential. Hence, it is always advised to minimise the consumption of beverages, especially amongst children and young adults to maintain a good oral health.

Effect of Various Sugary Beverages on Salivary pH, Flow Rate, and Oral Clearance Rate amongst Adults

PubMed Central

Hans, Rinki; Thomas, Susan; Garla, Bharat; Dagli, Rushabh J.

2016-01-01

Introduction. Diet is a major aetiological factor for dental caries and enamel erosion. This study was undertaken with the aim of assessing the effect of selected locally available beverages on salivary pH, flow rate, and oral clearance rate amongst adults. Materials and Method. This clinical trial comprised 120 subjects. Test beverages undertaken were pepsi, fruit drink, coffee, and sweetened milk. Statistical analysis was carried out using SPSS version 17. Descriptive statistics, one-way ANOVA, and post hoc Tukey's test were applied in the statistical tests. Results. It was found that salivary pH decreased for all the beverages immediately after consumption and the salivary flow rate increased after their consumption. The oral clearance rate of sweetened milk was found to be the least at 6.5 minutes and that of pepsi was found to be 13 minutes. However, the oral clearance rates of fruit drink and coffee were found to be equal at 15 minutes. Conclusion. Although it was found out that liquids cleared rapidly from the oral cavity, they had a significant cariogenic and erosive potential. Hence, it is always advised to minimise the consumption of beverages, especially amongst children and young adults to maintain a good oral health. PMID:27051556

A Six-Year Predictive Test of Adolescent Family Relationship Quality and Effortful Control Pathways to Emerging Adult Social and Emotional Health

PubMed Central

Fosco, Gregory M.; Caruthers, Allison S.; Dishion, Thomas J.

2012-01-01

This longitudinal study examined how a multimethod (youth report, parent report, direct observation) assessment of family relationship quality (cohesion and conflict) in adolescence (age 16 –17) predicted growth and maintenance of effortful control across ages 17, 22, and 23 years old, and, ultimately, subjective well-being, emotional distress, and aggressive behavior in emerging adulthood (23). A diverse sample of 792 youth at age 17 and their families, and youth at ages 22 and 23, were studied to examine family cohesion and conflict and the growth and maintenance of effortful control as predictors of emerging adult social and emotional health. Results indicated that family cohesion and conflict during late adolescence and mean-level effortful control at age 22 each served as unique pathways to emerging adult adjustment. These findings underscore the importance of family functioning during adolescence and the maintenance of effortful control into emerging adulthood for understanding adjustment during the emerging adulthood period. PMID:22709261

Factors Associated With Emergency Department Visits: A Multistate Analysis of Adult Fee-for-Service Medicaid Beneficiaries.

PubMed

Agarwal, Parul; Bias, Thomas K; Madhavan, Suresh; Sambamoorthi, Nethra; Frisbee, Stephanie; Sambamoorthi, Usha

2016-04-27

The objective of this study was to examine the association of patient- and county-level factors with the emergency department (ED) visits among adult fee-for-service (FFS) Medicaid beneficiaries residing in Maryland, Ohio, and West Virginia. A cross-sectional design using retrospective observational data was implemented. Patient-level data were obtained from 2010 Medicaid Analytic eXtract files. Information on county-level health-care resources was obtained from the Area Health Resource file and County Health Rankings file. In adjusted analyses, the following patient-level factors were associated with higher number of ED visits: African Americans (incidence rate ratios [IRR] = 1.47), Hispanics (IRR = 1.63), polypharmacy (IRR = 1.89), and tobacco use (IRR = 2.23). Patients with complex chronic illness had a higher number of ED visits (IRR = 3.33). The county-level factors associated with ED visits were unemployment rate (IRR = 0.94) and number of urgent care clinics (IRR = 0.96). Patients with complex healthcare needs had a higher number of ED visits as compared to those without complex healthcare needs. The study results provide important baseline context for future policy analysis studies around Medicaid expansion options.

Associations between online friendship and Internet addiction among adolescents and emerging adults.

PubMed

Smahel, David; Brown, B Bradford; Blinka, Lukas

2012-03-01

The past decades have witnessed a dramatic increase in the number of youths using the Internet, especially for communicating with peers. Online activity can widen and strengthen the social networks of adolescents and emerging adults (Subrahmanyam & Smahel, 2011), but it also increases the risk of Internet addiction. Using a framework derived from Griffiths (2000a), this study examined associations between online friendship and Internet addiction in a representative sample (n = 394) of Czech youths ages 12-26 years (M = 18.58). Three different approaches to friendship were identified: exclusively offline, face-to-face oriented, Internet oriented, on the basis of the relative percentages of online and offline associates in participants' friendship networks. The rate of Internet addiction did not differ by age or gender but was associated with communication styles, hours spent online, and friendship approaches. The study revealed that effects between Internet addiction and approaches to friendship may be reciprocal: Being oriented toward having more online friends, preferring online communication, and spending more time online were related to increased risk of Internet addiction; on the other hand, there is an alternative causal explanation that Internet addiction and preference for online communication conditions young people's tendency to seek friendship from people met online. PsycINFO Database Record (c) 2012 APA, all rights reserved.

Efficacy of a new spot-on formulation of selamectin plus sarolaner for cats against adult Ctenocephalides felis, flea egg production and adult flea emergence.

PubMed

Vatta, Adriano F; Everett, William R; Holzmer, Susan J; Cherni, Judith A; King, Vickie L; Rugg, Douglas; Geurden, Thomas

2017-04-01

A new spot-on formulation of selamectin plus sarolaner was evaluated against fleas for adulticidal efficacy, and for the effect on egg production and hatching when applied to flea-infested cats. Ten male and ten female adult domestic shorthair cats were randomly assigned to one of two treatment groups based on pre-treatment flea counts. Cats received topical treatment on Day 0 in a single spot to the dorsal scapular area with either a placebo formulation or with the combination formulation at the minimal dose of 6.0mg selamectin plus 1.0mg sarolaner per kg bodyweight. On Days -1, 5, 12, 19, 26 and 33, cats were infested with approximately 100 (±5) unfed Ctenocephalides felis fleas. At 24h after treatment or 48h after subsequent flea infestation, cats were housed for a 20-h period in a cage to allow collection of flea eggs. At the end of this period, flea eggs were collected from the cages and cats were combed to remove and count live fleas. Emerged viable larvae and emerged adult fleas were counted 3days and 35days, respectively, after egg collection. The new spot-on formulation of selamectin plus sarolaner provided 100% efficacy against adult fleas up to Day 36 following a single application. Fleas on placebo-treated cats produced large numbers of eggs throughout the study, with individual counts ranging from 110 to 1256 eggs. Following treatment, four flea eggs were collected from a single selamectin/sarolaner-treated cat on Day 29, but there were no eggs collected from any other selamectin/sarolaner-treated animal during the study. No larvae or adult fleas developed from these four eggs. From the eggs collected from the placebo-treated cats, the mean percentage of live larvae and adults that emerged ranged from 67.3% to 84.2% and from 50.7% to 81.8%, respectively. A single topical treatment with a new spot-on formulation of selamectin plus sarolaner at the minimum label dose thus controlled fleas on cats and was 100% effective in preventing flea reproduction

Developmental and ethnic issues experienced by emerging adult African American women related to developing a mature love relationship.

PubMed

Tyson, Sheryl Y

2012-01-01

This qualitative study explored perspectives of emerging adult African American women on the development of mature love relationships. Inductive analysis of focus group interviews, conducted with a purposive sample of 31 African American women, yielded themes related to relationship goals and characteristics, and interpersonal and societal challenges to finding the right partner and developing a mature love relationship. Core categories that emerged from analysis of the discussions were (1) age and relationship goal differences within the emerging adult group, (2) mature love relationship goals and characteristics, (3) interpersonal obstacles to finding the right partner, and (4) societal obstacles to finding the right partner. Two approaches-black womanist/feminist thought (Collins, 2000 ; Walker, 1983 ) and relationship maturity theory (Paul & White, 1990 )-were then combined to explain the influence of historic and contemporary interpersonal and societal factors on developmental and ethnic issues that challenge positive gender identity formation, hasten intimacy maturity, and hinder the development of mature love relationships among emerging adult African American women. For these women, premature responsibility, especially early caregiver burden, was related to the early development of intimacy capacity and the desire for a mature love relationship, to be protected, and to have someone to help carry the load. Interracial dating, negative stereotypic images of African American women, and even positive images of enduring black love relationships posed difficult challenges to positive identity formation and intimacy maturity. A primary challenge was to counteract negative stereotypic images, so that they could develop their own self-identities as women and as relationship partners.

The Effect of an Extended Wilderness Education Experience on Ill-Structured Problem-Solving Skill Development in Emerging Adult Students

ERIC Educational Resources Information Center

Collins, Rachel H.

2014-01-01

In a society that is becoming more dynamic, complex, and diverse, the ability to solve ill-structured problems has become an increasingly critical skill. Emerging adults are at a critical life stage that is an ideal time to develop the skills needed to solve ill-structured problems (ISPs) as they are transitioning to adult roles and starting to…

Racial discrimination as race-based trauma, coping strategies and dissociative symptoms among emerging adults

PubMed Central

Polanco-Roman, Lillian; Danies, Ashley; Anglin, Deidre M.

2016-01-01

Objective The race-based traumatic stress theory (Carter, 2007) suggests that some racial and ethnic minority individuals may experience racial discrimination as a psychological trauma, as it may elicit a response comparable to posttraumatic stress. The present study examined this further by determining the relation between racial discrimination and dissociation, a common response to trauma exposure. Further, we examined whether active coping strategies specifically employed to cope with racial discrimination related to less dissociative symptomatology. Methods The predominant racial and ethnic minority sample (N=743) of emerging adults (i.e., ages 18-29) recruited from a public university in Northeastern U.S. completed a battery of self-report measures on racial discrimination, responses to racial discrimination, traumatic life events and dissociative symptoms. Results Frequency of racial discrimination was positively associated with dissociative symptoms in regression analyses adjusted for demographics and other traumatic life events. Additionally, more active coping strategies in response to racial discrimination were negatively associated with dissociative symptoms. Conclusion Racial and ethnic minority emerging adults who experience racial discrimination, possibly as traumatic, may be more vulnerable to dissociative symptoms. However, different strategies of coping with racial discrimination may differentially impact risk for dissociation. PMID:26963957

Ventilation rate in adults with a tracheal tube during cardiopulmonary resuscitation: A systematic review.

PubMed

Vissers, Gino; Soar, Jasmeet; Monsieurs, Koenraad G

2017-10-01

The optimal ventilation rate during cardiopulmonary resuscitation (CPR) with a tracheal tube is unknown. We evaluated whether in adults with cardiac arrest and a secure airway (tracheal tube), a ventilation rate of 10min -1 , compared to any other rate during CPR, improves outcomes. A systematic review up to 14 July 2016. We included both adult human and animal studies. A GRADE (Grades of Recommendation, Assessment, Development and Evaluation) approach was used to evaluate the quality of evidence for each outcome. We identified one human observational study with 67 patients and ten animal studies (234 pigs and 30 dogs). All studies carried a high risk of bias. All studies evaluated for return of spontaneous circulation (ROSC). Studies showed no improvement in ROSC with a ventilation rate of 10 min-1 compared to any other rate. The evidence for longer-term outcomes such as survival to discharge and survival with favourable neurological outcome was very limited. A ventilation rate recommendation of 10 min-1 during adult CPR with a tracheal tube and no pauses for chest compression is a very weak recommendation based on very low quality evidence. Copyright © 2017 Elsevier B.V. All rights reserved.

Does Executive Functioning (EF) Predict Depression in Clinic-Referred Adults?: EF Tests vs. Rating Scales

PubMed Central

Knouse, Laura E.; Barkley, Russell A.; Murphy, Kevin R.

2012-01-01

Background Deficits in executive functioning (EF) are implicated in neurobiological and cognitive-processing theories of depression. EF deficits are also associated with Attention-deficit/hyperactivity disorder (ADHD) in adults, who are also at increased risk for depressive disorders. Given debate about the ecological validity of laboratory measures of EF, we investigated the relationship between depression diagnoses and symptoms and EF as measured by both rating scales and tests in a sample of adults referred for evaluation of adult ADHD. Method Data from two groups of adults recruited from an ADHD specialty clinic were analyzed together: Adults diagnosed with ADHD (N=146) and a clinical control group of adults referred for adult ADHD assessment but not diagnosed with the disorder ADHD (N=97). EF was assessed using a rating scale of EF deficits in daily life and a battery of tests tapping various EF constructs. Depression was assessed using current and lifetime SCID diagnoses (major depression, dysthymia) and self-report symptom ratings. Results EF as assessed via rating scale predicted depression across measures even when controlling for current anxiety and impairment. Self-Management to Time and Self-Organization and Problem-Solving showed the most robust relationships. EF tests were weakly and inconsistently related to depression measures. Limitations Prospective studies are needed to rigorously evaluate EF problems as true risk factors for depressive onset. Conclusions EF problems in everyday life were important predictors of depression. Researchers and clinicians should consistently assess for the ADHD-depression comorbidity. Clinicians should consider incorporating strategies to address EF deficits when treating people with depression. PMID:22858220

Exploring how nurses assess, monitor and manage acute pain for adult critically ill patients in the emergency department: protocol for a mixed methods study.

PubMed

Varndell, Wayne; Fry, Margaret; Elliott, Doug

2017-08-01

Many critically ill patients experience moderate to severe acute pain that is frequently undetected and/or undertreated. Acute pain in this patient cohort not only derives from their injury and/or illness, but also as a consequence of delivering care whilst stabilising the patient. Emergency nurses are increasingly responsible for the safety and wellbeing of critically ill patients, which includes assessing, monitoring and managing acute pain. How emergency nurses manage acute pain in critically ill adult patients is unknown. The objective of this study is to explore how emergency nurses manage acute pain in critically ill patients in the Emergency Department. In this paper, we provide a detailed description of the methods and protocol for a multiphase sequential mixed methods study, exploring how emergency nurses assess, monitor and manage acute pain in critically ill adult patients. The objective, method, data collection and analysis of each phase are explained. Justification of each method and data integration is described. Synthesis of findings will generate a comprehensive picture of how emergency nurses' perceive and manage acute pain in critically ill adult patients. The results of this study will form a knowledge base to expand theory and inform research and practice.

Are Older Adults Prepared to Ensure Food Safety during Extended Power Outages and Other Emergencies?: Findings from a National Survey

ERIC Educational Resources Information Center

Kosa, Katherine M.; Cates, Sheryl C.; Karns, Shawn; Godwin, Sandria L.; Coppings, Richard J.

2012-01-01

Natural disasters and other emergencies can cause an increased risk of foodborne illness. We conducted a nationally representative survey to understand consumers' knowledge and use of recommended practices during/after extended power outages and other emergencies. Because older adults are at an increased risk for foodborne illness, this paper…

Influence of social deprivation, overcrowding and family structure on emergency medical admission rates.

PubMed

Conway, R; Byrne, D; O'Riordan, D; Cournane, S; Coveney, S; Silke, B

2016-10-01

Patients from deprived backgrounds have a higher in-patient mortality following emergency medical admission. To evaluate the influence of Deprivation Index, overcrowding and family structure on hospital admission rates. Retrospective cohort study. All emergency medical admissions from 2002 to 2013 were evaluated. Based on address, each patient was allocated to an electoral division, whose small area population statistics were available from census data. Patients were categorized by quintile of Deprivation Index, overcrowding and family structure, and these were evaluated against hospital admission rate, calculated as rate/1000 population. Univariate and multivariable risk estimates (Odds Ratios or Incidence Rate Ratios) were calculated, using logistic or zero truncated Poisson regression as appropriate. There were 66 861 admissions in 36 214 patients over the 12-year study period. Deprivation Index quintile independently predicted the admission rate, with rates of Q1 12.0 (95% CI 11.8-12.2), Q2 19.5 (95% CI 19.3-19.6), Q3 33.7 (95% CI 33.3-34.0), Q4 31.4 (95% CI 31.2-31.6) and Q5 38.1 (95% CI 37.7-38.5). Similarly the proportions of families with children <15 years old, was an independent predictor of the admission rate with rates of Q1 20.8 (95% CI 20.4-21.1), Q2 23.0 (95% CI 22.7-23.3), Q3 32.2 (95% CI 31.9-32.5), Q4 32.4 (95% CI 32.2-32.7) and Q5 37.2 (95% CI 36.6-37.8). The proportion of families with children ≥15-years old was also predictive but quintile of overcrowding was only predictive in the univarate model. Deprivation Index and family structure strongly predict emergency medical hospital admission rates. © The Author 2016. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Health literacy and self-rated health in adults primary care patients.

PubMed

Marques, Suzana Raquel Lopes; Escarce, Andrezza Gonzalez; Lemos, Stela Maris Aguiar

2018-01-01

Purpose To verify the association between health literacy, social determinants and self-rated health in adult's primary health care patients. Methods this is an Observational cross-sectional study in which a total of 380 patients of the Unified Health System in the context of primary health care were interviewed. The sample was probabilistic, stratified by gender, age, and Basic Health Unit. Health literacy was evaluated by an instrument of analysis of the perception of adults about the understanding of health orientations and possible difficulties in this process (Health Literacy Scale). Descriptive and association analyses were performed (Pearson's chi-square test, p≤0.05). Results It was verified that the majority of the interviewees belongs to classes C1 and C2 and attended high school (complete or incomplete). Regarding self-rated health, to be considered healthy and with good health were the predominant perceptions. In the Health Literacy Scale, it was verified that most patients reported never presenting difficulties in the situations of this instrument, except understanding written orientations. It was observed the association with a statistical significance of the better perception of health literacy with higher educational level and economic classification, as well as with self-rated of good health. Conclusion There was a statistical association between health literacy, social determinants, and self-rated health in the analyzed adults. It is noteworthy the contribution of the Health Literacy Scale for emphasizing the perception of difficulties in everyday health situations. It is necessary to develop dialogic relationships that build more robust communication processes between professionals and healthcare patients to favor health literacy skills.

Discriminant of validity the Wender Utah rating scale in Iranian adults.

PubMed

Farokhzadi, Farideh; Mohammadi, Mohammad Reza; Salmanian, Maryam

2014-01-01

The aim of this study is the normalization of the Wender Utah rating scale which is used to detect adults with Attention-Deficit and Hyperactivity Disorder (ADHD). Available sampling method was used to choose 400 parents of children (200 parents of children with ADHD as compared to 200 parents of normal children). Wender Utah rating scale, which has been designed to diagnose ADHD in adults, is filled out by each of the parents to most accurately diagnose of ADHD in parents. Wender Utah rating scale was divided into 6 sub scales which consist of dysthymia, oppositional defiant disorder; school work problems, conduct disorder, anxiety, and ADHD were analyzed with exploratory factor analysis method. The value of (Kaiser-Meyer-Olkin) KMO was 86.5% for dysthymia, 86.9% for oppositional defiant disorder, 77.5% for school related problems, 90.9% for conduct disorder, 79.6% for anxiety and 93.5% for Attention deficit/hyperactivity disorder, also the chi square value based on Bartlett's Test was 2242.947 for dysthymia, 2239.112 for oppositional defiant disorder, 1221.917 for school work problems, 5031.511 for conduct, 1421.1 for anxiety, and 7644.122 for ADHD. Since mentioned values were larger than the chi square critical values (P<0.05), it found that the factor correlation matrix is appropriate for factor analysis. Based on the findings, we can conclude that Wender Utah rating scale can be appropriately used for predicting dysthymia, oppositional defiant disorder, school work problems, conduct disorder, anxiety, in adults with ADHD.

Unintentional fall injuries associated with walkers and canes in older adults treated in U.S. emergency departments.

PubMed

Stevens, Judy A; Thomas, Karen; Teh, Leesia; Greenspan, Arlene I

2009-08-01

To characterize nonfatal, unintentional, fall-related injuries associated with walkers and canes in older adults. Surveillance data of injuries treated in hospital emergency departments (EDs), January 1, 2001, to December 31, 2006. The National Electronic Injury Surveillance System All Injury Program, which collects data from a nationally representative stratified probability sample of 66 U.S. hospital EDs. People aged 65 and older treated in EDs for 3,932 nonfatal unintentional fall injuries and whose records indicated that a cane or a walker was involved in the fall. Sex, age, whether the fall involved a cane or walker, primary diagnosis, part of the body injured, disposition, and location and circumstances of the fall. An estimated 47,312 older adult fall injuries associated with walking aids were treated annually in U.S. EDs: 87.3% with walkers, 12.3% with canes, and 0.4% with both. Walkers were associated with seven times as many injuries as canes. Women's injury rates exceeded those for men (rate ratios=2.6 for walkers, 1.4 for canes.) The most prevalent injuries were fractures and contusions or abrasions. Approximately one-third of subjects were hospitalized for their injuries. Injuries and hospital admissions for falls associated with walking aids were frequent in this highly vulnerable population. The results suggest that more research is needed to improve the design of walking aids. More information also is needed about the circumstances preceding falls, both to better understand the contributing fall risk factors and to develop specific and effective fall prevention strategies.

How Private Is the Relation with God? Religiosity and Family Religious Socialization in Romanian Emerging Adults

ERIC Educational Resources Information Center

Negru, Oana; Haragâs, Cosmina; Mustea, Anca

2014-01-01

This qualitative study explores the dynamics of religious cognitions, behaviors, and emotions in emerging adult discourse in a sample of Romanian youth of heterogeneous socioeconomic, denominational (Orthodox Christian, Roman Catholic, Neo-protestant), and educational background. Also, from a parent-child dyad perspective, we investigate the role…

Emerging Adults with Type 1 Diabetes during the First Year Post-High School: Perceptions of Parental Behaviors

PubMed Central

Hanna, Kathleen M.; Weaver, Michael T.; Stump, Timothy E.; Guthrie, Diana; Oruche, Ukamaka M.

2014-01-01

Among 182 emerging adults with type 1 diabetes (93% White and 57% female), changes during the year post-high school were examined in perceptions of diabetes-specific conflict with parents, parent-youth shared responsibility, parental tangible aid, and parental autonomy support, as well as the moderating effects of living situation, gender, years with diabetes, and glycemic control. A linear mixed effects model, controlling for baseline values, tested the changes in and relationships among these variables over time. Changes over time in parent-youth conflict were moderated by living independently of parents; autonomy support and shared responsibility were moderated by years with diabetes; and tangible aid was moderated by glycemic control. Future longitudinal research needs to examine whether changes in parental behaviors lead to positive or negative diabetes outcomes among these emerging adults with diabetes. PMID:25019036

Health care resource utilization in adults with congenital heart disease.

PubMed

Mackie, Andrew S; Pilote, Louise; Ionescu-Ittu, Raluca; Rahme, Elham; Marelli, Ariane J

2007-03-15

The number of adults with congenital heart disease (CHD) is increasing. However, rates of health care resource utilization in this population are unknown. The objectives of this study were to describe the use of general health care resources in adults with CHD and to examine the impact of CHD severity on resource utilization. The study consisted of adults alive in 1996 who had > or = 1 diagnosis of a CHD lesion conforming to the International Classification of Disease, Ninth Revision, in the physician's claims database of the province of Quebec from 1983 to 2000. From 1996 to 2000, rates of health care utilization were measured. The impact of the severity of CHD on the use of health care resources was determined using multivariate models to adjust for age, gender, Charlson co-morbidity score, and duration of follow-up. The study population consisted of 22,096 adults with CHD (42% men). From 1996 to 2000, 87% received outpatient care from specialists, 68% visited emergency rooms, 51% were hospitalized, and 16% were admitted to critical care units. Patients with severe CHD had higher adjusted rates of outpatient cardiologist care (rate ratio [RR] 2.24, 95% confidence interval [CI] 2.06 to 2.45), emergency department utilization (RR 1.09, 95% CI 1.03 to 1.17), hospitalization (RR 1.30, 95% CI 1.19 to 1.43), and days in critical care (RR 2.12, 95% CI 1.80 to 2.50) than patients with other congenital cardiac lesions. Hospitalization rates were higher than in the general Quebec adult population (RR 2.08, 95% CI 2.00 to 2.17). In conclusion, adults with CHD have high rates of health care resource utilization, particularly those with severe lesions. Appropriate resource allocation is required to serve this growing population.

The Detroit Young Adult Asthma Project: Pilot of a Technology-Based Medication Adherence Intervention for African-American Emerging Adults.

PubMed

Kolmodin MacDonell, Karen; Naar, Sylvie; Gibson-Scipio, Wanda; Lam, Phebe; Secord, Elizabeth

2016-10-01

To conduct a randomized controlled pilot of a multicomponent, technology-based intervention promoting adherence to controller medication in African-American emerging adults with asthma. The intervention consisted of two computer-delivered sessions based on motivational interviewing combined with text messaged reminders between sessions. Participants (N = 49) were 18-29 years old, African-American, with persistent asthma requiring controller medication. Participants had to report poor medication adherence and asthma control. Youth were randomized to receive the intervention or an attention control. Data were collected through computer-delivered self-report questionnaires at baseline, 1, and 3 months. Ecological Momentary Assessment via two-way text messaging was also used to collect "real-time" data on medication use and asthma control. The intervention was feasible and acceptable to the target population, as evidenced by high retention rates and satisfaction scores. Changes in study outcomes from pre- to postintervention favored the intervention, particularly for decrease in asthma symptoms, t (42) = 2.22, p < .05 (Cohen's d = .071). Results suggest that the intervention is feasible and effective. However, findings are preliminary and should be replicated with a larger sample and more sophisticated data analyses. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Characteristics and determinants of adult patients with acute poisoning attending the accident and emergency department of a teaching hospital in Qatar.

PubMed

Khudair, I F; Jassim, Z; Hanssens, Y; Alsaad, W A

2013-09-01

Data about etiologic and demographic characteristics of acute poisoning in adults in Qatar are lacking. This prospective observational study was undertaken to analyze characteristics and possible determinants of acute poisoning in adults in Qatar. During 2010, 18,073 patients attended the emergency department of Hamad General Hospital, a teaching hospital in Qatar. Out of them, 599 (3.3%) patients were diagnosed as "poisoning case" with either chemical or pharmaceutical substances. The prevalence rate of poisoning incidence was 35.3/100,000 population. Seven patients died, corresponding with a case-fatality rate of 0.39/1000. The majority were male (65%) and the mean age was 34 years. The poisons involved were mainly chemicals (61.6%) and pharmaceuticals (38.4%). Female, mainly single, suffered more intentional poisoning compared to male. Of the patients aged 60 years and above (7.2%), the majority (95.3%) suffered unintentional poisoning with pharmaceuticals; 56% with warfarin, 12% with digoxin and 7% with insulin. Multivariate analysis shows that female gender, single status, younger than 35 years of age, being poisoned by pharmaceutical products, and the need for hospitalization are significant determinants for acute intentional poisoning after adjusting all other possible covariates. The findings of this study can be used to establish awareness and prophylactic campaigns in Qatar.

A Randomized Controlled Trial of Koru: A Mindfulness Program for College Students and Other Emerging Adults

ERIC Educational Resources Information Center

Greeson, Jeffrey M.; Juberg, Michael K.; Maytan, Margaret; James, Kiera; Rogers, Holly

2014-01-01

Objective: To evaluate the effectiveness of Koru, a mindfulness training program for college students and other emerging adults. Participants: Ninety students (66% female, 62% white, 71% graduate students) participated between Fall 2012 and Spring 2013. Methods: Randomized controlled trial. It was hypothesized that Koru, compared with a wait-list…

Generation Validation: The Role of Social Comparison in Use of Instagram Among Emerging Adults.

PubMed

Stapleton, Peta; Luiz, Gabriella; Chatwin, Hannah

2017-03-01

Social networking sites (SNSs) provide emerging adults with extreme and unprecedented transparency, exposing them to a plethora of opportunities for social comparison. In light of the growing use of the popular SNS, Instagram, among emerging adults, the purpose of this study was to examine the impact of exposure to social media-based social comparison information on self-esteem. The study recruited 237 participants through social media. The sample was narrowed to young adults aged 18-29 years. The study used a correlational nonexperimental approach to investigate two mediation models proposed in the literature. First, the study investigated the mediating role of social comparison on Instagram in the relationship between intensity of Instagram use and self-esteem. Second, the study examined the mediating role of social comparison in the relationship between self-worth contingent on approval from others and self-esteem. Although the first model was found to be nonsignificant, results observed a significant indirect pathway that confirmed the second model. Thus, social comparison on Instagram mediated the relationship between contingent self-worth and self-esteem. Furthermore, moderation analyses found that self-worth contingent on approval from others moderated the relationship between intensity of Instagram use and social comparison on Instagram. Thus, although Instagram did not directly affect self-esteem, the significant moderation suggested that intensity of Instagram use is influential when the young person's self-worth is contingent on approval from others. Overall, the findings are consistent with previous research and enhance our understanding of the mechanisms that link SNS use to low self-esteem.

Caste-fate determination primarily occurs after adult emergence in a primitively eusocial paper wasp: significance of the photoperiod during the adult stage

NASA Astrophysics Data System (ADS)

Yoshimura, Hideto; Yamada, Yoshihiro Y.

2018-02-01

Independent-founding paper wasps constitute a major group of primitively eusocial insects, and when caste-fate determination occurs in temperate species of these wasps, particularly regarding whether it occurs before or after emergence, remains unclear. No critical morphological differences occur between potential queens of the next generation (often called gynes) and workers in primitively eusocial insects. The gynes of temperate species are characterized by diapausing, and the nutrients available during the larval stage have often been believed to determine caste fate. Short days usually induce diapause in temperate nonsocial insects, although few investigations of the effects of day length on caste-fate determination in paper wasps have been conducted. By exposing individuals to different combinations of short and long days during the immature and adult stages, we show for the first time that short days during the adult stage (but not during the immature stage) facilitated caste-fate determination toward gynes in a paper wasp. Moreover, the decision to diapause partly depended on changes in the photoperiod during the pupal and adult stages. The size of the adult also affected caste-fate determination, with diapause more likely to occur in large adults, but this size effect did not occur when individuals were exposed to many short days during the pupal stage. In addition, all adults except for a small proportion of smaller individuals prepared for diapause under short days. These findings suggest that the photoperiod is a higher priority cue than adult size.

Speed discrimination predicts word but not pseudo-word reading rate in adults and children

PubMed Central

Main, Keith L.; Pestilli, Franco; Mezer, Aviv; Yeatman, Jason; Martin, Ryan; Phipps, Stephanie; Wandell, Brian

2014-01-01

Word familiarity may affect magnocellular processes of word recognition. To explore this idea, we measured reading rate, speed-discrimination, and contrast detection thresholds in adults and children with a wide range of reading abilities. We found that speed-discrimination thresholds are higher in children than in adults and are correlated with age. Speed discrimination thresholds are also correlated with reading rate, but only for words, not for pseudo-words. Conversely, we found no correlation between contrast sensitivity and reading rate and no correlation between speed discrimination thresholds WASI subtest scores. These findings support the position that reading rate is influenced by magnocellular circuitry attuned to the recognition of familiar word-forms. PMID:25278418

California emergency department visit rates for medical conditions increased while visit rates for injuries fell, 2005-11.

PubMed

Hsia, Renee Y; Nath, Julia B; Baker, Laurence C

2015-04-01

The emergency department (ED) is the source of most hospital admissions; provides care for patients with no other point of access to the health care system; receives advanced care referrals from primary care physicians; and provides surveillance data on injuries, infectious diseases, violence, and adverse drug events. Understanding the changes in the profile of disease in the ED can inform emergency services administration and planning and can provide insight into the public's health. We analyzed the trends in the diagnoses seen in California EDs from 2005 to 2011, finding that while the ED visit rate for injuries decreased by 0.7 percent, the rate of ED visits for noninjury diagnoses rose 13.4 percent. We also found a rise in symptom-related diagnoses, such as abdominal pain, along with nervous system disorders, gastrointestinal disease, and mental illness. These trends point out the increasing importance of EDs in providing care for complex medical cases, as well as the changing nature of illness in the population needing immediate medical attention. Project HOPE—The People-to-People Health Foundation, Inc.

Reducing High-Users' Visits to the Emergency Department by a Primary Care Intervention for the Uninsured: A Retrospective Study.

PubMed

Tsai, Meng-Han; Xirasagar, Sudha; Carroll, Scott; Bryan, Charles S; Gallagher, Pamela J; Davis, Kim; Jauch, Edward C

2018-01-01

Reducing avoidable emergency department (ED) visits is an important health system goal. This is a retrospective cohort study of the impact of a primary care intervention including an in-hospital, free, adult clinic for poor uninsured patients on ED visit rates and emergency severity at a nonprofit hospital. We studied adult ED visits during August 16, 2009-August 15, 2011 (preintervention) and August 16, 2011-August 15, 2014 (postintervention). We compared pre- versus post-mean annual visit rates and discharge emergency severity index (ESI; triage and resource use-based, calculated Agency for Healthcare Research and Quality categories) among high-users (≥3 ED visits in 12 months) and occasional users. Annual adult ED visit volumes were 16 372 preintervention (47.5% by high-users), versus 18 496 postintervention. High-users' mean annual visit rates were 5.43 (top quartile) and 0.94 (bottom quartile) preintervention, versus 3.21 and 1.11, respectively, for returning high-users, postintervention (all P < .001). Postintervention, the visit rates of new high-users were lower (lowest and top quartile rates, 0.6 and 3.23) than preintervention high-users' rates in the preintervention period. Visit rates of the top quartile of occasional users also declined. Subgroup analysis of medically uninsured high-users showed similar results. Upon classifying preintervention high-users by emergency severity, postintervention mean ESI increased 24.5% among the lowest ESI quartile, and decreased 12.2% among the top quartile. Pre- and post-intervention sample demographics and comorbidities were similar. The observed reductions in overall ED visit rates, particularly low-severity visits; highest reductions observed among high-users and the top quartile of occasional users; and the pattern of changes in emergency severity support a positive impact of the primary care intervention.

Reducing High-Users’ Visits to the Emergency Department by a Primary Care Intervention for the Uninsured: A Retrospective Study

PubMed Central

Tsai, Meng-Han; Xirasagar, Sudha; Carroll, Scott; Bryan, Charles S.; Gallagher, Pamela J.; Davis, Kim; Jauch, Edward C.

2018-01-01

Reducing avoidable emergency department (ED) visits is an important health system goal. This is a retrospective cohort study of the impact of a primary care intervention including an in-hospital, free, adult clinic for poor uninsured patients on ED visit rates and emergency severity at a nonprofit hospital. We studied adult ED visits during August 16, 2009-August 15, 2011 (preintervention) and August 16, 2011-August 15, 2014 (postintervention). We compared pre- versus post-mean annual visit rates and discharge emergency severity index (ESI; triage and resource use–based, calculated Agency for Healthcare Research and Quality categories) among high-users (≥3 ED visits in 12 months) and occasional users. Annual adult ED visit volumes were 16 372 preintervention (47.5% by high-users), versus 18 496 postintervention. High-users’ mean annual visit rates were 5.43 (top quartile) and 0.94 (bottom quartile) preintervention, versus 3.21 and 1.11, respectively, for returning high-users, postintervention (all P < .001). Postintervention, the visit rates of new high-users were lower (lowest and top quartile rates, 0.6 and 3.23) than preintervention high-users’ rates in the preintervention period. Visit rates of the top quartile of occasional users also declined. Subgroup analysis of medically uninsured high-users showed similar results. Upon classifying preintervention high-users by emergency severity, postintervention mean ESI increased 24.5% among the lowest ESI quartile, and decreased 12.2% among the top quartile. Pre- and post-intervention sample demographics and comorbidities were similar. The observed reductions in overall ED visit rates, particularly low-severity visits; highest reductions observed among high-users and the top quartile of occasional users; and the pattern of changes in emergency severity support a positive impact of the primary care intervention. PMID:29591539

SELF-RATED EXPECTATIONS OF SUICIDAL BEHAVIOR PREDICT FUTURE SUICIDE ATTEMPTS AMONG ADOLESCENT AND YOUNG ADULT PSYCHIATRIC EMERGENCY PATIENTS.

PubMed

Czyz, Ewa K; Horwitz, Adam G; King, Cheryl A

2016-06-01

This study's purpose was to examine the predictive validity and clinical utility of a brief measure assessing youths' own expectations of their future risk of suicidal behavior, administered in a psychiatric emergency (PE) department; and determine if youths' ratings improve upon a clinician-administered assessment of suicidal ideation severity. The outcome was suicide attempts up to 18 months later. In this medical record review study, 340 consecutively presenting youths (ages 13-24) seeking PE services over a 7-month period were included. Subsequent PE visits and suicide attempts were retrospectively tracked for up to 18 months. The 3-item scale assessing patients' perception of their own suicidal behavior risk and the clinician-administered ideation severity scale were used routinely at the study site. Cox regression results showed that youths' expectations of suicidal behavior were independently associated with increased risk of suicide attempts, even after adjusting for key covariates. Results were not moderated by sex, suicide attempt history, or age. Receiver-operating characteristic (ROC) analyses indicated that self-assessed expectations of risk improved the predictive accuracy of the clinician-administered suicidal ideation measure. Youths' ratings indicative of lower confidence in maintaining safety uniquely predicted follow-up attempts and provided incremental validity over and above the clinician-administered assessment and improved its accuracy, suggesting their potential for augmenting suicide risk formulation. Assessing youths' own perceptions of suicide risk appears to be clinically useful, feasible to implement in PE settings, and, if replicated, promising for improving identification of youth at risk for suicidal behavior. © 2016 Wiley Periodicals, Inc.

Characteristics of Emergency Department Visits by Older Versus Younger Homeless Adults in the United States

PubMed Central

Steinman, Michael A.

2013-01-01

Objectives. We compared the characteristics of emergency department (ED) visits of older versus younger homeless adults. Methods. We analyzed 2005–2009 data from the National Hospital Ambulatory Medical Care Survey, a nationally representative survey of visits to hospitals and EDs, and used sampling weights, strata, and clustering variables to obtain nationally representative estimates. Results. The ED visits of homeless adults aged 50 years and older accounted for 36% of annual visits by homeless patients. Although demographic characteristics of ED visits were similar in older and younger homeless adults, clinical and health services characteristics differed. Older homeless adults had fewer discharge diagnoses related to psychiatric conditions (10% vs 20%; P = .002) and drug abuse (7% vs 15%; P = .003) but more diagnoses related to alcohol abuse (31% vs 23%; P = .03) and were more likely to arrive by ambulance (48% vs 36%; P = .02) and to be admitted to the hospital (20% vs 11%; P = .003). Conclusions. Older homeless adults’ patterns of ED care differ from those of younger homeless adults. Health care systems need to account for these differences to meet the needs of the aging homeless population. PMID:23597348

Falls efficacy, postural balance, and risk for falls in older adults with falls-related emergency department visits: prospective cohort study.

PubMed

Pua, Yong-Hao; Ong, Peck-Hoon; Clark, Ross Allan; Matcher, David B; Lim, Edwin Choon-Wyn

2017-12-21

Risk for falls in older adults has been associated with falls efficacy (self-perceived confidence in performing daily physical activities) and postural balance, but available evidence is limited and mixed. We examined the interaction between falls efficacy and postural balance and its association with future falls. We also investigated the association between falls efficacy and gait decline. Falls efficacy, measured by the Modified Falls Efficacy Scale (MFES), and standing postural balance, measured using computerized posturography on a balance board, were obtained from 247 older adults with a falls-related emergency department visit. Six-month prospective fall rate and habitual gait speed at 6 months post baseline assessment were also measured. In multivariable proportional odds analyses adjusted for potential confounders, falls efficacy modified the association between postural balance and fall risk (interaction P = 0.014): increasing falls efficacy accentuated the increased fall risk related to poor postural balance. Low baseline falls efficacy was strongly predictive of worse gait speed (0.11 m/s [0.06 to 0.16] slower gait speed per IQR decrease in MFES; P < 0.001). Older adults with high falls efficacy but poor postural balance were at greater risk for falls than those with low falls efficacy; however, low baseline falls efficacy was strongly associated with worse gait function at follow-up. Further research into these subgroups of older adults is warranted. ClinicalTrials.gov identifier: NCT01713543 .

Impact of the roll out of comprehensive emergency obstetric care on institutional birth rate in rural Nepal.

PubMed

Maru, Sheela; Bangura, Alex Harsha; Mehta, Pooja; Bista, Deepak; Borgatta, Lynn; Pande, Sami; Citrin, David; Khanal, Sumesh; Banstola, Amrit; Maru, Duncan

2017-03-04

Increasing institutional births rates and improving access to comprehensive emergency obstetric care are central strategies for reducing maternal and neonatal deaths globally. While some studies show women consider service availability when determining where to deliver, the dynamics of how and why institutional birth rates change as comprehensive emergency obstetric care availability increases are unclear. In this pre-post intervention study, we surveyed two exhaustive samples of postpartum women before and after comprehensive emergency obstetric care implementation at a hospital in rural Nepal. We developed a logistic regression model of institutional birth factors through manual backward selection of all significant covariates within and across periods. Qualitatively, we analyzed birth stories through immersion crystallization. Institutional birth rates increased after comprehensive emergency obstetric care implementation (from 30 to 77%, OR 7.7) at both hospital (OR 2.5) and low-level facilities (OR 4.6, p < 0.01 for all). The logistic regression indicated that comprehensive emergency obstetric care availability (OR 5.6), belief that the hospital is the safest birth location (OR 44.8), safety prioritization in decision-making (OR 7.7), and higher income (OR 1.1) predict institutional birth (p ≤ 0.01 for all). Qualitative analysis revealed comprehensive emergency obstetric care awareness, increased social expectation for institutional birth, and birth planning as important factors. Comprehensive emergency obstetric care expansion appears to have generated significant demand for institutional births through increased safety perceptions and birth planning. Increasing comprehensive emergency obstetric care availability increases birth safety, but it may also be a mechanism for increasing the institutional birth rate in areas of under-utilization.

Pattern of non-trauma emergency department resource utilization in older adults: An 8-year experience in Taiwan.

PubMed

Chang, Julia Chia-Yu; Yuan, Zih-Han; Lee, I-Hsin; Hsu, Teh-Fu; How, Chorng-Kuang; Yen, David Hung-Tsang

2018-06-01

To describe the patterns of non-trauma emergency department (ED) resource utilization, cost of visit, acuity level, and admission rate in older adult patients in Taiwan. This is a retrospective observational cohort study conducted at the Taipei Veterans General Hospital with an annual ED population of 80,000 patients. Patients aged ≥20 years with non-trauma ED visits from 2005 to 2012 were included in the study. We analyzed 441,665 ED visits. Older adult patients had higher ED usage, with the ratio of their ED visit and population being 3.56, 8.34, and 7.64 in the age groups 70-79, 80-89, and ≥90 years, respectively. ED cost, acuity level, and risks of intensive care unit (ICU) admission increased with increasing age. Compared with patients aged 20-29 years, patients aged ≥90 years required almost twice as much ED resources per visit [adjusted risk ratio (aRR), 1.98]. aRRs for high acuity in the age groups 70-79, 80-89, and ≥90 years were 1.96, 1.87, and 1.91, respectively. The risk of ICU admission in the age groups 40-49, 50-59, 70-79, and ≥90 years also increased by 3-fold (aRR, 2.99), 4-fold (aRR, 4.09), >6-fold (aRR, 6.66), and almost 10-fold (aRR, 9.84), respectively, compared with that in the age group 20-29 years. Among patients aged ≥90 years, 2.9% with low acuity still required ICU admission, whereas 25.1% with high acuity required ICU admission. Our study shows that older adult patients are associated with more ED visits and higher acuity, higher ED costs, and higher risks of admission to both the ordinary ward and ICU than younger adult patients. Copyright © 2018. Published by Elsevier Taiwan LLC.

Effect of temperature on the standard metabolic rates of juvenile and adult Exopalaemon carinicauda

NASA Astrophysics Data System (ADS)

Zhang, Chengsong; Li, Fuhua; Xiang, Jianhai

2015-03-01

Ridgetail white prawn ( Exopalaemon carinicauda) are of significant economic importance in China where they are widely cultured. However, there is little information on the basic biology of this species. We evaluated the effect of temperature (16, 19, 22, 25, 28, 31, and 34°C) on the standard metabolic rates (SMRs) of juvenile and adult E. carinicauda in the laboratory under static conditions. The oxygen consumption rate (OCR), ammonia-N excretion rate (AER), and atomic ratio of oxygen consumed to nitrogen consumed (O:N ratio) of juvenile and adult E. carinicauda were significantly influenced by temperature ( P < 0.05). Both the OCR and AER of juveniles increased significantly with increasing temperature from 16 to 34°C, but the maximum OCR for adults was at 31°C. Juvenile shrimp exhibited a higher OCR than the adults from 19 to 34°C. There was no significant difference between the AERs of the two life-stages from 16 to 31°C ( P >0.05). The O:N ratio in juveniles was significantly higher than that in the adults over the entire temperature range ( P <0.05). The temperature coefficient ( Q 10) of OCR and AER ranged from 5.03 to 0.86 and 6.30 to 0.85 for the adults, respectively, and from 6.09-1.03 and 3.66-1.80 for the juveniles, respectively. The optimal temperature range for growth of the juvenile and adult shrimp was from 28 to 31°C, based on Q 10 and SMR values. Results from the present study may be used to guide pond culture production of E. carinicauda.

Exploration of Dating Violence and Related Attitudes Among Adolescents and Emerging Adults.

PubMed

Courtain, Audrey; Glowacz, Fabienne

2018-04-01

Young people's romantic relationships can be marked with various forms of dating violence (DV). However, adolescents and emerging adults do not necessarily acknowledge this violence because of their attitudes toward dating violence. Our study aims to study dating violence and attitudes toward this phenomenon through two well-established questionnaires administered jointly in their entirety. Indeed, too many studies report results on some dimensions and items, neglecting the richness of available tools. The Conflict in Adolescent Dating Relationship Inventory and the Attitudes Toward Dating Violence Scale were self-administered to 1,014 participants ( M age = 18.9) attending secondary schools or a regional college. They reported the frequency of their dating violence perpetration and victimization, and their attitudes toward dating violence. Results show that relational and sexual violence perpetration rates are higher for males, physical violence perpetration rate is higher for females, and relational violence victimization is higher for males. MANCOVAs not only show the same trends for scores but also underline more frequent emotional violence perpetrated by females, physical victimization for males, and sexual victimization for females. Males show higher tolerance toward every form of dating violence; younger participants are also more tolerant. Participants are more tolerant toward male-perpetrated psychological DV than female-perpetrated ones, and more tolerant toward female-perpetrated physical and sexual DV compared with male-perpetrated physical and sexual DV. There are patterns of multiperpetration, multivictimization, bidirectionality, and multi(in)tolerance. Our paper contributes to the symmetry debate, a better understanding of the link between attitudes and violent behaviors, a further step on gendered attitudes regarding who perpetrates and who sustains.

Exploring Relationships among Strengths Use, Spirituality, Religion and Positive Mental Health of College-Attending Emerging Adults

ERIC Educational Resources Information Center

Rankin, Wendy M.

2015-01-01

This exploratory study examined the relationships among strengths use, spirituality, religion, and positive mental health of 109 traditional undergraduate, college-attending emerging adults in a public university in the southern region of the United States, often referred to as the Bible-Belt. Constructs of the study were guided by a student…

Mental Health Literacy in Emerging Adults in a University Setting: Distinctions between Symptom Awareness and Appraisal

ERIC Educational Resources Information Center

Gagnon, Michelle M.; Gelinas, Bethany L.; Friesen, Lindsay N.

2017-01-01

Despite the high prevalence of mental health concerns in university populations, students are unlikely to seek formal help. The current study examined help-seeking behaviors among emerging adults in a university setting using a mental health literacy framework. Responses from 122 university undergraduates were examined. Students ranged in age from…

Admission rates and costs associated with emergency presentation of urolithiasis: analysis of the Nationwide Emergency Department Sample 2006-2009.

PubMed

Eaton, Samuel H; Cashy, John; Pearl, Jeffrey A; Stein, Daniel M; Perry, Kent; Nadler, Robert B

2013-12-01

We sought to examine a large nationwide (United States) sample of emergency department (ED) visits to determine data related to utilization and costs of care for urolithiasis in this setting. Nationwide Emergency Department Sample was analyzed from 2006 to 2009. All patients presenting to the ED with a diagnosis of upper tract urolithiasis were analyzed. Admission rates and total cost were compared by region, hospital type, and payer type. Numbers are weighted estimates that are designed to approximate the total national rate. An average of 1.2 million patients per year were identified with the diagnosis of urolithiasis out of 120 million visits to the ED annually. Overall average rate of admission was 19.21%. Admission rates were highest in the Northeast (24.88%), among teaching hospitals (22.27%), and among Medicare patients (42.04%). The lowest admission rates were noted for self-pay patients (9.76%) and nonmetropolitan hospitals (13.49%). The smallest increases in costs over time were noted in the Northeast. Total costs were least in nonmetropolitan hospitals; however, more patients were transferred to other hospitals. When assessing hospital ownership status, private for-profit hospitals had similar admission rates compared with private not-for-profit hospitals (16.6% vs 15.9%); however, costs were 64% and 48% higher for ED and inpatient admission costs, respectively. Presentation of urolithiasis to the ED is common, and is associated with significant costs to the medical system, which are increasing over time. Costs and rates of admission differ by region, payer type, and hospital type, which may allow us to identify the causes for cost discrepancies and areas to improve efficiency of care delivery.

The Effect of Childhood Supervisory Neglect on Emerging Adults’ Drinking

PubMed Central

Snyder, Susan M.; Merritt, Darcey H.

2016-01-01

This study investigated the effect of childhood supervisory neglect on emerging adults’ drinking. Child supervisory neglect is the most common form of child maltreatment in the United States, but few studies explore supervisory neglect separate from other forms of maltreatment among emerging adults, 18–25 years old. The study sample included (n = 11,117) emerging adults, 18–25 years old who participated in Waves I and III of the National Longitudinal Study of Adolescent Health (Add Health). We conducted separate analyses for male and female emerging adults, because they have different rates of alcohol consumption and alcohol risk behaviors. Our study used latent class analysis to understand how patterns of alcohol risk behaviors clustered together. For males, we found the following four classes: (1) multiple-risk drinkers, (2) moderate-risk drinkers, (3) binge-drinkers, and (4) low-risk drinkers or abstainers. For females, we found the following three classes: (1) multiple-risk drinkers, (2) moderate-risk drinkers, and (3) low-risk drinkers or abstainers. For both males and females, supervisory neglect increased the odds of membership in the multiple-risk drinkers’ class compared to the low-risk drinkers or abstainers’ class. Single males who did not live with their parents, and who were white had increased odds of being in the multiple-risk drinkers. For females, being more educated, or in a serious romantic relationship increased the odds of membership in the multiple-risk drinkers’ class. Practitioners should ask about histories of supervisory neglect among emerging adults who engage in alcohol risk behaviors. PMID:26771736

Alcohol use variability in a community-based sample of nonstudent emerging adult heavy drinkers

PubMed Central

Lau-Barraco, Cathy; Braitman, Abby L.; Stamates, Amy L.; Linden-Carmichael, Ashley N.

2017-01-01

Background While nonstudent emerging adults are at elevated risk for experiencing alcohol-related problems, there remains a paucity of research devoted specifically to addressing drinking in this group. Objectives The present study sought to offer unique insights into nonstudent drinking by examining drinking variability across 30 days using a retrospective diary method. Specific aims were to: (1) compare within- and between-person variability in alcohol use across 30 days, and (2) determine the extent to which central social-cognitive between-person factors (i.e., social expectancies, perceived drinking norms, social drinking motivations) predict between-person alcohol use as well as within-person variability in drinking. Methods Participants were 195 (65.1% men) nonstudent emerging adults recruited from the community with a mean age of 21.88 (SD = 2.08) years. Results Findings showed that a substantial portion of variation in daily alcohol consumption was attributable to the within-person (83%) rather than between-person (17.2%) level. Social expectancies, perceived drinking norms, and social motives were found to influence variability in daily alcohol consumption. Conclusion Our findings contribute to knowledge that could guide efforts to design and tailor intervention strategies to minimize the harms experienced by an understudied and at-risk population of drinkers. PMID:27314308

Racial discrimination as race-based trauma, coping strategies, and dissociative symptoms among emerging adults.

PubMed

Polanco-Roman, Lillian; Danies, Ashley; Anglin, Deidre M

2016-09-01

The race-based traumatic stress theory (Carter, 2007) suggests that some racial- and ethnic-minority individuals experience racial discrimination as psychological trauma, as it may elicit a response comparable to posttraumatic stress. In the present study, we examined this further by determining the relation between racial discrimination and dissociation, a common response to trauma exposure. Further, we examined whether active coping strategies specifically employed to cope with racial discrimination related to less dissociative symptomatology. The predominant racial- and ethnic-minority sample (N = 743) of emerging adults, ages 18-29, recruited from a public university in northeastern United States completed a battery of self-report measures on racial discrimination, responses to racial discrimination, traumatic life events, and dissociative symptoms. Frequency of racial discrimination was positively associated with dissociative symptoms in regression analyses adjusted for demographics and other traumatic life events. In addition, more active coping strategies in response to racial discrimination were negatively associated with dissociative symptoms. Racial- and ethnic-minority emerging adults who experience racial discrimination, possibly as traumatic, may be more vulnerable to dissociative symptoms. However, different strategies of coping with racial discrimination may differentially impact risk for dissociation. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Marriage (In)equality: The Perspectives of Adolescents and Emerging Adults with Lesbian, Gay, and Bisexual Parents

ERIC Educational Resources Information Center

Goldberg, Abbie E.; Kuvalanka, Katherine A.

2012-01-01

The debate over whether same-sex couples should be allowed to enter into civil marriages continues in the United States. Forty-nine adolescents and emerging adults (ages 14-29) with lesbian, gay, and bisexual parents were interviewed for the current exploratory study, which examined how individuals perceived themselves and their families as being…

A Structural Equation Modeling Approach to the Study of Stress and Psychological Adjustment in Emerging Adults

ERIC Educational Resources Information Center

Asberg, Kia K.; Bowers, Clint; Renk, Kimberly; McKinney, Cliff

2008-01-01

Today's society puts constant demands on the time and resources of all individuals, with the resulting stress promoting a decline in psychological adjustment. Emerging adults are not exempt from this experience, with an alarming number reporting excessive levels of stress and stress-related problems. As a result, the present study addresses the…

Children's Perception of Interparental Conflict Scale (CPIC): Factor Structure and Invariance across Adolescents and Emerging Adults

ERIC Educational Resources Information Center

Moura, Octavio; dos Santos, Rute Andrade; Rocha, Magda; Matos, Paula Mena

2010-01-01

The Children's Perception of Interparental Conflict Scale (CPIC) is based on the cognitive-contextual framework for understanding interparental conflict. This study investigates the factor validity and the invariance of two factor models of CPIC within a sample of Portuguese adolescents and emerging adults (14 to 25 years old; N = 677). At the…

TU-D-201-07: Severity Indication in High Dose Rate Brachytherapy Emergency Response Procedure

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, K; Rustad, F

Purpose: Understanding the corresponding dose to different staff during the High Dose Rate (HDR) Brachytherapy emergency response procedure could help to develop a strategy in efficiency and effective action. In this study, the variation and risk analysis methodology was developed to simulation the HDR emergency response procedure based on severity indicator. Methods: A GammaMedplus iX HDR unit from Varian Medical System was used for this simulation. The emergency response procedure was decomposed based on risk management methods. Severity indexes were used to identify the impact of a risk occurrence on the step including dose to patient and dose to operationmore » staff by varying the time, HDR source activity, distance from the source to patient and staff and the actions. These actions in 7 steps were to press the interrupt button, press emergency shutoff switch, press emergency button on the afterloader keypad, turn emergency hand-crank, remove applicator from the patient, disconnect transfer tube and move afterloader from the patient, and execute emergency surgical recovery. Results: Given the accumulated time in second at the assumed 7 steps were 15, 5, 30, 15, 180, 120, 1800, and the dose rate of HDR source is 10 Ci, the accumulated dose in cGy to patient at 1cm distance were 188, 250, 625, 813, 3063, 4563 and 27063, and the accumulated exposure in rem to operator at outside the vault, 1m and 10cm distance were 0.0, 0.0, 0.1, 0.1, 22.6, 37.6 and 262.6. The variation was determined by the operators in action at different time and distance from the HDR source. Conclusion: The time and dose were estimated for a HDR unit emergency response procedure. It provided information in making optimal decision during the emergency procedure. Further investigation would be to optimize and standardize the responses for other emergency procedure by time-spatial-dose severity function.« less

Propofol for procedural sedation and analgesia reduced dedicated emergency nursing time while maintaining safety in a community emergency department.

PubMed

Reynolds, Joshua C; Abraham, Michael K; Barrueto, Fermin F; Lemkin, Daniel L; Hirshon, Jon M

2013-09-01

Procedural sedation and analgesia is a core competency in emergency medicine. Propofol is replacing midazolam in many emergency departments. Barriers to performing procedural sedation include resource utilization. We hypothesized that emergency nursing time is shorter with propofol than midazolam, without increasing complications. Retrospective analysis of a procedural sedation registry for two community emergency departments with combined census of 100,000 patients/year. Demographics, procedure, and ASA physical classification status of adult patients receiving procedural sedation between 2007-2010 with midazolam or propofol were analyzed. Primary outcome was dedicated emergency nursing time. Secondary outcomes were procedural success, ED length of stay, and complication rate. Comparative statistics were performed with Mann-Whitney, Kruskal-Wallis, chi-square, or Fisher's exact test. Linear regression was performed with log-transformed procedural sedation time to define predictors. Of 328 procedural sedation and analgesia, 316 met inclusion criteria, of which 60 received midazolam and 256 propofol. Sex distribution varied between groups (midazolam 3% male; propofol 55% male; P = 0.04). Age, procedure, and ASA status were not significantly different. Propofol had shorter procedural sedation time (propofol 32.5 ± 24.2 minutes; midazolam 78.7 ± 51.5 minutes; P < 0.001) and higher rates of procedural success (propofol 98%; midazolam 92%; P = 0.02). There were no significant differences between complication rates (propofol 14%; midazolam 13%; P = 0.88) or emergency department length of stay (propofol 262.5 ± 132.8 minutes; midazolam 288.6 ± 130.6 minutes; P = 0.09). Use of propofol resulted in shorter emergency nursing time and higher procedural success rate than midazolam with a comparable safety profile. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

Age-Related Differences in the Rate, Timing, and Diagnosis of 30-Day Readmissions in Hospitalized Adults With Asthma Exacerbation.

PubMed

Hasegawa, Kohei; Gibo, Koichiro; Tsugawa, Yusuke; Shimada, Yuichi J; Camargo, Carlos A

2016-04-01

Reducing hospital readmissions has attracted attention from many stakeholders. However, the characteristics of 30-day readmissions after asthma-related hospital admissions in adults are not known. It is also unclear whether older adults are at higher risk of 30-day readmission. To investigate the rate, timing, and principal diagnosis of 30-day readmissions in adults with asthma and to determine age-related differences. Retrospective cohort study of adults hospitalized for asthma exacerbation using the population-based inpatient samples of three states (California, Florida, and Nebraska) from 2005 through 2011. Patients were categorized into three age groups: younger (18-39 years), middle aged (40-64 years), and older (≥ 65 years) adults. Outcomes were 30-day all-cause readmission rate, timing, and principal diagnosis of readmission. Of 301,164 asthma-related admissions at risk for 30-day readmission, readmission rate was 14.5%. Compared with younger adults, older adults had significantly higher readmission rates (10.1% vs 16.5%; OR, 2.15 [95% CI, 2.07-2.23]; P < .001). The higher rate attenuated with adjustment (OR, 1.19 [95% CI, 1.13-1.26]; P < .001), indicating that most of the age-related difference is explained by sociodemographics and comorbidities. For all age groups, readmission rate was highest in the first week after discharge and declined thereafter. Overall, only 47.1% of readmissions were assigned respiratory diagnoses (asthma, COPD, pneumonia, and respiratory failure). Older adults were more likely to present with nonrespiratory diagnoses (41.7% vs 53.8%; P < .001). After asthma-related admission, 14.5% of patients had 30-day readmission with wide range of principal diagnoses. Compared with younger adults, older adults had higher 30-day readmission rates and proportions of nonrespiratory diagnoses. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Association between helicopter with physician versus ground emergency medical services and survival of adults with major trauma in Japan

PubMed Central

2014-01-01

Introduction Helicopter emergency medical services with a physician (HEMS) has been provided in Japan since 2001. However, HEMS and its possible effect on outcomes for severe trauma patients have still been debated as helicopter services require expensive and limited resources. Our aim was to analyze the association between the use of helicopters with a physician versus ground services and survival among adults with serious traumatic injuries. Methods This multicenter prospective observational study involved 24,293 patients. All patients were older than 15 years of age, had sustained blunt or penetrating trauma and had an Injury Severity Score (ISS) higher than 15. All of the patient data were recorded between 2004 and 2011 in the Japan Trauma Data Bank, which includes data from 114 major emergency hospitals in Japan. The primary outcome was survival to discharge from hospitals. The intervention was either transport by helicopter with a physician or ground emergency services. Results A total of 2,090 patients in the sample were transported by helicopter, and 22,203 were transported by ground. Overall, 546 patients (26.1%) transported by helicopter died compared to 5,765 patients (26.0%) transported by ground emergency services. Patients transported by helicopter had higher ISSs than those transported by ground. In multivariable logistic regression, helicopter transport had an odds ratio (OR) for survival to discharge of 1.277 (95% confidence interval (CI), 1.049 to 1.556) after adjusting for age, sex, mechanism of injury, type of trauma, initial vital signs (including systolic blood pressure, heart rate and respiratory rate), ISS and prehospital treatment (including intubation, airway protection maneuver and intravenous fluid). In the propensity score–matched cohort, helicopter transport was associated with improved odds of survival compared to ground transport (OR, 1.446; 95% CI, 1.220 to 1.714). In conditional logistic regression, after adjusting for

Avoid falling for a jerk(ette): Effectiveness of the Premarital Interpersonal Choices and Knowledge Program among Emerging Adults.

PubMed

Bradford, Kay; Stewart, J Wade; Pfister, Roxane; Higginbotham, Brian J

2016-10-01

Premarital education may help emerging adults form healthy relationships, but evaluation research is needed, particularly with community samples. We studied emerging adults in the Premarital Interpersonal Choices and Knowledge (PICK) program, using a pre- to post- and a posttest-then-retrospective-pretest design to examine change in perceived relationship skills, partner selection, relational patterns, and relationship behaviors and attitudes. Mixed models analyses showed that scores for the treatment group (n = 682) increased from pre to post on all four outcomes. Changes in scores for the nonequivalent comparison group (n = 462) were nonsignificant. In addition, significant differences between pre- and retrospective prescores demonstrated evidence for response shift bias. The results suggest that the PICK program helps participants increase their knowledge regarding the components of healthy relationship formation. © 2016 American Association for Marriage and Family Therapy.

A Systematic Review of the Use of Buccal Midazolam in the Emergency Treatment of Prolonged Seizures in Adults with Learning Disabilities

ERIC Educational Resources Information Center

Marshall, Thomas

2007-01-01

Background: Buccal midazolam is widely used in children for the emergency treatment of epilepsy, and these children are graduating into adult learning disability services. Aims: The aim of this paper was to appraise the evidence for buccal midazolam as a treatment for prolonged seizures in adults with learning disabilities. Method: A literature…

Mortality Rates After Emergent Posterior Fossa Decompression for Ischemic or Hemorrhagic Stroke in Older Patients.

PubMed

Puffer, Ross C; Graffeo, Christopher; Rabinstein, Alejandro; Van Gompel, Jamie J

2016-08-01

Cerebellar stroke causes major morbidity in the aging population. Guidelines from the American Stroke Association recommend emergent decompression in patients who have brainstem compression, hydrocephalus, or clinical deterioration. The objective of this study was to determine 30-day and 1-year mortality rates in patients >60 years old undergoing emergent posterior fossa decompression. Surgical records identified all patients >60 years old who underwent emergent posterior fossa decompression. Mortality rates were calculated at 30 days and 1 year postoperatively, and these rates were compared with patient and procedure characteristics. During 2000-2014, 34 emergent posterior fossa decompressions were performed in patients >60 years old. Mortality rates at 30 days were 0%, 33%, and 25% for age deciles 60-69 years, 70-79 years, and ≥80 years. Increasing age (alive at 30 days 75.2 years ± 1.7 vs. deceased 81.1 years ± 1.7, P = 0.01) and smaller craniectomy dimensions were associated with 30-day mortality. Mortality rates at 1 year were 0%, 50%, and 67% for age deciles 60-69 years, 70-79 years, and ≥80 years. Increasing age was significantly associated with mortality at 1 year (alive at 1 year 72.3 years ± 2.0 vs. deceased 81.1 years ± 1.2, P < 0.01). Type of pathology, side of pathology, volume of bleed/infarct, and placement of an external ventricular drain were not associated with mortality. Age was independent of admission Glasgow Coma Scale score as a predictor of mortality at 30 days, 90 days, and 1 year postoperatively. Increasing age and smaller craniectomy size were significantly associated with mortality in patients undergoing emergent posterior fossa decompression. Among patients ≥80 years old, one-quarter were dead within 1 month of the operation, and more than two-thirds were dead within 1 year. Copyright © 2016 Elsevier Inc. All rights reserved.

Adult meerkats modify close call rate in the presence of pups.

PubMed

Wyman, Megan T; Rivers, Pearl R; Muller, Coline; Toni, Pauline; Manser, Marta B

2017-06-01

In animals, signaling behavior is often context-dependent, with variation in the probability of emitting certain signals dependent on fitness advantages. Senders may adjust signaling rate depending on receiver identity, presence of audiences, or noise masking the signal, all of which can affect the benefits and costs of signal production. In the cooperative breeding meerkat Suricata suricatta , group members emit soft contact calls, termed as "close calls", while foraging in order to maintain group cohesion. Here, we investigated how the close calling rate during foraging was affected by the presence of pups, that produce continuous, noisy begging calls as they follow older group members. Adults decreased their overall close call rate substantially when pups were foraging with the group in comparison to periods when no pups were present. We suggest this decrease was likely due to a masking effect of the loud begging calls, which makes the close call function of maintaining group cohesion partly redundant as the centrally located begging calls can be used instead to maintain cohesion. There was some support that adults use close calls strategically to attract specific pups based on fitness advantages, that is, as the philopatric sex, females should call more than males and more to female pups than male pups. Dominant females called more than dominant males when a pup was in close proximity, while subordinates showed no sex-based differences. The sex of the nearest pup did not affect the calling rate of adults. The study shows that meerkats modify their close call production depending on benefits gained from calling and provides an example of the flexible use of one calling system in the presence of another, here contact calls versus begging calls, within the same species.

A Randomized Controlled Trial of Koru: A Mindfulness Program for College Students and Other Emerging Adults

PubMed Central

Greeson, Jeffrey M.; Juberg, Michael K.; Maytan, Margaret; James, Kiera; Rogers, Holly

2014-01-01

Objective To evaluate the effectiveness of Koru, a mindfulness training program for college students and other emerging adults. Participants Ninety students (66% female, 62% white, 71% graduate students) participated between Fall 2012 and Spring 2013. Methods Randomized controlled trial. We hypothesized that Koru, compared to a wait-list control group, would reduce perceived stress and sleep problems, and increase mindfulness, self-compassion, and gratitude. Results As hypothesized, results showed significant Group (Koru, wait-list) X Time (pre, post) interactions for improvements in perceived stress (F=4.50, df [1, 76.40], p=.037, d=.45), sleep problems (F= 4.71, df [1,79.49], p=.033, d=.52), mindfulness (F=26.80, df [1, 79.09], p<.001, d=.95), and self-compassion (F=18.08, df [1, 74.77], p<.001, d=.75). All significant effects were replicated in the wait-list group. Significant correlations were observed among changes in perceived stress, sleep problems, mindfulness, and self-compassion. Conclusions Results support the effectiveness of the Koru program for emerging adults in the university setting. PMID:24499130

Feasibility and Acceptability of Text Messaging to Assess Daily Substance Use and Sexual Behaviors among Urban Emerging Adults.

PubMed

Bonar, Erin E; Cunningham, Rebecca M; Collins, R Lorraine; Cranford, James A; Chermack, Stephen T; Zimmerman, Marc A; Blow, Frederic C; Walton, Maureen A

2018-01-01

Daily process research can help distinguish causal relationships between substance use and sexual risk behaviors in high-risk groups, such as urban emerging adults. We employed text messaging to assess 18-25 year-olds' daily substance use and sexual risk behaviors over 28 days. We describe the implementation of this method, attitudes regarding the daily surveys, and correlates of survey completion. We recruited 111 emerging adults from an urban Emergency Department in a resource-limited area who reported recent drug use and unprotected sex ( M age =22.0; 53.2% female; 45.1% African American; 43.2% receiving public assistance). Respondents completed M =18.0 ( SD = 8.7) of 28 daily surveys (27 items each). Participants completing a 1-month follow-up found the surveys not at all/only a little annoying (90.3%) and were comfortable with questions about drugs/alcohol (97.9%) and sex (94.6%). Completion was higher on weekdays versus weekends, and earlier in the study. Daily survey completion was unrelated to same-day substance use measured by the Timeline Follow Back at follow-up; polysubstance use and drinks consumed were associated with lower odds of next-day completion. School enrollment, public assistance, unlimited texting plan, lower baseline alcohol use, and depression symptoms at follow-up were associated with higher completion. Technology difficulties were commonly mentioned barriers to completion. Participants in this urban, resource-constrained sample found the daily text message methodology acceptable for reporting sensitive information. With rapid advancements in technologies and increased accessibility, text messaging remains a promising methodology for the study of daily processes in substance use and HIV risk behaviors. Keywords: text messaging; assessment; emerging adults; substance use; risky sex; mobile technology.

Improving the Cooperation Rate of Older Adults and Their Caregivers in Research Surveys.

PubMed

Green, Ohad; Ayalon, Liat

2015-01-01

Recruiting older adults, their family members and their home care workers as participants in research studies is particularly complicated. This might be due to medical or cognitive problems of the older adult as well as the high workload and shortage of time experienced by caregivers. The present study compared the contribution of two different versions of an advanced letter followed by two different versions of a recruitment phone call to the cooperation rate of older adults, family caregivers and home care workers in a face-to-face survey. A quasi-experimental design was used to compare the contribution of the different types of appeal. A total of 2,014 caregiving units (composed of an older adult, a family member and a home care worker) were randomly sampled from a list of Israeli long-term care insurance beneficiaries. 74.32% of the sampled caregiving units were eligible to participate in the study. The first group of participants received formal and succinctly phrased written and oral appeals - an advanced letter followed by a recruitment phone call. The second group of participants received the original formal and succinctly phrased advanced letter, but a revised recruitment phone call that included a more personal approach, the provision of broader information about the study and the avoidance of words with a possible negative connotation. The third group of participants received both a revised advanced letter and a revised recruitment phone call. Using the succinctly phrased written and oral appeals, we had a cooperation rate of about 50% for the entire caregiving unit. Using a revised advanced letter and a revised recruitment phone call yielded an increase of 20-25% in the cooperation rate for the entire caregiving unit. Using the revised recruitment phone call and the original advanced letter yielded an increase in the cooperation rate only among migrant home care workers. This study showed that by changing the format of appeal we can increase the

Avian growth and development rates and age-specific mortality: the roles of nest predation and adult mortality.

PubMed

Remes, V

2007-01-01

Previous studies have shown that avian growth and development covary with juvenile mortality. Juveniles of birds under strong nest predation pressure grow rapidly, have short incubation and nestling periods, and leave the nest at low body mass. Life-history theory predicts that parental investment increases with adult mortality rate. Thus, developmental traits that depend on the parental effort exerted (pre- and postnatal growth rate) should scale positively with adult mortality, in contrast to those that do not have a direct relationship with parental investment (timing of developmental events, e.g. nest leaving). I tested this prediction on a sample of 84 North American songbirds. Nestling growth rate scaled positively and incubation period duration negatively with annual adult mortality rates even when controlled for nest predation and other covariates, including phylogeny. On the contrary, neither the duration of the nestling period nor body mass at fledging showed any relationship. Proximate mechanisms generating the relationship of pre- and postnatal growth rates to adult mortality may include increased feeding, nest attentiveness during incubation and/or allocation of hormones, and deserve further attention.

Electronic Books versus Adult Readers: Effects on Children's Emergent Literacy as a Function of Social Class

ERIC Educational Resources Information Center

Korat, Ofra; Shamir, A.

2007-01-01

We compared the effects of children's reading of an educational electronic storybook on their emergent literacy with those of being read the same story in its printed version by an adult. We investigated 128 5- to 6-year-old kindergarteners; 64 children from each of two socio-economic status (SES) groups: low (LSES) and middle (MSES). In each…

Emergency Department Visits for Drug-Related Suicide Attempts Involving Antidepressants by Adolescents and Young Adults: 2004 to 2008. The DAWN Report

ERIC Educational Resources Information Center

Substance Abuse and Mental Health Services Administration, 2011

2011-01-01

In 2008, adolescents made 23,124 visits to the emergency department (ED) for drug-related suicide attempts, and young adults made 38,036 such visits; of these visits, 23.0 percent (5,312 visits) among adolescents and 17.6 percent (6,700 visits) among young adults involved antidepressants. Among ED visits for suicide attempts involving…

Harsh Parenting and Food Insecurity in Adolescence: The Association With Emerging Adult Obesity.

PubMed

Lohman, Brenda J; Gillette, Meghan T; Neppl, Tricia K

2016-07-01

As the first study of its kind, the overall purpose of this article was to examine the relationships and interactions between harsh parenting (HP) and food insecurity (FI) in adolescence on the development of overweight/obesity (OW/OB) in emerging adulthood. Data came from the Iowa Youth and Families Project, a longitudinal study of 451 adolescent youth and their families that began in 1989 in the rural Midwest. Adolescents were aged 13 years at the initial assessment, and weight status in emerging adulthood was measured 10 years later at age 23. Experiencing HP in adolescence predicted greater odds of OW/OB at 23 years old. Higher body mass indexes of the adolescent and his or her father in adolescence also increased the odds of being OW/OB at 23 years. Having parents with higher levels of education lowered the odds of being OW/OB in emerging adulthood. Finally, females who experienced high levels of FI and HP in adolescence had higher odds of OW/OB at 23 years in comparison to males. HP, in combination with FI in adolescence, predicted OW/OB for females in emerging adulthood but not for males. This study contributes to an understanding of the interplay between multiple influences in adolescence: namely, parenting and economic influences. Assessing antecedents to OW/OB in emerging adulthood via multiple pathways provides a more complex understanding of how and why adolescents turn into OW/OB adults. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Improving the Neighborhood Environment for Urban Older Adults: Social Context and Self-Rated Health.

PubMed

Mathis, Arlesia; Rooks, Ronica; Kruger, Daniel

2015-12-22

By 2030, older adults will account for 20% of the U.S. Over 80% of older adults live in urban areas. This study examines associations between neighborhood environment and self-rated health (SRH) among urban older adults. We selected 217 individuals aged 65+ living in a deindustrialized Midwestern city who answered questions on the 2009 Speak to Your Health survey. The relationship between neighborhood environment and self-rated health (SRH) was analyzed using regression and GIS models. Neighborhood variables included social support and participation, perceived racism and crime. Additional models included actual crime indices to compare differences between perceived and actual crime. Seniors who have poor SRH are 21% more likely to report fear of crime than seniors with excellent SRH (p = 0.01). Additional analyses revealed Black seniors are 7% less likely to participate in social activities (p = 0.005) and 4% more likely to report experiencing racism (p < 0.001). Given the increasing numbers of older adults living in urban neighborhoods, studies such as this one are important for well-being among seniors. Mitigating environmental influences in the neighborhood which are associated with poor SRH may allow urban older adults to maintain health and reduce disability.

Young adults' health care utilization and expenditures prior to the Affordable Care Act.

PubMed

Lau, Josephine S; Adams, Sally H; Boscardin, W John; Irwin, Charles E

2014-06-01

To examine young adults' health care utilization and expenditures prior to the Affordable Care Act. We used 2009 Medical Expenditure Panel Survey to (1) compare young adults' health care utilization and expenditures of a full-spectrum of health services to children and adolescents and (2) identify disparities in young adults' utilization and expenditures, based on access (insurance and usual source of care) and other sociodemographic factors, including race/ethnicity and income. Young adults had (1) significantly lower rates of overall utilization (72%) than other age groups (83%-88%, p < .001), (2) the lowest rate of office-based utilization (55% vs. 67%-77%, p < .001) and (3) higher rate of emergency room visits compared with adolescents (15% vs. 12%, p < .01). Uninsured young adults had high out-of-pocket expenses. Compared with the young adults with private insurance, the uninsured spent less than half on health care ($1,040 vs. $2,150/person, p < .001) but essentially the same out-of-pocket expenses ($403 vs. $380/person, p = .57). Among young adults, we identified significant disparities in utilization and expenditures based on the presence/absence of a usual source of care, race/ethnicity, home language, and sex. Young adults may not be utilizing the health care system optimally by having low rates of office-based visits and high rates of emergency room visits. The Affordable Care Act provision of insurance for those previously uninsured or under-insured will likely increase their utilization and expenditures and lower their out-of-pocket expenses. Further effort is needed to address noninsurance barriers and ensure equal access to health services. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Higher mortality rates amongst emergency patients admitted to hospital at weekends reflect a lower probability of admission.

PubMed

Meacock, Rachel; Anselmi, Laura; Kristensen, Søren Rud; Doran, Tim; Sutton, Matt

2017-01-01

Objective Patients admitted as emergencies to hospitals at the weekend have higher death rates than patients admitted on weekdays. This may be because the restricted service availability at weekends leads to selection of patients with greater average severity of illness. We examined volumes and rates of hospital admissions and deaths across the week for patients presenting to emergency services through two routes: (a) hospital Accident and Emergency departments, which are open throughout the week; and (b) services in the community, for which availability is more restricted at weekends. Method Retrospective observational study of all 140 non-specialist acute hospital Trusts in England analyzing 12,670,788 Accident and Emergency attendances and 4,656,586 emergency admissions (940,859 direct admissions from primary care and 3,715,727 admissions through Accident and Emergency) between April 2013 and February 2014.Emergency attendances and admissions to hospital and deaths in any hospital within 30 days of attendance or admission were compared for weekdays and weekends. Results Similar numbers of patients attended Accident and Emergency on weekends and weekdays. There were similar numbers of deaths amongst patients attending Accident and Emergency on weekend days compared with weekdays (378.0 vs. 388.3). Attending Accident and Emergency at the weekend was not associated with a significantly higher probability of death (risk-adjusted OR: 1.010). Proportionately fewer patients who attended Accident and Emergency at weekend were admitted to hospital (27.5% vs. 30.0%) and it is only amongst the subset of patients attending Accident and Emergency who were selected for admission to hospital that the probability of dying was significantly higher at the weekend (risk-adjusted OR: 1.054). The average volume of direct admissions from services in the community was 61% lower on weekend days compared to weekdays (1317 vs. 3404). There were fewer deaths following direct admission on

An assessment of the efficacy and peak catch rates of emergence tents for measuring bee nesting.

PubMed

Pane, Alexander M; Harmon-Threatt, Alexandra N

2017-06-01

Emergence tents are a new tool used to understand nesting ecology of ground nesting bee species. However, many questions remain about how to use tents effectively. We assessed (a) variance in tent capture rates over time, (b) the effects of site characteristics on proportion of tents capturing bees, and (c) the effect of soil characteristics on nest site choice. Emergence tents were placed out for one week in May, June, and August and checked daily. Soil, bee, and floral characteristics were recorded. Across all sites and months the average number of tents capturing bees was less than 20% during one week of sampling, but this varied between sites. Tent captures decreased after 48 h deployment, but accumulation differed seasonally, with slower accumulation of total bees caught in May than in June or August. Although capture rates were not affected by bee or floral abundance, soil moisture beneath a tent influenced where bees were captured. Effective use of emergence tents may require adjusting the length of deployment depending on season and will require a minimum of 48 h installation to help maximize efficacy. The overall low capture rates demonstrate the need to optimize emergence tent use.

Five-month comparative efficacy evaluation of three ectoparasiticides against adult cat fleas (Ctenocephalides felis), flea egg hatch and emergence, and adult brown dog ticks (Rhipicephalus sanguineus sensu lato) on dogs housed outdoors.

PubMed

Varloud, Marie; Hodgkins, Elizabeth

2015-03-01

This study was designed to compare the efficacy of three topical combinations on dogs in outdoor conditions against adult cat fleas (Ctenocephalides felis), flea egg hatch and emergence, and against adult brown dog ticks (Rhipicephalus sanguineus sensu lato). Treatment was performed on day 0 with a placebo; dinotefuran, pyriproxifen and permethrin (DPP); fipronil and (S)-methoprene (FM) or imidacloprid and permethrin (IP). Dogs (n = 32), housed outdoors for 7 months, were treated monthly for four consecutive months (on days 0, 30, 60 and 90) and infested with ~100 unfed adult fleas on days 14, 55, 74, 115 and 150 and with ~50 unfed adult ticks on days 28, 44, 88 and 104. Adult fleas were counted and removed 24 h after infestation. Immediately after flea removal, dogs were reinfested with ~100 new adult fleas 72 h prior to egg collection for up to 48 h. Flea eggs were incubated for 32 days, and newly emerged adults were counted. Ticks were counted and removed 48 h after each infestation. FM had >90 % efficacy against fleas at each time point and variable efficacy against ticks (38.0-99.6 %). Efficacy of IP was <90 % against fleas at day 64 and against ticks at day 30 of the first post-treatment. No flea eggs were laid in the treated groups until infestation was carried out >60 days after the last treatment. Despite challenging weather conditions, DPP was highly effective, providing >90 % efficacy against adult ticks as well as adult and immature fleas at every time point of the study.

Two Prospective Studies of Changes in Stress Generation across Depressive Episodes in Adolescents and Emerging Adults

PubMed Central

Morris, Matthew C.; Kouros, Chrystyna D.; Hellman, Natalie; Rao, Uma; Garber, Judy

2014-01-01

The stress generation hypothesis was tested in two different longitudinal studies examining relations between weekly depression symptom ratings and stress levels in adolescents and emerging adults at varied risk for depression. Participants in Study 1 included 240 adolescents who differed with regard to their mother’s history of depressive disorders. Youth were assessed annually across 6 years (Grades 6 through 12). Consistent with the depression autonomy model, higher numbers of prior major depressive episodes (MDEs) were associated with weaker stress generation effects, such that higher levels of depressive symptoms predicted increases in levels of dependent stressors for adolescents with ≤ 2 prior MDEs, but depressive symptoms were not significantly related to dependent stress levels for youth with ≥ 3 prior MDEs. In Study 2, participants were 32 remitted-depressed and 36 never-depressed young adults who completed a psychosocial stress task to determine cortisol reactivity and were re-assessed for depression and stress approximately eight months later. Stress generation effects were moderated by cortisol responses to a laboratory psychosocial stressor, such that individuals with higher cortisol responses exhibited a pattern consistent with the depression autonomy model, whereas individuals with lower cortisol responses showed a pattern more consistent with the depression sensitization model. Finally, comparing across the two samples, stress generation effects were weaker for older participants and for those with more prior MDEs. The complex, multi-factorial relation between stress and depression is discussed. PMID:25422968

Availability and readability of emergency preparedness materials for deaf and hard-of-hearing and older adult populations: issues and assessments.

PubMed

Neuhauser, Linda; Ivey, Susan L; Huang, Debbie; Engelman, Alina; Tseng, Winston; Dahrouge, Donna; Gurung, Sidhanta; Kealey, Melissa

2013-01-01

A major public health challenge is to communicate effectively with vulnerable populations about preparing for disasters and other health emergencies. People who are Deaf or Hard of Hearing (Deaf/HH) and older adults are particularly vulnerable during health emergencies and require communications that are accessible and understandable. Although health literacy studies indicate that the readability of health communication materials often exceeds people's literacy levels, we could find no research about the readability of emergency preparedness materials (EPM) intended for Deaf/HH and older adult populations. The objective of this study was to explore issues related to EPM for Deaf/HH and older adult populations, to assess the availability and readability of materials for these populations, and to recommend improvements. In two California counties, we interviewed staff at 14 community-based organizations (CBOs) serving Deaf/HH clients and 20 CBOs serving older adults selected from a stratified, random sample of 227 CBOs. We collected 40 EPM from 10 CBOs and 2 public health departments and 40 EPM from 14 local and national websites with EPM for the public. We used computerized assessments to test the U.S. grade reading levels of the 16 eligible CBO and health department EPM, and the 18 eligible website materials. Results showed that less than half of CBOs had EPM for their clients. All EPM intended for clients of Deaf/HH-serving CBOs tested above the recommended 4(th) grade reading level, and 91% of the materials intended for clients of older adult-serving CBOs scored above the recommended 6(th) grade level. EPM for these populations should be widely available through CBOs and public health departments, adhere to health literacy principles, and be accessible in alternative formats including American Sign Language. Developers should engage the intended users of EPM as co-designers and testers. This study adds to the limited literature about EPM for these populations.

Differences in the way older and younger adults rate threat in faces but not situations.

PubMed

Ruffman, Ted; Sullivan, Susan; Edge, Nigel

2006-07-01

We compared young and healthy older adults' ability to rate photos of faces and situations (e.g., sporting activities) for the degree of threat they posed. Older adults did not distinguish between more and less dangerous faces to the same extent as younger adults did. In contrast, we found no significant age differences in young and older adults' ability to distinguish between high- and low-danger situations. The differences between young and older adults on the face task were independent of age differences in older adults' fluid IQ. We discuss results in relation to differences between young and older adults on emotion-recognition tasks; we also discuss sociocognitive and neuropsychological (e.g., amygdala) theories of aging.

Chronic psychosocial stressors and salivary biomarkers in emerging adults.

PubMed

Bergen, Andrew W; Mallick, Aditi; Nishita, Denise; Wei, Xin; Michel, Martha; Wacholder, Aaron; David, Sean P; Swan, Gary E; Reid, Mark W; Simons, Anne; Andrews, Judy A

2012-08-01

We investigated whole saliva as a source of biomarkers to distinguish individuals who have, and who have not, been chronically exposed to severe and threatening life difficulties. We evaluated RNA and DNA metrics, expression of 37 candidate genes, and cortisol release in response to the Trier Social Stress Test, as well as clinical characteristics, from 48 individuals stratified on chronic exposure to psychosocial stressors within the last year as measured by the Life Events and Difficulties Schedule. Candidate genes were selected based on their differential gene expression ratio in circulating monocytes from a published genome-wide analysis of adults experiencing different levels of exposure to a chronic stressor. In univariate analyses, we observed significantly decreased RNA integrity (RIN) score (P = 0.04), and reduced expression of glucocorticoid receptor-regulated genes (Ps < 0.05) in whole saliva RNA from individuals exposed to chronic stressors, as compared to those with no exposure. In those exposed, we observed significantly decreased BMI (P < 0.001), increased ever-smoking and increased lifetime alcohol abuse or dependence (P ≤ 0.03), and a reduction of cortisol release. In post hoc multivariate analyses including clinical and biospecimen-derived variables, we consistently observed significantly decreased expression of IL8 (Ps<0.05) in individuals exposed, with no significant association to RIN score. Alcohol use disorders, tobacco use, a reduced acute stress response and decreased salivary IL8 gene expression characterize emerging adults chronically exposed to severe and threatening psychosocial stressors. Copyright © 2011 Elsevier Ltd. All rights reserved.

Emerging Issues in Adult Female Acne

PubMed Central

Baldwin, Hillary E.; Cook-Bolden, Fran E.; Eichenfield, Lawrence F.; Friedlander, Sheila F.; Rodriguez, David A.

2017-01-01

Acne vulgaris (acne) is a common affliction in adolescence and is a growing problem in adult women. Despite an increasing awareness of acne in the adult female population, there is a lack of good prospective studies assessing the severity, distribution, and differential response to treatment in this group. The long-held dogma that acne in adult women develops on the lower one-third of the face has been recently challenged, and here the authors critically review data from available literature. Moreover, while adult female acne has traditionally been defined as disease in women over age 25, it is the authors’ experience that this group is subdivided into women ages 25 to 44 years, separate from perimenopausal patients, ages 45 years and up. While there is no data specifically comparing these two groups, the authors will review the existing data and provide practical recommendations based on our experience in treating these groups of patients. Finally, while there is a lack of data on this subject, it is the group’s opinion that adherence to medication regimens is likely higher in women than men, which influences therapeutic outcomes. PMID:28210380

Suicide Attempts in Israel: Age by Gender Analysis of a National Emergency Departments Database

ERIC Educational Resources Information Center

Levinson, Daphna; Haklai, Ziona; Stein, Nechama; Gordon, Ethel-Sherry

2006-01-01

An analysis of all emergency department admissions in Israel classified as an attempted suicide in the years 1996-2002 was done to examine attempted suicide rates by age and gender with particular attention to adolescents and young adults. Gender differences in attempted suicide rates were significant only during adolescence and young adulthood,…

Exploring the relationship between child physical abuse and adult dating violence using a causal inference approach in an emerging adult population in South Korea.

PubMed

Jennings, Wesley G; Park, MiRang; Richards, Tara N; Tomsich, Elizabeth; Gover, Angela; Powers, Ráchael A

2014-12-01

Child maltreatment is one of the most commonly examined risk factors for violence in dating relationships. Often referred to as the intergenerational transmission of violence or cycle of violence, a fair amount of research suggests that experiencing abuse during childhood significantly increases the likelihood of involvement in violent relationships later, but these conclusions are primarily based on correlational research designs. Furthermore, the majority of research linking childhood maltreatment and dating violence has focused on samples of young people from the United States. Considering these limitations, the current study uses a rigorous, propensity score matching approach to estimate the causal effect of experiencing child physical abuse on adult dating violence among a large sample of South Korean emerging adults. Results indicate that the link between child physical abuse and adult dating violence is spurious rather than causal. Study limitations and implications are discussed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Emerging Research Directions in Adult Congenital Heart Disease: A Report from a National Heart, Lung, and Blood Institute/Adult Congenital Heart Association Working Group

PubMed Central

Gurvitz, Michelle; Burns, Kristin M.; Brindis, Ralph; Broberg, Craig S.; Daniels, Curt J.; Fuller, Stephanie M.P.N.; Honein, Margaret A.; Khairy, Paul; Kuehl, Karen S.; Landzberg, Michael J.; Mahle, William T.; Mann, Douglas L.; Marelli, Ariane; Newburger, Jane W.; Pearson, Gail D.; Starling, Randall C.; Tringali, Glenn R.; Valente, Anne Marie; Wu, Joseph C.; Califf, Robert M.

2016-01-01

Congenital heart disease (CHD) is the most common birth defect, affecting about 0.8% of live births. Advances in recent decades have allowed >85% of children with CHD to survive to adulthood, creating a growing population of adults with CHD. Little information exists regarding survival, demographics, late outcomes, and comorbidities in this emerging group, and multiple barriers impede research in adult CHD (ACHD). The National Heart, Lung, and Blood Institute and the Adult Congenital Heart Association convened a multidisciplinary Working Group to identify high-impact research questions in ACHD. This report summarizes the meeting discussions in the broad areas of CHD-related heart failure, vascular disease and multisystem complications. High-priority subtopics identified included heart failure in tetralogy of Fallot, mechanical circulatory support/transplantation, sudden cardiac death, vascular outcomes in coarctation of the aorta, late outcomes in single ventricle disease, cognitive and psychiatric issues, and pregnancy. PMID:27102511

Effect of larval diet on cat flea (Siphonaptera: Pulicidae) developmental times and adult emergence.

PubMed

Moser, B A; Koehler, P G; Patterson, R S

1991-08-01

The natural diet of cat flea, Ctenocephalides felis (Bouche), larvae is primarily adult flea feces, but dried bovine blood may be substituted in the laboratory. Percentage adult emergence (79.4% on feces; 78.9% on blood) and developmental times (20.6 d on feces; 17.1 d on blood) did not significantly differ for the two diets. The drying temperature of blood determined its quality; blood dried at 120 degrees C was unsatisfactory for larval development. The dietary value of dried bovine blood was not enhanced when supplemented with brewer's yeast, rodent chow, or a combination of those constituents. Blood particle size ranging from less than 180 to greater than 500u did not affect the value of blood as a diet. Rodent chow, yeast, albumen, hemoglobin, and mixtures of these constituents were unsuitable as larval diets.

The association between crowding and mortality in admitted pediatric patients from mixed adult-pediatric emergency departments in Korea.

PubMed

Cha, Won Chul; Shin, Sang Do; Cho, Jin Sung; Song, Kyoung Jun; Singer, Adam J; Kwak, Young Ho

2011-12-01

We aimed to investigate the effect of crowding on the hospital mortality of pediatric patients from adult-pediatric mixed emergency departments (EDs). We used the National Emergency Department Information System database, which included demographic, clinical, diagnostic, and procedural information with all emergency patients visiting to 116 EDs from Korea since 2004. We enrolled EDs with mean length of stay of more than 6 hours. Study period was from January 2006 to December 2008. Pediatric patients younger than 15 years admitted from these EDs were study targets. We calculated the mean patient volume (mean number of patients in the ED) over 8-hour shift for each hospital. When the volume reached the highest quartile, the period was considered as crowded. Patients who came during the overcrowded period were defined as the crowded group. We performed a Kaplan-Meier analysis, and hazard ratio and 95% confidence intervals (95% CIs) were calculated using a Cox proportional hazards regression model. A total of 34 EDs and 125,031 admitted pediatric patients were included; 74,152 (59.3%) were male, and the mean age was 3.84 (95% CI, 3.82-3.86) years; 35,924 (28.7%) were determined as the crowded group. The 30-day mortality rates were 0.4% and 0.3% (P = 0.063) for the crowded group and for the noncrowded group, respectively. The hazard ratio for hospital mortality of the crowded group was 1.230 (95% CI, 1.019-1.558). The ED crowding was associated with increased hazard for hospital mortality for pediatric patients in mixed EDs.

Growing pains: understanding the needs of emerging adults with chronic pain

PubMed Central

Twiddy, Hannah; Hanna, Julie; Haynes, Louise

2017-01-01

Background: Emerging adulthood (18–30 years), in the Western world, is often a time of identity development and exploration, focusing on areas of work, relationships and education. Individuals with chronic illnesses, such as chronic pain, may be more vulnerable to facing challenges during this time. This study aims to investigate the needs of young adults (YAs) attending a tertiary level National Health Service (NHS) Pain Management Programme (PMP) Service in the United Kingdom; exploring how these needs may translate on to clinical assessment and the delivery of rehabilitation interventions. Method: This is a descriptive qualitative study influenced by phenomenological approaches. YA with a diagnosis of chronic pain were recruited and assigned to one of four focus groups facilitated by a clinical psychologist and occupational therapist. A semi-structured interview guide was used to help facilitate the group discussion. Results: Qualitative analysis identified four key themes in understanding the needs of YAs with chronic pain: (1) thwarted opportunities, (2) peer separation, (3) perceived illness validity in the context of age and (4) dependency/parental enmeshment. Conclusions: The emerging adulthood literature provides a valuable framework for examining a normal developmental trajectory and highlights the relevance of age-related processes in YAs with chronic pain. The idealisation of opportunity and the role of perception in this developmental phase both appear relevant. It is significant that emotional stability is not yet established in emerging adulthood and links to unhelpful management strategies that may be differentiated from older populations are identified. PMID:28785407

The Ethnic Identity, Other-Group Attitudes, and Psychosocial Functioning of Asian American Emerging Adults from Two Contexts

ERIC Educational Resources Information Center

Juang, Linda P.; Nguyen, Huong H.; Lin, Yunghui

2006-01-01

Drawing from two samples of Asian American emerging adults, one in an ethnically concentrated context (n = 108) and the other in an ethnically-dispersed, mainly White context (n = 153), we examined (a) how ethnic identity and other-group attitudes were related to psychosocial functioning (i.e., depression, self-esteem, and connectedness to…

Association between resting heart rate, metabolic syndrome and cardiorespiratory fitness in Korean male adults.

PubMed

Kang, Seol-Jung; Ha, Gi-Chul; Ko, Kwang-Jun

2017-06-01

The present study aimed to investigate the association between metabolic syndrome and cardiorespiratory fitness according to resting heart rate of Korean male adults. A total of 11,876 male adults aged 20-65 years who underwent health examinations from 2010 to 2015 at a National Fitness Centre in South Korea were included. Subjects' resting heart rate, cardiorespiratory fitness (VO 2 max), and metabolic syndrome parameters were collected. The subjects were divided into 5 categories (<60 bpm, 60-69 bpm, 70-79 bpm, 80-89 bpm, and ≥90 bpm) of resting heart rate for further analysis. We found that elevated resting heart rate was positively associated with body mass index, systolic blood pressure, diastolic blood pressure, triglycerides, and fasting blood glucose levels ( p  < 0.001, respectively); in contrast, elevated resting heart rate was inversely associated with VO 2 max ( p  < 0.001). When resting heart rate of subjects was categorized into quintiles and analysed, the results showed that the relative risk of metabolic syndrome was 1.53-fold higher (95% CI, 1.34 to 1.82) in the range of 60-69 beats per minute (bpm), 2.08-fold higher (95% CI, 1.77 to 2.45) in the range of 70-79 bpm, 2.28-fold higher (95% CI, 1.73 to 3.00) in the range of 80-89 bpm, and 2.61-fold higher (95% CI, 1.62 to 4.20) in the range of ≥90 bpm, compared to those <60 bpm; this indicated that as resting heart rate increased, the relative risk of metabolic syndrome also increased. Resting heart rate of male adults was found to be associated with cardiorespiratory fitness; the risk factors for metabolic syndrome and relative risk of metabolic syndrome increased as resting heart rate increased.

48 CFR 52.211-14 - Notice of Priority Rating for National Defense, Emergency Preparedness, and Energy Program Use.

Code of Federal Regulations, 2010 CFR

2010-10-01

... for National Defense, Emergency Preparedness, and Energy Program Use. 52.211-14 Section 52.211-14... for National Defense, Emergency Preparedness, and Energy Program Use. As prescribed in 11.604(a), insert the following provision: Notice of Priority Rating for National Defense, Emergency Preparedness...

Increasing hip fracture rates among older adults in Ecuador: analysis of the National Hospital Discharge System, 1999-2016.

PubMed

Orces, Carlos H; Gavilanez, Enrique Lopez

2017-12-07

The Ecuadorian hospital discharge system examined trends in hip fracture hospitalization rates among older adults. A significant upward trend in hip fracture rates occurred in both genders over the study period. Previous research has reported increasing hip fracture rates in Ecuador. Thus, this study aimed to extend previous findings by examining the nationwide incidence of hip fractures among adults aged 65 years and older between 1999 and 2016. A secondary objective was to compare hip fracture trends among older Ecuadorians with their counterparts in the United States (U.S.). The National Hospital Discharge System and the Healthcare Cost and Utilization Project net were assessed to identify older adults hospitalized with a principal diagnosis of hip fractures in Ecuador and the U.S., respectively. The Joinpoint regression analysis software was used to examine the average annual percent change in hip fracture rates. A total of 20,091 adults with a mean age of 82.3 (SD 8.1) years were hospitalized with a principal diagnosis of hip fractures during the study period. After an adjustment for age, hip fracture rates increased annually on average by 4.6% (95% CI 3.8%, 5.4%) from 96.4/100,000 in 1999 to 173.1/100,000 persons in 2016. Between 1999 and 2014, hip fracture age-adjusted rates decreased on average by - 2.5% (95% CI - 2.7%, - 2.3%) among older adults in the U.S. while hip fracture rates steadily increased by 4.6% (95% CI, 3.6%, 5.7%) per year in their Ecuadorian counterparts. Hip fracture rates markedly increased among older adults in Ecuador. The present findings should alert public health authorities to implement policies of osteoporosis awareness and prevention in Ecuador.

The organizational culture of emergency departments and the effect on care of older adults: a modified scoping study.

PubMed

Skar, Pål; Bruce, Anne; Sheets, Debra

2015-04-01

How does the organizational micro culture in emergency departments (EDs) impact the care of older adults presenting with a complaint or condition perceived as non-acute? This scoping study reviews the literature and maps three levels of ED culture (artifacts, values and beliefs, and assumptions). Findings on the artifact level indicate that EDs are poorly designed for the needs of older adults. Findings on the ED value and belief level indicate that EDs are for urgent cases (not geriatric care), that older adults do not receive the care and respect they should be given, that older adults require too much time, and that the basic nursing needs of older adults are not a priority for ED nurses. Finally, finding on the assumptions level underpinning ED behaviors suggest that older adults do not belong in the ED, most older adults in the ED are not critically ill and therefore can wait, and staff need to be available for acute cases at all times. A systematic review on the effect of ED micro culture on the quality of geriatric care is warranted. Copyright © 2014. Published by Elsevier Ltd.

A Daily Analysis of Physical Activity and Satisfaction with Life in Emerging Adults

PubMed Central

Maher, Jaclyn P.; Doerksen, Shawna E.; Elavsky, Steriani; Hyde, Amanda L.; Pincus, Aaron L.; Ram, Nilam; Conroy, David E.

2014-01-01

Objective Subjective well-being has well-established positive health consequences. During emerging adulthood, from ages 18 to 25 years, people’s global evaluations of their well-being (i.e., satisfaction with life [SWL]) appear to worsen more than any other time in the adult lifespan, indicating that this population would benefit from strategies to enhance SWL. In these studies, we investigated top-down (i.e., time-invariant, trait-like) and bottom-up (i.e., time-varying, state-like) influences of physical activity (PA) on daily SWL. Methods Two daily diary studies lasting 8 days (N = 190) and 14 days (N = 63) were conducted with samples of emerging adults enrolled in college to evaluate relations between daily PA and SWL while controlling for established and plausible top-down and bottom-up influences on SWL. Results In both studies, multilevel models indicated that people reported greater SWL on days when they were more active (a within-person, bottom-up effect). Top-down effects of PA were not significant in either study. These findings were robust when we controlled for competing top-down influences (e.g., sex, personality traits, self-esteem, body mass index, mental health symptoms, fatigue) and bottom-up influences (e.g., daily self-esteem, daily mental health symptoms, daily fatigue). Conclusions We concluded that SWL was impacted by people’s daily PA rather than their trait level of PA over time. These findings extend evidence that PA is a health behavior with important consequences for daily well-being and should be considered when developing national policies to enhance SWL. PMID:23088171

Health impact of sport and exercise in emerging adult men: a prospective study.

PubMed

Henchoz, Yves; Baggio, Stéphanie; N'Goran, Alexandra A; Studer, Joseph; Deline, Stéphane; Mohler-Kuo, Meichun; Daeppen, Jean-Bernard; Gmel, Gerhard

2014-10-01

Health benefits of sport and exercise are well documented in children, adolescents and adults, but little is known about emerging adulthood-a period of life characterized by significant demographic and developmental changes. The present study aimed to assess the health impact of changes in sport and exercise levels during that specific period of life. The analysis used baseline and 15-month follow-up data (N = 4,846) from the cohort study on substance use risk factors. Associations between baseline exercise levels or changes in exercise levels and health indicators (i.e., health-related quality of life, depression, body mass index, alcohol dependence, nicotine dependence and cannabis use disorder) were measured using chi-squared tests and ANOVA. Direction of effects was tested using cross-lagged analysis. At baseline, all health indicator scores were observed to be better for regular exercisers than for other exercise levels. At follow-up, participants who had maintained regular exercise over time had better scores than those who had remained irregular exercisers or had discontinued, but their scores for health-related quality of life and depression were close to those of participants who had adopted regular exercise after the baseline questionnaire. Cross-lagged analysis indicated that regular exercise at baseline was a significant predictor of health-related quality of life and substance use dependence at follow-up, but was itself predicted only by health-related quality of life. From a health promotion perspective, this study emphasizes how important it is for emerging adult men to maintain, or adopt, regular sport and exercise.

Using Oral Language Skills to Build on the Emerging Literacy of Adult English Learners. CAELA Network Brief

ERIC Educational Resources Information Center

Vinogradov, Patsy; Bigelow, Martha

2010-01-01

In addition to learning to read and write for the first time, adult English language learners with limited or emerging literacy skills must acquire oral English. Often, learners with limited print literacy in their first language have oral skills in English that exceed their English literacy skills (Geva & Zadeh, 2006). While this mismatch of oral…

Effects of emergency department expansion on emergency department patient flow.

PubMed

Mumma, Bryn E; McCue, James Y; Li, Chin-Shang; Holmes, James F

2014-05-01

Emergency department (ED) crowding is an increasing problem associated with adverse patient outcomes. ED expansion is one method advocated to reduce ED crowding. The objective of this analysis was to determine the effect of ED expansion on measures of ED crowding. This was a retrospective study using administrative data from two 11-month periods before and after the expansion of an ED from 33 to 53 adult beds in an academic medical center. ED volume, staffing, and hospital admission and occupancy data were obtained either from the electronic health record (EHR) or from administrative records. The primary outcome was the rate of patients who left without being treated (LWBT), and the secondary outcome was total ED boarding time for admitted patients. A multivariable robust linear regression model was used to determine whether ED expansion was associated with the outcome measures. The mean (±SD) daily adult volume was 128 (±14) patients before expansion and 145 (±17) patients after. The percentage of patients who LWBT was unchanged: 9.0% before expansion versus 8.3% after expansion (difference = 0.6%, 95% confidence interval [CI] = -0.16% to 1.4%). Total ED boarding time increased from 160 to 180 hours/day (difference = 20 hours, 95% CI = 8 to 32 hours). After daily ED volume, low-acuity area volume, daily wait time, daily boarding hours, and nurse staffing were adjusted for, the percentage of patients who LWBT was not independently associated with ED expansion (p = 0.053). After ED admissions, ED intensive care unit (ICU) admissions, elective surgical admissions, hospital occupancy rate, ICU occupancy rate, and number of operational ICU beds were adjusted for, the increase in ED boarding hours was independently associated with the ED expansion (p = 0.005). An increase in ED bed capacity was associated with no significant change in the percentage of patients who LWBT, but had an unintended consequence of an increase in ED boarding hours. ED expansion alone does

Observed Macro- and Micro-Level Parenting Behaviors During Preadolescent Family Interactions as Predictors of Adjustment in Emerging Adults With and Without Spina Bifida

PubMed Central

Amaro, Christina M.; Devine, Katie A.; Psihogios, Alexandra M.; Murphy, Lexa K.; Holmbeck, Grayson N.

2015-01-01

Objective To examine observed autonomy-promoting and -inhibiting parenting behaviors during preadolescence as predictors of adjustment outcomes in emerging adults with and without spina bifida (SB). Methods Demographic and videotaped interaction data were collected from families with 8/9-year-old children with SB (n = 68) and a matched group of typically developing youth (n = 68). Observed interaction data were coded with macro- and micro-coding schemes. Measures of emerging adulthood adjustment were collected 10 years later (ages 18/19 years; n = 50 and n = 60 for SB and comparison groups, respectively). Results Autonomy-promoting (behavioral control, autonomy-relatedness) and -inhibiting (psychological control) observed preadolescent parenting behaviors prospectively predicted emerging adulthood adjustment, particularly within educational, social, and emotional domains. Interestingly, high parent undermining of relatedness predicted better educational and social adjustment in the SB sample. Conclusions Parenting behaviors related to autonomy have long-term consequences for adjustment in emerging adults with and without SB. PMID:24864277

The heart rate response to nintendo wii boxing in young adults.

PubMed

Bosch, Pamela R; Poloni, Joseph; Thornton, Andrew; Lynskey, James V

2012-06-01

To determine if 30 minutes of Nintendo Wii Sports boxing provides cardiorespiratory benefits and contributes to the daily exercise recommendations for healthy young adults. Twenty healthy 23- to 27-year-olds participated in two sessions to measure maximum heart rate (HR(max)) via a treadmill test and heart rate (HR) response to 30 minutes of Wii Sports boxing. Heart rate in beats per minute (bpm) was measured continuously, and exercise intensity during each minute of play was stratified as a percentage of HR(max). Mixed designs analysis of variance (ANOVA) and Pearson product moment correlations were used to analyze the data. Mean (SD) HR response to boxing was 143 (15) bpm or 77.5% (10.0%) of HR(max). The mean HR response for experienced participants was significantly lower than inexperienced participants, P = .007. The ANOVA revealed a significant interaction between experience and time spent at various intensities, P = .009. Experienced participants spent more time in light to vigorous intensities, inexperienced participants in moderate to very hard intensities. Fitness was not correlated with mean HR response to boxing, P = .49. Thirty minutes of Nintendo Wii Sports boxing provides a moderate to vigorous aerobic response in healthy young adults and can contribute to daily recommendations for physical activity.

The Heart Rate Response to Nintendo Wii Boxing in Young Adults

PubMed Central

Bosch, Pamela R.; Poloni, Joseph; Thornton, Andrew; Lynskey, James V.

2012-01-01

Purpose To determine if 30 minutes of Nintendo Wii Sports boxing provides cardiorespiratory benefits and contributes to the daily exercise recommendations for healthy young adults. Methods Twenty healthy 23- to 27-year-olds participated in two sessions to measure maximum heart rate (HRmax) via a treadmill test and heart rate (HR) response to 30 minutes of Wii Sports boxing. Heart rate in beats per minute (bpm) was measured continuously, and exercise intensity during each minute of play was stratified as a percentage of HRmax. Mixed designs analysis of variance (ANOVA) and Pearson product moment correlations were used to analyze the data. Results Mean (SD) HR response to boxing was 143 (15) bpm or 77.5% (10.0%) of HRmax. The mean HR response for experienced participants was significantly lower than inexperienced participants, P = .007. The ANOVA revealed a significant interaction between experience and time spent at various intensities, P = .009. Experienced participants spent more time in light to vigorous intensities, inexperienced participants in moderate to very hard intensities. Fitness was not correlated with mean HR response to boxing, P = .49. Conclusion Thirty minutes of Nintendo Wii Sports boxing provides a moderate to vigorous aerobic response in healthy young adults and can contribute to daily recommendations for physical activity. PMID:22833705

Ethnic differences in blood pressure, pulse rate, and related characteristics in young adults. The CARDIA study.

PubMed

Liu, K; Ballew, C; Jacobs, D R; Sidney, S; Savage, P J; Dyer, A; Hughes, G; Blanton, M M

1989-08-01

This study examined ethnic differences in blood pressure and pulse rate in young adults to see whether the differences, if they exist, can be explained by differences in body mass index, lifestyle, psychological, and socioeconomic characteristics. Data used were from the baseline examination of the Coronary Artery Risk Development in (Young) Adults Study (CARDIA). CARDIA is a longitudinal study of lifestyle and evolution of cardiovascular disease risk factors in 5,116 young adults, black and white, men and women, aged 18-30 years, of varying socioeconomic status. Young black adults had higher mean systolic blood pressure and slightly higher mean diastolic blood pressure than young white adults. For both men and women, the blood pressure differences between blacks and whites tended to be greater for the age group 25-30 than for the age group 18-24 years. Among the variables studied, body mass index, duration of exercise on the treadmill, number of cigarettes smoked per day, and number of alcoholic drinks per week were consistently associated with blood pressure. The blood pressure differences were greatly reduced after adjusting for these variables. Black participants had lower mean pulse rate than white participants. The differences tended to be greater for the age group 18-24 than for the age group 25-30 years. Among the variables studied, only duration on treadmill and number of cigarettes smoked per day were consistently correlated with pulse rate. With adjustment for duration on treadmill, the differences in pulse rate increased. These results suggest that differences in ethnic pattern of blood pressures and pulse rate with age may be due in part to obesity, physical fitness, alcohol consumption, and cigarette smoking.

The effects of religiosity on psychopathology in emerging adults: intrinsic versus extrinsic religiosity.

PubMed

Power, Leah; McKinney, Cliff

2014-10-01

Recent research has suggested that religion may play an important role in determining mental health. Although research has examined the effects of religiosity on specific types of psychopathology, less research has examined psychopathology broadly in the context of particular aspects of religion. Thus, the current study examined intrinsic and extrinsic religiosity and a range of psychopathology in 486 emerging adult college students. Results of a MANOVA indicated a main effect for intrinsic religiosity on a range of psychopathology and an interaction effect between intrinsic and extrinsic religiosity on antisocial personality problems. Implications and limitations of the current study are discussed.

Health Human Capital in Sub-Saharan Africa: Conflicting Evidence from Infant Mortality Rates and Adult Heights

PubMed Central

Akachi, Yoko; Canning, David

2011-01-01

We investigate trends in cohort infant mortality rates and adult heights in 39 developing countries since 1960. In most regions of the world improved nutrition, and reduced childhood exposure to disease, have lead to improvements in both infant mortality and adult stature. In Sub-Saharan Africa, however, despite declining infant mortality rates, adult heights have not increased. We argue that in Sub-Saharan Africa the decline in infant mortality may have been due to interventions that prevent infant deaths rather than improved nutrition and childhood morbidity. Despite declining infant mortality, Sub-Saharan Africa may not be experiencing increases in health human capital. PMID:20634153

Older adults and high-risk medication administration in the emergency department.

PubMed

Kim, Mitchell; Mitchell, Steven H; Gatewood, Medley; Bennett, Katherine A; Sutton, Paul R; Crawford, Carol A; Bentov, Itay; Damodarasamy, Mamatha; Kaplan, Stephen J; Reed, May J

2017-01-01

Older adults are susceptible to adverse effects from opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and benzodiazepines (BZDs). We investigated factors associated with the administration of elevated doses of these medications of interest to older adults (≥65 years old) in the emergency department (ED). ED records were queried for the administration of medications of interest to older adults at two academic medical center EDs over a 6-month period. Frequency of recommended versus elevated ("High doses" were defined as doses that ranged between 1.5 and 3 times higher than the recommended starting doses; "very high doses" were defined as higher than high doses) starting doses of medications, as determined by geriatric pharmacy/medicine guidelines and expert consensus, was compared by age groups (65-69, 70-74, 75-79, 80-84, and ≥85 years), gender, and hospital. There were 17896 visits representing 11374 unique patients >65 years of age (55.3% men, 44.7% women). A total of 3394 doses of medications of interest including 1678 high doses and 684 very high doses were administered to 1364 different patients. Administration of elevated doses of medications was more common than that of recommended doses. Focusing on opioids and BZDs, the 65-69-year age group was much more likely to receive very high doses (1481 and 412 doses, respectively) than the ≥85-year age groups (relative risk [RR] 5.52, 95% CI 2.56-11.90), mainly reflecting elevated opioid dosing (RR 8.28, 95% CI 3.69-18.57). Men were more likely than women to receive very high doses (RR 1.47, 95% CI 1.26-1.72), primarily due to BZDs (RR 2.12, 95% CI 2.07-2.16). Administration of elevated doses of opioids and BZDs in the older population occurs frequently in the ED, especially to the 65-69-year age group and men. Further attention to potentially unsafe dosing of high-risk medications to older adults in the ED is warranted.

Associations of ethnic discrimination with symptoms of anxiety and depression among Hispanic emerging adults: a moderated mediation model.

PubMed

Cano, Miguel Ángel; Castro, Yessenia; de Dios, Marcel A; Schwartz, Seth J; Lorenzo-Blanco, Elma I; Roncancio, Angelica M; Martinez, Marcos J; Sheehan, Diana M; Auf, Rehab; Piña-Watson, Brandy; Huynh, Que-Lam; Zamboanga, Byron L

2016-11-01

Emerging adulthood is often marked with elevated symptoms of anxiety and depression. Hispanic emerging adults may face cultural stressors such as ethnic discrimination that further increase levels of anxiety and depression symptoms. The study aims were to examine if (a) self-esteem mediated effects of ethnic discrimination on symptoms of anxiety and depression, and (b) if gender moderated the indirect effects of discrimination. The study design was cross-sectional self-report. Two moderated mediation models were tested, with 1084 Hispanic emerging adults (ages 18-25) enrolled in institutions of post-secondary in the United States. Results indicated that (a) higher ethnic discrimination was associated with higher anxiety symptoms (β = .05, p = .04), higher depression symptoms (β = .06, p = .02), and lower self-esteem (β = -.30, p < .001); (b) self-esteem mediated the associations of ethnic discrimination with anxiety and depression symptoms; and (c) gender moderated the indirect effects of discrimination, whereby self-esteem was a stronger mediator among men than women. Each moderated mediation model explained 26% of variability in symptoms of anxiety and depression, respectively. Findings suggest that the mediating effects of self-esteem linking ethnic discrimination with symptoms of anxiety and depression vary between genders.

Respondent-Driven Sampling with Hard-to-Reach Emerging Adults: An Introduction and Case Study with Rural African Americans

ERIC Educational Resources Information Center

Kogan, Steven M.; Wejnert, Cyprian; Chen, Yi-fu; Brody, Gene H.; Slater, LaTrina M.

2011-01-01

Obtaining representative samples from populations of emerging adults who do not attend college is challenging for researchers. This article introduces respondent-driven sampling (RDS), a method for obtaining representative samples of hard-to-reach but socially interconnected populations. RDS combines a prescribed method for chain referral with a…

Insurance Churning Rates For Low-Income Adults Under Health Reform: Lower Than Expected But Still Harmful For Many.

PubMed

Sommers, Benjamin D; Gourevitch, Rebecca; Maylone, Bethany; Blendon, Robert J; Epstein, Arnold M

2016-10-01

Changes in insurance coverage over time, or "churning," may have adverse consequences, but there has been little evidence on churning since implementation of the major coverage expansions in the Affordable Care Act (ACA) in 2014. We explored the frequency and implications of churning through surveying 3,011 low-income adults in Kentucky, which used a traditional expansion of Medicaid; Arkansas, which chose a "private option" expansion that enrolled beneficiaries in private Marketplace plans; and Texas, which opted not to expand. We also compared 2015 churning rates in these states to survey data from 2013, before the coverage expansions. Nearly 25 percent of respondents in 2015 changed coverage during the previous twelve months-a rate lower than some previous predictions. We did not find significantly different churning rates in the three states over time. Common causes of churning were job-related changes and loss of eligibility for Medicaid or Marketplace subsidies. Churning was associated with disruptions in physician care and medication adherence, increased emergency department use, and worsening self-reported quality of care and health status. Even churning without gaps in coverage had negative effects. Churning remains a challenge for many Americans, and policies are needed to reduce its frequency and mitigate its negative impacts. Project HOPE—The People-to-People Health Foundation, Inc.

Oxygen uptake and ratings of perceived exertion at the lactate threshold and maximal fat oxidation rate in untrained adults

PubMed Central

Rynders, Corey A.; Angadi, Siddhartha S.; Weltman, Nathan Y.; Gaesser, Glenn A.; Weltman, Arthur

2014-01-01

The purpose of the study was to examine the relationship between VO2 and RPE at the lactate threshold (LT) and maximal fat oxidation rate (FATMAX) in untrained adults and determine the stability of the relationship across sex, age, and fitness status. A total of 148 untrained adults (mean age [year] = 30.5 ± 13.9, height [m] = 1.72 ± 0.08 m, body mass [kg] = 82.6 ± 20.5, body fat [%] = 28.7 ± 12.0) completed a continuous incremental VO2 peak/LT protocol. Fat oxidation rates were determined using indirect calorimetry. The highest recorded fat oxidation rate was chosen as FATMAX. The breakpoint in the VO2–blood lactate relationship was chosen as LT. RPE was based on the Borg 6–20 scale. Bland–Altman plot analysis demonstrated that VO2 FATMAX systematically preceded VO2 LT (mean bias = 1.3 ml kg−1 min−1) with wide limits of agreement (+9.6 to −6.9 ml kg−1 min−1). Multivariate ANOVA revealed a significant difference between VO2 FATMAX (12.7 ± 7.5 ml kg−1 min−1) and VO2 LT (14.1 ± 5.9 ml kg−1 min−1) in the total sample (p = 0.04). There were no differences between the intensities when the sample was divided into sex, age, and fitness comparison groups (p values [0.05). RPE FATMAX (9.4 ± 2.5) preceded RPE LT (10.4 ± 2.0) in the total sample (p = 0.008), but was not different across comparison groups (p > 0.05). The present data indicate that the highest rate of fat oxidation slightly precedes the LT in untrained adults. For exercise prescription, a Borg-RPE of 9–12 identifies both FATMAX and LT. PMID:21259025

Diagnostics of Turbulent Dynamo from the Flux Emergence Rate in Solar Active Regions

NASA Astrophysics Data System (ADS)

Abramenko, V. I.; Tikhonova, O. I.; Kutsenko, A. S.

2017-12-01

Line-of-sight magnetograms acquired by the Helioseismic and Magnetic Imager (HMI) onboard the Solar Dynamic Observatory (SDO) and by the Michelson Doppler Imager (MDI) onboard the Solar and Heliospheric Observatory (SOHO) for 14 emerging ARs were used to study the derivative of the total unsigned flux-the flux emergence rate, R( t). We found that the emergence regime is not universal: each AR displays a unique emergence process. Nevertheless, two types of the emergence process can be identified. First type is a "regular" emergence with quasi-constant behavior of R( t) during a 1-3 day emergence interval with a rather low magnitude of the flux derivative, R max = (0.57 ± 0.22) × 1022 Mx day-1. The second type can be described as "accelerated" emergence with a long interval (>1 day) of the rapidly increasing flux derivative R( t) that result in a rather high magnitude of R max= (0.92 ± 0.29) × 1022 Mx day-1, which later changes to a very short (about a one third of day) interval of R( t) = const followed by a monotonous decrease of R( t). The first type events might be associated with emergence of a flux tube with a constant amount of flux that rises through the photosphere with a quasi-constant speed. Such events can be explained by the traditional largescale solar dynamo generating the toroidal flux deep in the convective zone. The second-type events can be interpreted as a signature of sub-surface turbulent dynamo action that generates additional magnetic flux (via turbulent motions) as the magnetic structure makes its way up to the solar surface.

Differentiating Forms and Functions of Aggression in Emerging Adults: Associations with Hostile Attribution Biases and Normative Beliefs

ERIC Educational Resources Information Center

Bailey, Christopher A.; Ostrov, Jamie M.

2008-01-01

The purpose of this study was to extend the current literature on forms (i.e., physical and relational) and functions (i.e., proactive and reactive) of participants' cognitions and beliefs about aggressive behavior. Participants included an ethnically diverse group of emerging adults (N = 165; M = 19.05 years; SD = 1.55) and completed a battery of…

Older adult falls prevention behaviors 60 days post-discharge from an urban emergency department after treatment for a fall.

PubMed

Shankar, Kalpana Narayan; Treadway, Nicole J; Taylor, Alyssa A; Breaud, Alan H; Peterson, Elizabeth W; Howland, Jonathan

2017-12-01

Falls are a common and debilitating health problem for older adults. Older adults are often treated and discharged home by emergency department (ED)-based providers with the hope they will receive falls prevention resources and referrals from their primary care provider. This descriptive study investigated falls prevention activities, including interactions with primary care providers, among community-dwelling older adults who were discharged home after presenting to an ED with a fall-related injury. We enrolled English speaking patients, aged ≥ 65 years, who presented to the ED of an urban level one trauma center with a fall or fall related injury and discharged home. During subjects' initial visits to the ED, we screened and enrolled patients, gathered patient demographics and provided them with a flyer for a Matter of Balance course. Sixty-days post enrollment, we conducted a phone follow-up interview to collect information on post-fall behaviors including information regarding the efforts to engage family and the primary care provider, enroll in a falls prevention program, assess patients' attitudes towards falling and experiences with any subsequent falls. Eighty-seven community-dwelling people between the ages of 65 and 90 were recruited, the majority (76%) being women. Seventy-one percent of subjects reported talking to their provider regarding the fall; 37% reported engaging in falls prevention activities. No subjects reported enrolling in a fall prevention program although two reported contacting falls program staff. Fourteen percent of subjects (n=12) reported a recurrent fall and 8% (7) reported returning to the ED after a recurrent fall. Findings indicate a low rate of initiating fall prevention behaviors following an ED visit for a fall-related injury among community-dwelling older adults, and highlight the ED visit as an important, but underutilized, opportunity to mobilize health care resources for people at high risk for subsequent falls.

Social Grooming in the Kindergarten: The Emergence of Flattery Behavior

ERIC Educational Resources Information Center

Fu, Genyue; Lee, Kang

2007-01-01

The present study examined the emergence of flattery behavior in young children and factors that might affect whether and how it is displayed. Preschool children between the ages of 3 and 6 years were asked to rate drawings produced by either a present or absent adult stranger (Experiments 1 and 2), child stranger (Experiments 2 and 3), classmate,…