Cancer researchers, advocates, and a cancer survivor introduce the topic of adolescent and young adult (AYA) cancers, covering distinct aspects of cancer in these patients and research questions to answer.
Risser, William L.; Risser, Jan M. H.
Reviews the prevalence, natural history, causes, impact on performance, diagnosis, and treatment of iron deficiency in adolescent and young adult athletes. All athletes should be screened and treated. The best diagnosis involves determining serum ferritin and hemoglobin levels. Treatment requires therapeutic doses of oral ferrous iron for several…
Little attention has been paid to hearing abilities and the effects of noise on the normal adolescent and young adult population. A series of studies will be presented on the prevalence of hearing loss and reported effects of hearing loss and tinnitus in adolescents and young adults from different cultural backgrounds. Adolescents and young adults from different backgrounds may tend to seek or avoid various noise environments that could be detrimental to their hearing and cause tinnitus. Attitudes and exposures to noise environments were evaluated to see if these may be correlated with their hearing losses and/or tinnitus. In addition, these adolescent and young adult subjects reported how often they used hearing protection in various noise environments. Finally, the issues of quality of life and the need for hearing conservation programs with these populations will be presented.
Intended to help parents and teachers select books for young people that reflect the actual interests of adolescents, this booklet discusses titles that both appeal to teenagers and help adults gain insight into their needs, their concerns, and their values. Titles of chapters in the booklet are as follows: (1) "Are Young Adult Books…
Watts, Elizabeth L.
Discusses (1) a rationale for using young adult literature with adolescent English-as-a-Second-Language learners; (2) an approach to teaching the novel "Make Lemonade" by Virginia Euwer Wolff; (3) activities in which students engaged and samples of their work; and (4) implications for teachers who explore young adult literature with…
de Anda, Diane; Smith, Melanie A.
Examined data on 165 adolescents, 65 young adults, and 175 adults who called 2 suicide help lines. Adults and young adults reported depression as primary reason for contemplating suicide; adolescents reported interpersonal problems. Although callers reported suicide ideation, very small percentage fell into high-risk categories with regard to…
Moseley, David S.; Tonge, Bruce J.; Brereton, Avril V.; Einfeld, Stewart L.
This article reports the findings of a study investigating rates and types of comorbid mental disorder evident in adolescents and young adults with autism. A sample of 84 young people (M = 19.5 years, SD = 4.6) with "Diagnostic and Statistical Manual of Mental Disorders," 4th Edition, Text Revision (DSM-IV-TR; American Psychiatric…
Rousset-Jablonski, Christine; Chevillon, Florian; Dhedin, Nathalie; Poirot, Catherine
Fertility impairment due to treatments is a major concern for patients who have survived cancer in adolescence or as a young adult. The impact of cancer treatments on fertility depends on the age at treatments, types and cumulative doses of chemotherapy, radiation doses to organs at risk, and on surgeries conducted. Fertility preservation strategies have been developed for many years, and recently diversified thanks to advances in reproductive biology. In female adolescents and young adults, ovarian stimulation followed by oocyte (or embryo) vitrification, ovarian tissue cryopreservation, and sometimes oocyte vitrification after in vitro maturation are options that can be discussed. In some diseases, potential risk of residual disease in cryopreserved ovarian cortex has to be taken into account before ovarian tissue transplantation, which should always be discussed with the oncological team. The use of GnRH agonists for fertility preservation remains controversial. In case of pelvic radiation therapy, intensity-modulated conformal radiotherapy, and ovarian transposition can preserve organs at risk. In male adolescents and young adults, sperm crypopreservation is an established fertility preservation method, which can in most cases, including adolescents, be carried out. In prepubertal or peripubertal patients, testicular tissue cryopreservation can be proposed. Information on the effects of treatments and discussion of fertility preservation options should be systematic in adolescents and young adults with cancer.
Ribera, Josep-Maria; Ribera, Jordi; Genescà, Eulàlia
The primary objective of this review was to update and discuss the current concepts and the results of the treatment of acute lymphoblastic leukemia (ALL) in adolescents and young adults (AYA). After a brief consideration of the epidemiologic and clinicobiologic characteristics of ALL in the AYA population, the main retrospective comparative studies stating the superiority of pediatric over adult-based protocols were reviewed. The most important prospective studies in young adults using pediatric inspired or pediatric unmodified protocols were also reviewed emphasizing their feasibility at least up to the age of 40 yr and their promising results, with event-free survival rates of 60–65% or greater. Results of trials from pediatric groups have shown that the unfavourable prognosis of adolescents is no more adequate. The majority of the older adolescents with ALL can be cured with risk-adjusted and minimal residual disease-guided intensive chemotherapy, without stem cell transplantation. However, some specific subgroups, which are more frequent in adolescents than in children (e.g., early pre-T, iAMP21, and BCR-ABL-like), deserve particular attention. In summary, the advances in treatment of ALL in adolescents have been translated to young adults, and that explains the significant improvement in survival of these patients in recent years. PMID:25045460
Dagorne, Loïc; Bruckner, Tania; Gaudry, Bruno; Dumont, Sarah; Gaspar, Nathalie
The medical-psycho-socio-educational characteristics of adolescents and young adults affected by cancer require adapted management. Dedicated programmes and life spaces, as well as the availability of a mobile and transversal multidisciplinary team allow care to be customised. In this context, the coordinating nurse is an essential linchpin in the care team.
Wymbs, Brian T.; Molina, Brooke S. G.; Belendiuk, Katherine A.; Pedersen, Sarah L.; Walther, Christine A. P.; Cheong, Jee Won; McGinley, James S.; Marshal, Michael P.; Gnagy, Elizabeth M.; Pelham, William E.
Although children with attention-deficit/hyperactivity disorder (ADHD) are at risk for impulsive, health-endangering behavior, few studies have examined nonsubstance, use-related risk-taking behaviors. This study examined whether adolescents and young adults with ADHD histories were more likely than those without ADHD histories to report frequent…
Johnson, Rebecca H; Macpherson, Catherine Fiona; Smith, Ashley W; Block, Rebecca G; Keyton, Joann
A case of a young adult patient in the days immediately after a cancer diagnosis illustrates the critical importance of three interrelated core coordinating mechanisms-closed-loop communication, shared mental models, and mutual trust-of teamwork in an adolescent and young adult multidisciplinary oncology team. The case illustrates both the opportunities to increase team member coordination and the problems that can occur when coordination breaks down. A model for teamwork is presented, which highlights the relationships among these coordinating mechanisms and demonstrates how balance among them works to optimize team function and patient care. Implications for clinical practice and research suggested by the case are presented.
Kent, Erin E; Parry, Carla; Montoya, Michael J; Sender, Leonard S; Morris, Rebecca A; Anton-Culver, Hoda
Adolescent and young adult cancer survivors face unique challenges not systematically addressed by cancer clinicians. Four focus groups and two individual interviews were conducted with 19 survivors to profile experiences and identify key concerns for future interventions. The resultant themes reflect cancer care continuum challenges (such as delays in diagnosis, problems with adherence), psychosocial concerns (such as infertility and reproductive concerns, changing social relationships, financial burden), and the paradox of being diagnosed with cancer as a young adult. Future intervention development for adolescent and young adult survivors should involve patient voices at each stage of the research process.
Ramphal, R.; Aubin, S.; Czaykowski, P.; De Pauw, S.; Johnson, A.; McKillop, S.; Szwajcer, D.; Wilkins, K.; Rogers, P.
Adolescents and young adults (ayas) with cancer in active treatment face a number of barriers to optimal care. In the present article, we focus on the 3 critical domains of care for ayas—medical, psychosocial, and research—and how changes to the system could overcome barriers. We summarize the current literature, outline recommended principles of care, raise awareness of barriers to optimal care, and suggest specific changes to the system to overcome those barriers in the Canadian context. Many of the recommendations can nevertheless be applied universally. These recommendations are endorsed by the Canadian Task Force on Adolescents and Young Adults with Cancer and build on outcomes from two international workshops held by that group. PMID:27330350
Hoopes, Andrea J; Manskopf, Inga; Walker, Leslie
Marijuana is the most common illicit drug of abuse in adolescents, nationally and globally. What is currently known about the effects of marijuana on adolescents and their lives reveals a number of concerns, ranging from acute physical effects to long-term physical, mental, and social consequences. As states begin to re-evaluate marijuana policies, it is important that the health and well-being of adolescents and young adults remain a priority. Much about marijuana and its medicinal uses is still not known, nor is there adequate data about the long-term effects of use of stronger marijuana products over the life course. Although much research is needed on marijuana and its derivatives, enough is known about its effects on adolescents to recommend an increased focus on preventing marijuana use in this stage of life.
Biller, José; Elkind, Mitchell S.; Fullerton, Heather J.; Jauch, Edward C.; Kittner, Steven J.; Levine, Deborah A.; Levine, Steven R.
Approximately 15% of all ischemic strokes (IS) occur in young adults and adolescents. To date, only limited prior public health and research efforts have specifically addressed stroke in the young. Early diagnosis remains challenging because of the lack of awareness and the relative infrequency of stroke compared with stroke mimics. Moreover, the causes of IS in the young are heterogeneous and can be relatively uncommon, resulting in uncertainties about diagnostic evaluation and cause-specific management. Emerging data have raised public health concerns about the increasing prevalence of traditional vascular risk factors in young individuals, and their potential role in increasing the risk of IS, stroke recurrence, and poststroke mortality. These issues make it important to formulate and enact strategies to increase both awareness and access to resources for young stroke patients, their caregivers and families, and health care professionals. The American Academy of Neurology recently convened an expert panel to develop a consensus document concerning the recognition, evaluation, and management of IS in young adults and adolescents. The report of the consensus panel is presented herein. PMID:23946297
During the last decade, increasing attention has been paid to a unique group of patients with acute lymphoblastic leukemia (ALL) who lie at the crossroad of therapeutic care by pediatric and adult hematologists/oncologists. ALL is a disease that affects infants, children, adolescents, and adult patients. With current therapies, the vast majority of children with ALL are now long-term survivors; unfortunately, the same good results have not yet been obtained for adults with ALL. This review will describe current controversies surrounding the treatment of adolescents and young adults with ALL--a group who finds themselves in the transition from "pediatric" to "adult" treatment approaches. The review focuses on recent insights into disease biology, prognostic factors, and treatment outcomes that have led to a series of prospective clinical trials specifically designed for adolescents and younger adults (AYAs) with ALL. These trials have been designed to provide important new clinical, psychosocial, and biological insights, and to further improve the survival of this challenging and unique group of patients.
Finestack, Lizbeth H.; Palmer, Meghan; Abbeduto, Leonard
Purpose: To gain a better understanding of language abilities, the expressive macrostructural narrative language abilities of verbally expressive adolescents and young adults with Down syndrome (DS) and those with fragile X syndrome (FXS) were examined. Method: The authors evaluated 24 adolescents and young adults with DS, 12 male adolescents and…
Zhao, Sibo; Zhang, Jie
Background: In China, suicide is one of the major causes of death among adolescents and young adults aged 15 to 34 years. Aim: The current study examines how risk factors vary by age groups in rural China, referring to those aged 15 to 24 years and those aged 25 to 34 years. Method: A case-control psychological autopsy (PA) study is conducted in sixteen counties from three Chinese provinces, including 392 suicide cases and 416 community living controls in the sample. Results: In China, young adults aged 25 to 34 years have a higher risk for suicide than adolescents aged 15 to 24 years, and it holds true even controlling for relevant social factors. In addition, age-related factors such as education, marital status, whether having children, status in the family, physical health, and personal income all have varying degrees of impact on suicide risks for rural youth. Conclusions: This study shows that there are some age-related risk factors for suicide at certain life stages and emphasizes that young adults in rural China aged 25 to 34 years have an increased risk of suicide as a result of experiencing more psychological strains with age. PMID:25546276
Park, M Jane; Scott, Jazmyn T; Adams, Sally H; Brindis, Claire D; Irwin, Charles E
Adolescence and young adulthood are unique developmental periods that present opportunities and challenges for improving health. Health at this age can affect health throughout the lifespan. This review has two aims: (1) to examine trends in key indicators in outcomes, behaviors, and health care over the past decade for U.S. adolescents and young adults; and (2) to compare U.S. adolescents and young adults on these indicators. The review also assesses sociodemographic differences in trends and current indicators. Guided by our aims, previous reviews, and national priorities, the present review identified 21 sources of nationally representative data to examine trends in 53 areas and comparisons of adolescents and young adults in 42 areas. Most health and health care indicators have changed little over the past decade. Encouraging exceptions were found for adolescents and young adults in unintentional injury, assault, and tobacco use, and, for adolescents, in sexual/reproductive health. Trends in violence and chronic disease and related behaviors were mixed. Review of current indicators demonstrates that young adulthood continues to entail greater risk and worse outcomes than adolescence. Young adults fared worse on about two-thirds of the indicators examined. Differences among sociodemographic subgroups persisted for both trends and current indicators.
Tonorezos, Emily S; Oeffinger, Kevin C
Every year in Canada and the United States, about 26,000 adolescent and young adults (AYA) between ages 15 and 29 years are diagnosed with cancer. Although the majority of AYA cancer patients will survive their primary cancer, many will develop serious health problems or die prematurely secondary to their curative cancer therapy. Much is known about the long-term health outcomes after adolescent cancer. In contrast, there remain substantial gaps in our understanding of the long-term outcomes after most young adult cancers. To optimize the health and quality of life of AYA cancer survivors and improve upon curative cancer therapy, it is essential to further investigate the long-term outcomes of this population. Before embarking upon this endeavor, it is important for the investigator and the funding agency to be cognizant about some of the unique challenges in research of AYA cancer survivors. To this end, the authors present a brief overview of some of the key research challenges, discuss the strengths and limitations of using available AYA cohorts and databases, and highlight potential future directions.
Tuval-Mashiach, Rivka; Shulman, Shmuel
The study was designed to explore qualitatively developmental differences in disagreement negotiation and resolution skills between adolescent and young adult romantic partners. Twenty adolescent and 20 young adult couples participated in the study. The Knox inventory was used to measure the level of disagreement between partners on ten domains…
Carlo, Gustavo; Crockett, Lisa J.; Wilkinson, Jamie L.; Beal, Sarah J.
While many adolescents and young adults experiment with substances (e.g., alcohol, cigarette smoking, marijuana), recent research suggests that rural youth and young adults may be more at risk for substance use than their urban counterparts. This study was designed to examine the longitudinal relationships between rural adolescents' prosocial…
Joe, Sean; Romer, Daniel; Jamieson, Patrick E.
The association between adolescents' and young adults' attitudes toward suicide and their own suicidality across five racial-ethnic classifications was studied in a nationally representative sample of 3,301 youth ages 14 to 22 years from the National Annenberg Risk Survey of Youth. Results indicate that adolescents and young adults who most…
Mikulecky, Larry, Comp.; And Others
This handbook presents two core units for a distance education course that provides an introduction to the genre of texts targeted for adolescent/young adult readers. The first core unit in the handbook discusses the teaching of literary aspects of using adolescent/young adult literature. The second core unit addresses alternative approaches to…
Iselin, Anne-Marie R.; DeCoster, Jamie
This study compared the cognitive control skills of male incarcerated adolescents (n = 44), male control adolescents (n = 33), male incarcerated young adults (n = 41), and male control young adults (n = 35) using the AX-continuous performance test (AX-CPT). This test measures proactive control (the ability to maintain a mental representation of…
Park, Eliza M.; Rosenstein, Donald L.
Adolescents and young adults (AYAs) with cancer are at risk for depression due to disruptions in their developmental trajectory, greater physical symptom burden, and increased likelihood of developing aggressive disease. Rates of depression and other psychological disorders are substantially higher in AYAs with cancer when compared with older adults. Psychiatrists caring for these patients must consider the age-appropriate developmental context of these patients along with familial and medical factors that may influence the presentation and treatment of depression. Previous research suggests that psychosocial interventions specifically designed for AYA patients are promising, but studies of psychopharmacology treatments for depression are lacking. There is a pressing need for prospective studies and controlled clinical trials that evaluate the optimal strategies for treating depression in this patient group. PMID:26246791
Park, Eliza M; Rosenstein, Donald L
Adolescents and young adults (AYAs) with cancer are at risk for depression due to disruptions in their developmental trajectory, greater physical symptom burden, and increased likelihood of developing aggressive disease. Rates of depression and other psychological disorders are substantially higher in AYAs with cancer when compared with older adults. Psychiatrists caring for these patients must consider the age-appropriate developmental context of these patients along with familial and medical factors that may influence the presentation and treatment of depression. Previous research suggests that psychosocial interventions specifically designed for AYA patients are promising, but studies of psychopharmacology treatments for depression are lacking. There is a pressing need for prospective studies and controlled clinical trials that evaluate the optimal strategies for treating depression in this patient group.
Wiesner, Margit; Windle, Michael
This longitudinal study extended work from Wiesner and Windle (2004) by examining young adult outcomes (i.e., alcohol and illicit drug use, depression) of middle-adolescent trajectories of delinquent behavior for a community sample of 724 young women and men (at average ages 23.8 years). Each domain of young adult adjustment problems was assessed…
Nakata-Yamada, Kayo; Inoue, Masami; Ioka, Akiko; Ito, Yuri; Tabuchi, Takahiro; Miyashiro, Isao; Masaie, Hiroaki; Ishikawa, Jun; Hino, Masayuki; Tsukuma, Hideaki
The survival gap between adolescents and young adults (AYAs) with hematological malignancies persists in many countries. To determine to what extent it does in Japan, we investigated survival and treatment regimens in 211 Japanese AYAs (15-29 years) in the Osaka Cancer Registry diagnosed during 2001-2005 with hematological malignancies, and compared adolescents (15-19 years) with young adults (20-29 years). AYAs with acute lymphoblastic leukemia (ALL) had a poor 5-year survival (44%), particularly young adults (29% vs. 64% in adolescents, p = 0.01). Additional investigation for patients with ALL revealed that only 19% of young adults were treated with pediatric treatment regimens compared with 45% of adolescents (p = 0.05). Our data indicate that we need to focus on young adults with ALL and to consider establishing appropriate cancer care system and guidelines for them in Japan.
Benedict, Catherine; Shuk, Elyse
Purpose: Many adolescent and young adult (AYA) cancer survivors place great importance on fertility. This study explored AYAs' discussions of fertility in the context of discussing their survivorship experiences. Methods: Secondary analyses of a qualitative study of young adult survivors of adolescent cancers (“AYA survivors”) was performed using semistructured individual interviews and focus groups. Analyses were conducted using grounded theory using thematic content analysis with an inductive data-driven approach. Results: Participants (n = 43) were 16–24 years old, diagnosed with cancer between ages 14 and 18 years, and were at least 6 months post-treatment. Before treatment, 5 males banked sperm and no females preserved fertility. More males (50%) than females (39%) reported uncertainty about their fertility. Three major categories emerged from the data: fertility concerns, emotions raised when discussing fertility, and strategies used to manage fertility concerns. Fertility concerns focused on dating/partner reactions, health risks, and what potential infertility would mean for their life narrative. Emotions included distress, feeling overwhelmed and hopeful/wishful thinking. Females were more likely to feel distressed and overwhelmed than males. Strategies to manage concerns included acceptance/“making do,” desire to postpone concerns, and reliance on assisted reproductive technology. Conclusions: Most AYAs in our study reported a number of reproductive concerns and fertility-related distress after treatment, which may affect other areas of psychosocial functioning. Females may be more at-risk for distress than males, particularly in situations of uncertainty and limited knowledge. Future work should explore how to best incorporate fertility-related informational and support services more fully into survivorship care. Implications for survivorship care are discussed. PMID:26812452
Krakovsky, Gina; Huth, Myra Martz; Lin, Li; Levin, Ron S.
Children with multiple handicaps, including cerebral palsy (CP), often lose or regress in their functional ability through adolescence and young adulthood. The purpose of this study was to examine functional and psychosocial changes in children, adolescents, and young adults with CP. A retrospective chart review and a prospective telephone…
Giordano, Peggy C; Johnson, Wendi L; Manning, Wendy D; Longmore, Monica A
Most prior studies of intimate partner violence (IPV) have relied on traditional indices of parental support, control or coercion to examine the nature and extent of parental influences. We explore whether parents' more general attitudes toward their child's dating and associated parenting practices are related to the young adult child's report of IPV, once traditional parent factors and other covariates are introduced. Using data from the Toledo Adolescent Relationships Study (n = 625), results indicate that net of other parenting dimensions and controls for child and neighborhood characteristics, parental negativity about their child's dating and related parenting practices are associated with later reports of IPV during young adulthood. Parent-child conflict and the child's own feelings of gender mistrust were considered as potential mediators. Results suggest the importance of widening the lens beyond support, control and even the parents' own use of violence to include a range of parental attitudes and behaviors that influence the child's approach to and conduct within the romantic realm.
Giordano, Peggy C.; Johnson, Wendi L.; Manning, Wendy D.; Longmore, Monica A.
Most prior studies of intimate partner violence (IPV) have relied on traditional indices of parental support, control or coercion to examine the nature and extent of parental influences. We explore whether parents’ more general attitudes toward their child’s dating and associated parenting practices are related to the young adult child’s report of IPV, once traditional parent factors and other covariates are introduced. Using data from the Toledo Adolescent Relationships Study (n = 625), results indicate that net of other parenting dimensions and controls for child and neighborhood characteristics, parental negativity about their child’s dating and related parenting practices are associated with later reports of IPV during young adulthood. Parent-child conflict and the child’s own feelings of gender mistrust were considered as potential mediators. Results suggest the importance of widening the lens beyond support, control and even the parents’ own use of violence to include a range of parental attitudes and behaviors that influence the child’s approach to and conduct within the romantic realm. PMID:26903688
Martsolf, Donna S.; Colbert, Crystal; Draucker, Claire B.
Adolescent dating violence (ADV) is a significant community problem. In this study, we examine the perspectives of two groups (young adults who experienced ADV as teens and professionals who work with teens) on ADV prevention/intervention in a community context. We interviewed 88 young adults and 20 professionals. Our research team used Thorne's…
White, Claire M; Gummerum, Michaela; Hanoch, Yaniv
Young people are exposed to and engage in online risky activities, such as disclosing personal information and making unknown friends online. Little research has examined the psychological mechanisms underlying young people's online risk taking. Drawing on fuzzy trace theory, we examined developmental differences in adolescents' and young adults' online risk taking and assessed whether differential reliance on gist representations (based on vague, intuitive knowledge) or verbatim representations (based on specific, factual knowledge) could explain online risk taking. One hundred and twenty two adolescents (ages 13-17) and 172 young adults (ages 18-24) were asked about their past online risk-taking behavior, intentions to engage in future risky online behavior, and gist and verbatim representations. Adolescents had significantly higher intentions to take online risks than young adults. Past risky online behaviors were positively associated with future intentions to take online risks for adolescents and negatively for young adults. Gist representations about risk negatively correlated with intentions to take risks online in both age groups, while verbatim representations positively correlated with online risk intentions, particularly among adolescents. Our results provide novel insights about the underlying mechanisms involved in adolescent and young adults' online risk taking, suggesting the need to tailor the representation of online risk information to different age groups.
Steinbeck, Kate; Towns, Susan; Bennett, David
Adolescent and young adult medicine is a concept that has gained traction in the last decade or so. The medical literature has come primarily from oncology. Advances in neuroscience that document continuing brain development into the third decade, and research that shows risk behaviours associated with adolescence both remain and may increase in the third decade, have been two of the drivers in the conversation around linking these two age groups together as a medical practice group. A third driver of importance is transition care in chronic illness, where older adolescents and young adults continue to have difficulties making effective linkages with adult care. The case for specific training in adolescent and young adult medicine, including the developmental concepts behind it, the benefits of the delineation and the particular challenges in the Australian health-care system, are discussed. On balance, there is a strong case for managing the health issues of adolescents and young adults together. This scenario does not fit easily with the age demarcations that are in place in acute care facilities. However, this is less the case in community services and can work in focused private practice. Such a situation suggests that both paediatric and adult physicians might be interested in adolescent and young adult medicine training and practice.
Kiff, Cara J; Cortes, Rebecca; Lengua, Lilana; Kosterman, Rick; Hawkins, J David; Mason, W Alex
Effects of Timing of Adversity on Adolescent and Young Adult Adjustment Abstract Exposure to adversity during childhood and adolescence predicts adjustment across development. Further, adolescent adjustment problems persist into young adulthood. This study examined relations of contextual adversity with concurrent adolescent adjustment and prospective mental health and health outcomes in young adulthood. A longitudinal sample (N = 808) was followed from age 10 through 27. Perceptions of neighborhood in childhood predicted depression, alcohol use disorders, and HIV risk in young adulthood. Further, the timing of adversity was important in determining the type of problem experienced in adulthood. Youth adjustment predicted adult outcomes, and in some cases, mediated the relation between adversity and outcomes. These findings support the importance of adversity in predicting adjustment and elucidate factors that affect outcomes into young adulthood.
The importance of protecting confidential health care for adolescents and young adults is well documented. State and federal confidentiality protections exist for both minors and young adults, although the laws vary among states, particularly for minors. However, such confidentiality is potentially violated by billing practices and in the processing of health insurance claims. To address this problem, policies and procedures should be established so that health care billing and insurance claims processes do not impede the ability of providers to deliver essential health care services on a confidential basis to adolescents and young adults covered as dependents on a family's health insurance plan.
Garciaz, Sylvain; Coso, Diane; Brice, Pauline; Bouabdallah, Réda
Lymphoma is one of the most frequent cancers in adolescent and young adults. Hodgkin Lymphoma is curable in more than 90% of cases. Recent pediatric and adults protocols aimed to decrease long term toxicities (mostly gonadic and cardiovascular) and secondary malignancies, reducing the use of alkylating agents and limiting radiation fields. Risk-adapted strategies, using positron emission tomography staging, are about to become a standard, both in adult and pediatric protocols. These approaches allow obtaining excellent results in adolescents with Hodgkin lymphoma. On the other hand, treatment of adolescents with diffuse large B-cell lymphoma raises some questions. Even through children have good outcomes when treated with risk-adapted strategies, adolescents who are between 15 and 18 years old seem to experience poorer survivals, whereas patients older than 18 years old have globally the same outcome than older adults. This category of patient needs a particular care, based on a tight coordination between adults and pediatric oncologists. Primary mediastinal lymphomas, a subtype of BLDCL frequent in young adult population, exhibits poorer outcomes in children or young adolescent population than in older ones. Taking together, B-cell lymphoma benefited from recent advances in immunotherapy (in particular with the extended utilization of rituximab) and metabolic response-adapted strategies. In conclusion, adolescent and young adult's lymphomas are very curable diseases but require a personalized management in onco-hematological units.
Gill, Sam D.
Argues that young adult literature can play a significant role in the emotional and mental health of an adolescent as well as help young males become more literate. Offers a 19-item annotated list of young adult novels with male protagonists, sorted by themes: nature and adventure stories, sports stories, genre stories, historical stories, and…
Dahan-Oliel, Noemi; Majnemer, Annette; Mazer, Barbara
Research on quality of life (QoL) of adolescents and young adults born preterm and those with congenital heart disease (CHD) was systematically reviewed, and factors associated with QoL were identified. Forty-five studies met the inclusion criteria for review. Although the majority of studies found that self-reported QoL of adolescents and young…
Malti, Tina; Buchmann, Marlis
Socialization and individual differences were examined as antecedents of moral motivation in representative samples of 15-year-old adolescents (N = 1,258; 54% female) and 21-year-old young adults (N = 584; 53% female). The adolescents' primary caregivers (N = 1,056) also participated. The strength of moral motivation was rated by participants'…
Georgiades, Katholiki; Boyle, Michael H.
Background: This study examines the longitudinal associations between adolescent tobacco and cannabis use and young adult functioning. Methods: Data for analysis come from the Ontario Child Health Study (OCHS), a prospective study of child health, psychiatric disorder and adolescent substance use in a general population sample that began in 1983,…
Keller-Bell, Yolanda D.; Abbeduto, Leonard D.
The narratives of 18 adolescents and young adults with fragile X syndrome were compared to those of 23 adolescents with Down syndrome and 21 typically developing children matched for nonverbal MA. Narratives were elicited using a wordless picture book and analyzed for use of narrative evaluation, linguistic productivity, and complexity. Results…
Jaeger, Antonio; Selmeczy, Diana; O'Connor, Akira R.; Diaz, Michael; Dobbins, Ian G.
Cortical regions supporting cognitive control and memory judgment are structurally immature in adolescents. Here we studied adolescents (13-15 y.o.) and young adults (20-22 y.o.) using a recognition memory paradigm that modulates cognitive control demands through cues that probabilistically forecast memory probe status. Behaviorally, adolescence…
Halperin, Jeffrey M.; Trampush, Joey W.; Miller, Carlin J.; Marks, David J.; Newcorn, Jeffrey H.
Background: This study examined neuropsychological functioning in a longitudinal sample of adolescents/young adults with attention deficit/hyperactivity disorder (ADHD) and controls as a function of the persistence of ADHD. We hypothesized that measures of executive processes would parallel adolescent clinical status, with ADHD-persisters, but not…
Cardoos, Stephanie L.; Loya, Fred; Hinshaw, Stephen P.
Our goal was to examine the role of adolescent perceived deviant peer affiliation in mediating or moderating the association between adolescent attention-deficit/hyperactivity disorder (ADHD) symptoms and young adult driving risk in females with and without ADHD. The overall sample included 228 ethnically and socioeconomically diverse girls with…
ANTIBODIES TO ENUMERATE SPIROCHETES AND IDENTIFY TREPONEMA DENTICOLA IN DENTAL PLAQUE OF CHILDREN, ADOLESCENTS AND YOUNG ADULTS S. L. BARRON G. R...TREPONEMA DENTICOLA IN DENTAL PLAQUE OF CHILDREN, ADOLESCENTS AND YOUNG ADULTS S. L. BARRON G. R. RIVIERE L. G. SIMONSON S. A. LUKEHART D. E. TIRA D. W...enumerate spirochetes and identify Treponema denticola o . in dental plaque of children, adolescents and young adults. ’................. Oral Microbiol
Giarelli, Ellen; Ruttenberg, Jean; Segal, Andrea
In this thematic content analysis we examined the expectations, and perceived facilitators of (referred to as bridges) and barriers to transition to community as reported by adolescents and young adults with Asperger syndrome. Participants were adolescents/young adults, ages 18-23 years were from the East Coast of the United States. Seventy percent of adolescents hoped for employment (n = 10). Thirty percent desired to find a partner and raise a family. Perceived barriers were: self-assessed behavioral problems, self-assessed associated features, other personal factors, and institutional factors. Bridges to facilitate transition were: accommodations in the community, cognitive abilities, personal qualities/strengths, and mentor's qualities.
In Cambodia, Care (Deutschland), through the Cambodia Health Education Development (CHED) and the Reproductive Health Association of Cambodia, is working towards the promotion of reproductive health (RH) practices among working adolescents and young adults. The project seeks to reach a minimum target group of 10,000 out-of-school, single, working adolescents and young adults aged 12-29 years, and at least 50 trained RH providers and educators in selected project sites. It also aims to provide specialist RH services to at least 200 single adolescents and young adults per month and per newly operational RH facility in project areas; and to build the capacity of at least two partner nongovernmental organizations in adolescent RH services. As its two-part strategy, the project is sharing information, education, and communication (IEC) expertise and using CHED as an informal IEC clearing house. The main activities of the project are outlined.
Dozzo, Massimo; Carobolante, Francesca; Donisi, Pietro Maria; Scattolin, Annamaria; Maino, Elena; Sancetta, Rosaria; Viero, Piera; Bassan, Renato
About one-half of all Burkitt lymphoma (BL) patients are younger than 40 years, and one-third belong to the adolescent and young adult (AYA) subset, defined by an age between 15 and 25–40 years, based on selection criteria used in different reports. BL is an aggressive B-cell neoplasm displaying highly characteristic clinico-diagnostic features, the biologic hallmark of which is a translocation involving immunoglobulin and c-MYC genes. It presents as sporadic, endemic, or epidemic disease. Endemicity is pathogenetically linked to an imbalance of the immune system which occurs in African children infected by malaria parasites and Epstein–Barr virus, while the epidemic form strictly follows the pattern of infection by HIV. BL shows propensity to extranodal involvement of abdominal organs, bone marrow, and central nervous system, and can cause severe metabolic and renal impairment. Nevertheless, BL is highly responsive to specifically designed short-intensive, rotational multiagent chemotherapy programs, empowered by the anti-CD20 monoclonal antibody rituximab. When carefully applied with appropriate supportive measures, these modern programs achieve a cure rate of approximately 90% in the average AYA patient, irrespective of clinical stage, which is the best result achievable in any aggressive lymphoid malignancy to date. The challenges ahead concern the following: optimization of management in underdeveloped countries, with reduction of diagnostic and referral-for-care intervals, and the applicability of currently curative regimens; the development of lower intensity but equally effective treatments for frail or immunocompromised patients at risk of death by complications; the identification of very high-risk patients through positron-emission tomography and minimal residual disease assays; and the assessment in these and the few refractory/relapsed ones of new monoclonals (ofatumumab, blinatumomab, inotuzumab ozogamicin) and new molecules targeting c-MYC and
Trivedi, Itishree; Holl, Jane L; Hanauer, Stephen; Keefer, Laurie
Planned healthcare transition, initiated in pediatric care, is a gradual process aimed at fostering the adolescent patient's disease knowledge and skills with the ultimate objective of preparing patients and families for adult-centered care. The process is critical in inflammatory bowel diseases (IBD) where there is an increased risk of non-adherence, hospitalizations, and emergency department use as young adult patients graduate from pediatric to adult-centered care. While evidence for healthcare transition in IBD is mounting, important gaps remain in the understanding of this process from the perspective of the adult gastroenterologist. This paper summarizes what is known about healthcare transition in IBD and explores the unanswered questions-a conceptual and methodological framework for transition interventions, relevant outcomes that define successful transition, and key stakeholder perspectives. For the adult gastroenterologist managing the young adult patient population, this paper presents the paradigm of "care integration"-a process of ongoing, multi-modality support for the patient, initiated in the adult care setting, with the goal of improving self-management skills and active participation in medical decision-making.
In contrast to the educational research and policy literature depicting urban adolescents as reluctant and struggling readers and writers, young people in recent young adult novels claim writing as an efficacious practice for self-discovery and social understanding. Analysis of the images of writers and writing in "Locomotion" and "Call Me Maria"…
Tsang, Anna; Moriarty, Carmel; Towns, Susan
With survival now into the fourth decade and rapid growth of the adolescent and adult population of people with cystic fibrosis CF sexual and reproductive health issues are integral to the management of adolescents and adults with CF. Education and counseling for sexual health related issues must be included in the daily routine of CF care. With advances in genetic counseling, contraception, assisted reproductive technology and collaborative management adolescents and young adults with CF realizing their sexual and reproductive potentials safely and realistically can be possible .
Jones, Darolyn Lyn
This paper presents descriptions of the 10 best young adult novels (and teaching suggestions) appropriate for studying the Holocaust in the middle school. Each description begins with a summary and "hook" that can be used with students, and then ends with discussion for the teacher about reading abilities and applications in the…
Hemphill, Sheryl A.; Heerde, Jessica A.
Purpose The purpose of the current paper was to examine the adolescent risk and protective factors (at the individual, peer group, and family level) for young adult cyber-bullying perpetration and victimization. Methods Data from 2006 (Grade 9) to 2010 (young adulthood) were analyzed from a community sample of 927 Victorian students originally recruited as a state-wide representative sample in Grade 5 (age 10–11 years) in 2002 and followed up to age 18–19 years in 2010 (N = 809). Participants completed a self-report survey on adolescent risk and protective factors and traditional and cyber-bullying perpetration and victimization, and young adult cyber-bullying perpetration and victimization. Results As young adults, 5.1% self-reported cyber-bullying perpetration only, 5.0% cyber-bullying victimization only, and 9.5% reported both cyber-bullying perpetration and victimization. In fully adjusted logistic regression analyses, the adolescent predictors of cyber-bullying perpetration only were traditional bullying perpetration, traditional bullying perpetration and victimization, and poor family management. For young adulthood cyber-bullying victimization only, the adolescent predictor was emotion control. The adolescent predictors for young adult cyber-bullying perpetration and victimization were traditional bullying perpetration and cyber-bullying perpetration and victimization. Conclusions Based on the results of this study, possible targets for prevention and early intervention are reducing adolescent involvement in (traditional or cyber-) bullying through the development of social skills and conflict resolution skills. In addition, another important prevention target is to support families with adolescents to ensure they set clear rules and monitor adolescent’s behavior. Universal programs that assist adolescents to develop skills in emotion control are warranted. PMID:24939014
Nguyen, Quynh C.; Hussey, Jon M.; Halpern, Carolyn T.; Villaveces, Andres; Marshall, Stephen W.; Siddiqi, Arjumand; Poole, Charles
Among adolescents, expectations of early death have been linked to future risk behaviors. These expectations may also reduce personal investment in education and training, thereby lowering adult socioeconomic status attainment. The importance of socioeconomic status is highlighted by pervasive health inequities and dramatic differences in life expectancy among education and income groups. The objectives of this study were to investigate patterns of change in perceived chances of living to age 35 (Perceived Survival Expectations; PSE), predictors of PSE, and associations between PSE and future socioeconomic status attainment. We utilized the U.S. National Longitudinal Study of Adolescent Health (Add Health) initiated in 1994-95 among 20,745 adolescents in grades 7-12 with follow-up interviews in 1996 (Wave II), 2001-02 (Wave III) and 2008 (Wave IV; ages 24-32). At Wave I, 14% reported ≤ 50% chance of living to age 35 and older adolescents reported lower PSE than younger adolescents. At Wave III, PSE were similar across age. Changes in PSE from Wave I to III were moderate, with 89% of respondents reporting no change (56%), one level higher (22%) or one level lower (10%) in a 5-level PSE variable. Higher block group poverty rate, perceptions that the neighborhood is unsafe, and less time in the U.S. (among the foreign-born) were related to low PSE at Waves I and III. Low PSE at Waves I and III predicted lower education attainment and personal earnings at Wave IV in multinomial logistic regression models controlling for confounding factors such as previous family socioeconomic status, individual demographic characteristics, and depressive symptoms. Anticipation of an early death is prevalent among adolescents and predictive of lower future socioeconomic status. Low PSE reported early in life may be a marker for worse health trajectories. PMID:22405687
Scirica, Christina V; Jethwani, Kamal
Background Social media has emerged as a potentially powerful medium for communication with adolescents and young adults around their health choices. Objective The goal of this systematic review is to identify research on the use of social media for interacting with adolescents and young adults in order to achieve positive health outcomes. Methods A MEDLINE/PubMed electronic database search was performed between January 1, 2002 and October 1, 2013, using terms to identify peer-reviewed research in which social media and other Web 2.0 technologies were an important feature. We used a systematic approach to retrieve papers and extract relevant data. Results We identified 288 studies involving social media, of which 87 met criteria for inclusion; 75 studies were purely observational and 12 were interventional. The ways in which social media was leveraged by these studies included (1) observing adolescent and young adult behavior (n=77), (2) providing health information (n=13), (3) engaging the adolescent and young adult community (n=17), and (4) recruiting research participants (n=23). Common health topics addressed included high-risk sexual behaviors (n=23), alcohol, tobacco, and other drug use (n=19), Internet safety (n=8), mental health issues (n=18), medical conditions (n=11), or other specified issues (n=12). Several studies used more than one social media platform and addressed more than one health-related topic. Conclusions Social media technologies offer an exciting new means for engaging and communicating with adolescents and young adults; it has been successfully used to engage this age group, identify behaviors, and provide appropriate intervention and education. Nevertheless, the majority of studies to date have been preliminary and limited in their methodologies, and mostly center around evaluating how adolescents and young adults use social media and the resulting implications on their health. Although these explorations are essential, further
Forsyth, Sophie; Rogstad, Karen
Adolescence is a time of sexual risk-taking and experimentation but also vulnerability. Young people may present to general physicians with systemic symptoms of sexually transmitted infections (STIs), such as arthritis, hepatitis or rash, but may not necessarily volunteer information about sexual activity. It is important for physicians to ask directly about sexual risks and if appropriate test for STIs and pregnancy. Knowing how to take a sexual history and consent a patient for an HIV test are core medical skills that all physicians should be trained to competently perform. Safeguarding young people is the responsibility of all healthcare professionals who come into contact with them, and young victims of abuse may present with physical symptoms such as abdominal pain or deliberate self-harm. We must all be aware of indicators of both child sexual exploitation and HIV infection and not be afraid to ask potentially awkward questions. If we don't we may miss vital opportunities to prevent or minimise harm to young people.
Hyden, Christel; Cohall, Alwyn
Over the past decade, new technology and media have changed the way we communicate, access information, and share content with one another. Most 12- to 17-year-olds now own cell phones, and most adolescents and young adults spend several hours per day on computers and cell phones. The American Academy of Pediatrics now encourages all pediatricians to increase their knowledge of new media and technology. This article details technology access among adolescents and young adults, highlights several current and potential innovative applications for new technology and social networking in health promotion, and discusses issues to consider as practitioners move toward integrating new media into clinical and health education settings.
Riser, Diana K; Pegram, Sheri E; Farley, Julee P
The current review explores the complex paths that can lead to adolescent and young adult males becoming sexually abusive. Because sexual abuse is an ongoing issue in our society that is often oversimplified, this article distinguishes between the various risk factors that predict sexually abusive behavior and types of sex offenders, particularly recidivistic offenders. It is imperative to focus on adolescents and young adults who sexually abuse because they represent a particularly important intervention point in preventing sexual abuse in comparison to older age groups and address the importance of differentiating among youths who sexually abuse, particularly between one-time offenders and recidivistic offenders. Implications for addressing these differences are discussed.
Wong, Charlene A.; Merchant, Raina M.; Moreno, Megan A.
We focus on the potential of social media related to the health of adolescent and young adults, who are nearly ubiquitous social media users but difficult to engage with their health and relatively low healthcare utilizers. Opportunities to better engage adolescents and young adults through social media exist in healthcare delivery, health education and health policy. However, challenges remain for harnessing social media, including making a clear value proposition and developing evidence-based frameworks for measuring the impact of social media on health. PMID:25984444
Drevon, Daniel D; Almazan, Elbert P; Jacob, Susan; Rhymer, Katrina N
Using the National Longitudinal Study of Adolescent Health and the Adolescent Health and Academic Achievement study datasets, this study examined whether natural mentoring relationships during adolescence were associated with young adult outcomes among lesbian, gay, and bisexual (LGB) persons. Outcomes in three domains were investigated: education and employment, psychological wellbeing, and substance use and abuse. Results indicated that LGB persons reporting natural mentors during adolescence were about three times as likely to graduate from high school as those without. Discussion surrounds strategies to foster mentoring relationships within the school environment or community.
Manifold, Marjorie Cohee
In this article, the art developmental progression of adolescents and young adults within the cultural context of an interest-based community is described; the role of narrative and sociocultural community to the art development of adolescents and young adults is highlighted. Artistic development begins in response to an aesthetic phenomenon, is…
Stock, Michelle L.; Gerrard, Meg; Weng, Chih-Yuan; Gibbons, Frederick X.; Houlihan, Amy E.; Lorenz, Fred O.; Simons, Ronald L.
Objective Two studies examined racial identity (RI) as a protective factor against substance-related cognitions and substance use among Black adolescents and young adults living in high versus low percentage Black social environments. Method Using structural equation modeling techniques, Study 1 examined longer term effects of RI on substance use cognitions and behaviors among 720 Black adolescents. Study 2 examined the impact of RI and percentage Black peer environment on alcohol use among 203 Black young adults. Results Study 1 revealed that RI was prospectively associated with lower levels of perceived friends’ use and lower favorability of the substance user prototype and, in turn, lower substance willingness and use, but only among Black adolescents in predominantly White neighborhoods. These adolescents also reported greater access to substances. In Study 2, low RI Black young adults who reported predominantly White peer environments reported the highest levels of alcohol use. Conclusions These findings highlight the importance of RI among Black youth and the impact of the social context on the health risk behaviors of adolescents and young adults. This research also demonstrates the utility of social psychological models, such as the prototype–willingness model, to examine mediating and moderating effects of individual differences and contextual factors on health risk cognitions and behavior. Theoretical and applied implications of the results are discussed. PMID:23088177
Joseph, Jane E.; Zhu, Xun; Lynam, Donald; Kelly, Thomas H.
Adolescence is a particularly vulnerable period for the onset of substance use disorders and other psychopathology. Individual variability in motivational tendencies and temperament and significant changes in functional brain organization during adolescence are important factors to consider in the development of substance use and dependence. Recent conceptualizations suggest that sensitivity to reward is heightened in adolescence and that this motivation tendency may precipitate subsequent substance abuse. The present study examined the role of personality traits in mesolimbic neurobehavioral response on a monetary incentive delay (MID) task in young adolescents (11–14 years) and emerging adults (18–25 years) using functional magnetic resonance imaging. As a group, adolescents were not more sensitive to gains than losses compared to adults during either anticipatory and feedback phases; instead, compared to adults they showed less sensitivity to incentive magnitude in mesolimbic circuitry during anticipation and feedback stages. However, personality modulated this response such that adolescents high in impulsivity or low in avoidance tendencies showed greater gain sensitivity and adolescents high in avoidance showed greater loss sensitivity during cue anticipation. In adults, mesolimbic response was modulated by the impulsivity construct such that high-impulsive adults showed reduced magnitude sensitivity during both anticipation and feedback compared to low impulsive adults. The present findings suggest that impulsive personality significantly modulates mesolimbic reward response during both adolescence and adulthood but avoidance and approach tendencies also modulate this response in adolescents. Moreover, personality modulated incentive valence in adolescents but incentive magnitude in adults. Collectively, these findings suggest that mesolimbic reward circuitry function is modulated by somewhat different parameters in adolescence than in adulthood. PMID
Joseph, Jane E; Zhu, Xun; Lynam, Donald; Kelly, Thomas H
Adolescence is a particularly vulnerable period for the onset of substance use disorders and other psychopathology. Individual variability in motivational tendencies and temperament and significant changes in functional brain organization during adolescence are important factors to consider in the development of substance use and dependence. Recent conceptualizations suggest that sensitivity to reward is heightened in adolescence and that this motivation tendency may precipitate subsequent substance abuse. The present study examined the role of personality traits in mesolimbic neurobehavioral response on a monetary incentive delay (MID) task in young adolescents (11-14 years) and emerging adults (18-25 years) using functional magnetic resonance imaging. As a group, adolescents were not more sensitive to gains than losses compared to adults during either anticipatory and feedback phases; instead, compared to adults they showed less sensitivity to incentive magnitude in mesolimbic circuitry during anticipation and feedback stages. However, personality modulated this response such that adolescents high in impulsivity or low in avoidance tendencies showed greater gain sensitivity and adolescents high in avoidance showed greater loss sensitivity during cue anticipation. In adults, mesolimbic response was modulated by the impulsivity construct such that high-impulsive adults showed reduced magnitude sensitivity during both anticipation and feedback compared to low impulsive adults. The present findings suggest that impulsive personality significantly modulates mesolimbic reward response during both adolescence and adulthood but avoidance and approach tendencies also modulate this response in adolescents. Moreover, personality modulated incentive valence in adolescents but incentive magnitude in adults. Collectively, these findings suggest that mesolimbic reward circuitry function is modulated by somewhat different parameters in adolescence than in adulthood.
Carreira, Helena; Antunes, Luís; Castro, Clara; Lunet, Nuno; Bento, Maria José
Cancer is the first cause of natural death among young subjects. Population-based statistics are important to evaluate the burden of disease and the effectiveness of healthcare provision. We aimed to describe cancer incidence and survival among adolescents (15-19 years) and young adults (20-24 years) in the north of Portugal. Data on the cancers diagnosed between 1997 and 2006 were obtained from the Portuguese North Region Cancer Registry, and incidence rates were computed. Vital status was determined until December 2010. Survival was estimated using the Kaplan-Meier survival function. Trends on cancer incidence were assessed using the Joinpoint regression analysis. A total of 1223 cases were diagnosed: 441 among adolescents and 782 among young adults. Overall incidence rate was 198.3 per million adolescents [95% confidence interval (95% CI): 135.7-260.9] and 306.2 per million young adults (95% CI: 262.3-350.0). The most frequent tumors were Hodgkin lymphoma (adolescents: 21.0%; young adults: 14.8%), thyroid carcinoma (adolescents: 11.5%; young adults: 16.2%), and germ cell tumors (adolescents: 11.1%; young adults: 16.3%). Cancer incidence significantly increased among young adults [annual average percent change: 3.6%, (95% CI: 1.7-5.4)], while appears to vary randomly among adolescents. Overall five-year observed survival was 77.2% (95% CI: 72.9%-80.8%) among adolescents and 81.3% (95% CI: 78.4%-83.9%) among young adults, lower in males. In conclusion, cancer incidence among adolescents and young adults is higher in the north of Portugal than in other European countries, especially of thyroid tumors. Between 1997 and 2006, the incidence increased significantly in young adults.
Egas-Bejar, Daniela; Huh, Winston W
Rhabdomyosarcoma (RMS), a malignant tumor of mesenchymal origin, is the third most common extracranial malignant solid tumor in children and adolescents. However, in adults, RMS represents <1% of all solid tumor malignancies. The embryonal and alveolar histologic variants are more commonly seen in pediatric patients, while the pleomorphic variant is rare in children and seen more often in adults. Advances in the research of the embryonal and alveolar variants have improved our understanding of certain genes and biologic pathways that are involved in RMS, but much less is known for the other variants. Multimodality therapy that includes surgery and chemotherapy with or without radiation therapy is the mainstay of treatment for RMS. Improvements in the risk stratification of the pediatric patients based on presurgical (primary tumor site, tumor size, regional lymph node involvement, presence of metastasis) and postsurgical parameters (completeness of resection or presence of residual disease or metastasis) has allowed for the treatment assignment of patients in different studies and therapeutic trials, leading to increases in 5-year survival from 25%–70% over the past 40 years. However, for adult patients, in great part due to rarity of the disease and the lack of consensus on optimal treatment, clinical outcome is still poor. Many factors have been implicated for the differing outcomes between pediatric RMS versus adult RMS, such as the lack of standardized treatment protocols for adult RMS patients and the increased prevalence of advanced presentations. Now that there are increased numbers of survivors, we can appreciate the sequelae from therapy in these patients, such as bone growth abnormalities, endocrinopathies, and infertility. Improvements in risk stratification have led to clinical trials using lower doses of chemotherapy or radiation therapy with the intention of decreasing the incidence of side effects without compromising survival outcome. PMID
Tucker, Joan S.; Edelen, Maria Orlando; Ellickson, Phyllis L.; Klein, David J.
Little is known about the adolescent risk factors and young adult health-related outcomes associated with running away from home. We examined these correlates of running away using longitudinal data from 4,329 youth (48% female, 85% white) who were followed from Grade 9 to age 21. Nearly 14% of the sample reported running away in the past year at…
Mendelson, Tamar; Turner, Alezandria K.; Tandon, S. Darius
The psychological effects of exposure to different types of violence among urban adolescents and young adults are not yet well understood. This study investigated exposure to neighborhood violence, relationship violence, and forced sex among 677 urban African Americans aged 16-23 enrolled at an employment and training center. We assessed…
Black, Shimrit K.; de Moor, Carl; Kendall, Ashley D.; Shrier, Lydia A.
This study examines the feasibility of recruiting and retaining adolescents and young adults with frequent cannabis use for a 2-week momentary sampling study of cannabis use. Participants responded to random signals on a handheld computer with reports of their use. Participants also initiated reports pre- and post-cannabis use. Participants had…
Teaching Research, 1992
This newsletter issue describes a programmatic line of research to develop and standardize a test battery of transition skills (employment and independent living skills) for adolescents and young adults (ages 14 to 25) who are deaf. The newsletter first discusses the importance of assessment data to the transition process for persons who are deaf.…
Houck, Christopher D.; Brown, Larry K.; Doherty, Glenn; DiClemente, Ralph J.; Fernandez, M. Isabel; Pugatch, David; Schlenger, William E.; Silver, Barbara J.
Objectives. We sought to learn what factors are associated with anal intercourse among adolescents and young adults. We examined demographic, behavioral, relationship context, attitudinal, substance use, and mental health correlates of recent heterosexual anal intercourse among adolescents and young adults who reported engaging in recent unprotected sex. Methods. Among 1348 at-risk adolescents and young adults aged 15 to 21 years in 3 US cities, we assessed sexual risk behavior with each sexual partner in the past 90 days. Data were collected from 2000 to 2001. Results. Recent heterosexual anal intercourse was reported by 16% of respondents. Females who engaged in anal intercourse were more likely to be living with a sexual partner, to have had 2 or more partners, and to have experienced coerced intercourse. For males, only a sexual orientation other than heterosexual was a significant predictor of engaging in heterosexual anal intercourse. Conclusions. Our findings document the prevalence of heterosexual anal intercourse among adolescents and young adults who had recent unprotected sex. Among females, the variables associated with anal intercourse relate to the context and power balance of sexual relationships. Different influences for males and females suggest different foci for interventions. PMID:19008522
McGuire, Jayne; McDonnell, John
Self-determination continues to be a focus for secondary students who have intellectual disabilities. This study examined the relationship between recreation and self-determination for adolescents and young adults with intellectual disabilities. Students from secondary and post-high school special education programs tracked their involvement in…
Riser, Diana K.; Pegram, Sheri E.; Farley, Julee P.
The current review explores the complex paths that can lead to adolescent and young adult males becoming sexually abusive. Because sexual abuse is an ongoing issue in our society that is often oversimplified, this article distinguishes between the various risk factors that predict sexually abusive behavior and types of sex offenders, particularly…
Vasic, Nenad; Lohr, Christina; Steinbrink, Claudia; Martin, Claudia; Wolf, Robert Christian
Behavioral studies indicate deficits in phonological working memory (WM) and executive functioning in dyslexics. However, little is known about the underlying functional neuroanatomy. In the present study, neural correlates of WM in adolescents and young adults with dyslexia were investigated using event-related functional magnetic resonance…
Greher, Gena R.; Hillier, Ashleigh; Dougherty, Margaret; Poto, Nataliya
Service provision for adolescents and young adults with autism spectrum disorders (ASD) is lacking, particularly post high school. We report on a music intervention program, outline our program model, and report some initial pilot data evaluating the program outcomes. We also discuss implications for undergraduate and graduate students who were…
Babinski, Dara E.; Pelham, William E., Jr.; Molina, Brooke S. G.; Gnagy, Elizabeth M.; Waschbusch, Daniel A.; Yu, Jihnhee; MacLean, Michael G.; Wymbs, Brian T.; Sibley, Margaret H.; Biswas, Aparajita; Robb, Jessica A.; Karch, Kathryn M.
Objective: To characterize the late adolescent and young adult outcomes of girls diagnosed with ADHD in childhood. Method: The study included 58 women from a larger longitudinal study of ADHD. A total of 34 (M = 19.97 years old) met "DSM" criteria for ADHD in childhood, whereas the remaining 24 (M = 19.83 years old) did not. Self- and…
Mazur, Elizabeth; Kozarian, Lauri
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;…
Mikulecky, Larry, Comp.; And Others
This handbook presents course information, reading materials, and application/research projects for a distance education course that provides an introduction to the genre of texts targeted for adolescent/young adult readers. The first section of the handbook discusses the goals, structure, assessment scheme, readings, and resources for the course.…
Bregman, George; Killen, Melanie
Examined adolescents' and young adults' evaluations of reasons for career decisions, and the role of parental influence. Found that subjects supported career choices for reasons of personal growth and rejected choices when decisions were based on interpersonal relationships or hedonism. Parental influence was judged most important when…
Hughes, Cathy; Thomas, Trang
A research review identified a range of family process variables associated with enhanced career development for adolescents and young adults. Findings were consistent with the theories of Roe (personality development and career choice) and Super (life-span, life-space) regarding the influence of family processes on career development. (Contains…
Sundahl, Lina; Zetterberg, Marie; Wester, Anita; Rehn, Börje; Blomqvist, Sven
Background: As physical activity can prevent overweight and promote general health, the aim was to investigate the amount of physical activity among adolescent and young adult women and men with intellectual disability (ID), compared to age-matched control groups without intellectual disability. A further aim was to examine whether physical…
Hellemans, Hans; Colson, Kathy; Verbraeken, Christine; Vermeiren, Robert; Deboutte, Dirk
Group home caregivers of 24 institutionalized, male, high-functioning adolescents and young adults with Autism Spectrum Disorder, were interviewed with the Interview Sexuality Autism. Most subjects were reported to express sexual interest and to display some kind of sexual behavior. Knowledge of socio-sexual skills existed, but practical use was…
Biederman, Joseph; Ball, Sarah W.; Monuteaux, Michael C.; Mick, Eric; Spencer, Thomas J.; McCreary, Michelle; Cote, Michelle; Faraone, Stephen V.
The association between attention-deficit/hyperactivity disorder (ADHD) and major depression (MD) in adolescent and young adult females is evaluated. Findings indicate that MD emerging in the context of ADHD is an impairing and severe comorbidity that needs to be considered further clinically and scientifically.
Cinamon, Rachel Gali; Gifsh, Limor
Semistructured interviews were conducted with 16 Israeli adolescents and young adults with mild mental retardation to examine their perceptions of the world of work. A consensual qualitative strategy of analysis (C. E. Hill, B. J. Thompson, & E. N. Williams, 1997) yielded 4 domains (Definitions of Work, Reasons for Working, Self-Awareness,…
Turnquist, Bruce Eric
This document reviews research concerning the factors affecting premarital sexual attitudes and behaviors of adolescents and young adults. Trends in the literature prior to 1980 are discussed briefly together with summaries of literature reviews from the decades of the 1950s, 1960s, and 1970s. Studies from 1980 to the present are reviewed in some…
Sibley, Margaret H.; Pelham, William E.; Molina, Brooke S. G.; Waschbusch, Daniel A.; Gnagy, Elizabeth M.; Babinski, Dara E.; Biswas, Aparajita
The purpose of the current study was to test the ability of adolescents and young adults with childhood ADHD to reliably self-report delinquency history. Data were examined from the Pittsburgh ADHD Longitudinal Study (PALS), a follow-up study of children diagnosed with ADHD between 1987 and 1996. Self-report of lifetime delinquency history was…
Russell, Stephen T.; Ryan, Caitlin; Toomey, Russell B.; Diaz, Rafael M.; Sanchez, Jorge
Background: Adolescent school victimization due to lesbian, gay, bisexual, or transgender (LGBT) status is commonplace, and is associated with compromised health and adjustment. Few studies have examined the long-term implications of LGBT school victimization for young adult adjustment. We examine the association between reports of LGBT school…
Vasilenko, Sara A; Kugler, Kari C; Butera, Nicole M; Lanza, Stephanie T
Adolescent sexual behavior is multidimensional, yet most studies of the topic use variable-oriented methods that reduce behaviors to a single dimension. In this study, we used a person-oriented approach to model adolescent sexual behavior comprehensively, using data from the National Longitudinal Study of Adolescent Health. We identified five latent classes of adolescent sexual behavior: Abstinent (39%), Oral Sex (10%), Low-Risk (25%), Multi-Partner Normative (12%), and Multi-Partner Early (13%). Membership in riskier classes of sexual behavior was predicted by substance use and depressive symptoms. Class membership was also associated with young adult STI outcomes although these associations differed by gender. Male adolescents' STI rates increased with membership in classes with more risky behaviors whereas females' rates were consistent among all sexually active classes. These findings demonstrate the advantages of examining adolescent sexuality in a way that emphasizes its complexity.
Baumgartner, Emma; Laghi, Fiorenzo
Although the link between cognition and affect in the advertising context has been demonstrated in several studies, no research to date has considered adolescents' affective responses to movie posters and their attitudes to negative and positive images. A 2 (between subjects) × 4 (within subjects) mixed-factorial experiment design comprising two groups of subjects (80 adolescents and 80 young adults) and four advertising stimuli (two highly positive images and two highly negative images) was used to test the differences in the subjects' attitudes to advertising, positive and negative affect, and viewing intentions. Although the adolescents, compared to the young adults, did not appear to have significantly stronger attitudes to emotional advertisements (ads), they showed a similar level of intensity of affective response when exposed to negative and positive images.
Allott, Kelly; Proffitt, Tina-Marie; McGorry, Patrick D; Pantelis, Christos; Wood, Stephen J; Cumner, Marnie; Brewer, Warrick J
Historically, clinical neuropsychology has made significant contributions to the understanding of brain-behavior relationships, particularly in neurological conditions. During the past several decades, neuropsychology has also become established as an important discipline in psychiatric settings. Cognition is increasingly recognized as being core to psychiatric illnesses and predictive of functional outcomes, augmenting theories regarding symptomatology and illness progression. Adult-type psychiatric disorders (including schizophrenia and other psychotic, mood, anxiety, eating, substance-related, and personality disorders) typically emerge during adolescence or young adulthood, a critical neurodevelopmental period. Clinical neuropsychological assessment in adolescent psychiatric patients is particularly valuable in informing clinical formulation and intervention and can be therapeutic across a number of levels. This article articulates the theoretical considerations and practical challenges and applications of clinical neuropsychology within adolescent and young-adult psychiatry. The importance of considering the neurodevelopmental context and its relationship to current theoretical models underpinning clinical practice are discussed.
Evans-Whipp, Tracy J; Plenty, Stephanie M; Toumbourou, John W; Olsson, Craig; Rowland, Bosco; Hemphill, Sheryl A
The purpose of this study was to investigate the influence of exposure to others' drink driving during adolescence on self-reported driving under the influence (DUI) of alcohol in young adulthood. Data were drawn from 1956 participants with a driving license enrolled in the International Youth Development Study from Victoria, Australia. During 2003 and 2004, adolescents in Grades 7, 9 and 10 (aged 12-17) completed questionnaires examining whether they had ridden in a vehicle with a driver who had been drinking, as well as other demographic, individual, peer and family risk factors for DUI. In 2010, the same participants (aged 18-24) then reported on their own DUI behaviour. 18% of young adults with a driving license reported DUI in the past 12 months. Exposure to others' drink driving during adolescence was associated with an increased likelihood of DUI as a young adult (OR=2.13, 95% CI 1.68-2.69). This association remained after accounting for the effects of other potential confounding factors from the individual, peer and family domains (OR=1.62, 95% CI 1.23-2.13). Observing the drink driving behaviours of others during adolescence may increase the likelihood of DUI as a young adult. Strategies to reduce youth exposure to drink driving are warranted.
Thurston, Idia B.; Bogart, Laura M.; Wachman, Madeline; Closson, Elizabeth F.; Skeer, Margie R.; Mimiaga, Matthew J.
Rising rates of human immunodeficiency virus (HIV) infection among adolescents and young adults underscore the importance of interventions for this population. While the morbidity and mortality of HIV has greatly decreased over the years, maintaining high rates of adherence is necessary to receive optimal medication effects. Few studies have developed interventions for adolescents and young adults and none have specifically been developed for sexual minority (lesbian, gay, and bisexual; LGB) youth. Guided by an evidence-based adult intervention and adolescent qualitative interviews, we developed a multicomponent, technology-enhanced, customizable adherence intervention for adolescents and young adults for use in a clinical setting. The two cases presented in this paper illustrate the use of the five-session positive strategies to enhance problem solving (Positive STEPS) intervention, based on cognitive-behavioral techniques and motivational interviewing. We present a perinatally infected heterosexual woman and a behaviorally infected gay man to demonstrate the unique challenges faced by these youth and showcase how the intervention can be customized. Future directions include varying the number of intervention sessions based on mode of HIV infection and incorporating booster sessions. PMID:25452680
Raley, R Kelly; Crissey, Sarah; Muller, Chandra
To better understand the social factors that influence the diverse pathways to family formation young adults experience today, this research investigates the association between opposite-gender relationships during late adolescence and union formation in early adulthood. Using data from the first and third waves of the Add Health (n = 4,911), we show that, for both men and women, there is continuity between adolescent and adult relationship experiences. Those involved in adolescent romantic relationships at the end of high school are more likely to marry and to cohabit in early adulthood. Moreover, involvement in a nonromantic sexual relationship is positively associated with cohabitation, but not marriage. We conclude that the precursors to union formation patterns in adulthood are observable in adolescence.
Hazlett, Lisa A.; Sweeney, William J.; Reins, Kevin J.
Adolescence is chaotic for all individuals, but LGBTQ adolescents with intellectual and/or physical disabilities struggle with what it means to be furthest from the majority. These teens experience varying exclusions and harassments from peers, educators, and family members. Contemporary young adult literature can assist these adolescents through…
Stollon, Natalie B; Paine, Christine W; Lucas, Matthew S; Brumley, Lauren D; Poole, Erika S; Peyton, Tamara; Grant, Anne W; Jan, Sophia; Trachtenberg, Symme; Zander, Miriam; Bonafide, Christopher P; Schwartz, Lisa A
The transition from pediatric to adult health care is often challenging for adolescents and young adults with sickle cell disease (SCD). Our study aimed to identify (1) measures of success for the transition to adult health care; and (2) barriers and facilitators to this process. We interviewed 13 SCD experts and asked them about their experiences caring for adolescents and young adults with SCD. Our interview guide was developed based on Social-Ecological Model of Adolescent and Young Adult Readiness to Transition framework, and interviews were coded using the constant comparative method. Our results showed that transition success was measured by health care utilization, quality of life, and continuation on a stable disease trajectory. We also found that barriers to transition include negative experiences in the emergency department, sociodemographic factors, and adolescent skills. Facilitators include a positive relationship with the provider, family support, and developmental maturity. Success in SCD transition is primarily determined by the patients' quality of relationships with their parents and providers and their developmental maturity and skills. Understanding these concepts will aid in the development of future evidence-based transition care models.
Linker, Julie; Gillespie, Nathan A; Maes, Hermine; Eaves, Lindon; Silberg, Judy L
The co-occurrence of suicidal ideation, depression, and conduct disturbance is likely explained in part by correlated genetic and environmental risk factors. Little is known about the specific nature of these associations. Structured interviews on 2,814 twins from the Virginia Twin Study of Adolescent Behavioral Development (VTSABD) and Young Adult Follow-Up (YAFU) yielded data on symptoms of depression, conduct disorder, and adolescent and young adult suicidal ideation. Univariate analyses revealed that the familial aggregation for each trait was explained by a combination of additive genetic and shared environmental effects. Suicidal ideation in adolescence was explained in part by genetic influences, but predominantly accounted for by environmental factors. A mixture of genetic and shared environmental influences explained ideation occurring in young adulthood. Multivariate analyses revealed that there are genetic and shared environmental effects common to suicidal ideation, depression, and conduct disorder. The association between adolescent suicidal ideation and CD was attributable to the same genetic and environmental risk factors for depression. These findings underscore that prevention and intervention strategies should reflect the different underlying mechanisms involving depression and conduct disorder to assist in identifying adolescents at suicidal risk.
Bocerean, Christine; Canut, Emmanuelle; Musiol, Michel
The aim of this research is to compare the types and functions of repetitions in two different corpora, one constituted of verbal interactions between adults and multiply-handicapped adolescents, the other between adults and young children of the same mental age as the adolescents. Our overall aim is to observe whether the communicative…
Backinger, C; Fagan, P; Matthews, E; Grana, R
Data sources:Data were collected from published literature. Searches for adolescent prevention were conducted using PubMed, PsycInfo, and ERIC; and for cessation, PubMed, and two major reviews that span January 1978 to May 2002. PubMed, PsychInfo, and SCCI were searched for young adults from January 1990 to May 2002. Study selection:Data included smoking prevention studies published from January 1990 to May 2002 and conducted in the USA; all identified smoking cessation studies for adolescents. Young adult data were limited to initiation and cessation studies. Data extraction:Extraction of data was by consensus of the authors. Data synthesis:Results of the review are qualitative in nature using a consensus approach of the authors. Conclusions:School based curricula alone have been generally ineffective in the long term in preventing adolescents from initiating tobacco use but are effective when combined with other approaches such as media and smoke-free policies. Prevention research should consider multiple approaches and the social conditions that influence the development of youth problem behaviours including tobacco use. Because youth smoking cessation has been understudied to date, scientifically rigorous adolescent smoking cessation studies need to be conducted with attention to high risk smokers and less than daily smokers. Tobacco prevention and cessation for young adults needs focused attention. Prevention and cessation programmes need to address other tobacco products in addition to cigarettes. PMID:14645940
Although there are many positive aspects of social media for adolescents and young adults, there are also risks. Adolescence is a time of significant developmental changes, during which adolescents exhibit a limited capacity for self-regulation and an increased risk of susceptibility to peer pressure and experimentation. Social media can be harmful, and obstetrician-gynecologists may screen their adolescent and young adult patients for high-risk sexual behaviors, especially if sexualized text communication (sexting), exposure to pornography, online dating, or other risk-taking behaviors are present. Victims of cyberbullying and those who engage in sexting are at increased risk of sexually transmitted infections and pregnancy. The effect of social media may be considered in the differential diagnosis of myriad health problems during adolescence. Referrals to mental health care providers or providing outside resources may be indicated. A multidisciplinary approach to address these issues can include the obstetrician-gynecologist, guardians, and school officials and personnel. Knowledge of resources, including those within the schools and community, allows the obstetrician-gynecologist to provide support to adolescents facing these issues.
Bares, Cristina B.; Kendler, Kenneth S.; Maes, Hermine H. M.
Introduction Although epidemiologic studies suggest low levels of cigarette use among African American adolescents relative to White U.S. adolescents, it is not known whether this may be due to racial differences in the relative contribution of genes and environment to cigarette use initiation and progression to regular use. Methods Using data from White (n=2,665) and African American (n=809) twins and full siblings sampled in the National Longitudinal Study of Adolescent, we fitted age-, sex- and race-specific variance decomposition models to estimate the magnitude of genetic and environmental effects on cigarette use initiation and cigarette use quantity in Whites and African Americans across adolescence and adulthood. We employ a causal-contingent-common pathway model to estimate the amount of variance explained in quantity of cigarettes smoked contingent on cigarette use initiation. Results African Americans had lower cigarette use prevalence from adolescence through adulthood, and used cigarettes less heavily than Whites. Race-specific causal-contingent-common pathway models indicate that racial differences in genetic and environmental contributions to cigarette use initiation and cigarette use quantities are not present in adolescence but appear in young adulthood. Additive genetic factors were an important risk factor for cigarette use initiation for White but less so for African American young adults and adults. Conclusions Genetic and environmental contributions for cigarette use are similar by race in adolescence. In adulthood, genes have a stronger influence for cigarette use among White adolescents while the influence of the environment is minimal. For African Americans, both genetic and environmental influences are important in young adulthood and adulthood. PMID:27427414
Nolan, Terry; O'Ryan, Miguel; Wassil, James; Abitbol, Véronique; Dull, Peter
Vaccination programs employing capsular-based meningococcal vaccines have proved successful in a variety of settings globally since first introduced over 40 years ago. Similar successes have been demonstrated using meningococcal vaccines for use against serogroup B (MenB) outbreak strains but the diversity of MenB strains has limited vaccine use outside targeted geographic regions. MenB continues to be a significant cause of outbreaks in adolescents and young adults, as recently demonstrated in university settings in the US (Princeton, New Jersey and Santa Barbara, California) and has the potential for hyperendemic disease levels such as currently experienced in Québec and the United Kingdom. In adolescents, increased endemic disease rates and outbreak potential are likely associated with social behaviors putting individuals at risk for carriage acquisition and may explain regional and temporal variations in epidemiology. A protein-based, multi-component MenB vaccine (4CMenB) is currently licensed for use in 37 countries including EU/EEA countries, Australia, Canada, Chile, Colombia, Uruguay, and the US. In this article we review the most recent clinical trial data with 4CMenB with a focus on adolescents and young adults. The vaccine appears to have an acceptable safety profile and is well-tolerated in adolescents and young adults while providing robust, persistent levels of bactericidal antibodies considered protective for each of the four antigenic components of the vaccine. With the recent availability of this vaccine, health care providers have the first comprehensive opportunity to control meningococcal disease, a highly disruptive public health problem with a disproportionate impact on adolescents and young adults.
ALFaris, Nora A; Al-Tamimi, Jozaa Z; Al-Jobair, Moneera O; Al-Shwaiyat, Naseem M
Background : Saudi Arabia has passed through lifestyle changes toward unhealthy dietary patterns such as high fast food consumption. Adolescents and young adults, particularly girls, are the main groups exposed to and affected by these adverse eating behaviors. Objective : The aim of this study was to examine the trends of fast food consumption among adolescent and young adult Saudi girls living in Riyadh, and to compare between them. Design : In a cross-sectional survey, 127 adolescent Saudi girls (13-18 years) and 69 young adult Saudi girls (19-29 years) were randomly recruited to participate in this study. Weight, height, waist circumference, and hip circumference were measured using standardized methods. Twenty-four-hour diet recall and a face-to-face interview food questionnaire were performed. Results : Most of the participants had adequate intake of protein, riboflavin, iron, and sodium, but exhibited low intake for several other nutrients. Among study participants, 95.4% consume restaurants' fast food and 79.1% eat fast food at least once weekly. Burgers and carbonated soft drinks were the main kinds of fast food meals and beverages usually eaten by girls. Adolescent girls who usually ate large portion sizes of fast food had significantly higher mean waist circumference and hip circumference. Participants eat fast food primarily for enjoying the delicious taste, followed by convenience. Restaurants' hygiene and safety standards were the main concern regarding fast food for 62.2% of girls. Finally, international restaurants were preferable by participants to buy fast food compared with local restaurants (70.9% vs. 29.1%). Conclusion : Our findings provide evidence on the high prevalence of fast food consumption among Saudi girls, suggesting an urgent need for community-based nutrition interventions that consider the trends of fast food consumption and targeted eating behaviors of adolescent and young adult girls.
ALFaris, Nora A.; Al-Tamimi, Jozaa Z.; Al-Jobair, Moneera O.; Al-Shwaiyat, Naseem M.
Background Saudi Arabia has passed through lifestyle changes toward unhealthy dietary patterns such as high fast food consumption. Adolescents and young adults, particularly girls, are the main groups exposed to and affected by these adverse eating behaviors. Objective The aim of this study was to examine the trends of fast food consumption among adolescent and young adult Saudi girls living in Riyadh, and to compare between them. Design In a cross-sectional survey, 127 adolescent Saudi girls (13–18 years) and 69 young adult Saudi girls (19–29 years) were randomly recruited to participate in this study. Weight, height, waist circumference, and hip circumference were measured using standardized methods. Twenty-four-hour diet recall and a face-to-face interview food questionnaire were performed. Results Most of the participants had adequate intake of protein, riboflavin, iron, and sodium, but exhibited low intake for several other nutrients. Among study participants, 95.4% consume restaurants’ fast food and 79.1% eat fast food at least once weekly. Burgers and carbonated soft drinks were the main kinds of fast food meals and beverages usually eaten by girls. Adolescent girls who usually ate large portion sizes of fast food had significantly higher mean waist circumference and hip circumference. Participants eat fast food primarily for enjoying the delicious taste, followed by convenience. Restaurants’ hygiene and safety standards were the main concern regarding fast food for 62.2% of girls. Finally, international restaurants were preferable by participants to buy fast food compared with local restaurants (70.9% vs. 29.1%). Conclusion Our findings provide evidence on the high prevalence of fast food consumption among Saudi girls, suggesting an urgent need for community-based nutrition interventions that consider the trends of fast food consumption and targeted eating behaviors of adolescent and young adult girls. PMID:25792229
... Adolescent Brain Comorbidity College-Age & Young Adults Criminal Justice Drugged Driving Drug Testing Drugs and the Brain ... Age & Young Adults College Addiction Studies Programs Criminal Justice Drugged Driving Drug Testing Drugs and the Brain ...
Mueller, Christian E.; Prout, H. Thompson
Issues with adolescents with intellectual disabilities have received little attention in the research literature. This study compared adolescents with and without intellectual disabilities on several indices of psychosocial adjustment. The participants were selected from a large longitudinal database and comparisons were made at three points in…
Smith, Carolyn A.; Ireland, Timothy O.; Thornberry, Thornberry P.
Statement of problem: "Childhood" maltreatment is known to be a risk factor for a range of later problems, but much less is known about "adolescent" maltreatment. The present study aims to investigate the impact of adolescent maltreatment on antisocial behavior, while controlling for prior levels of problem behavior as well as sociodemographic…
Grégoire, Solène; Flahault, Cécile; Laurence, Valérie; Levy, Dominique; Dolbeault, Sylvie
The purpose of this literature review is to make a point on the state of health of adolescents and young adults (15-25 years) suffering from cancer. The adaptation strategies and the impact of the announcement of cancer will be discussed. In addition, we are going to consider the characteristics of teenagers and young adults, given the fact that development is still in progress. This period is especially punctuated by various experiments and the emergence of some clinical signs. Also, we have identified various studies concerning the use of licit and illicit substances. Furthermore, we have taken interest in behavioral addictions, particularly cyber addiction. While trying to cross these variables with a population of teenagers and young adults in the context of somatic diseases, it occurred that this population was not well known and studied. The interest of this synthesis is to underline the importance to make future researches in these perspectives.
Alsup, Janet, Ed.
Taking a critical, research-oriented perspective, this exploration of the theoretical, empirical, and pedagogical connections between the reading and teaching of young adult literature and adolescent identity development centers around three key questions: (1) Who are the teens reading young adult literature?; (2) Why should teachers teach young…
Weiss, Jonathan A; Cappadocia, M Catherine; Tint, Ami; Pepler, Debra
Bullying victimization is commonly associated with anxiety among individuals with and without Autism Spectrum Disorder (ASD), and both bullying victimization and anxiety are more prevalent among youth with ASD than in the general population. We explored individual and contextual factors that relate to anxiety in adolescents and young adults with ASD who also experience bullying victimization. Participants included 101 mothers of adolescents and young adults diagnosed with ASD. Hierarchical multiple regression analyses were conducted to investigate the relationship between bullying victimization and anxiety in children with ASD, as well as parenting stress as a potential moderator of that relationship. Findings indicate that parenting stress moderates the association between bullying victimization and anxiety. The severity of anxiety was most strongly associated with bullying victimization when mothers reported high levels of stress. Implications for interventions that assist parents with coping and address bullying victimization are discussed.
Zanoni, Brian C.
Abstract Little is known about how adolescents and young adults contribute to the declines in the cascade of care from HIV-1 diagnosis to viral suppression. We reviewed published literature from the Unites States reporting primary data for youth (13–29 years of age) at each stage of the HIV cascade of care. Approximately 41% of HIV-infected youth in the United States are aware of their diagnosis, while only 62% of those diagnosed engage medical care within 12 months of diagnosis. Of the youth who initiate antiretroviral therapy, only 54% achieve viral suppression and a further 57% are not retained in care. We estimate less than 6% of HIV-infected youth in the United States remain virally suppressed. We explore the cascade of care from HIV diagnosis through viral suppression for HIV-infected adolescents and young adults in the United States to highlight areas for improvement in the poor engagement of the infected youth population. PMID:24601734
Marino, Claudia; Vieno, Alessio; Altoè, Gianmarco; Spada, Marcantonio M
Background and aims Recent research on problematic Facebook use has highlighted the need to develop a specific theory-driven measure to assess this potential behavioral addiction. The aim of the present study was to examine the factorial validity of the Problematic Facebook Use Scale (PFUS) adapted from Caplan's Generalized Problematic Internet Scale model. Methods A total of 1,460 Italian adolescents and young adults (aged 14-29 years) participated in the study. Confirmatory factor analyses were performed in order to assess the factorial validity of the scale. Results Results revealed that the factor structure of the PFUS provided a good fit to the data. Furthermore, results of the multiple group analyses supported the invariance of the model across age and gender groups. Discussion and conclusions This study provides evidence supporting the factorial validity of the PFUS. This new scale provides a theory-driven tool to assess problematic use of Facebook among male and female adolescents and young adults.
Myers, Mark G.; McCarthy, Denis M.; MacPherson, Laura; Brown, Sandra A.
The goal of the present studies was to construct and validate a short form of the 50-item Smoking Consequences Questionnaire (SCQ; T. H. Brandon & T. B. Baker, 1991), a measure of smoking outcome expectancies. In Study 1, a 21-item short form (S-SCQ) was derived from a sample of 107 young adults previously treated for substance abuse. In Study 2, the measure was cross-validated on 125 adolescents in treatment for substance abuse. Confirmatory factor analyses revealed good model fit and factorial invariance for the 4 S-SCQ subscales across both samples. Validation analyses on each sample found that subscale scores generally correlated significantly with smoking-related variables. The present studies provide initial evidence for the utility of the S-SCQ when used with young adults and adolescents. PMID:12847776
Silva, Graciela E.; Goodwin, James L.; Vana, Kimberly D.; Vasquez, Monica M.; Wilcox, Peter G.; Quan, Stuart F.
Objective: Clinical reports in children implicate restless legs syndrome (RLS) with sleep and behavior problems. However, population-based studies on this association in adolescents and young adults are limited. Furthermore, few studies have evaluated the association between symptoms consistent with RLS and quality of life (QoL). Study Design: This cross-sectional study included 214 Caucasian and Hispanic adolescents and young adults aged 12-20 years. Symptoms consistent with RLS were based on four essential criteria and if the symptoms occurred ≥ 5 days/ month. Trouble falling asleep was present if reported “yes, still have the problem.” Quality of life (QoL) was assessed using the Pediatric QoL Inventory. Three summary QoL scores ranging from 0-100 were evaluated; higher scores indicated better QoL. Results: Participants were 50% male and 68.1% Caucasian. Prevalence of RLS was 8.4% (n = 18). RLS was associated with trouble falling asleep (OR = 3.1, p = 0.049), and trouble falling asleep was associated with worse Psychosocial Health scores (Coeff. −5.6, p = 0.004) and Total Scale scores for quality of life (Coeff. −4.6, p = 0.007). Conclusions: The prevalence of symptoms consistent with RLS in this community-based sample of adolescents and young adults, aged 12-20, is comparable to rates reported in older cohorts. Symptoms consistent with RLS may be associated with trouble falling asleep and psychosocial distress that may contribute to a lower health-related quality of life. Citation: Silva GE, Goodwin JL, Vana KD, Vasquez MM, Wilcox PG, Quan SF. Restless legs syndrome, sleep, and quality of life among adolescents and young adults. J Clin Sleep Med 2014;10(7):779-786. PMID:25024656
Mun, Eun Young; Windle, Michael; Schainker, Lisa M
Data from a community-based sample of 1,126 10th- and 11th-grade adolescents were analyzed using a model-based cluster analysis approach to empirically identify heterogeneous adolescent subpopulations from the person-oriented and pattern-oriented perspectives. The model-based cluster analysis is a new clustering procedure to investigate population heterogeneity utilizing finite mixture multivariate normal densities and accordingly to classify subpopulations using more rigorous statistical procedures for the comparison of alternative models. Four cluster groups were identified and labeled multiproblem high-risk, smoking high-risk, normative, and low-risk groups. The multiproblem high risk exhibited a constellation of high levels of problem behaviors, including delinquent and sexual behaviors, multiple illicit substance use, and depressive symptoms at age 16. They had risky temperamental attributes and lower academic functioning and educational expectations at age 15.5 and, subsequently, at age 24 completed fewer years of education, and reported lower levels of physical health and higher levels of continued involvement in substance use and abuse. The smoking high-risk group was also found to be at risk for poorer functioning in young adulthood, compared to the low-risk group. The normative and the low risk groups were, by and large, similar in their adolescent and young adult functioning. The continuity and comorbidity path from middle adolescence to young adulthood may be aided and abetted by chronic as well as episodic substance use by adolescents.
Cervellione, Kelly; Cottone, John; Ardekani, Babak A.; Kumra, Sanjiv
Background There is growing evidence that adolescence is a key period for neuronal maturation. Despite the high prevalence of marijuana use among adolescents and young adults in the United States and internationally, very little is known about its impact on the developing brain. Based on neuroimaging literature on normal brain developmental during adolescence, we hypothesized that individuals with heavy cannabis use (HCU) would have brain structure abnormalities in similar brain regions that undergo development during late adolescence, particularly the fronto-temporal connection. Method Fourteen young adult males in residential treatment for cannabis dependence and 14 age-matched healthy male control subjects were recruited. Patients had a history of HCU throughout adolescence; 5 had concurrent alcohol abuse. Subjects underwent structural and diffusion tensor magnetic resonance imaging. White matter integrity was compared between subject groups using voxelwise and fiber tractography analysis. Results Voxelwise and tractography analyses revealed that adolescents with HCU had reduced fractional anisotropy, increased radial diffusivity, and increased trace in the homologous areas known to be involved in ongoing development during late adolescence, particularly in the fronto-temporal connection via arcuate fasciculus. Conclusions Our results support the hypothesis that heavy cannabis use during adolescence may affect the trajectory of normal brain maturation. Due to concurrent alcohol consumption in five HCU subjects, conclusions from this study should be considered preliminary, as the DTI findings reported here may be reflective of the combination of alcohol and marijuana use. Further research in larger samples, longitudinal in nature, and controlling for alcohol consumption is needed to better understand the pathophysiology of the effect of cannabis on the developing brain. PMID:19111160
Tanner-Smith, Emily E.; Lipsey, Mark W.
This study reports findings from a meta-analysis summarizing the effectiveness of brief alcohol interventions for adolescents (age 11-18) and young adults (age 19-30). We identified 185 eligible study samples using a comprehensive literature search and synthesized findings using random-effects meta-analyses with robust standard errors. Overall, brief alcohol interventions led to significant reductions in alcohol consumption and alcohol-related problems among adolescents (ḡ = 0.27 and ḡ = 0.19) and young adults (ḡ = 0.17 and ḡ = 0.11). These effects persisted for up to one year after intervention and did not vary across participant demographics, intervention length, or intervention format. However, certain intervention modalities (e.g., motivational interviewing) and components (e.g., decisional balance, goal-setting exercises) were associated with larger effects. We conclude that brief alcohol interventions yield beneficial effects on alcohol-related outcomes for adolescents and young adults that are modest but potentially worthwhile given their brevity and low cost. PMID:25300577
Escota, Gerome; Önen, Nur
Tobacco use is inextricably linked to a number of health risks both in the general and HIV-infected populations. There is, however, a dearth of research on effective tobacco control programs among people living with HIV, and especially among adolescents, young adults and pregnant women, groups with heightened or increased vulnerability secondary to tobacco use. Adolescents and young adults constitute a growing population of persons living with HIV infection. Early and continued tobacco use in this population living with a disease characterized by premature onset multimorbidity and chronic inflammation is of concern. Additionally, there is an increased acuity for tobacco control among HIV-infected pregnant women to reduce pregnancy morbidity and improve fetal outcome. This review will provide an important summary of current knowledge of tobacco use among HIV-infected adolescents, young adults and pregnant women. The effects of tobacco use in these specific populations will be presented and the current state of tobacco control within these populations, assessed. PMID:23778059
Pelatti, Christina Yeager
Oral and written language development for adolescents and young adults with Down syndrome (Ds) are particularly challenging. Yet, research supports a syndrome-specific profile highlighting strengths and particular areas of difficulty for this group of individuals. For example, adolescents and young adults with Ds tend to understand more than they produce. In terms of oral language development, the domains of semantics and pragmatics are relative strengths whereas morphosyntax is particularly difficult. Much less is known about written language development because most adolescents and young adults with Ds are at the emergent literacy or word identification (i.e., ability to recognize and name single words) stages; however, relative strengths emerge in the area of word identification. The purpose of this article is to explore the research findings on oral and written language strengths and weaknesses and intervention strategies and techniques that facilitate development in these two interrelated domains. In addition, a case study example is provided to further enhance the clinical skills of speech-language pathologists who work with this population.
Tanner-Smith, Emily E; Lipsey, Mark W
This study reports findings from a meta-analysis summarizing the effectiveness of brief alcohol interventions for adolescents (age 11-18) and young adults (age 19-30). We identified 185 eligible study samples using a comprehensive literature search and synthesized findings using random-effects meta-analyses with robust standard errors. Overall, brief alcohol interventions led to significant reductions in alcohol consumption and alcohol-related problems among adolescents (g = 0.27 and g = 0.19) and young adults (g = 0.17 and g = 0.11). These effects persisted for up to 1 year after intervention and did not vary across participant demographics, intervention length, or intervention format. However, certain intervention modalities (e.g., motivational interviewing) and components (e.g., decisional balance, goal-setting exercises) were associated with larger effects. We conclude that brief alcohol interventions yield beneficial effects on alcohol-related outcomes for adolescents and young adults that are modest but potentially worthwhile given their brevity and low cost.
Fridgen, Olivia; Sehovic, Ivana; Bowman, Meghan L; Reed, Damon; Tamargo, Christina; Vadaparampil, Susan; Quinn, Gwendolyn P
Little is known about oncology provider recommendations regarding best practices in contraception use during cancer treatment and through survivorship for adolescent and young adult (AYA) cancer patients. This review examined the literature to identify related studies on contraception recommendations, counseling discussions, and methods of contraception in the AYA oncology population. A literature review was conducted using PubMed, including all peer-reviewed journals with no publication date exclusions. A systematic review of the literature was conducted using combinations of the following phrases or keywords: "oncology OR cancer" AND "contraception, family planning, contraceptive devices, contraceptive agents, intrauterine devices OR IUD, vaccines, spermatocidal agents, postcoital, immunologic, family planning, vasectomy, tubal ligation, sterilization" AND "young adult OR adolescent" AND "young adult AND adolescent". Reviewers assessed articles using the "Quality Assessment Tool for Quantitative Studies" which considers: (1) selection bias; (2) study design; (3) confounders; (4) blinding; (5) data collection methods; and (6) withdrawals and dropouts. A total of five articles were included and all studies were quantitative. Results showed no consistent recommendations among providers, references to guidelines, or methods of contraceptive types. Provider guidelines for discussions with AYA patients should be expanded to provide comprehensive, consistent, and quality cancer care in the AYA population.
Buffart, Laurien M; van den Berg-Emons, Rita J G; van Wijlen-Hempel, Marie S; Stam, Henk J; Roebroeck, Marij E
To assess components of health-related physical fitness in adolescents and young adults with myelomeningocele (MMC), and to study relations between aerobic capacity and other health-related physical fitness components. This cross-sectional study included 50 adolescents and young adults with MMC, aged 16-30 years (25 males). Aerobic capacity was quantified by measuring peak oxygen uptake (peakVO2) during a maximal exercise test on a cycle or arm ergometer depending on the main mode of ambulation. Muscle strength of upper and lower extremity muscles was assessed using a hand-held dynamometer. Regarding flexibility, we assessed mobility of hip, knee and ankle joints. Body composition was assessed by measuring thickness of four skin-folds. Relations were studied using linear regression analyses. Average peakVO2 was 1.48+/-0.52 l/min, 61% of the participants had subnormal muscle strength, 61% had mobility restrictions in at least one joint and average sum of four skin-folds was 74.8+/-38.8 mm. PeakVO2 was significantly related to gender, ambulatory status and muscle strength, explaining 55% of its variance. Adolescents and young adults with MMC have poor health-related physical fitness. Gender and ambulatory status are important determinants of peakVO2. In addition, we found a small, but significant relationship between peakVO2 and muscle strength.
Freyer, David R.
Purpose Young adult survivors of childhood and adolescent cancer are an ever-growing population of patients, many of whom remain at lifelong risk for potentially serious complications of their cancer therapy. Yet research shows that many of these older survivors have deficient health-related knowledge and are not engaging in recommended health promotion and screening practices that could improve their long-term outcomes. The purpose of this review is to address these disparities by discussing how formal transition of care from pediatric to adult-focused survivorship services may help meet the unique medical, developmental, and psychosocial challenges of these young adults. Design Literature review and discussion. Results This article summarizes current research documenting the medical needs of young adult survivors, their suboptimal compliance with recommended follow-up, and the rationale, essential functions, current models, and innovative approaches for transition of follow-up care. Conclusion Systematic health care transition constitutes the standard of care for young adult survivors of childhood cancer. In developing a transitional care program, it is necessary to consider the scope of services to be provided, available resources, and other local exigencies that help determine the optimal model for use. Additional research is needed to improve health services delivery to this population. Effective advocacy is needed, particularly in the United States, to ensure the availability of uninterrupted health insurance coverage for survivorship services in young adulthood. PMID:20351333
Manning, Wendy D; Longmore, Monica A; Copp, Jennifer; Giordano, Peggy C
The complexity of adolescents' dating and sexual lives is not easily operationalized with simple indicators of dating or sexual activity. While building on prior work that emphasizes the "risky" nature of adolescents' intimate relationships, we assess whether a variety of indicators reflecting the complexity of adolescents' relationships influence early adult well-being (i.e., depressive symptoms, self-esteem, gainful activity, intimate partner violence, and relationship quality). Our analysis of longitudinal data from the Toledo Adolescent Relationships Study showed that the number of adolescent dating and sexual partners does not uniformly influence indicators of young adult well-being, which is at odds with a risk framework. The number of dating partners with whom the individual was sexually active, and not the number of "casual" sex partners, increased the odds of intimate partner violence during young adulthood. Relationship churning and sexual nonexclusivity during adolescence were associated with lower relationship quality during young adulthood. Sexual nonexclusivity during adolescence influenced self-reports of depressive symptoms and lower self-esteem among young adults. Future research should develop more nuanced conceptualizations of adolescent dating and sexual relationships and integrate adolescent dating and sexual experiences into research on early adult well-being.
Sprague, Marsha M.; Keeling, Kara K.
Authors Marsha M. Sprague and Kara K. Keeling propose a language arts curriculum that incorporates literature-based discussions to help adolescent girls deal constructively with difficult issues and develop their own authentic voices. To help put such a curriculum into action, this book offers the following resources: (1) A research base to frame…
Miles, Rodney R.; Shah, Rikin K.; Frazer, J. Kimble
Summary Molecular genetic abnormalities are ubiquitous in non-Hodgkin lymphoma (NHL), but genetic changes are not yet used to define specific lymphoma subtypes. Certain recurrent molecular genetic abnormalities in NHL underlie molecular pathogenesis and/or are associated with prognosis or represent potential therapeutic targets. Most molecular genetic studies of B- and T-NHL have been performed on adult patient samples, and the relevance of many of these findings for childhood, adolescent and young adult NHL remains to be demonstrated. In this review, we focus on NHL subtypes that are most common in young patients and emphasize features actually studied in younger NHL patients. This approach highlights what is known about NHL genetics in young patients but also points to gaps that remain, which will require cooperative efforts to collect and share biological specimens for genomic and genetic analyses in order to help predict outcomes and guide therapy in the future. PMID:26969846
Feigelman, William; Rosen, Zohn; Joiner, Thomas; Silva, Caroline; Mueller, Anna S
Using longitudinal data spanning a 7-year period, we investigated the behavioral and psycho-social effects resulting from a parent's death during early childhood or teenage years on adolescent and early adulthood functioning. Findings confirmed previous work demonstrating various behavioral problems and social-psychological adjustment deficits during adolescence. Results suggested that most detrimental adjustment behaviors among parentally bereaved youth fade as they entered into young adulthood. Yet, premature school withdrawals and diminished interests in college attendance at Wave 1 left many of these young adults with diminished academic accomplishments, lingering economic disadvantages and for females a hesitancy to marry as their lives progressed into adulthood.
Albon, Lorraine; Vaughan, Louella
It is a common perception that young people do not become ill and do not pose a challenge in the unscheduled healthcare setting. The research, however, increasingly suggests that young adults and adolescents (YAAs) are a highly vulnerable group, with poorer outcomes than either older adults or children, and distinct healthcare needs. The acute medical unit (AMU) setting poses particular challenges to the care of this patient group. To improve care and patient experience, adult clinicians need to look critically at their services and seek to adapt them to meet the needs of YAAs. This requires cooperation and linkage with local paediatric and emergency services, as well as the input of other relevant stakeholder groups. Staff on AMUs also need to develop the knowledge, skills and attitudes to communicate effectively and address the developmental and health needs of YAAs and their parents/carers at times of high risk and stress.
Diamond, L M
Although some research suggests that sexual orientation is a stable, early appearing trait, interviews with 89 young sexual-minority women revealed that a majority of women failed to report at least one of the following: childhood indicators of sexual orientation, stability in same-sex attractions, or awareness of same-sex attractions prior to the conscious process of sexual questioning. Lesbians were not more likely to report these experiences than bisexuals, although they reported significantly greater same-sex attractions. Consistent with studies on older cohorts, few young women reported exclusive same-sex attractions. These findings suggest that recollected consistency among prior and current behavior, ideation, and attractions are not systematically associated with sexual orientation among contemporary young women.
Zhou, Qing; King, Kevin M; Chassin, Laurie
This study examined the prospective relations among family history density of alcoholism (FHD), adolescent family harmony, and young adults' alcohol and drug dependence. Family harmony was rated by mothers and fathers in adolescence, and young adults' substance dependence diagnoses were obtained through structured interviews. Higher FHD predicted lower adolescent family harmony, which in turn increased young adults' odds of being diagnosed with drug dependence (with and without alcohol dependence) compared to no diagnoses or to alcohol dependence only. Family harmony also interacted with FHD such that the protective effect of family harmony on young adults' drug dependence with or without alcohol dependence decreased as FHD rose, and was nonsignificant at high levels of FHD. The findings suggest the importance of distinguishing among alcohol and drug dependence disorders and examining their differential etiological pathways, and also suggest that the protective effects of harmonious family environments on substance dependence may be limited at high levels of FHD.
Babinski, Dara E.; Pelham, William E.; Molina, Brooke S.G.; Gnagy, Elizabeth M.; Waschbusch, Daniel A.; Yu, Jihnhee; MacLean, Michael G.; Wymbs, Brian T.; Sibley, Margaret H.; Biswas, Aparajita; Robb, Jessica A.; Karch, Kathryn M.
Objective The study aims to characterize the late adolescent and young adult outcomes of girls diagnosed with ADHD in childhood. Method The study included 58 females from a larger longitudinal study of ADHD. Thirty-four (M=19.97 years old) met DSM criteria for ADHD in childhood, while the remaining 24 (M=19.83 years old) did not. Self- and parent-reports of psychopathology, delinquency, interpersonal relationships, academic achievement, job performance, and substance use were collected. Results The findings suggest that girls with ADHD experience difficulties in late adolescence and young adulthood, such as more conflict with their mothers, being involved in fewer romantic relationships, and experiencing more depressive symptoms than comparison women. However, differences did not emerge in all domains, such as job performance, substance use, and self-reported ADHD symptomatology. Conclusion The findings of this study add to the literature on the negative late adolescent and young adult outcomes associated with childhood ADHD in females. PMID:20562386
Bigler, Thomas; Filippi, Andreas
Over the last few years, halitosis has become an increasingly important issue for dentists and their patients. For this study, a questionnaire was distributed in four different vocational/vocational-technical schools in Zurich to find out more about the personal oral hygiene and general knowledge of halitosis of 888 young women and 921 young men between the ages of 15 and 25. The factors of gender, education, professional customer contact, age and size of the residential community were taken into account. Findings were presented on the basis of a visual analogue scale. The survey results showed women to have a more intensive oral hygiene regimen and more frequent check-ups than their male counterparts (p < 0.001). Bad breath was also seen to be a more important issue to women who took more measures against it (p < 0.001). Education and customer contact both had an influence on the perceived importance of halitosis, as well as on the knowledge of possible measures against it (p < 0.001). However, the age of those surveyed and the size of their respective communities did not seem to have an impact (p > 0.05). The analysis showed that halitosis is an important issue for young people, and that a large part of the young population sees tongue cleaning as a part of oral hygiene and intraoral change as a cause of halitosis.
Latimore, Amanda D; Aramrattana, Apinun; Sherman, Susan G; Galai, Noya; Srirojn, Bangorn; Thompson, Nick; Ellen, Jonathan M; Willard, Nancy; Celentano, David D
Sexually transmitted infection (STI) prevalence and risks in a sample of rural Thai adolescents and young adults (14-29 years) were examined. Unprotected sex with a casual partner conferred the greatest risk for prevalent STIs, particularly for younger adolescents, and alcohol use increased the STI risk for women but not for men.
Trampush, Joey W.; Miller, Carlin J.; Newcorn, Jeffrey H.; Halperin, Jeffrey M.
Objective: To examine cognitive and psychosocial factors associated with high school dropout in urban adolescents with and without childhood ADHD. Method: In a longitudinal study, 49 adolescents/young adults with childhood ADHD and 44 controls who either dropped out or graduated from high school are included. Risk factors examined as potential…
Giarelli, Ellen; Bernhardt, Barbara A.; Pyeritz, Reed E.
Adolescents and young adults with Marfan syndrome (MFS) use information from self-surveillance to manage their disorder. Thirty-seven male and female adolescents with MFS aged 14 to 21 years were interviewed. They identified 58 distinct self-surveillance behaviors that fell into four categories and multiple subcategories (SCs): tracking phenotype…
Zanolie, Kiki; Kleibeuker, Sietske W.; Crone, Eveline A.
Adolescence and early adulthood are developmental time periods during which creative cognition is highly important for adapting to environmental changes. Divergent thinking, which refers to generating novel and useful solutions to open-ended problems, has often been used as a measure of creative cognition. The first goal of this structural neuroimaging study was to elucidate the relationship between gray matter morphology and performance in the verbal (AUT; alternative uses task) and visuo-spatial (CAT; creative ability test) domain of divergent thinking in adolescents and young adults. The second goal was to test if gray matter morphology is related to brain activity during AUT performance. Neural and behavioral data were combined from a cross-sectional study including 25 adolescents aged 15–17 and 20 young adults aged 25–30. Brain-behavior relationships were assessed without a priori location assumptions and within areas that were activated during an AUT-scanner task. Gray matter volume and cortical thickness were not significantly associated with verbal divergent thinking. However, visuo-spatial divergent thinking (CAT originality and fluency) was positively associated with cortical thickness of the right middle temporal gyrus and left brain areas including the superior frontal gyrus and various occipital, parietal, and temporal areas, independently of age. AUT brain activity was not associated with cortical thickness. The results support an important role of a widespread brain network involved in flexible visuo-spatial divergent thinking, providing evidence for a relation between cortical thickness and visuo-spatial divergent thinking in adolescents and young adults. However, studies including visuo-spatial divergent thinking tasks in the scanner are warranted. PMID:25514366
Cousijn, Janna; Koolschijn, P Cédric M P; Zanolie, Kiki; Kleibeuker, Sietske W; Crone, Eveline A
Adolescence and early adulthood are developmental time periods during which creative cognition is highly important for adapting to environmental changes. Divergent thinking, which refers to generating novel and useful solutions to open-ended problems, has often been used as a measure of creative cognition. The first goal of this structural neuroimaging study was to elucidate the relationship between gray matter morphology and performance in the verbal (AUT; alternative uses task) and visuo-spatial (CAT; creative ability test) domain of divergent thinking in adolescents and young adults. The second goal was to test if gray matter morphology is related to brain activity during AUT performance. Neural and behavioral data were combined from a cross-sectional study including 25 adolescents aged 15-17 and 20 young adults aged 25-30. Brain-behavior relationships were assessed without a priori location assumptions and within areas that were activated during an AUT-scanner task. Gray matter volume and cortical thickness were not significantly associated with verbal divergent thinking. However, visuo-spatial divergent thinking (CAT originality and fluency) was positively associated with cortical thickness of the right middle temporal gyrus and left brain areas including the superior frontal gyrus and various occipital, parietal, and temporal areas, independently of age. AUT brain activity was not associated with cortical thickness. The results support an important role of a widespread brain network involved in flexible visuo-spatial divergent thinking, providing evidence for a relation between cortical thickness and visuo-spatial divergent thinking in adolescents and young adults. However, studies including visuo-spatial divergent thinking tasks in the scanner are warranted.
Seifert, Sara M.; Schaechter, Judith L.; Hershorin, Eugene R.
OBJECTIVE: To review the effects, adverse consequences, and extent of energy drink consumption among children, adolescents, and young adults. METHODS: We searched PubMed and Google using “energy drink,” “sports drink,” “guarana,” “caffeine,” “taurine,” “ADHD,” “diabetes,” “children,” “adolescents,” “insulin,” “eating disorders,” and “poison control center” to identify articles related to energy drinks. Manufacturer Web sites were reviewed for product information. RESULTS: According to self-report surveys, energy drinks are consumed by 30% to 50% of adolescents and young adults. Frequently containing high and unregulated amounts of caffeine, these drinks have been reported in association with serious adverse effects, especially in children, adolescents, and young adults with seizures, diabetes, cardiac abnormalities, or mood and behavioral disorders or those who take certain medications. Of the 5448 US caffeine overdoses reported in 2007, 46% occurred in those younger than 19 years. Several countries and states have debated or restricted energy drink sales and advertising. CONCLUSIONS: Energy drinks have no therapeutic benefit, and many ingredients are understudied and not regulated. The known and unknown pharmacology of agents included in such drinks, combined with reports of toxicity, raises concern for potentially serious adverse effects in association with energy drink use. In the short-term, pediatricians need to be aware of the possible effects of energy drinks in vulnerable populations and screen for consumption to educate families. Long-term research should aim to understand the effects in at-risk populations. Toxicity surveillance should be improved, and regulations of energy drink sales and consumption should be based on appropriate research. PMID:21321035
Cardoos, Stephanie L; Loya, Fred; Hinshaw, Stephen P
Our goal was to examine the role of adolescent perceived deviant peer affiliation in mediating or moderating the association between adolescent attention-deficit/hyperactivity disorder (ADHD) symptoms and young adult driving risk in females with and without ADHD. The overall sample included 228 ethnically and socioeconomically diverse girls with or without a diagnosis of ADHD in childhood (Wave 1; 6-12 years) followed through adolescence (Wave 2; 11-18 years) and into young adulthood (Wave 3; 17-24 years). A subsample of 103 girls with a driving license by Wave 3 and with full data for all study variables was utilized in this investigation. In adolescence, mothers and teachers reported on ADHD symptoms (inattention and hyperactivity/impulsivity), and participants reported on perceived deviant peer affiliation. In young adulthood, participants reported on driving behavior and outcomes, including number of accidents, number of moving vehicle citations, and ever having driven illegally. Covariates included age and adolescent oppositional defiant disorder/conduct disorder. Inattention directly predicted citations. Perceived deviant peer affiliation mediated the association between inattention and (a) accidents and (b) citations. In addition, perceived deviant peer affiliation moderated the association between hyperactivity/impulsivity and accidents, with hyperactivity/impulsivity predicting accidents only for those with low perceived deviant peer affiliation. Perceived deviant peer affiliation appears to play an important role in the association between ADHD symptoms and driving outcomes. Our findings provide preliminary evidence that both ADHD symptoms and peer processes should be targeted in interventions that aim to prevent negative driving outcomes in young women with and without ADHD.
Anand, Enu; Unisa, Sayeed; Singh, Jayakant
This study examined the relationship between Intimate Partner Violence (IPV) and unintended pregnancy among young women in South Asia using Demographic and Health Survey data from India (2005-2006), Bangladesh (2007) and Nepal (2011). The respondents were adolescent and young adult married women aged 15-24 years who had at least one childbirth in the five years preceding the survey. Bivariate and stepwise multivariate logistic regression analyses were performed to assess the relationship between IPV and unintended pregnancy. Thirty-eight per cent of the respondents in India, 52% in Bangladesh and 28% in Nepal reported having experienced physical or sexual IPV. Those who reported physical or sexual IPV had higher odds of unintended pregnancy (1.36 in India and 1.99 in Bangladesh). The findings indicate that IPV is a risk factor for unintended pregnancy among adolescent and young adult married women. Along with violence prevention programmes, a more responsive and youth-friendly health system needs to be in place to provide health care services to young women in these countries.
Stawarczyk, David; Majerus, Steve; Catale, Corinne; D'Argembeau, Arnaud
Recent findings suggest that mind-wandering-the occurrence of thoughts that are both stimulus-independent and task-unrelated-corresponds to temporary failures in attentional control processes involved in maintaining constant task-focused attention. Studies supporting this proposal are, however, limited by a possible confound between mind-wandering episodes and other kinds of conscious experiences, such as external distractions (i.e., interoceptive sensations and exteroceptive perceptions). In the present study, we addressed this issue by examining, in adolescents and young adults, the relations between tasks measuring attentional control abilities and a measure of mind-wandering that is distinct from external distractions. We observed (1) that adolescents experienced more frequent external distractions, but not more mind-wandering, than young adults during the Sustained Attention to Response Task (SART) and (2) that, in young adults, the influence of external distractions on SART performance was fully accounted for by attentional control abilities, whereas mind-wandering was associated with decreases in SART performance above and beyond what was explained by attentional control abilities. These results show that mind-wandering cannot be entirely reduced to failures in the ability to maintain one's attention focused on task, and suggest that external distractions rather than mind-wandering are due to attentional control failures.
Miodrag, Nancy; Silverberg, Sophie E.; Urbano, Richard C.; Hodapp, Robert M.
Background: Although life expectancies in Down syndrome (DS) have doubled over the past 3-4 decades, there continue to be many early deaths. Yet, most research focuses on infant mortality or later adult deaths. Materials and Methods: In this US study, hospital discharge and death records from the state of Tennessee were linked to examine 2046…
Orri, Massimiliano; Paduanello, Matteo; Lachal, Jonathan; Falissard, Bruno; Sibeoni, Jordan; Revah-Levy, Anne
Background Suicide by adolescents and young adults is a major public health concern, and repetition of self-harm is an important risk factor for future suicide attempts. Objective Our purpose is to explore the perspective of adolescents directly involved in suicidal acts. Methods Qualitative study involving 16 purposively selected adolescents (sex ratio1∶1) from 3 different centers. Half had been involved in repeated suicidal acts, and the other half only one. Data were gathered through semistructured interviews and analyzed according to Interpretative Phenomenological Analysis. Results We found five main themes, organized in two superordinate themes. The first theme (individual dimensions of the suicide attempt) describes the issues and explanations that the adolescents saw as related to themselves; it includes the subthemes: (1) negative emotions toward the self and individual impasse, and (2) the need for some control over their lives. The second main theme (relational dimensions of attempted suicide) describes issues that adolescents mentioned that were related to others and includes three subthemes: (3) perceived impasse in interpersonal relationships, (4) communication, and (5) revenge. Conclusions Adolescents involved in suicidal behavior are stuck in both an individual and a relational impasse from which there is no exit and no apparent way to reach the other. Revenge can bridge this gap and thus transforms personal distress into a relational matter. This powerful emotion has been neglected by both clinicians and researchers. PMID:24802777
Rosenberg, Abby R; Bona, Kira; Wharton, Claire M; Bradford, Miranda; Shaffer, Michele L; Wolfe, Joanne; Baker, Kevin Scott
Conducting patient-reported outcomes research with adolescents and young adults (AYAs) is difficult due to low participation rates and high attrition. Forty-seven AYAs with newly diagnosed cancer at two large hospitals were prospectively surveyed at the time of diagnosis and 3-6 and 12-18 months later. A subset participated in 1:1 semistructured interviews. Attrition prompted early study closure at one site. The majority of patients preferred paper-pencil to online surveys. Interview participants were more likely to complete surveys (e.g., 93% vs. 58% completion of 3-6 month surveys, P = 0.02). Engaging patients through qualitative methodologies and using patient-preferred instruments may optimize future research success.
Magni, Chiara; Veneroni, Laura; Silva, Matteo; Casanova, Michela; Chiaravalli, Stefano; Massimino, Maura; Clerici, Carlo Alfredo; Ferrari, Andrea
Adolescents and young adults (AYA) with cancer form a particular group of patients with unique characteristics, who inhabit a so-called “no man’s land” between pediatric and adult services. In the last 10 years, the scientific oncology community has started to pay attention to these patients, implementing dedicated programs. A standardized model of care directed toward patients in this age range has yet to be developed and neither the pediatric nor the adult oncologic systems perfectly fit these patients’ needs. The Youth Project of the Istituto Nazionale Tumori in Milan, dedicated to AYA with pediatric-type solid tumors, can be seen as a model of care for AYA patients, with its heterogeneous multidisciplinary staff and close cooperation with adult medical oncologists and surgeons. Further progress in the care of AYA cancer patients is still needed to improve their outcomes. PMID:27606308
Nielsen, Kathleen; Abbott, Robert; Griffin, Whitney; Lott, Joe; Raskind, Wendy; Berninger, Virginia W.
The same working memory and reading and writing achievement phenotypes (behavioral markers of genetic variants) validated in prior research with younger children and older adults in a multi-generational family genetics study of dyslexia were used to study 81 adolescent and young adults (ages 16 to 25) from that study. Dyslexia is impaired word reading and spelling skills below the population mean and ability to use oral language to express thinking. These working memory predictor measures were given and used to predict reading and writing achievement: Coding (storing and processing) heard and spoken words (phonological coding), read and written words (orthographic coding), base words and affixes (morphological coding), and accumulating words over time (syntax coding); Cross-Code Integration (phonological loop for linking phonological name and orthographic letter codes and orthographic loop for linking orthographic letter codes and finger sequencing codes), and Supervisory Attention (focused and switching attention and self-monitoring during written word finding). Multiple regressions showed that most predictors explained individual difference in at least one reading or writing outcome, but which predictors explained unique variance beyond shared variance depended on outcome. ANOVAs confirmed that research-supported criteria for dyslexia validated for younger children and their parents could be used to diagnose which adolescents and young adults did (n=31) or did not (n=50) meet research criteria for dyslexia. Findings are discussed in reference to the heterogeneity of phenotypes (behavioral markers of genetic variables) and their application to assessment for accommodations and ongoing instruction for adolescents and young adults with dyslexia. PMID:26855554
Nielsen, Kathleen; Abbott, Robert; Griffin, Whitney; Lott, Joe; Raskind, Wendy; Berninger, Virginia W
The same working memory and reading and writing achievement phenotypes (behavioral markers of genetic variants) validated in prior research with younger children and older adults in a multi-generational family genetics study of dyslexia were used to study 81 adolescent and young adults (ages 16 to 25) from that study. Dyslexia is impaired word reading and spelling skills below the population mean and ability to use oral language to express thinking. These working memory predictor measures were given and used to predict reading and writing achievement: Coding (storing and processing) heard and spoken words (phonological coding), read and written words (orthographic coding), base words and affixes (morphological coding), and accumulating words over time (syntax coding); Cross-Code Integration (phonological loop for linking phonological name and orthographic letter codes and orthographic loop for linking orthographic letter codes and finger sequencing codes), and Supervisory Attention (focused and switching attention and self-monitoring during written word finding). Multiple regressions showed that most predictors explained individual difference in at least one reading or writing outcome, but which predictors explained unique variance beyond shared variance depended on outcome. ANOVAs confirmed that research-supported criteria for dyslexia validated for younger children and their parents could be used to diagnose which adolescents and young adults did (n=31) or did not (n=50) meet research criteria for dyslexia. Findings are discussed in reference to the heterogeneity of phenotypes (behavioral markers of genetic variables) and their application to assessment for accommodations and ongoing instruction for adolescents and young adults with dyslexia.
Kiff, Cara J.; Cortes, Rebecca C.; Lengua, Liliana J.; Kosterman, Rick; Hawkins, J. David; Mason, W. Alex
Exposure to adversity during childhood and adolescence predicts adjustment across development. Furthermore, adolescent adjustment problems persist into young adulthood. This study examined relations of contextual adversity with concurrent adolescent adjustment and prospective mental health and health outcomes in young adulthood. A longitudinal…
Staff, Jeremy; Kloska, Deborah D.; Patrick, Megan E.; O’Malley, Patrick M.; Schulenberg, John
Purpose Assess whether infrequent and frequent marijuana use at age 19/20 predicts receipt of educational degrees by the mid 20s, independent of confounding age 18 adolescent risk factors. Methods Data were from the Monitoring the Future study, an annual nationally-representative survey of high school seniors followed into adulthood. Thirteen cohorts (1990 to 2002) of high school seniors were followed longitudinally to their mid 20s (n=4,925; 54% female). We used logistic regression and propensity score matching with successive inclusion of age 18 risk factors and substance use to compare age 19/20 frequent marijuana users (6+ occasions in past 30 days) to non-users, frequent users to infrequent users (1 to 6 occasions), and infrequent users to non-users on their likelihood of degree attainment by the mid 20s. Results Frequent marijuana users were less likely than infrequent users and non-users to earn Bachelor’s degrees, even after controlling for a host of age 18 risk factors (e.g., family socioeconomic background, academic performance, educational expectations, truancy). However, these differences were reduced in magnitude to statistical non-significance when we controlled for age 18 substance use. Across analyses, the proportion reaching this educational milestone did not differ significantly between infrequent users and non-users. Conclusions Results support a growing body of work suggesting that frequent marijuana use predicts a lower likelihood of post-secondary educational attainment, and this difference may originate during secondary school. PMID:26206441
Gou, J.; Smith, J.; Valero, J.; Rubio, I.
This paper reports on a clinical trial evaluating outcomes of a frequency-lowering technique for adolescents and young adults with severe to profound hearing impairment. Outcomes were defined by changes in aided thresholds, speech perception, and acceptance. The participants comprised seven young people aged between 13 and 25 years. They were…
Kasen, S; Cohen, P; Brook, J S
Outside of the family, schools are the most proximal socializing agent available to convey societal norms and prohibitions to young people. In some cases, a positive school experience can compensate for the antisocial influence of family and community. The present study investigated the predictive ability of school-related factors on later deviancy in a random sample of 452 US adolescents 12-18 years of age attending 150 junior or senior high schools in upstate New York and enrolled in a broader prospective study. A measure of conduct problems, obtained 2 years before measurement of school factors, was used to control for the predisposing effects of problematic behavior on later deviance. Academic achievement, academic aspirations, and a learning-focused school environment had deterrent effects on all deviant outcomes assessed--dropping out of school, adolescent pregnancy, engaging in criminal activities, criminal conviction, antisocial personality disorder, and alcohol abuse--independent of age, gender, intelligence quotient, socioeconomic status, childhood conduct problems, and proportion of deviance-oriented friends in adolescence. Given the persistence of deviant behavioral patterns of adolescence into adulthood, the systems-level influences identified in this study should be given careful attention.
Groenke, Susan; Maples, Joellen; Henderson, Jill
While young adult literature increases adolescents' motivation to read, and adolescents choose to read young adult novels over more canonical works when given opportunities to choose, the authors present yet another reason for teaching young adult literature in the middle school classroom: it provides a medium through which adolescents and their…
Nitzburg, George C.; DeRosse, Pamela; Burdick, Katherine E.; Peters, Bart D.; Gopin, Chaya B.; Malhotra, Anil K.
Background Neurodevelopmental models of schizophrenia suggest that cognitive deficits may be observed during childhood and adolescence, long before the onset of psychotic symptoms. Elucidating the trajectory of normal cognitive development during childhood and adolescence may therefore provide a basis for identifying specific abnormalities related to the development of schizophrenia. The MATRICS Consensus Cognitive Battery (MCCB), which was designed for use in clinical trials targeting cognitive deficits most common in schizophrenia, may provide a mechanism to understand this trajectory. To date, however, there is no performance data for the MCCB in healthy children and adolescents. The present study sought to establish performance data for the MCCB in healthy children, adolescents, and young adults. Methods The MCCB was administered to a community sample of 190 healthy subjects between the ages of 8 and 23 years. All MCCB domain scores were converted to T-scores using sample means and standard deviations and were compared for significant performance differences between sex and age strata. Results Analyses revealed age effects following quadratic trends in all MCCB domains, which is consistent with research showing a leveling off of childhood cognitive improvement upon approaching late adolescence. Sex effects after controlling for age only presented for one MCCB domain, with males exhibiting well-known spatial reasoning advantages. Conclusions Utilizing this performance data may aid future research seeking to elucidate specific deficits that may be predictive of later development of SZ. PMID:24321710
McDonald, Fiona E J; Patterson, Pandora; Costa, Daniel S J; Shepherd, Heather L
Health literacy can influence long-term health outcomes. This study aimed to validate an adapted version of the Functional, Communicative and Critical Health Literacy measure for adolescent and young adult (AYA) cancer patients and survivors (N = 105; age 12-24 years). Exploratory factor analysis was used to validate the measure, and indicated that a slightly modified item structure better fit the results. Furthermore, item response theory analysis highlighted location and discrimination parameter differences among items. Acceptability of the measure was high. This is the first validation of a health literacy measure among AYAs with an illness such as cancer.
Santos, Fábio R M; Sigulem, Daniel; Areco, Kelsy C N; Gabbay, Monica A L; Dib, Sergio A; Bernardo, Viviane
This study investigated the association of hope and its factors with depression and glycemic control in adolescents and young adults with type 1 diabetes. A total of 113 patients were invited to participate. Significant negative correlations were found between hope and HbA1c and also between hope and depression. Hope showed a significant association with HbA1c and depression in the stepwise regression model. Among the hope factors, "inner positive expectancy" was significantly associated with HbA1c and depression. This study supports that hope matters to glycemic control and depression. Intervention strategies focusing on hope should be further explored.
Kuschner, Emily S.; Eisenberg, Ian W.; Orionzi, Bako; Simmons, W. Kyle; Kenworthy, Lauren; Martin, Alex; Wallace, Gregory L.
Although it is well-established that picky eating is a common feature of early development in autism spectrum disorder (ASD), far less is known about food selectivity during adolescence and adulthood. Using portions of the Adult/Adolescent Sensory Profile, food selectivity self-ratings were obtained from 65 high-functioning adolescents/young adults with ASD and compared to those of 59 typically developing controls matched on age, IQ, and sex ratio. Individuals with ASD reported preferring familiar foods (food neophobia) and disliking foods with particular textures and strong flavors. Providing linkage to everyday behavior, parent ratings of daily living skills were lower among individuals with ASD and food neophobia than among those without food neophobia. Food selectivity continues to be an important issue for adolescents/young adults with ASD. PMID:26309446
Chung, Richard J.; Touloumtzis, Currie
OPINION STATEMENT Approaches to the prevention and management of cardiovascular disease (CVD) are often too narrow in scope and initiated too late. While the majority of adolescents are free of CVD, far fewer are free of CVD risk factors, especially lifestyle factors such as poor exercise and dietary habits. Most clinicians are familiar with behavioral and pharmacologic strategies for modifying these and other traditional CVD risk factors such as hypertension, hypercholesterolemia, and diabetes. In this review, we highlight those strategies most applicable to teens and also propose a fundamental reframing that recognizes the importance of early choices and life experiences to achieving cardiovascular health. Population- and individual-level approaches that support the establishment of positive health behaviors early in life are the foundation of preserving ideal cardiovascular health and promoting positive cardiovascular outcomes. The Positive Youth Development movement supports a frame shift away from seeing young people as merely the sum of their risk factors and instead as developmentally dynamic youth capable of making healthy choices. Informed by the Positive Youth Development framework, our approach to cardiovascular prevention among adolescents is both broad-based and proactive, paying heed as early as possible to social, familial, and developmental factors that underlie health behaviors, and employing evidence- based behavioral, pharmacologic, and surgical treatments when needed. PMID:26511137
Richardson, Laura P; McCarty, Carolyn A; Radovic, Ana; Suleiman, Ahna Ballonoff
Despite the recognition that behavioral and medical health conditions are frequently intertwined, the existing health care system divides management for these issues into separate settings. This separation results in increased barriers to receipt of care and contributes to problems of underdetection, inappropriate diagnosis, and lack of treatment engagement. Adolescents and young adults with mental health conditions have some of the lowest rates of treatment for their conditions of all age groups. Integration of behavioral health into primary care settings has the potential to address these barriers and improve outcomes for adolescents and young adults. In this paper, we review the current research literature for behavioral health integration in the adolescent and young adult population and make recommendations for needed research to move the field forward.
Ayer, Lynsay; Rettew, David; Althoff, Robert R; Willemsen, Gonneke; Ligthart, Lannie; Hudziak, James J; Boomsma, Dorret I
Personality traits and socioeconomic factors such as neighborhood income have been identified as risk factors for future alcohol abuse, but findings have been inconsistent possibly due to interactions between risk and protective factors. The present study examined the prediction of drinking behavior using empirically derived multi-trait patterns and tested for moderation by average neighborhood income. Using latent profile analysis (LPA) in a sample of 863 Dutch adolescents, four empirical personality profiles based on 6 traits were observed: Extraverted, Dysregulated, Neurotic, and Regulated. Dysregulated and Extraverted youth drank higher quantities of alcohol more frequently in young adulthood relative to the Regulated group, above and beyond the effects of baseline adolescent drinking, age, and sex. Profile levels of neuroticism did not appear to affect drinking behavior. Average neighborhood income did not moderate adolescent personality and young adult drinking. These findings suggest that future alcohol research should consider individual trait patterns to inform prevention and intervention efforts, and theories implicating both positive and negative emotionality traits as risk factors for drinking are preferable to those emphasizing the importance of the latter.
Ayer, Lynsay; Rettew, David; Althoff, Robert R.; Willemsen, Gonneke; Ligthart, Lannie; Hudziak, James J.; Boomsma, Dorret I.
Personality traits and socioeconomic factors such as neighborhood income have been identified as risk factors for future alcohol abuse, but findings have been inconsistent possibly due to interactions between risk and protective factors. The present study examined the prediction of drinking behavior using empirically derived multi-trait patterns and tested for moderation by average neighborhood income. Using latent profile analysis (LPA) in a sample of 863 Dutch adolescents, four empirical personality profiles based on 6 traits were observed: Extraverted, Dysregulated, Neurotic, and Regulated. Dysregulated and Extraverted youth drank higher quantities of alcohol more frequently in young adulthood relative to the Regulated group, above and beyond the effects of baseline adolescent drinking, age, and sex. Profile levels of neuroticism did not appear to affect drinking behavior. Average neighborhood income did not moderate adolescent personality and young adult drinking. These findings suggest that future alcohol research should consider individual trait patterns to inform prevention and intervention efforts, and theories implicating both positive and negative emotionality traits as risk factors for drinking are preferable to those emphasizing the importance of the latter. PMID:21820248
LYNNE-LANDSMAN, SARAH D.; BRADSHAW, CATHERINE P.; IALONGO, NICHOLAS S.
Developmental models highlight the impact of early risk factors on both the onset and growth of substance use, yet few studies have systematically examined the indirect effects of risk factors across several domains, and at multiple developmental time points, on trajectories of substance use and adult adjustment outcomes (e.g., educational attainment, mental health problems, criminal behavior). The current study used data from a community epidemiologically defined sample of 678 urban, primarily African American youth, followed from first grade through young adulthood (age 21) to test a developmental cascade model of substance use and young adult adjustment outcomes. Drawing upon transactional developmental theories and using growth mixture modeling procedures, we found evidence for a developmental progression from behavioral risk to adjustment problems in the peer context, culminating in a high-risk trajectory of alcohol, cigarette, and marijuana use during adolescence. Substance use trajectory membership was associated with adjustment in adulthood. These findings highlight the developmental significance of early individual and interpersonal risk factors on subsequent risk for substance use and, in turn, young adult adjustment outcomes. PMID:20883591
Fulkerson, Jayne; Story, Mary; Neumark-Sztainer, Dianne
Objective To describe shared meal patterns and examine associations with dietary intake among young adults. Design Population-based, longitudinal cohort study (Project EAT: Eating and Activity in Teens and Young Adults). Setting Participants completed surveys and food frequency questionnaires in Minneapolis/St. Paul, Minnesota high school classrooms in 1998–1999 (mean age=15.0, “adolescence”) and follow-up measures online or by mail in 2008–2009 (mean age=25.3, “young adulthood”). Subjects There were 2,052 participants who responded to the 10-year follow-up survey and reported on frequency of having shared meals. Results Among young adults, the frequency of shared meals during the past week was as follows: never (9.9%), one or two times (24.7%), three to six times (39.1%), and seven or more times (26.3%). Having more frequent family meals during adolescence predicted a higher frequency of shared meals in young adulthood above and beyond other relevant sociodemographic factors such as household composition and parental status. Compared to young adults who never had family meals during adolescence, those young adults who reported seven or more family meals per week during adolescence had an average of one additional shared meal per week. Having more frequent shared meals in young adulthood was associated with greater intake of fruit among males and females, and with higher intakes of vegetables, milk products, and some key nutrients among females. Conclusions Nutrition professionals should encourage families of adolescents to share meals often and establish the tradition of eating together, and work with young adults to ensure that healthy food and beverage choices are offered at mealtimes. PMID:22857517
Grigsby, Timothy J.; Forster, Myriam; Soto, Daniel W.; Baezconde-Garbanati, Lourdes; Unger, Jennifer B.
Using data collected between 2005–2012 from a longitudinal study of acculturation patterns and substance use among Hispanic youth in Southern California (N = 2,722), we fit multivariate logistic regression models to estimate the association of type and frequency of drug use, friend and parent drug use, cultural orientation (measured by the ARSMA-II), and psychological distress (CES-D score) in 10th grade with problematic substance use (measured with the RAPI) in (i) 11th grade and (ii) young adulthood. We conclude that future intervention efforts with Hispanic adolescents and young adults should target polysubstance and problem users and emphasize inter-individual, structural and cultural processes as they relate to problematic substance use. PMID:24779502
Chorlian, David B.; Rangaswamy, Madhavi; Manz, Niklas; Kamarajan, Chella; Pandey, Ashwini K.; Edenberg, Howard; Kuperman, Samuel; Porjesz, Bernice
The developmental trajectories of theta band (4-7 Hz) event-related oscillations (EROs), a key neurophysiological constituent of the P3 response, were assessed in 2170 adolescents and young adults ages 12 to 25. The theta EROs occurring in the P3 response, important indicators of neurocognitive function, were elicited during the evaluation of task-relevant target stimuli in visual and auditory oddball tasks. These tasks call upon attentional and working memory resources. Large differences in developmental rates between males and females were found; scalp location and task modality (visual or auditory) differences within males and females were small compared to gender differences. Trajectories of interregional and intermodal correlations between ERO power values exhibited increases with age in both genders, but showed a divergence in development between auditory and visual systems during ages 16 to 21. These results are consistent with previous electrophysiological and imaging studies and provide additional temporal detail about the development of neurophysiological indices of cognitive activity. Since measures of the P3 response has been found to be a useful endophenotypes for the study of a number of clinical and behavioral disorders, studies of its development in adolescents and young adults may illuminate neurophysiological factors contributing to the onset of these conditions. PMID:26102560
Yi-Frazier, Joyce P.; Wharton, Claire; Gordon, Karen; Jones, Barbara
Purpose: Self-perceived resilience may enable coping and mitigate poor psychosocial outcomes among adolescent and young adult (AYA) patients with cancer. In order to inform the development of resilience-promoting interventions, we aimed to: (1) describe AYA patient-reported resilience and (2) identify AYA patient-reported contributors and inhibitors of resilience. Methods: The “Resilience in Adolescents and Young Adults with Cancer” study was a prospective longitudinal mixed-methods study. Consecutive Caucasian patients aged 14–25 years old enrolled 14–60 days following their diagnosis of cancer and completed one-on-one semi-structured interviews both at the time of enrollment and 3–6 months later. Constant comparative analyses identified salient themes describing modifiable contributors and inhibitors to patient-perceived resilience. Results: Seventeen patients (85% of those approached) enrolled in the study. The mean age was 17 years (SD=2.6) and 53% were female. All patient definitions of resilience inferred an ability to handle adversity. Five themes emerged as predominant contributors or inhibitors of resilience: (1) stress and coping; (2) goals, purpose, and planning; (3) optimism; (4) gratitude and meaning; and (5) connection and belonging. Merged analyses suggested that AYA resilience was a balance that may be enabled by promoting certain skills. Conclusion: AYA patients with cancer perceive resilience as a balance. Learned skills in stress management, goal-setting, and benefit-finding may empower AYAs during their cancer experience, in turn improving long-term psychosocial outcomes. PMID:25969794
Toazza, Rudineia; Franco, Alexandre Rosa; Buchweitz, Augusto; Molle, Roberta Dalle; Rodrigues, Danitsa Marcos; Reis, Roberta Sena; Mucellini, Amanda Brondani; Esper, Nathalia Bianchini; Aguzzoli, Cristiano; Silveira, Patrícia Pelufo; Salum, Giovanni Abrahão; Manfro, Gisele Gus
Anxiety disorders (AD) are the most prevalent group of psychiatric disorders in adolescents and young adults. Nevertheless, the pathophysiology of anxiety disorders is still poorly understood. This study investigated differences in the functional connectivity of intrinsic amygdala-based networks of participants with and without AD. Resting state fMRI data were obtained from 18 participants with an AD and 19 healthy comparison individuals. Psychiatric diagnosis was assessed using standardized structured interviews. The comparison between groups was carried out using functional connectivity maps from six seed regions defined using probabilistic maps bilaterally within the amygdala (basolateral, superficial and centromedial amygdala). We found significant between-group differences in five clusters, which showed aberrant functional connectivity with the left basolateral amygdala: right precentral gyrus, right cingulate gyrus, bilateral precuneus, and right superior frontal gyrus in subjects with AD as compared with the comparison subjects. For the comparison subjects, the correlations between the amygdala and the five clusters were either non-significant, or negative. The present study suggests there is an intrinsic disruption in the communication between left basolateral amygdala and a network of brain regions involved with emotion regulation, and with the default mode network in adolescents and young adults with anxiety disorders.
Festinger, David S; Dugosh, Karen L; Clements, Nicolle; Flynn, Anna B; Falco, Mathea; McLellan, A Thomas; Arria, Amelia M
Nonmedical use of prescription drugs is common and poses risks such as injury, overdose, and development of abuse and dependence. Internet pharmacies offer prescription drugs without a prescription, creating a source of illicit drugs accessible to anyone with an Internet connection. We examined this issue in a convenience sample of 1,860 adolescents and young adults from 24 residential and outpatient treatment programs. Few individuals obtained drugs from the Internet (n = 26, 2.3%). Pain relievers were the most frequently purchased type of drug. The majority of adolescents and young adult online purchasers made the purchases from their own or a friend's house.
Tandon, Darius; Mendelson, Tamar; Mance, GiShawn
This study examines the acceptability and preliminary outcomes from an open trial of a depression prevention intervention for low-income African American adolescents and young adults in employment training programs. The sample (N=42) consisted of predominately African American adolescents and young adults (mean age=19.1) exhibiting subclinical…
Substance Abuse and Mental Health Services Administration, 2011
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…
Gupta, Abha A; Papadakos, Janet K; Jones, Jennifer M; Amin, Leila; Chang, Eugene K; Korenblum, Chana; Santa Mina, Daniel; McCabe, Lianne; Mitchell, Laura; Giuliani, Meredith E
Literature regarding the development of adolescent and young adult (AYA) cancer programs has been dominantly informed by pediatric centers and practitioners. However, the majority of young adults are seen and treated at adult cancer centers, in which cancer volumes afford the development of innovative supportive care services. Although the supportive care services in adult cancer centers are helpful to AYAs, some of the most prominent and distinct issues faced by AYAs are not adequately addressed through these services alone. This article describes how the AYA Program at Princess Margaret Cancer Centre has collaborated with existing supportive care services in addition to supplying its own unique services to meet the comprehensive needs of AYAs in the domains of: symptom management (sexuality and fatigue), behavior modification (return to work and exercise), and health services (advanced cancer and survivorship). These collaborations are augmented by patient education interventions and timely referrals. The objective of this article was to assist other centers in expanding existing services to address the needs of AYA patients with cancer.
Tricoli, James V; Seibel, Nita L; Blair, Donald G; Albritton, Karen; Hayes-Lattin, Brandon
Each year in the United States, nearly 70 000 individuals between the ages of 15 and 40 years are diagnosed with cancer. Although overall cancer survival rates among pediatric and older adult patients have increased in recent decades, there has been little improvement in survival of adolescent and young adult (AYA) cancer patients since 1975 when collected data became adequate to evaluate this issue. In 2006, the AYA Oncology Progress Review Group made recommendations for addressing the needs of this population that were later implemented by the LIVESTRONG Young Adult Alliance. One of their overriding questions was whether the cancers seen in AYA patients were biologically different than the same cancers in adult and/or pediatric patients. On June 9-10, 2009, the National Cancer Institute (NCI) and the Lance Armstrong Foundation (LAF) convened a workshop in Bethesda, MD, entitled "Unique Characteristics of AYA Cancers: Focus on Acute Lymphocytic Leukemia (ALL), Breast Cancer and Colon Cancer" that aimed to examine the current state of basic and translational research on these cancers and to discuss the next steps to improve their prognosis and treatment.
Merten, Michael J.; Wickrama, K. A. S.; Williams, Amanda L.
Using a sample of 7,881 African American (915 males and 1,073 females) and White (2,864 males and 3,029 females) adolescents from Waves 1 and 3 of the National Longitudinal Study of Adolescent Health, this study examined the psychosocial consequences that obese adolescents encounter as they reach young adulthood. Results indicate that obesity…
Beach, Steven R H; Lei, Man Kit; Brody, Gene H; Miller, Gregory E; Chen, Edith; Mandara, Jelani; Philibert, Robert A
We examined two potentially interacting, connected pathways by which parental supportiveness during early adolescence (ages 1-13) may come to be associated with later African American young adult smoking. The first pathway is between parental supportiveness and young adult stress (age 19), with stress, in turn, predicting increased smoking at age 20. The second pathway is between supportive parenting and tumor necrosis factor (TNF) gene methylation (i.e., TNFm), a proinflammatory epitype, with low levels indicating greater inflammatory potential and forecasting increased risk for smoking in response to young adult stress. In a sample of 382 African American youth residing in rural Georgia, followed from early adolescence (age 10-11) to young adulthood (age 20), supportive parenting indirectly predicted smoking via associations with young adult stress, IE = -0.071, 95% confidence interval [-0.132, -0.010]. In addition, supportive parenting was associated with TNFm measured at age 20 (r = .177, p = .001). Further, lower TNFm was associated with a significantly steeper slope (b = 0.583, p = .003) of increased smoking in response to young adult stress compared to those with higher TNFm (b = 0.155, p = .291), indicating an indirect, amplifying role for supportive parenting via TNFm. The results suggest that supportive parenting in early adolescence may play a role in understanding the emergence of smoking in young adulthood.
Wickrama, K A S; Simons, Leslie Gordon; Baltimore, Diana
Previous research has documented that adverse life experiences during adolescence, particularly for ethnic minorities, have a long-term influence on income and asset attainment and that this relationship is largely mediated by educational achievement. We extend prior research by investigating three research questions. First, we investigate the extent to which community disadvantage, family factors and race/ethnicity each exert an independent influence on young adult socioeconomic attainment. Second, we examine whether youths' educational attainment mediates these independent influences on socioeconomic attainment. Third, we test whether educational attainment ameliorates the negative influences of disadvantaged community and family conditions and race/ethnicity on socioeconomic attainment. We address these questions using multilevel modeling with longitudinal, prospective data from Waves 1 and 4 of National Longitudinal Study of Adolescent Health, which has a nationally representative sample of adolescents (N = 13, 450; 53 % females). Regarding our first research question, our results indicated that African Americans, youth from disadvantaged communities, lower SES families achieve significantly lower levels of earnings, assets, and job quality during young adulthood. Second, we found that young adults' educational level only partially mediate the influences of family and race/ethnicity influences on young adults' socioeconomic attainment. Third, we found that young adults' educational level buffered the influence of early socioeconomic adversities and accentuated the positive influences of family resources. Findings highlight the importance of social context as well as educational opportunities during childhood and adolescence for economic stability in early adulthood.
Desandes, Emmanuel; Lacour, Brigitte; Clavel, Jacqueline
In adolescents and young adults (AYA), cancers are rare but represent the third significant cause of death. The aim of this paper was to investigate epidemiological data and pathways of care of AYA in France. During the 2000-2008 period, overall age-standardized incidence rates (ASR) were 254.1/10(6) in 15-24-year-olds. The most frequently diagnosed cancers in male AYA were malignant gonadal germ-cell tumors and Hodgkin's lymphoma, and were melanoma, thyroid carcinoma and Hodgkin's disease in females. The ASR appeared stable over time. During the 2000-2004 period, the 5-year overall survival for all cancers was 81.8%, with differences between genders and age groups: 78.8% for males and 85.2% for females; 78.5% in 15-19-year-olds and 84.3% in 20-24-year-olds. Survival has significantly improved over time. During the 2006-2007 period, the pathways of care for French adolescent patients with cancer were heterogeneous: 82% were treated in an adult environment, 27% were included in clinical studies, and in 54% of cases the management decisions were taken in the context of a multidisciplinary team. Studies looking at management of AYA with cancer have shown a wide disparity and a lack of collaboration between adult oncologists and pediatric oncologist. An AYA cancer multidisciplinary interest group has been created to determine priorities and coordinate efforts to improve AYA cancer services and care.
Chen, Wan-Yi; Corvo, Kenneth; Lee, Yookyong; Hahm, Hyeouk Chris
Research on the impact of exposure to community violence tends to define victimization as a single construct. This study differentiates between direct and indirect violence victimization in their association with mental health problems and mental health service use. This study includes 8947 individuals from four waves of the National Longitudinal Study of Adolescent to Adult Health and examines (1) whether sub-types of adolescent victimization are linked to depressive symptoms; (2) whether adolescent victimization is linked with mental health service use; and (3) the role of mental health service use in attenuating symptoms arising from victimizations. Adolescents witnessing community violence were more likely to experience depressive symptoms during adolescence but not during their young adulthood; direct exposure to violence during adolescence does not predict depressive symptoms in adolescence but does in adulthood. Use of mental health service mediates report of depressive symptoms for adolescent witnessing community violence.
Evans, Subhadra; Lung, Kirsten C.; Seidman, Laura C.; Sternlieb, Beth; Zeltzer, Lonnie K.; Tsao, Jennie C.I.
Objectives Irritable bowel syndrome (IBS) is a chronic, disabling condition that greatly compromises patient functioning. The aim of this study was to assess the impact of a 6-week twice per week Iyengar yoga (IY) program on IBS symptoms in adolescents and young adults (YA) with IBS compared with a usual-care waitlist control group. Methods Assessments of symptoms, global improvement, pain, health-related quality of life, psychological distress, functional disability, fatigue, and sleep were collected pre- and posttreatment. Weekly ratings of pain, IBS symptoms, and global improvement were also recorded until 2-month follow-up. A total of 51 participants completed the intervention (yoga = 29; usual-care waitlist = 22). Results Baseline attrition was 24%. On average, the yoga group attended 75% of classes. Analyses were divided by age group. Relative to controls, adolescents (14–17 years) assigned to yoga reported significantly improved physical functioning, whereas YA (18–26 years) assigned to yoga reported significantly improved IBS symptoms, global improvement, disability, psychological distress, sleep quality, and fatigue. Although abdominal pain intensity was statistically unchanged, 44% of adolescents and 46% of YA reported a minimally clinically significant reduction in pain following yoga, and one-third of YA reported clinically significant levels of global symptom improvement. Analysis of the uncontrolled effects and maintenance of treatment effects for adolescents revealed global improvement immediately post-yoga that was not maintained at follow-up. For YA, global improvement, worst pain, constipation, and nausea were significantly improved postyoga, but only global improvement, worst pain, and nausea maintained at the 2-month follow-up. Conclusions The findings suggest that a brief IY intervention is a feasible and safe adjunctive treatment for young people with IBS, leading to benefits in a number of IBS-specific and general functioning domains for
Linebarger, Jennifer S; Ajayi, Toluwalase A; Jones, Barbara L
This article will cover the special considerations, challenges, and opportunities presented by caring for adolescents and young adults with life-threatening illnesses when the possibility of transition to an adult care setting arises.
Doré, E; Bedu, M; França, N M; Van Praagh, E
The purpose of this study was to determine whether the relationships between short-term power and body dimensions in young females were similar whatever the age of the individuals. A cohort of 189 prepubescent (mean age 9.5 years), adolescent (mean age 14.4 years) and young adult (mean age 18.2 years) females performed three all-out sprints on a friction-loaded cycle ergometer against three braking forces corresponding to applied loads of 25, 50 and 75 g.kg-1 body mass (BM). For each sprint, peak power including flywheel inertia was calculated. Results showed that a braking load of 75 g.kg-1 BM was too high for prepubescent and adolescent girls. Therefore, when measuring short-term cycling performance in heterogeneous female populations, a braking load of 50 g.kg-1 BM (0.495 N.kg-1 BM) is recommended. During growth, cycling peak power (CPP; defined as the highest peak power obtained during the three sprints) increased, as did total BM, fat-free mass (FFM) and lean leg volume (LLV) (P < 0.001). Analysis of covariance revealed that the slopes of the linear relationships between CPP and biometric characteristics were similar in the three groups (P > 0.7 for the CPP/BM and CPP/FFM relationships, and P > 0.2 for the CPP/LLV relationship). However, the adjusted means were always significantly higher in young women (P < 0.001) compared with both of the other groups. Although differences in performance during anaerobic cycling in growing females are primarily dependent upon body dimensions, other as yet undetermined factors may be involved during late adolescence.
Sornpaisarn, Bundit; Shield, Kevin D; Cohen, Joanna E; Schwartz, Robert; Rehm, Jürgen
The objective of this study is to assess the relationship between alcohol taxation changes and drinking initiation among adolescents and young adults (collectively "youth") in Thailand (a middle-income country). Using a survey panel, this study undertook an age-period-cohort analysis using four large-scale national cross-sectional surveys of alcohol consumption performed in Thailand in 2001, 2004, 2007 and 2011 (n=87,176 Thai youth, 15-24 years of age) to test the hypothesis that changes in the inflation-adjusted alcohol taxation rates are associated with drinking initiation. Regression analyses were used to examine the association between inflation-adjusted taxation increases and the prevalence of lifetime drinkers. After adjusting for potential confounders, clear cohort and age effects were observed. Furthermore, a 10% increase of the inflation-adjusted taxation rate of the total alcohol market was significantly associated with a 4.3% reduction in the prevalence of lifetime drinking among Thai youth. In conclusion, tax rate changes in Thailand from 2001 to 2011 were associated with drinking initiation among youth. Accordingly, increases in taxation may prevent drinking initiation among youth in countries with a high prevalence of abstainers and may reduce the harms caused by alcohol.
Monseau, Virginia R.
This book focuses on how readers respond to the power of young adult literature--negating the assumption that because such literature appeals to adolescents it cannot possibly be worthy of a place in the language arts curriculum. The book serves two purposes: it describes and discusses the oral and written response of adolescents and adults to…
Hong Le, Minh Thi; Tran, Thach Duc; Nguyen, Huong Thanh; Fisher, Jane
Research about the association between early marriage and intimate partner violence (IPV) in low-income countries has yielded conflicting evidence. The aim of this study was to describe the prevalence of and associations between early marriage, and IPV among adolescents and young adults in Viet Nam. Secondary analysis of data from the national Survey Assessment of Viet Namese Youth-Round II (SAVY-II) conducted in 2009-2010, which assessed a representative cohort of people aged 14 to 25 years recruited via a systematic household survey was undertaken. Prevalence was established using descriptive statistics. The association between early marriage and IPV was examined using multiple logistic regressions, adjusting for potential risk factors. Of 10,044 participants, 1,701 had ever married and were included in analyses. Early marriage (before age 18), and experiences of verbal, physical, or sexual IPV were more common among females than males. More young married men than women reported experiences of controlling behaviors by their partners. Early marriage, being illiterate, and exposure to sexual abuse were associated with experience of IPV among young females, but not among young males. Poverty and exposure to family violence was associated with IPV in both sexes. Addressing early marriage, low educational opportunities for girls, childhood sexual abuse, family violence, and poverty should be considered in strategies to reduce IPV in Viet Nam.
Wood, William A; Lee, Stephanie J; Brazauskas, Ruta; Wang, Zhiwei; Aljurf, Mahmoud D; Ballen, Karen K; Buchbinder, David K; Dehn, Jason; Freytes, Cesar O; Lazarus, Hillard M; Lemaistre, Charles F; Mehta, Paulette; Szwajcer, David; Joffe, Steven; Majhail, Navneet S
Adolescents and young adults (AYAs, ages 15 to 40 years) with cancer have not experienced survival improvements to the same extent as younger and older patients. We compared changes in survival after myeloablative allogeneic hematopoietic cell transplantation (HCT) for acute lymphoblastic leukemia (ALL) among children (n = 981), AYAs (n = 1218), and older adults (n = 469) who underwent transplantation over 3 time periods: 1990 to 1995, 1996 to 2001, and 2002 to 2007. Five-year survival varied inversely with age group. Survival improved over time in AYAs and paralleled that seen in children; however, overall survival did not change over time for older adults. Survival improvements were primarily related to lower rates of early treatment-related mortality in the most recent era. For all cohorts, relapse rates did not change over time. A subset of 222 AYAs between the ages of 15 and 25 at 46 pediatric or 49 adult centers were also analyzed to describe differences by center type. In this subgroup, there were differences in transplantation practices among pediatric and adult centers, although HCT outcomes did not differ by center type. Survival for AYAs undergoing myeloablative allogeneic HCT for ALL improved at a similar rate as survival for children.
Mundt, Marlon P; Antonaccio, Olena P; French, Michael T; Zakletskaia, Larissa I
Weapon-related violent crime is a serious, complex, and multifaceted public health problem. The present study uses data from Waves I and III of Add Health (n = 10,482, 54% female) to examine how friendship group integration and cohesion in adolescence (ages 12-19) is associated with weapon-related criminal activity as a young adult (ages 18-26). Results indicate that greater cohesion in friendship groups is associated with significantly lower weapon-related criminal activity in young adulthood. In addition, for adolescent girls, a greater number of close friendship ties-an indicator of friendship group integration-is associated with less weapon-related criminal activity in young adulthood. These findings suggest that school-based initiatives to facilitate inclusive and cohesive adolescent peer communities may be an effective strategy to curb weapon-related criminal activity in young adulthood.
Bocéréan, Christine; Canut, Emmanuelle; Musiol, Michel
The aim of this research is to compare the types and functions of repetitions in two different corpora, one constituted of verbal interactions between adults and multiply-handicapped adolescents, the other between adults and young children of the same mental age as the adolescents. Our overall aim is to observe whether the communicative (linguistic and pragmatic) behaviour of adults varies according to the interlocutor and, if it does vary, in what ways. The main results show that adults do not use repetition strategy with the same aims according to the interlocutor. When interacting with a child, repetitions form part of a strategy of linguistic 'tutoring' which allow the child to take on board progressively more complex linguistic constructions; it also enriches exchanges from a pragmatic point of view. On the other hand, when adults communicate with multiply-handicapped adolescents, their main aim is the maintaining of dialogue.
Abramoff, Benjamin A.; Lange, Hannah L. H.; Matson, Steven C.; Cottrill, Casey B.; Bridge, Jeffrey A.; Abdel-Rasoul, Mahmoud; Bonny, Andrea E.
Objective. To evaluate ego strengths, in the context of Erikson's framework, among adolescents and young adults diagnosed with opioid dependence as compared to non-drug using youth. Methods. Opioid dependent (n = 51) and non-drug using control (n = 31) youth completed the self-administered Psychosocial Inventory of Ego Strengths (PIES). The PIES assesses development in the framework of Erikson's ego strength stages. Multivariate linear regression modeling assessed the independent association of the primary covariate (opioid dependent versus control) as well as potential confounding variables (e.g., psychiatric comorbidities, intelligence) with total PIES score. Results. Mean total PIES score was significantly lower in opioid dependent youth (231.65 ± 30.39 opioid dependent versus 270.67 ± 30.06 control; p < 0.01). Evaluation of the PIES subscores found significant (p < 0.05) delays in all ego strength areas (hope, will, purpose, competence, fidelity, love, care, and wisdom). When adjusting for potential confounders, opioid dependence remained a significant (p < 0.001) independent predictor of total PIES score. Conclusion. Adolescents with opioid dependence demonstrated significant delays in ego strength development. A treatment approach acknowledging this delay may be needed in the counseling and treatment of adolescents with opioid dependence. PMID:26664819
Segrin, Chris; Nevarez, Natalie; Arroyo, Analisa; Harwood, Jake
This study tested parental loneliness, family of origin environment, and a history of being bullied as predictors of loneliness in young adults. The role of social skills in young adults' loneliness was also examined. Participants were 111 young-adult-parent dyads who completed measures of loneliness and the family communication environment. In addition, young adults completed measures of social skills and history of being bullied. Predictions were tested with structural equation modeling, path analysis, and multiple regression analysis. Results showed that parental loneliness and a history of being bullied were each significant predictors of young adult loneliness. A family environment that supported open communication was negatively associated with young adults' loneliness. Parental loneliness and a history of being bullied each had direct effects on young adults' loneliness as well as indirect effects through reduced social skills.
In the era of an ageing population, young adults on medical wards are quite rare, as only 12% of young adults report a long-term illness or disability. However, mental health problems remain prevalent in the younger population. In a recent report, mental health and obesity were listed as the most common problems in young adults. Teams set up specifically for the needs of younger adults, such as early intervention in psychosis services are shown to work better than traditional care and have also proven to be cost effective. On the medical wards, younger patients may elicit strong emotions in staff, who often feel protective and may identify strongly with the young patient's suffering. In order to provide holistic care for young adults, general physicians need to recognise common presentations of mental illness in young adults such as depression, deliberate self-harm, eating disorders and substance misuse. Apart from treating illness, health promotion is particularly important for young adults.
Boulaamane, Lamiaa; Essaadi, Ismail; Lalya, Issam; M'rabti, Hind; Errihani, Hassan
Cancer is an uncommon disease; its imaginary concept is very particularly on adolescent and young adults. It disturbs their lives on the whole. The purpose of this study is to describe the specific psychosocial effects of cancer on adolescent and young adults in Moroccan population in order to help physicians educate and counsel future young patients and their families. During the period from January to July 2009, patients aged between 15 and 30 years with histologically confirmed cancer, were prospectively interviewed by a questionnaire covering socio-epidemiological characteristics, repercussions of disease on physical, psychic, sexual and religious practices. The aim of this study is to determine the impact of cancer, particularly on this young North African population, which is underrepresented in the psychosocial cancer literature.
Werch, Chudley E.; Dunn, Michael; Woods, Robert
Examines the alcohol and cigarette use patterns of adolescent and young adult female patients (N=246). Results indicate that smoking differences between Whites and Blacks was inversely related to education: less-educated Whites and more-educated Blacks had a greater smoking risk. Conclusions show females' differential needs regarding alcohol and…
Portlock, Carol S
Radiation therapy technology has permitted the development of new treatment planning techniques. Involved field, involved node, and involved site radiotherapy fields are discussed and compared. Indications for and implications of combined modality therapy are examined, particularly as pertinent to the adolescent and young adult population. PMID:26767184
Mulder, Juul; Ter Bogt, Tom F. M.; Raaijmakers, Quinten A. W.; Gabhainn, Saoirse Nic; Sikkema, Paul
The structure of music preferences has been investigated extensively. However, development of music preferences in terms of consistency of music taste is as yet understudied. In this study, intra-individual consistency of music taste was assessed among Dutch adolescents and young adults over three points in time in a 21-month period. An…
Schaefer-Schiumo, Kristin; Colangelo, James; Bordan, Terry
A metaphorical intervention is introduced for counseling professionals, utilizing the terminology of hold 'em poker, the current game of choice among juvenile populations. This metaphor serves as a guide for counselors when assisting adolescents and young adults in developing healthier life choices and deterring potentially impulsive behaviors,…
Zhao, Fei; French, David; Manchaiah, Vinaya K.C.; Liang, Maojin; Price, Sharon M.
Introduction: Adolescents and young adults have been shown to be the age group most at risk of music-induced hearing loss (MIHL), which is already evident and increasing among this group. Objective: The purpose of this review is to provide further insight into the effectiveness of education programmes on attitude and behaviour towards loud music…
Finestack, Lizbeth H.; Abbeduto, Leonard
Purpose: In this study, the authors examined the expressive language abilities of a subset of highly verbally expressive adolescents and young adults with Down syndrome (DS) and those with fragile X syndrome (FXS) for evidence of syndrome-related differences. FXS gender differences were also examined in an exploratory fashion. Method: The authors…
Hustyi, Kristin M.; Hall, Scott S.; Quintin, Eve-Marie; Chromik, Lindsay C.; Lightbody, Amy A.; Reiss, Allan L.
Few studies have examined the relationship between autistic symptomatology and competence in independent living skills in adolescents and young adults with fragile X syndrome (FXS). In this study, 70 individuals with FXS, aged 15-25 years, and 35 matched controls were administered direct measures of independent living skills and autistic…
Fosco, Gregory M.; Van Ryzin, Mark J.; Xia, Mengya; Feinberg, Mark E.
The formation and maintenance of young adult romantic relationships that are free from violence and are characterized by love, connection, and effective problem-solving have important implications for later well-being and family functioning. In this study, we examined adolescent hostile-aggressive behavior (HAB) and family relationship quality as…
Hillier, Ashleigh; Greher, Gena; Poto, Nataliya; Dougherty, Margaret
Music interventions are frequently utilized with those with autism spectrum disorders (ASD) and have shown a range of benefits. However, empirical evaluations are lacking and would be a timely step forward in the field. Here we report the findings of our pilot music program for adolescents and young adults with ASD. Evaluation of the program…
de Bruin, Catriona L.; Deppeler, Joanne M.; Moore, Dennis W.; Diamond, Neil T.
This article reviews research on the effectiveness of four categories of intervention when implemented in public schools with adolescents and young adults diagnosed with an autism spectrum disorder. The study's inclusionary criteria include a setting of public schools, participants aged between 12 and 22 years, and the investigation of an…
Huguelet, P S; Sheehan, C; Spitzer, R F; Scott, S
This case series reports on the safety and efficacy of the levonorgestrel 52-mg intrauterine system in adolescent and young adult solid organ transplant recipients. All patients used the device for contraception, with no documented cases of disseminated pelvic infection or unplanned pregnancy.
Allen, Keith D.; Wallace, Dustin P.; Renes, Diana; Bowen, Scott L.; Burke, Ray V.
As part of a collaborative project between a University Center for Excellence in Developmental Disabilities and a local private business, we examined the effects of video modeling to teach vocational skills to four adolescents and young adults with Autism Spectrum Disorders. Video modeling was used to teach the participants to wear a WalkAround[R]…
Hartley, Sigan L.; Seltzer, Marsha Mailick; Head, Lara; Abbeduto, Leonard
The psychological well-being of fathers of children with developmental disabilities remains poorly understood. The present study examined depressive symptoms, pessimism, and coping in fathers of adolescents and young adults with Down syndrome (DS;n = 59), autism spectrum disorders (ASDs;n = 135), and Fragile X syndrome (n = 46). Fathers of sons or…
Lahat, Ayelet; Helwig, Charles C.; Zelazo, Philip David
The neurocognitive development of moral and conventional judgments was examined. Event-related potentials were recorded while 24 adolescents (13 years) and 30 young adults (20 years) read scenarios with 1 of 3 endings: moral violations, conventional violations, or neutral acts. Participants judged whether the act was acceptable or unacceptable…
Milan, Stephanie; Kershaw, Trace S.; Lewis, Jessica; Westdahl, Claire; Rising, Sharon Schindler; Patrikios, Mary; Ickovics, Jeannette R.
Prenatal depressive symptoms have been linked to negative outcomes for mothers and children. Using attachment theory as a framework, this study examined developmental differences in the interpersonal context of prenatal depressive symptoms among adolescents (age 14 to 19 years; n= 352) and young adults (age 20 to 24 years; n= 348). Participants…
Steppan, Diana A; Pratilas, Christine A; Loeb, David M
Soft tissue sarcomas (STSs) are a heterogeneous group of tumors originating from the mesenchyme. Even though they affect individuals in all age groups, the prevalence of subtypes of STSs changes significantly from childhood through adolescence into adulthood. The mainstay of therapy is surgery, with or without the addition of chemotherapy and/or radiation therapy. These treatment modalities are associated, in many cases, with significant morbidity and, given the heterogeneity of tumor histologies encompassed by the term “STS”, have not uniformly improved outcomes. Moreover, some subgroups of STSs appear to be more, and others less, responsive to conventional chemotherapy agents. Over the last two decades, our understanding of the biology of STSs is slowly increasing, allowing for the development of more targeted therapies. We review the new treatment modalities that have been tested on patients with STSs, with a special focus on adolescents and young adults, a group of patients that is often underrepresented in clinical trials and has not received the dedicated attention it deserves, given the significant differences in biology and treatment response in comparison to children and adults.
Dahl, Angie L; Galliher, Renee V
Religious contexts have traditionally been understood as protective for a variety of psychosocial health outcomes. However, the generalizability of these findings to youth who identify as lesbian, gay, bisexual, transgender or queer (LGBTQ) is questioned due to denominational teachings on same-sex attractions and sexual behavior. Eight adolescents (15-17 years) and 11 young adults (19-24 years) who identify as LGBTQ raised in Christian religious affiliations (16 participants raised in the Church of Jesus Christ of Latter Day Saints, 2 participants raised Catholic and 1 participant raised Presbyterian) participated in individual in-depth interviews, journal writings, and focus groups to provide greater insight into the lived experiences of LGBTQ individuals raised within a Christian religious environment. Findings suggest the religious context is related to both positive and negative outcomes. Eight themes are explored using participant's own words and experiences. Directions for future research and implications are discussed.
Deaf and hard of hearing (DHH) adolescents and young adults with disabilities (DWD) are a highly diverse group who may also demonstrate a range of functional limitations. These present unique challenges to professional efforts to provide high-quality transition services. Despite these issues, a majority of this population has cognitive abilities within the typical range, and therefore, their transition expectations should be commensurately high in comparison to those of their DHH peers. Research-based transition practices offer a range of interventions, and although none have been validated with DHH or DWD students, several provide important foundational learning opportunities. Yet their implementation will require modifications with programming and expertise beyond what is available in most school districts. Use of a multilevel, ecological framework and person-centered planning offers systematic strategies for increasing access to transition resources and supports to address these unique needs and lead to successful adulthood.
Zucchetti, Giulia; Bellini, Simona; Bertolotti, Marina; Bona, Francesca; Biasin, Eleonora; Bertorello, Nicoletta; Tirtei, Elisa; Fagioli, Franca
This study focuses on body image discomfort (BID) of 50 adolescent and young adult (AYA) hematologic cancer survivors (age range 15-23; 52% males). The study results were obtained through data from a self-report questionnaire: the Body Uneasiness Test. Findings differed according to gender: a greater proportion of females were in the Risk category of impaired body image than males (χ(2) = 5.258, p < 0.05). No significant body image differences were found according to the type of diagnosis or to the length of survival. To manage survivors' BIDs and to improve their quality of life, assessing BID in AYA cancer survivors is important for identifying those who might be in need of additional supportive care or a program.
Harpin, Scott B.; Grubenhoff, Joseph A.; Rivara, Frederick P.
Objectives. We examined the prevalence of self-reported traumatic brain injury (TBI) among homeless young people and explored whether sociodemographic characteristics, mental health diagnoses, substance use, exposure to violence, or difficulties with activities of daily living (ADLs) were associated with TBI. Methods. We analyzed data from the Wilder Homelessness Study, in which participants were recruited in 2006 and 2009 from streets, shelters, and locations in Minnesota that provide services to homeless individuals. Participants completed 30-minute interviews to collect information about history of TBI, homelessness, health status, exposure to violence (e.g., childhood abuse, assault), and other aspects of functioning. Results. Of the 2732 participating adolescents and young adults, 43% reported a history of TBI. Participants with TBI became homeless at a younger age and were more likely to report mental health diagnoses, substance use, suicidality, victimization, and difficulties with ADLs. The majority of participants (51%) reported sustaining their first injury prior to becoming homeless or at the same age of their first homeless episode (10%). Conclusions. TBI occurs frequently among homeless young people and is a marker of adverse outcomes such as mental health difficulties, suicidal behavior, substance use, and victimization. PMID:25122029
Desandes, Emmanuel; Lacour, Brigitte; Belot, Aurélien; Molinie, Florence; Delafosse, Patricia; Tretarre, Brigitte; Velten, Michel; Sauleau, Erik-André; Woronoff, Anne-Sophie; Guizard, Anne-Valérie; Ganry, Olivier; Bara, Simona; Grosclaude, Pascale; Troussard, Xavier; Bouvier, Véronique; Brugieres, Laurence; Clavel, Jacqueline
This study aimed to describe cancer incidence (2000-2008) and survival (2000-2004) in France in adolescents and young adults (AYA). All cases of cancer diagnosed in 15-24 years, recorded by all French population-based registries (14% of the French population), over the 2000-2008 period, were included. Incidence change over time was described with the conventional annual percentage change (cAPC). The survival of cases diagnosed (2000-2004) was estimated using Kaplan-Meier method. A total of 1022 in adolescents and 1396 in young adults were diagnosed. Overall incidence rates were 219.4/10(6) in 15-19 year olds and 293.1/10(6) in 20-24 year olds. The most frequently diagnosed cancers in male AYA were malignant gonadal germ-cell tumors and Hodgkin's disease, and were melanoma, thyroid carcinoma, and Hodgkin's disease in females. The age-standardized rates appeared stable over time in AYA, with a cAPC of +2.0% (P = 0.68). The 5-year overall survival for all cancers was different between genders and age groups, with 78.8% (95%CI: 75.6-82.0) for males and 85.2% (95%CI: 82.2-88.1) for females (P = 0.01), and 78.5% (95%CI: 75.0-82.1) in 15-19 year olds and 84.3% (95% CI: 81.6-87.0) in 20-24 year olds (P = 0.02). Noteworthy, the frequency and the distribution of tumor types in AYA are unique and different from the observed at any other age group. Survival in French AYA has improved over time. Epidemiological data might reflect major trends in the risk factors and preventive interventions. Thus, further research into etiology of cancers affecting AYA should become key priorities for cancer control among AYA.
Gardner, Andrew W.; Parker, Donald E.; Krishnan, Sowmya; Chalmers, Laura J.
Purposes To compare daily ambulatory measures in children, adolescents, and young adults with and without metabolic syndrome, and to assess which metabolic syndrome components, demographic measures, and body composition measures are associated with daily ambulatory measures. Methods Two-hundred fifty subjects between the ages of 10 and 30 years were assessed on metabolic syndrome components, demographic and clinical measures, body fat percentage, and daily ambulatory strides, durations, and cadences during seven consecutive days. Forty-five of the 250 subjects had metabolic syndrome, as defined by the International Diabetes Federation. Results Subjects with metabolic syndrome ambulated at a slower daily average cadence than those without metabolic syndrome (13.6 ± 2.2 strides/min vs. 14.9 ± 3.2 strides/min; p=0.012), and they had slower cadences for continuous durations of 60 minutes (p=0.006), 30 minutes (p=0.005), 20 minutes (p=0.003), 5 minutes (p=0.002), and 1 minute (p=0.001). However, the total amount of time spent ambulating each day was not different (p=0.077). After adjustment for metabolic syndrome status, average cadence is linearly associated with body fat percentage (p<0.001) and fat mass (p<0.01). Group difference in average cadence was no longer significant after adjusting for body fat percentage (p=0.683) and fat mass (p=0.973). Conclusion Children, adolescents, and young adults with metabolic syndrome ambulate more slowly and take fewer strides throughout the day than those without metabolic syndrome, even though the total amount of time spent ambulating is not different. Furthermore, the detrimental influence of metabolic syndrome on ambulatory cadence is primarily a function of body fatness. PMID:22811038
Quinn, Gwendolyn P; Gonçalves, Vânia; Sehovic, Ivana; Bowman, Meghan L; Reed, Damon R
Introduction Adolescent and young adult (AYA) cancer survivors experience many unique challenges and quality of life (QoL) effects that persist beyond cancer diagnosis and treatment. Due to continuous improvements in technology and cancer treatments resulting in improved survival rates, the identification of late effects, survivorship issues, and QoL is moving to the forefront of cancer research. The goal of this systematic review was to identify key psychosocial factors impacting QoL in AYA oncology populations. Methods A systematic review of the literature was conducted using combinations of these phrases or keywords: “adolescent and young adult or AYA” AND “health outcomes OR quality of life OR psychology” AND “neoplasm OR cancer OR oncology”. A total of 35 articles were included in this review. Studies were classified into two categories: AYA perceptions and stakeholder perceptions. Results AYA cancer survivors were more likely to have “worse” or impaired QoL compared with the general population, regardless of other demographic factors. AYAs described both positive and negatives experiences with their medical care, the educational information received, and the supportive care services. Although health care professionals were likely to underestimate or misjudge the health preferences and support needs of AYAs, these perceptions varied across disciplines and levels of experience. Conclusion The literature is lacking in sufficient evidence-based interventions to improve QoL in AYA cancer populations. Further, the tools to adequately measure QoL in this population are also unsatisfactory. The literature, however, consistently shows agreement regarding the unique needs of this population, indicating a trend toward health care standardization within age ranges or life stages. We suggest the need for AYA-specific programs in health care institutions that comprise a multidisciplinary team that addresses all the unique medical and QoL needs of AYAs. PMID
Counter, S Allen; Buchanan, Leo H; Ortega, Fernando
This study was designed to assess the utility of two psychometric tests with putative minimal cultural bias for use in field screening of lead (Pb)-exposed Ecuadorian Andean workers. Specifically, the study evaluated the effectiveness in Pb-exposed adolescents and young adults of a nonverbal reasoning test standardized for younger children, and compared the findings with performance on a test of auditory memory. The Raven Coloured Progressive Matrices (RCPM) was used as a test of nonverbal intelligence, and the Digit Span subtest of the Wechsler IV intelligence scale was used to assess auditory memory/attention. The participants were 35 chronically Pb-exposed Pb-glazing workers, aged 12-21 yr. Blood lead (PbB) levels for the study group ranged from 3 to 86 microg/dl, with 65.7% of the group at and above 10 microg/dl. Zinc protoporphyrin heme ratios (ZPP/heme) ranged from 38 to 380 micromol/mol, with 57.1% of the participants showing abnormal ZPP/heme (>69 micromol/mol). ZPP/heme was significantly correlated with PbB levels, suggesting chronic Pb exposure. Performance on the RCPM was less than average on the U.S., British, and Puerto Rican norms, but average on the Peruvian norms. Significant inverse associations between PbB/ZPP concentrations and RCPM standard scores using the U.S., Puerto Rican, and Peruvian norms were observed, indicating decreasing RCPM test performance with increasing PbB and ZPP levels. RCPM scores were significantly correlated with performance on the Digit Span test for auditory memory. Mean Digit Span scale score was less than average, suggesting auditory memory/attention deficits. In conclusion, both the RCPM and Digit Span tests were found to be effective instruments for field screening of visual-spatial reasoning and auditory memory abilities, respectively, in Pb-exposed Andean adolescents and young adults.
Söderberg, Siv; Skär, Lisa
Young adults with mental illness who need continuing care when they turn 18 are referred from child and adolescent psychiatry to general adult psychiatry. During this process, young adults are undergoing multiple transitions as they come of age while they transfer to another unit in healthcare. The aim of this study was to explore expectations and experiences of transition from child and adolescent psychiatry to general adult psychiatry as narrated by young adults and relatives. Individual interviews were conducted with three young adults and six relatives and analysed according to grounded theory. The analysis resulted in a core category: managing transition with support, and three categories: being of age but not mature, walking out of security and into uncertainty, and feeling omitted and handling concerns. The young adults' and relatives' main concerns were that they might be left out and feel uncertainty about the new situation during the transition process. To facilitate the transition process, individual care planning is needed. It is essential that young adults and relatives are participating in the process to be prepared for the changes and achieve a successful transition. Knowledge about the simultaneous processes seems to be an important issue for facilitating transition. PMID:24829900
Campana, Erika Maria Gonçalves; Brandão, Andréa Araujo; Pozzan, Roberto; Magalhães, Maria Eliane Campos; Fonseca, Flávia Lopes; Pizzi, Oswaldo Luiz; de Freitas, Elizabete Viana; Brandão, Ayrton Pires
Background The impact of blood pressure (BP) during adolescence on other cardiovascular risk factors in young adults is important for the primary prevention. Objective To evaluate BP, anthropometric indexes, metabolic and inflammatory profiles in young individuals stratified by their BP behavior recorded for 18 years. Methods A total of 116 individuals, of whom 63 were males, from the Rio de Janeiro study (follow-up of 17.76 ± 1.63 years), were assessed at two moments: A1 (12.40 ± 1.49 years) and A2 (30.09 ± 2.01 years). The 116 individuals were divided into two groups: GN (n = 71), of participants with normal BP at A1; and GH (n = 45), of those with abnormal BP at A1. BP, weight, height and body mass index (BMI) were measured at A1 and A2. At A2, abdominal circumference (AC) and laboratory, metabolic and inflammatory variables were included. Results 1) No difference was observed between the groups as regards age and gender; 2) At A2, GH showed higher mean weight, BMI, BP, insulin, HOMA-IR (p < 0.001), leptin (p < 0.02), apolipoprotein B100 and A1 (p < 0.02), apolipoprotein B100 / apolipoprotein A1 ratio (p < 0.010); and higher prevalences of overweight/obesity (p < 0.001), of increased AC (p < 0.001) and of hypertension (p < 0.02); 3) No difference was observed between the groups as regards the inflammatory variables; 4) There was a positive correlation of BP at A1 with BP, BMI, insulin, leptin and HOMA-IR at A2 (p < 0.05). Conclusion BP in adolescence was associated with higher values of BP, and anthropometric and metabolic variables in young adulthood, but not with inflammatory variables. PMID:24263778
Divney, Anna A.; Magriples, Urania; Hansen, Nathan; Gordon, Derrick; Kershaw, Trace
Abstract Background Rates of breastfeeding remain disproportionately low among young mothers in the United States. Although breastfeeding behavior may be most directly related to breastfeeding intention, little is known about breastfeeding intentions among young women who are expecting a baby. Subjects and Methods Pregnant adolescents and young adults (14–21 years old) and their male partners were recruited for participation. Females were asked if they intended to breastfeed, and their partners were asked if they wanted their partners to breastfeed; participants indicated reasons for their responses. Logistic regression modeling was used to determine the associations between breastfeeding intentions and sociodemographic characteristics, relationship characteristics, and partner's intention to breastfeed. Results Approximately 73% of females reported intending to breastfeed, and 80% of males reported wanting his partner to breastfeed, most commonly because it is “healthier for the baby” and “a more natural way to feed the baby.” Sociodemographic and relationship characteristics explained a small amount of variance of breastfeeding intention (15% and 4% among females, respectively, and 8% and 4% among males, respectively). Partner intention explained an additional 23% and 24% of the variance in individual intention for females and males, respectively. Females who had experienced intimate partner violence (IPV) from their current partner had lower odds of intending to breastfeed (odds ratio=0.37; 95% confidence interval=0.16, 0.84). Race/ethnicity modified associations among both genders. Conclusions These findings emphasize the importance of dyadic approaches and suggest strategies for improving breastfeeding intentions and behavior among young couples expecting a baby. These results are also among the first to document the relationship between IPV and breastfeeding intentions among young women. PMID:23611330
Auld, Andrew F; Agolory, Simon G; Shiraishi, Ray W; Wabwire-Mangen, Fred; Kwesigabo, Gideon; Mulenga, Modest; Hachizovu, Sebastian; Asadu, Emeka; Tuho, Moise Zanga; Ettiegne-Traore, Virginie; Mbofana, Francisco; Okello, Velephi; Azih, Charles; Denison, Julie A; Tsui, Sharon; Koole, Olivier; Kamiru, Harrison; Nuwagaba-Biribonwoha, Harriet; Alfredo, Charity; Jobarteh, Kebba; Odafe, Solomon; Onotu, Dennis; Ekra, Kunomboa A; Kouakou, Joseph S; Ehrenkranz, Peter; Bicego, George; Torpey, Kwasi; Mukadi, Ya Diul; van Praag, Eric; Menten, Joris; Mastro, Timothy; Dukes Hamilton, Carol; Swaminathan, Mahesh; Dokubo, E Kainne; Baughman, Andrew L; Spira, Thomas; Colebunders, Robert; Bangsberg, David; Marlink, Richard; Zee, Aaron; Kaplan, Jonathan; Ellerbrock, Tedd V
Although scale-up of antiretroviral therapy (ART) since 2005 has contributed to declines of about 30% in the global annual number of human immunodeficiency (HIV)-related deaths and declines in global HIV incidence, estimated annual HIV-related deaths among adolescents have increased by about 50% and estimated adolescent HIV incidence has been relatively stable. In 2012, an estimated 2,500 (40%) of all 6,300 daily new HIV infections occurred among persons aged 15-24 years. Difficulty enrolling adolescents and young adults in ART and high rates of loss to follow-up (LTFU) after ART initiation might be contributing to mortality and HIV incidence in this age group, but data are limited. To evaluate age-related ART retention challenges, data from retrospective cohort studies conducted in seven African countries among 16,421 patients, aged ≥15 years at enrollment, who initiated ART during 2004-2012 were analyzed. ART enrollment and outcome data were compared among three groups defined by age at enrollment: adolescents and young adults (aged 15-24 years), middle-aged adults (aged 25-49 years), and older adults (aged ≥50 years). Enrollees aged 15-24 years were predominantly female (81%-92%), commonly pregnant (3%-32% of females), unmarried (54%-73%), and, in four countries with employment data, unemployed (53%-86%). In comparison, older adults were more likely to be male (p<0.001), employed (p<0.001), and married, (p<0.05 in five countries). Compared with older adults, adolescents and young adults had higher LTFU rates in all seven countries, reaching statistical significance in three countries in crude and multivariable analyses. Evidence-based interventions to reduce LTFU for adolescent and young adult ART enrollees could help reduce mortality and HIV incidence in this age group.
Goldston, David B.; Daniel, Stephanie Sergent; Erkanli, Alaattin; Reboussin, Beth A.; Mayfield, Andrew; Frazier, Patricia H.; Treadway, Sarah L.
The purpose of this prospective, naturalistic study was to examine the relationships between suicide attempts and contemporaneous psychiatric disorders, and developmental changes in these relationships from adolescence to young adulthood. The sample consisted of 180 adolescents, 12-19 years of age at hospitalization, repeatedly assessed for up to…
Bogart, Laura M.; Collins, Rebecca L.; Ellickson, Phyllis L.; Klein, David J.
The present study investigated whether adolescent cigarette, alcohol, marijuana, and hard drug use predicts life satisfaction in young adulthood. Survey data were used from a longitudinal cohort of 2376 adolescents at ages 18 and 29, originally recruited from California and Oregon middle schools at age 13. Results of multivariate models indicated…
Burke, Jeffrey D.; Rowe, Richard; Boylan, Khrista
Background: Oppositional defiant disorder (ODD) is considered to be a disorder of childhood, yet evidence suggests that prevalence rates of the disorder are stable into late adolescence and trajectories of symptoms persist into young adulthood. Functional outcomes associated with ODD through childhood and adolescence include conflict within…
Boissel, Nicolas; Sender, Leonard S
The inclusion of asparaginase in chemotherapy regimens to treat acute lymphoblastic leukemia (ALL) has had a positive impact on survival in pediatric patients. Historically, asparaginase has been excluded from most treatment protocols for adolescent and young adult (AYA) patients because of perceived toxicity in this population, and this is believed to have contributed to poorer outcomes in these patients. However, retrospective analyses over the past 12 years have shown that 2-, 5-, and 7-year overall survival of AYA patients is significantly improved with pediatric versus adult protocols. The addition of asparaginase to adult protocols yielded high rates of first remission and improved survival. However, long-term survival remains lower compared with what has been seen in pediatrics. The notion that asparaginase is poorly tolerated by AYA patients has been challenged in multiple studies. In some, but not all, studies, the incidences of hepatic and pancreatic toxicities were higher in AYA patients, whereas the rates of hypersensitivity reactions did not appear to differ with age. There is an increased risk of venous thromboembolic events, and management with anti-coagulation therapy is recommended. Overall, the risk of therapy-related mortality is low. Together, this suggests that high-intensity pediatric protocols offer an effective and tolerable approach to treating ALL in the AYA population.
Frappaz, Didier; Sunyach, Marie-Pierre; Le Rhun, Emilie; Blonski, Marie; Laurence, Valérie; Bonneville Levard, Alice; Loiseau, Hugues; Meyronnet, David; Callies, Arnaud; Laigle-Donadey, F; Faure Conter, Cecile
The skills of adult versus pediatric neuro-oncologists are not completely similar though additive. Because the tumors and their protocols are different and the tolerance and expected sequelae are specific. Multidisciplinary meetings including adult and pediatric neuro-oncologists are warranted to share expertise. Since 2008, a weekly national web based conference was held in France. Any patient with the following criteria could be discussed: Adolescent and Young Adults aged between 15 and 25 years, and any adult with a pediatric type pathology, including medulloblastoma, germ cell tumors, embryonic tumors, ependymoma, pilocytic astrocytoma.
Ishibashi, Akiko; Okamura, Jun; Ueda, Reiko; Sunami, Shosuke; Kobayashi, Ryoji; Ogawa, Junko
The purpose of this study was to explore ways of enhancing psychosocial strengths in newly diagnosed and relapsed adolescents and young adults (AYAs) to improve their resilience. A descriptive case study was used. The adolescent resilience model (ARM) and the self-sustaining process model were applied as theories. The data were analyzed using pattern-matching logic. Semistructured interviews were conducted with 18 patients aged 12 to 24 years and discharged within 10 years. We found that the newly diagnosed and the relapsing AYAs developed the 5 strength factors of the ARM during and after treatment. Whether the individuals cultivated a positive attitude and sense of purpose early or late, the AYAs developed resilience eventually. A positive attitude and sense of purpose during the early phase of care may be essential for improving resilience. The AYAs benefited from the support of their parents, friends, and previous experience. Individualized support and social resources may be important to develop these strengths. Further research is needed to develop strengths and improve resilience in newly diagnosed AYAs.
Because consensually accepted programs of sexual education are lacking, erotica have come to serve as the primary agent of sexual socialization. The new media technology gives prepubertal children and postpubertal adolescents ready access to erotica in all their manifestations. However, next to nothing is known about the consequences of the steadily increasing amount of such exposure. A brief overview of what is known and what remains unknown about the effects of pornography on young adults is presented. Thereafter, the focus is on the development of sexual callousness across the pubertal threshold, and on how this callousness might be influenced by extensive exposure to erotica. The erotica under consideration are not so much those explicitly depicting coital behaviors as those that are less explicit and present a fuller social context of sexual engagements. A program of research is outlined that would help provide an understanding of erotica's effects on adolescents' sexual callousness, an understanding that is sorely needed for the construction of effective educational efforts aiming at the removal of callousness and coercion from sexual relations.
Di Fabio, Annamaria; Gori, Alessio
This study examined the factor structure and the psychometric properties of the Satisfaction With Life Scale (SWLS) in a sample of 1,515 Italian (females = 60.26%, males = 39.74%) adolescents and young adults (M[subscript age] = 17.6 years, SD = 1.21). Results confirmed the unidimensionality, good reliability, and concurrent validity of the…
Sadeghi Bahmani, Dena; Gerber, Markus; Kalak, Nadeem; Lemola, Sakari; Clough, Peter J; Calabrese, Pasquale; Shaygannejad, Vahid; Pühse, Uwe; Holsboer-Trachsler, Edith; Brand, Serge
Background Multiple sclerosis (MS) is the most common chronic autoimmune demyelinating and inflammatory disease of the central nervous system, afflicting both the body and mind. The risk of suffering from MS is 2.5–3.5 times greater in females than in males. While there is extant research on fatigue, depression, and cognitive impairment in patients with MS during its clinical course, there is a lack of research focusing on sleep, psychological functioning, and physical activity (PA) at the point of disease onset. The aims of the present study were therefore, to assess the markers of mental toughness (MT) as a dimension of psychological functioning, sleep disturbances (SD), and PA among patients at the moment of disease onset and to compare these with the corresponding values for healthy adolescents and young adults. Methods A total of 23 patients with MS at disease onset (mean age =32.31 years; 91% females), 23 healthy adolescents (mean age =17.43 years; 82% females), and 25 healthy young adults (mean age =20.72 years; 80% females) took part in the study. They completed questionnaires covering sociodemographic data, MT, SD, and PA. Results Patients with MS had similar scores for MT traits as those in healthy adolescents and healthy young adults, and equivalent levels of moderate-intensity PA and SD as young adults. MS patients reported lower levels of vigorous PA compared to both healthy adolescents and young adults. Conclusion The pattern of the results of the present study suggests that the onset of MS is not associated with poor MT, poor sleep, or reduced moderate-intensity PA. Lower levels of vigorous PA were observed in MS patients. Low levels of vigorous PA may lead to decreased cardiorespiratory fitness in patients with MS and, in the long run, to reduced cardiovascular health and degraded psychological functioning. PMID:27390520
MacPhail, R C; Farmer, J D; Jarema, K A
Life stage is an important risk factor for toxicity. Children and aging adults, for example, are more susceptible to certain chemicals than are young adults. In comparison to children, relatively little is known about susceptibility in older adults. Additionally, few studies have compared toxicant susceptibility across a broad range of life stages. Results are presented for behavioral evaluations of male Brown Norway rats obtained as adolescents (1 month), or young (4 months), middle-age (12 months) and senescent (24 months) adults. Motor activity was evaluated in photocell devices during 30-min sessions. Age-related baseline characteristics and sensitivity to toluene (0, 300, 650, or 1000mg/kg, p.o.) were determined. In Experiment 1, young-adult, middle-age and senescent rats were treated with corn-oil vehicle before five weekly test sessions. Baselines of horizontal and vertical activity decreased with age, but each age-group's averages remained stable across weeks of testing. Baseline activity of older rats was more variable than that of the young adults; older rats were also more variable individually from week to week. Toluene (1000mg/kg) increased horizontal activity proportionately more in senescent rats (ca. 300% of control) than in middle-age or young-adult rats (ca.145-175% of control). Experiment 2 established toluene dose-effect functions in individual adolescent, young-adult, middle-age and senescent rats; each rat received all treatments, counterbalanced across four weekly sessions. Toluene produced dose-related increases in horizontal activity that increased proportionately with age. Experiment 3 replicated the effects of toluene (1000mg/kg) in Experiment 1, showing that toluene-induced increases in horizontal activity were greatest in the oldest rats. Collectively, the results show that aging increased susceptibility to toluene and also increased variability in toluene response. Given the rapid growth of the aged population, further research is
Warner, Echo L.; Kent, Erin E.; Trevino, Kelly M.; Parsons, Helen M.; Zebrack, Brad J.; Kirchhoff, Anne C.
BACKGROUND A cancer diagnosis during adolescence or young adulthood may negatively influence social well-being. The existing literature concerning the social well-being of adolescents and young adults (AYAs) with cancer was reviewed to identify gaps in current research and highlight priority areas for future research. METHODS A systematic review of the scientific literature published in English from 2000 through 2014 was performed. Eligible studies included patients and survivors diagnosed between the ages of 15 to 39 years that reported on social well-being domains in the City of Hope Cancer Survivor Quality of Life Model. Each article was reviewed for relevance using a standardized template. A total of 253 potential articles were identified. After exclusions, a final sample of 26 articles identified domains of social well-being that are believed to be understudied among AYAs with cancer: 1) educational attainment, employment, and financial burden; 2) social relationships; and 3) supportive care. Articles were read in their entirety, single coded, and summarized according to domain. RESULTS AYAs with cancer report difficulties related to employment, educational attainment, and financial stability. They also report problems with the maintenance and development of peer and family relationships, intimate and marital relationships, and peer support. Supportive services are desired among AYAs. Few studies have reported results in reference to comparison samples or by cancer subtypes. CONCLUSIONS Future research studies on AYAs with cancer should prioritize the inclusion of underserved AYA populations, more heterogeneous cancer samples, and comparison groups to inform the development of supportive services. Priority areas for potential intervention include education and employment reintegration, and social support networks. PMID:26848713
Moisala, M; Salmela, V; Hietajärvi, L; Salo, E; Carlson, S; Salonen, O; Lonka, K; Hakkarainen, K; Salmela-Aro, K; Alho, K
The current generation of young people indulges in more media multitasking behavior (e.g., instant messaging while watching videos) in their everyday lives than older generations. Concerns have been raised about how this might affect their attentional functioning, as previous studies have indicated that extensive media multitasking in everyday life may be associated with decreased attentional control. In the current study, 149 adolescents and young adults (aged 13-24years) performed speech-listening and reading tasks that required maintaining attention in the presence of distractor stimuli in the other modality or dividing attention between two concurrent tasks. Brain activity during task performance was measured using functional magnetic resonance imaging (fMRI). We studied the relationship between self-reported daily media multitasking (MMT), task performance and brain activity during task performance. The results showed that in the presence of distractor stimuli, a higher MMT score was associated with worse performance and increased brain activity in right prefrontal regions. The level of performance during divided attention did not depend on MMT. This suggests that daily media multitasking is associated with behavioral distractibility and increased recruitment of brain areas involved in attentional and inhibitory control, and that media multitasking in everyday life does not translate to performance benefits in multitasking in laboratory settings.
Moreno, Megan A.; Whitehill, Jennifer M.
Participation in online social media Web sites (e.g., Facebook and Twitter) has skyrocketed in recent years and created a new environment in which adolescents and young adults may be exposed to and influenced by alcohol-related content. Thus, young people are exposed to and display pro-alcohol messages and images through online portrayals of drinking on personal pages as well as unregulated alcohol marketing on social media sites that may reach underage people. Such online displays of alcohol behavior have been correlated with offline alcohol behavior and risky drinking. Health behavior theories have been used to describe the influence of social media sites, including Social Learning Theory, the Media Practice Model, and a more recent conceptual approach called the Facebook Influence Model. Researchers are beginning to assess the potential of social media sites in identifying high-risk drinkers through online display patterns as well as delivering prevention messages and interventions. Future studies need to further expand existing observational work to better understand the role of social media in shaping alcohol-related behaviors and fully exploit the potential of these media for alcohol-related interventions. PMID:26259003
Moreno, Megan A; Whitehill, Jennifer M
Participation in online social media Web sites (e.g., Facebook and Twitter) has skyrocketed in recent years and created a new environment in which adolescents and young adults may be exposed to and influenced by alcohol-related content. Thus, young people are exposed to and display pro-alcohol messages and images through online portrayals of drinking on personal pages as well as unregulated alcohol marketing on social media sites that may reach underage people. Such online displays of alcohol behavior have been correlated with offline alcohol behavior and risky drinking. Health behavior theories have been used to describe the influence of social media sites, including Social Learning Theory, the Media Practice Model, and a more recent conceptual approach called the Facebook Influence Model. Researchers are beginning to assess the potential of social media sites in identifying high-risk drinkers through online display patterns as well as delivering prevention messages and interventions. Future studies need to further expand existing observational work to better understand the role of social media in shaping alcohol-related behaviors and fully exploit the potential of these media for alcohol-related interventions.
Gabel, L.; Macdonald, H.M.; Nettlefold, L.; Race, D.; McKay, H.A.
Objectives: To provide age- and sex-specific reference data for mechanography-derived parameters of muscle function in Canadian children and youth using the single two-legged jump (S2LJ) with hands-on-waist. Methods: Our sample included 2017 observations from 715 participants (9-21 years; 338 girls). Participants performed three S2LJ with hands-on-waist on a force platform (Leonardo Mechanograph, Novotec). Outcomes were maximum peak power (Pmax), Pmax /mass, peak force/body weight (Fmax /BW), force efficiency, maximum jump height (Hmax), and velocity (Vmax). We used the LMS method to construct age- and sex-specific percentile curves and mixed effects models to examine sex and ethnic differences. Results: With the exception of Efficiency, mechanography outcomes were greater in girls (4-40%, p<0.05) than boys at age 9. Boys’ advantage in mechanography parameters emerged in adolescence (age 11-13 years; 3-65%, p<0.05) and persisted into young adulthood, except for Fmax/BW which was not greater in boys until age 17 (4-10%, p<0.05). Mechanography outcomes were 3-9% (p<0.05) greater in Asian compared with white participants. Conclusions: We provide the first reference data for the S2LJ using the hands-on-waist protocol in children, youth and young adults. These data support previous findings using freely moving arms and can be used when evaluating muscle function in pediatric studies. PMID:27973380
Silva, Carolina Carvalho; Costa, Maria Conceição Oliveira; de Carvalho, Rosely Cabral; Amaral, Magali Teresópolis Reis; Cruz, Nilma Lázara de Almeida; da Silva, Mariana Rocha
The study seeks to characterize the initiation and consumption pattern of psychoactive substances among adolescents and young adults enrolled in an Alcohol and Drug Psychosocial Care Center (CAPS-AD). This study was conducted with records of attendance and the consumption pattern was classified in accordance with WHO: infrequent use (lifetime use, per year or up to five days per month); frequent use (6 to 19 times in the past 30 days); heavy use (≥ 20 times in the last 30 days). In the age group comparison, the test for proportion and association analysis was used and the prevalence and prevalence ratio was calculated with a significance level of 5% and 95% confidence interval. Of the total of adolescents and young adults treated between 2003 and 2008 (475), most were male, single, poorly educated, live with relations and have psychic symptoms. Statistical significance was found for age at initiation of use: adolescents compared to young adults started earlier (≤ 14 years): tobacco, marijuana, cocaine, crack and other SPA consumption. Among adolescents, significant results were found for the less frequent consumption of tobacco, more frequent use of alcohol, and heavy consumption of marijuana. These findings may contribute to the preventive and therapeutic CAPS-AD programs.
Although there are many positive aspects of social media for adolescents and young adults, there are also risks. Adolescence is a time of significant developmental changes, during which adolescents exhibit a limited capacity for self-regulation and an increased risk of susceptibility to peer pressure and experimentation. Social media can be harmful, and obstetrician-gynecologists may screen their adolescent and young adult patients for high-risk sexual behaviors, especially if sexualized text communication (sexting), exposure to pornography, online dating, or other risk-taking behaviors are present. Victims of cyberbullying and those who engage in sexting are at increased risk of sexually transmitted infections and pregnancy. The effect of social media may be considered in the differential diagnosis of myriad health problems during adolescence. Referrals to mental health care providers or providing outside resources may be indicated. A multidisciplinary approach to address these issues can include the obstetrician-gynecologist, guardians, and school officials and personnel. Knowledge of resources, including those within the schools and community, allows the obstetrician-gynecologist to provide support to adolescents facing these issues.
McCourt, Hannah J; Draffin, Claire R; Woodside, Jayne V; Cardwell, Chris R; Young, Ian S; Hunter, Steven J; Murray, Liam J; Boreham, Colin A; Gallagher, Alison M; Neville, Charlotte E; McKinley, Michelle C
Dietary pattern (DP) analysis allows examination of the combined effects of nutrients and foods on the markers of CVD. Very few studies have examined these relationships during adolescence or young adulthood. Traditional CVD risk biomarkers were analysed in 12-15-year-olds (n 487; Young Hearts (YH)1) and again in the same individuals at 20-25 years of age (n 487; YH3). Based on 7 d diet histories, in the present study, DP analysis was performed using a posteriori principal component analysis for the YH3 cohort and the a priori Mediterranean Diet Score (MDS) was calculated for both YH1 and YH3 cohorts. In the a posteriori DP analysis, YH3 participants adhering most closely to the 'healthy' DP were found to have lower pulse wave velocity (PWV) and homocysteine concentrations, the 'sweet tooth' DP were found to have increased LDL concentrations, and decreased HDL concentrations, [corrected] the 'drinker/social' DP were found to have lower LDL and homocysteine concentrations, but exhibited a trend towards a higher TAG concentration, and finally the 'Western' DP were found to have elevated homocysteine and HDL concentrations. In the a priori dietary score analysis, YH3 participants adhering most closely to the Mediterranean diet were found to exhibit a trend towards a lower PWV. MDS did not track between YH1 and YH3, and nor was there a longitudinal relationship between the change in the MDS and the change in CVD risk biomarkers. In conclusion, cross-sectional analysis revealed that some associations between DP and CVD risk biomarkers were already evident in the young adult population, namely the association between the healthy DP (and the MDS) and PWV; however, no longitudinal associations were observed between these relatively short time periods.
Sarigianides, Sophia Tatiana
Identifying English Education courses focused on young adult literature as apposite sites for exploring teacher conceptions of youth and the texts aimed for youths' consumptions, this article addresses the multiple sources of tension--and pedagogical potential--of teaching a young adult literature course centrally framed around controversial…
Galán, S; de la Vega, R; Tomé Pires, C; Racine, M; Solé, E; Jensen, M P; Miró, J
Advances in the early detection of cancer and the development of more effective treatments have resulted in a larger number of adolescents and young adults (AYAs), becoming cancer survivors. However, knowledge regarding their needs and if those needs are adequately addressed remains limited. The aims of this study were to: (1) better understand the needs of AYAs after cancer treatment; (2) analyse the importance of those needs; (3) determine which needs are not adequately addressed; and (4) test the hypothesis that AYA cancer survivors have different needs than adult survivors. Twenty-nine health oncology professionals, 17 AYA survivors and 12 relatives of AYA survivors participated in the Delphi study. The needs identified could be classified into six categories, and all were rated as highly important by all participants. The category perceived as least adequately addressed across the three groups was 'Counselling and psychological support.' The findings provide important new information regarding the needs of AYA cancer survivors that can inform the development of interventions to improve the quality of life of these individuals.
Sambisa, William; Curtis, Sian L; Stokes, C Shannon
Understanding the social and cultural contextual determinants of sexual behaviour of adolescents and young adults is an essential step towards curtailing the spread of HIV. This study examined the effects of one cultural factor, ethnicity, on sexual abstinence, faithfulness, condom use at last sex, and risky sex among young people in Zimbabwe. Data from the cross-sectional, population-based 2005-06 Zimbabwe Demographic and Health Survey were used. Net of the effect of sociodemographic and social-cognitive factors, and using multinomial logistic regression, ethnicity was found to have a strong and consistent effect on sexual behaviour among youth. In addition, the study found that there were ethnic-specific and within-gender differences in sexual behaviour, for both men and women. Shona youth were more likely to be abstinent than Ndebele youth. Compared with Shona youth, Ndebele youth were more likely to have engaged in risky sex. However, Ndebele men were more likely have used condoms at last sex, compared with Shona men. For both men and women, sexual behaviour was more socially controlled. School attendance and religion exerted protective effects on sexual abstinence. For men only, those living in rural areas were less likely to be faithful and more likely to have engaged in risky sexual behaviour than those living in urban areas. The study attests to the fact that ethnic norms and ideologies of sexuality need to be identified and more thoroughly understood. In addition, the study provides evidence that in order to promote safe and healthy sexuality among young people in Zimbabwe, cultural, social and gender-specific approaches to the development of HIV prevention strategies should be seriously considered. Current success in the Abstinence, Being faithful and Condom use (ABC) approach could be strengthened by recognizing and responding to cultural forces that reproduce and perpetuate risky sexual behaviours.
Xu, Y.; Stavrides-Eid, M.; Baig, A.; Cardoso, M.; Rho, Y.S.; Shams, W.M.; Mamo, A.; Kavan, P.
Background: Since the end of the 1980s, the magnitude of survival prolongation or mortality reduction has not been the same for adolescents and young adults (ayas) with cancer as for their older and younger counterparts. Precise reasons for those observations are unknown, but the differences have been attributed in part to delays in diagnosis and treatment. In 2003 at the Jewish General Hospital, we developed the first Canadian multidisciplinary aya oncology clinic to better serve this unique patient population. The aim of the present study was to develop an approach to quantify diagnosis delays in our aya patients and to study survival in relation to the observed delay. Methods: In a retrospective chart review, we collected information about delays, treatment efficacy, and obstacles to treatment for patients seen at our aya clinic. Results: From symptom onset, median time to first health care contact was longer for girls and young women (62 days) than for boys and young men (6 days). Median time from symptom onset to treatment was 173 days; time from first health care contact to diagnosis was the largest contributor to that duration. Delays in diagnosis were shorter for patients who initially presented to the emergency room, but compared with patients whose first health contact was of another type, patients presenting to the emergency room were 3 times more likely to die from their disease. Conclusions: Delays in diagnosis are frequently reported in ayas with cancer, but the duration of the delay was unrelated to survival in our sample. Application of this approach to larger prospective samples is warranted to better understand the relation between treatment delay and survival in ayas—and in other cancer patient groups. PMID:26715885
Karam, Jocelyne G; McFarlane, Samy I
Type 2 Diabetes has reached epidemic proportions among adults in the USA and worldwide. With the rising epidemic of obesity among children and adolescents, a parallel epidemic of type 2 diabetes is also observed in this patient population. Control of diabetes and its complications, mainly cardiovascular disease has been sub-optimal at best. Therefore, effort trials have been conducted and others are ongoing to assess various modalities for diabetes prevention among adults, ranging from diet and exercise to pharmacological agents of various classes. Recently, concerted efforts have been made for prevention of type 2 diabetes among children and adolescents. In this paper we discuss the diabetes prevention rationale and methods among adults and the implications of these efforts for children and adolescents. We also highlight the ongoing efforts for diabetes prevention in trials specifically designed to address the adolescent population.
Wan, Yu-Hui; Hu, Chuan-Lai; Hao, Jia-Hu; Sun, Ying; Tao, Fang-Biao
The aim of this paper was to describe the prevalence of deliberate self-harm (DSH) and to determine the socio-demographic, behavioral, and psychological correlates of DSH behaviors in Chinese adolescents and young adults in a representative sample of the general population. The data were obtained from an epidemiologic study involving adolescents and young adults from junior and senior schools and colleges located in eight provinces of China. A total of 17,622 cases were retained for analysis. The relationship between the explanatory variables with self-harm was analyzed using a Pearson χ (2) test and a multinomial logistic regression model. A total of 3,001 (17.0%) students reported that they had harmed themselves deliberately in the past 12 months. The act of DSH occurring 1 and >2 times accounted for 4.2% (742) and 12.8% (2,259) of all respondents, respectively. The most frequently reported form of DSH was self-hitting. If the reference category was No DSH, the findings indicated that family composition, father's education, perceived family economic status, cigarette use, perceived body image, and higher scores in depression scales were important concomitants of repeat-incidents of DSH. The students, in western areas, who were younger, reported that having unhealthy weight control behaviors, and alcohol use had a higher risk for both types of DSH. Regarding students of age 15-18 years perceived body image (too fat), having unhealthy weight control behaviors or a high level of depression symptoms demonstrated an elevated risk for repeat-incident DSH when single-incident DSH was used as the reference category, whereas the students in middle area reported family composition (both parents), education of the father (less than college) or alcohol use had a decreased risk for repeat-incident DSH. The results of this study suggest that both types of DSH are associated with other wide-ranging problems in the students' lives. Despite their common features, these
Bergier, Józef; Kapka-Skrzypczak, Lucyna; Biliński, Przemysław; Paprzycki, Piotr; Wojtyła, Andrzej
The alarming problem of a decline in physical activity among children and adolescents and its detrimental effects on public health has been well recognised worldwide. Low physical activity is responsible for 6% of deaths worldwide and 5-10% of deaths in the countries of the WHO European Region, according to country. Within the last decade, many initiatives have been launched to counteract this phenomenon. The objective of presented study was analysis of the level of physical activity among adolescents and young adults in Poland, according to the IPAQ questionnaire. The study group covered 7,716 adolescents: 5,086 children attending high school and secondary schools and 2,630 university students. Low physical activity was noted among 57% of schoolchildren and 20.84% of students. Analysis of the level of physical activity according to the IPAQ indicated that it was lower among girls, compared to boys. An additional analysis, with the consideration of the place of residence, showed that the highest percentage of the population with low physical activity was noted in the rural areas (29.30%), while among the urban inhabitants of cities with a population above 100,000 it was on the level of 23.69% and 20.57%. Median for weekly physical activity by respondents" gender was on the level of 1,554.00 MET*min. weekly among females, and 2,611.00 MET*min. weekly among males (p<0.000). The highest weekly physical activity expressed in MET*min. was observed among the inhabitants of towns with a population less than 100,000, whereas among the rural population and inhabitants of large cities with a population of over 100,000 the weekly physical activity was on a similar level (1,830.50 and 1,962.00 respectively). An extended analysis of respondents' physical activity showed that during the day students spend significantly more time in a sedentary position, compared to schoolchildren. The presented results of studies indicate the necessity to continue and intensify actions to
Jelenchick, Lauren A; Eickhoff, Jens; Christakis, Dimitri A; Brown, Richard L; Zhang, Chong; Benson, Meghan; Moreno, Megan A
Problematic Internet use (PIU) is a growing health concern among adolescents and young adults. The purpose of this mixed-methods study was to develop and refine a theoretically-grounded and psychometrically-validated assessment instrument for PIU specifically tailored to adolescents and young adults. An item pool was developed using concept mapping and a review of the literature, and administered to 714 students from two universities between 18 and 25 years of age. Exploratory and confirmatory factor analyses were used in a development subsample (n=500) to construct the scale. A cross-validation sample (n=214) was used to confirm the scale's reliability. The Problematic and Risky Internet Use Screening Scale (PRIUSS) is an 18-item scale with three subscales: Social Impairment, Emotional Impairment, and Risky/Impulsive Internet Use. Based on its strong theoretical foundation and promising psychometric performance, the PRIUSS may be a valuable tool for screening and prevention efforts in this population.
Jelenchick, Lauren A.; Eickhoff, Jens; Christakis, Dimitri A; Brown, Richard L.; Zhang, Chong; Benson, Meghan; Moreno, Megan A.
Problematic Internet use (PIU) is a growing health concern among adolescents and young adults. The purpose of this mixed-methods study was to develop and refine a theoretically-grounded and psychometrically-validated assessment instrument for PIU specifically tailored to adolescents and young adults. An item pool was developed using concept mapping and a review of the literature, and administered to 714 students from two universities between 18 and 25 years of age. Exploratory and confirmatory factor analyses were used in a development subsample (n=500) to construct the scale. A cross-validation sample (n=214) was used to confirm the scale’s reliability. The Problematic and Risky Internet Use Screening Scale (PRIUSS) is an 18-item scale with three subscales: Social Impairment, Emotional Impairment, and Risky/Impulsive Internet Use. Based on its strong theoretical foundation and promising psychometric performance, the PRIUSS may be a valuable tool for screening and prevention efforts in this population. PMID:24882938
Lahat, Ayelet; Helwig, Charles C; Zelazo, Philip David
The neurocognitive development of moral and conventional judgments was examined. Event-related potentials were recorded while 24 adolescents (13 years) and 30 young adults (20 years) read scenarios with 1 of 3 endings: moral violations, conventional violations, or neutral acts. Participants judged whether the act was acceptable or unacceptable when a rule was assumed or removed. Across age, reaction times were faster for moral than conventional violations when a rule was assumed. Adolescents had larger N2 amplitudes than adults for moral and neutral, but not conventional, acts. N2 amplitudes were larger when a rule was removed than assumed for moral, but not conventional, violations. These findings suggest that the neurocognitive mechanisms underlying moral and conventional judgments continue to develop beyond early adolescence.
Sadeh, Naomi; Londahl-Shaller, Esme A; Piatigorsky, Auran; Fordwood, Samantha; Stuart, Barbara K; McNiel, Dale E; Klonsky, E David; Ozer, Elizabeth M; Yaeger, Alison M
Rates of deliberate non-suicidal self-injury (NSSI) increase during adolescence and young adulthood, particularly in clinical samples, making these important developmental stages for understanding the functions of NSSI. Borderline Personality Disorder (BPD) symptoms also begin to emerge in adolescence, though little research has examined relationships between BPD symptoms and the functions of NSSI in youth, the primary goal of the present study. Adolescents and young adults recruited from an outpatient psychotherapy clinic (N=36) endorsed a range of NSSI functions on the Inventory of Statements about Self-Injury (Klonsky and Glenn, 2009). Participants engaged in NSSI to serve intrapersonal functions (e.g., regulate affect, punish oneself) more frequently than interpersonal functions (e.g., bond with peers, establish autonomy). As predicted, linear regression analyses indicated that BPD affective dysregulation symptoms were associated with the intrapersonal but not the interpersonal functions of NSSI. In contrast, BPD interpersonal dysfunction symptoms were differentially associated with the interpersonal rather than intrapersonal functions of NSSI. These preliminary data indicate that clusters of BPD symptoms show unique relationships with functions of NSSI in treatment-seeking adolescents and young adults, relationships that can be used to target specific functions of NSSI in treatment planning.
Barnett, Marie E.; Shuk, Elyse M.; Conway, Francine P.
Purpose: Adolescents and young adults (AYAs) employ self-disclosure in normative social interactions and in promoting identity development. Disclosure is associated with numerous psychological and physical benefits. Little research has examined how AYA cancer survivors diagnosed during adolescence disclose their cancer history. Methods: Using a qualitative design, this study explored cancer-related disclosures among survivors (N=26) 16–24 years old at study (M=19.6 years), 14–18 years old at diagnosis (M=15.6 years), and currently at least 6 months post-treatment (M=3.2 years). Semi-structured interview guides were developed and used. Disclosure-related topics included survivorship communications and others' responses to AYAs' disclosure of their cancer experiences. Results: Grounded theory and thematic content analysis guided analyses, with an inductive data-driven approach. Three themes and eight subthemes emerged: “it depends” decision-making processes (don't ask/don't tell, shared experience, relationship potential), perceptions of others' responses (perceived apprehension, positive responses), and methods of disclosure (verbal, written, behavioral). No thematic differences were found by gender or age, although females reported greater frequency of disclosures. Conclusion: Disclosure emerged as a nuanced and complex process. “It depends” decision-making processes were most frequently endorsed, consistent with developmental complexities of this age group. This reflects social and psychological changes and highlights unique challenges for AYA survivors. This also reflects the importance of peers and social interactions as variables that influence disclosure. In the context of AYA cancer survivorship, understanding ways in which disclosure may bolster or hinder social support can assist survivors, clinicians, and families navigate survivorship. Implications for future research are discussed. PMID:25276496
Clark, Trenette T.; Nguyen, Anh B.; Coman, Emanuel
Introduction Cigarette smoking trajectories were assessed among monorace Blacks, Black-American Indians, Black-Asians, Black-Hispanics, and Black-Whites. Method We used a subsample of nationally representative data obtained from the National Longitudinal Study of Adolescent Health (Add Health). The sample consisted of adolescents who were in Grades 7 – 12 in 1994, and followed across four waves of data collection into adulthood. Wave 4 data were collected in 2007–2008 when most respondents were between 24 and 32 years old. Respondents could report more than one race/ethnicity. Poisson regression was used to analyze the data. Results We found distinct smoking trajectories among monorace and biracial/ethnic Blacks, with all groups eventually equaling or surpassing trajectories of Whites. The age of cross-over varied by gender for some subgroups, with Black-American Indian males catching up earlier than Black-American Indian females. Black-White females smoked on more days than monorace Black females until age 26 and also smoked more than Black-White males between ages 11 and 29 years. Black-Hispanic males smoked on more days than Black-Hispanic females from ages 11 to 14. The results of the interaction tests also indicated different smoking trajectories across SES levels among White, Black, and Black-White respondents. Conclusion Significant heterogeneity was observed regarding smoking trajectories between monoracel and biracial/ethnic Blacks. Knowledge of cigarette smoking patterns among monorace and biracial/ethnic Black youth and young adults extends our understanding of the etiology of tobacco use and may inform interventions. PMID:28344360
Zhong, Jieming; Cao, Shuangshuang; Gong, Weiwei; Fei, Fangrong; Wang, Meng
Electronic cigarettes (e-cigarettes) use is becoming increasingly common, especially among adolescents and young adults, and there is little evidence on the impact of e-cigarettes use on never-smokers. With a meta-analysis method, we explore the association between e-cigarettes use and smoking intention that predicts future cigarette smoking. Studies were identified by searching three databases up to January 2016. The meta-analysis results were presented as pooled odds ratio (OR) with 95% confidence interval (CI) calculated by a fixed-effects model. A total of six studies (91,051 participants, including 1452 with ever e-cigarettes use) were included in this meta-analysis study. We found that never-smoking adolescents and young adults who used e-cigarettes have more than 2 times increased odds of intention to cigarette smoking (OR = 2.21, 95% CI: 1.86–2.61) compared to those who never used, with low evidence of between-study heterogeneity (p = 0.28, I2 = 20.1%). Among never-smoking adolescents and young adults, e-cigarettes use was associated with increased smoking intention. PMID:27153077
Wiener, Lori; Weaver, Meaghann Shaw; Bell, Cynthia J; Sansom-Daly, Ursula M
Medical providers are trained to investigate, diagnose, and treat cancer. Their primary goal is to maximize the chances of curing the patient, with less training provided on palliative care concepts and the unique developmental needs inherent in this population. Early, systematic integration of palliative care into standard oncology practice represents a valuable, imperative approach to improving the overall cancer experience for adolescents and young adults (AYAs). The importance of competent, confident, and compassionate providers for AYAs warrants the development of effective educational strategies for teaching AYA palliative care. Just as palliative care should be integrated early in the disease trajectory of AYA patients, palliative care training should be integrated early in professional development of trainees. As the AYA age spectrum represents sequential transitions through developmental stages, trainees experience changes in their learning needs during their progression through sequential phases of training. This article reviews unique epidemiologic, developmental, and psychosocial factors that make the provision of palliative care especially challenging in AYAs. A conceptual framework is provided for AYA palliative care education. Critical instructional strategies including experiential learning, group didactic opportunity, shared learning among care disciplines, bereaved family members as educators, and online learning are reviewed. Educational issues for provider training are addressed from the perspective of the trainer, trainee, and AYA. Goals and objectives for an AYA palliative care cancer rotation are presented. Guidance is also provided on ways to support an AYA's quality of life as end of life nears. PMID:25750863
Medlow, S; Patterson, P
The Australian Youth Cancer Service (YCS) is part of a growing international movement to provide advocacy and better targeted health-care services for adolescents and young adults (AYAs) with cancer. One of the key initiatives of the YCS is to determine and implement priorities within Australian AYA cancer research. The YCS used the value-weighting online survey technique of allocating 100 hypothetical units of funding across pre-determined topics of research in order to determine Australian consumers' and health professionals' AYA cancer research priorities. A total of 101 participants (26 consumers and 75 health professionals) took part in the online survey. Biomedical and Clinical Medicine Research was allocated the greatest proportion of available funding. A number of priority populations were also identified, although these were distributed across pre-treatment and post-treatment stages. The preferences of consumers and health professionals to invest available AYA cancer research funds in Biomedical and Clinical Medicine Research will be an important consideration in guiding the Australian YCS decision-making process in the immediate future. 'Prevention, screening and early detection' was also an important research funding target, along with survivorship populations.
Bleyer, Archie; Ferrari, Andrea; Whelan, Jeremy; Barr, Ronald D
In high-income countries, cancer remains the commonest cause of disease-related death in adolescents and young adults (AYAs) despite survival improvements. With more than 1,000,000 new diagnoses of cancer in AYAs annually worldwide, and their number of life-years affected by cancer being greatest of all ages, the global burden of cancer in AYAs exceeds that in all other ages. In low- and middle-income countries, where the great majority of the world's 3 billion AYAs reside, the needs of those with cancer have been identified and demand attention. Unique to the age group but universal, the psychosocial challenges they face are the utmost across life's spectrum. This lead-off article of a new series in Pediatric Blood and Cancer on AYA oncology attempts to assess the global status of this emerging discipline. The review includes the changing incidence and survival of the common cancers in AYAs-there is no other age group with a similar array of malignancies-and the specific challenges to quality and quantity of life that compromise their lives.
The aim of the present study was to determine the severity of stress, anxiety, and depression using Depression Anxiety Stress Scales (DASS) in adolescents and young adults with auditory neuropathy spectrum disorder (ANSD). DASS was administered to 20 individuals with auditory neuropathy spectrum disorder. The effect of gender on severity of anxiety, stress, and depression on DASS scores was determined. It was attempted to determine the correlation of severity of anxiety, stress, and depression with the reported onset of the problem, degree of hearing loss, and speech identification scores. The results of the study showed that individuals with ANSD had a moderate degree of depression and anxiety. The results also showed that the symptoms were more seen in females than in males. Correlation analysis revealed that DASS scores correlated with the reported onset of condition and speech identification scores (SIS) and the degree of hearing loss showed no correlation. The study concludes that individuals with ANSD experience depression and anxiety and this could be because of the inadequate management options available for individuals with ANSD. Thus, there is a need to develop appropriate management strategies for individuals with ANSD and provide appropriate referral for management of psychological issues. PMID:27579218
Satwani, Prakash; Ahn, Kwang Woo; Carreras, Jeanette; Abdel-Azim, Hisham; Cairo, Mitchell S.; Cashen, Amanda; Chen, Andy I.; Cohen, Jonathon B.; Costa, Luciano J.; Dandoy, Christopher; Fenske, Timothy S.; Freytes, César O.; Ganguly, Siddhartha; Gale, Robert Peter; Ghosh, Nilanjan; Hertzberg, Mark S.; Hayashi, Robert J.; Kamble, Rummurti T.; Kanate, Abraham S.; Keating, Armand; Kharfan-Dabaja, Mohamed A.; Lazarus, Hillard M.; Marks, David I.; Nishihori, Taiga; Olsson, Richard F.; Prestidge, Tim D.; Rolon, Juliana Martinez; Savani, Bipin N.; Vose, Julie M.; Wood, William A.; Inwards, David J.; Bachanova, Veronika; Smith, Sonali M.; Maloney, David G.; Sureda, Anna; Hamadani, Mehdi
Autologous hematopoietic cell transplantation (AutoHCT) is a potentially curative treatment modality for relapsed/refractory Hodgkin lymphoma (HL). However, no large studies have evaluated pre-transplant factors predictive of outcomes of AutoHCT in children, adolescents and young adults (CAYA, age <30 years). In a retrospective study, we analyzed 606 CAYA patients (median age 23 years) with relapsed/refractory HL who underwent AutoHCT between 1995–2010. The probabilities of progression free survival (PFS) at 1, 5 and 10 years were 66% (95% CI: 62–70), 52% (95% CI: 48–57) and 47% (95% CI: 42–51), respectively. Multivariate analysis for PFS demonstrated that at the time of AutoHCT patients with Karnofsky/Lansky score ≥90, no extranodal involvement and chemosensitive disease had significantly improved PFS. Patients with time from diagnosis to first relapse of <1 year had a significantly inferior PFS. A prognostic model for PFS was developed that stratified patients into low, intermediate and high-risk groups, predicting for 5-year PFS probabilities of 72% (95% CI: 64–80), 53% (95% CI: 47–59) and 23% (95% CI: 9–36), respectively. This large study identifies a group of CAYA patients with relapsed/refractory HL who are at high risk for progression after AutoHCT. Such patients should be targeted for novel therapeutic and/or maintenance approaches post-AutoHCT. PMID:26237164
Kellogg, Scott; Melia, Dorothy; Khuri, Elizabeth; Lin, Amy; Ho, Ann; Kreek, Mary Jeanne
This study examined the impact of methadone maintenance treatment on an inclusive group of adolescent and young adult opiate-dependent patients, ages 15-23, admitted over a 6-year period, during their first year in the program. Retention in treatment was the primary outcome variable, and at 12 months, 48% were still in treatment. The findings were: (a) a stepwise discriminant function analysis revealed that patients who consistently used heroin were at a greater risk of leaving treatment within the first 12 months; (b) the use of cocaine was an indicator of higher levels of heroin use in those who reached the one-year mark; (c) among patients who stayed in treatment for one year, there was a significant reduction in heroin use, a trend toward a reduction in cocaine use, and no significant impact on benzodiazepine use; and (d) the group that stayed in treatment was slightly younger than the group that left before the first year ended. There were no gender or ethnic differences between the two groups. Suggestions for interventions that might improve treatment outcome are presented.
Johnson, Kurt L.; Dudgeon, Brian; Kuehn, Carrie; Walker, William
Objectives. We sought to determine the use of assistive technology among a population of individuals with spina bifida. Methods. We performed a descriptive analysis of individuals aged 13 to 27 years diagnosed with myelomeningocele (n=348) using data obtained from an existing database at Children’s Hospital and Regional Medical Center, Seattle, Washington. We summarized disease characteristics, utilization of assistive technology, community and self-care independence, and other variables. Results. Eighty-four percent of the respondents lived with at least 1 of their natural parents. Fifty-seven percent used wheelchairs, 35% used braces, and 23% used walking aids. Independent self-care was a common skill, but 72% reported limited participation in structured activities. Half were aged 18 years or older; of those, only 50% had completed high school and 71% were unemployed. Those aged younger than 18 years were all still in school (100%). Conclusions. Adolescents and young adults with spina bifida rely on assistive technology and specialized care routines to maintain their health. Assistive technology use for mobility is common; little is known about secondary complications associated with use of these technologies or the use of assistive technology to address learning disabilities and other societal barriers. Underutilization of assistive technology could delay successful transitions to independent living and community participation. PMID:17194874
Wilens, Timothy E.; Martelon, MaryKate; Fried, Ronna; Petty, Carter; Bateman, Clancey; Biederman, Joseph
Objective There is increasing interest regarding the risk and overlap of executive function deficits (EFDs) in stable cigarette smoking and substance use disorders (SUD). Therefore, we examined whether earlier EFD was a risk factor for subsequent cigarette smoking and SUD and further explored the relationship between EFD and SUD. Method We assessed 435 subjects at the five-year follow-up (232 cases of ADHD; mean age ± SD: 15.4 ± 3.43 and 203 controls: 16.3 ± 3.42 years) and again four to five years later as part of a prospective family study of ADHD youth. Individuals were assessed by structured psychiatric interview for psychopathology and SUD. EFD was categorically defined in an individual that had at least 2 out of 6 abnormal neuropsychological tests of executive functioning. Results At the final follow-up period, ADHD was found to be a significant predictor of stable cigarette smoking (p<0.01) and SUD into late adolescence and young adult years (p<0.01). However, EFDs were not associated with an increase in subsequent substance use outcomes. New onset stable cigarette smoking, but not SUD, was associated with subsequent EFD (p<0.01). Conclusions Our results do not support the hypothesis that EFDs predicts later stable cigarette smoking or SUD in children with ADHD growing up. However, stable cigarette smoking is associated with subsequent EFD. PMID:21241951
Field, Alison E.; Sonneville, Kendrin R.; Falbe, Jennifer; Flint, Alan; Haines, Jess; Rosner, Bernard; Camargo, Carlos A.
Objective Sales of regular soda are declining, but sales of other sweetened beverages, such as sports drinks, are increasing. Our objective was to determine the prospective associations between sports drinks and body mass index (BMI) gains among adolescents and young adults. Design and Methods We prospectively followed 4,121 females and 3,438 males in the Growing Up Today Study II, aged 9–16 in 2004, from across the United States. Data was collected by questionnaire in 2004, 2006, 2008, and 2011. Servings per day of various beverages were assessed with a food frequency questionnaire. Results Among the girls, each serving per day of sports drink predicted an increase of 0.3 BMI units (95% confidence interval (CI) CI 0.03–0.54) more than their peers over the next 2–3 years. Among the males, each serving of sports drinks predicted a 0.33 BMI (95% CI 0.09, 0.66) increase. In addition, boys who increased their intake over the 2–3 year interval gained significantly more than their peers during the same time interval. Conclusions Intake of sports drinks predicted larger increases in BMI among both females and males. Our results suggest that school policies focused on obesity prevention should be augmented to restrict sports drinks. PMID:25044989
Tshabalala, Celokuhle; Laher, Fatima
Human immunodeficiency virus (HIV) management of adolescents and young adults (AYAs) is particularly pertinent to sub-Saharan Africa, where the pediatric HIV burden is marked. Antiretroviral treatment (ART) adherence is a major challenge for AYAs. This qualitative study explored knowledge and experiences of adherence amongst AYAs attending treatment at the Perinatal HIV Research Unit (PHRU), Soweto, South Africa. Four focus group discussions (FGDs) and eight in-depth interviews (IDIs) were conducted with HIV-infected 15–25-year-old ART recipients. Transcripts were coded thematically. Participants (n = 26) were aged median 18.5 years, 59.1% female and 69.2% virally suppressed <400 cp/ml. Three main themes emerged during FGDs and IDIs: (i) correct knowledge about how to be adherent, benefits, and nonadherence consequences, (ii) social, personal, and medication-related barriers to adherence, and (iii) reminder, concealment, and motivational strategies to optimize adherence. Interventions to improve AYA adherence could focus on practical strategies, including status disclosure and medication concealment.
Hobbie, Wendy L.; Ogle, Sue; Reilly, Maureen; Barakat, Lamia; Lucas, Matthew S.; Ginsberg, Jill P.; Fisher, Michael J.; Volpe, Ellen M.; Deatrick, Janet A.
Background To date there are few studies that examine the perspectives of older survivors of childhood brain tumors who are living with their families in terms of their sense of self and their role in their families. Objective To describe how adolescent and young adult survivors (AYA) of childhood brain tumors describe their HRQOL, that is their physical, emotional, and social functioning. Methods This qualitative descriptive study included a purposive sample of 41 AYA survivors of a childhood brain tumor who live with their families. Home interviews were conducted using a semi-structured interview guide. Directed content analytic techniques were used to analyze data using HRQOL as a framework. Results This group of brain tumor survivors described their everyday lives in terms of their physical health, neurocognitive functioning, emotional health, social functioning, and self-care abilities. Overall, survivors struggle for normalcy in the face of changed functioning due to their cancer and the (late) effects of their treatment. Conclusions Neurocognitive issues seemed most compelling in the narratives. The importance of families went beyond the resources, structure, and support for functioning. Their families provided the recognition that they were important beings and their existence mattered to someone. Implications for Practice The value and complexity of care coordination was highlighted by the multifaceted needs of the survivors. Advocacy for appropriate and timely educational, vocational, and social support is critical as part of comprehensive cancer survivorship care. PMID:25950583
Unger, Jennifer B.
Hispanic adolescents represent a growing segment of the U.S. population. In addition to the typical stressors encountered during adolescence, Hispanic adolescents may experience acculturative stress, perceived discrimination, and conflicts with parents about acculturation, which can lead to maladaptive behaviors such as substance use. Personal cultural resources may help Hispanic youth cope with cultural stressors and avoid substance use, but little is known about how such factors affect decisions about substance use. In 2005, my research group began studying a group of Hispanic adolescents in Los Angeles. The participants completed surveys annually about cultural issues such as acculturation, ethnic identity, and perceived discrimination; family and peer relationships; and use of alcohol, tobacco, and marijuana. We found that Hispanic adolescents’ perceptions that they were discriminated against put them at greater risk for substance use, and that Hispanic orientation protected the youth from substance use. The findings can inform the development of culturally relevant prevention interventions for Hispanic adolescents and emerging adults. PMID:24729791
Smith, E; Sweeting, H; Wright, C
Objective: Individual behaviour change to reduce obesity requires awareness of, and concern about, weight. This paper therefore describes how young adults, known to have been overweight or obese during early adolescence, recalled early adolescent weight-related awareness and concerns. Associations between recalled concerns and weight-, health- and peer-related survey responses collected during adolescence are also examined. Design: Qualitative semi-structured interviews with young adults; data compared with responses to self-report questionnaires obtained in adolescence. Participants: A total of 35 participants, purposively sub-sampled at age 24 from a longitudinal study of a school year cohort, previously surveyed at ages 11, 13 and 15. Physical measures during previous surveys allowed identification of participants with a body mass index (BMI) indicative of overweight or obesity (based on British 1990 growth reference) during early adolescence. Overall, 26 had been obese, of whom 11 had BMI⩾99.6th centile, whereas 9 had been overweight (BMI=95th–97.9th centile). Measures: Qualitative interview responses describing teenage life, with prompts for school-, social- and health-related concerns. Early adolescent self-report questionnaire data on weight-worries, self-esteem, friends and victimisation (closed questions). Results: Most, but not all recalled having been aware of their overweight. None referred to themselves as having been obese. None recalled weight-related health worries. Recollection of early adolescent obesity varied from major concerns impacting on much of an individual's life to almost no concern, with little relation to actual severity of overweight. Recalled concerns were not clearly patterned by gender, but young adult males recalling concerns had previously reported more worries about weight, lower self-esteem, fewer friends and more victimisation in early adolescence; no such pattern was seen among females. Conclusion: The popular image of
Dreyer, Juliet; Schwartz-Attias, Irit
Cancer patients belonging to the adolescent and young adult (AYA) age group have unique and very specific needs, which require special attention from the caring staff. The difficulty in maintaining the personal and professional development at this age is both natural and normal. Adding to this, coping with a life-threatening disease turns this stage in life into a period with many dilemmas and challenges of quite a complex nature. AYA patients have to deal with issues above and beyond the disease itself, which create a very complex coping picture. On top of that, prognosis for this age group has not improved in recent years, unlike the situation in other age groups like children and adults. The literature on this subject is extensive and comprehensive. However, most of the papers on this subject are very specific and narrow in their approach, each dealing with a specific topic. In this article, we bring together many different papers which make a wide and comprehensive picture of the subject of AYAs coping with cancer, coupled with recommendations for the caring staff. In this review we focus on the various aspects of the disease and treatments in AYAs, based on the conceptual model of quality of life proposed by Ferrell and colleagues [Cancer Nurs 1992;15:153-160; Cancer Nurs 1992;15:247-253], including physical, social, emotional and spiritual aspects. From the psychological standpoint, most of the papers discuss the negative aspects; however, in this article we try to include some articles from the positive psychology school of thought. From our findings it is apparent that there is an opportunity and need to further explore research in this regard. It is apparent that taking a unique approach to AYA cancer patients is needed in order to deal with the unique needs of this age group. This article aims at putting a framework around this issue, with actionable recommendations for the caring staff.
Roman-Urrestarazu, Andres; Lindholm, Päivi; Moilanen, Irma; Kiviniemi, Vesa; Miettunen, Jouko; Jääskeläinen, Erika; Mäki, Pirjo; Hurtig, Tuula; Ebeling, Hanna; Barnett, Jennifer H; Nikkinen, Juha; Suckling, John; Jones, Peter B; Veijola, Juha; Murray, Graham K
When adolescents with ADHD enter adulthood, some no longer meet disorder diagnostic criteria but it is unknown if biological and cognitive abnorma lities persist. We tested the hypothesis that people diagnosed with ADHD during adolescence present residual brain abnormalities both in brain structure and in working memory brain function. 83 young adults (aged 20-24 years) from the Northern Finland 1986 Birth Cohort were classified as diagnosed with ADHD in adolescence (adolescence ADHD, n = 49) or a control group (n = 34). Only one patient had received medication for ADHD. T1-weighted brain scans were acquired and processed in a voxel-based analysis using permutation-based statistics. A sub-sample of both groups (ADHD, n = 21; controls n = 23) also performed a Sternberg working memory task whilst acquiring fMRI data. Areas of structural difference were used as a region of interest to evaluate the implications that structural abnormalities found in the ADHD group might have on working memory function. There was lower grey matter volume bilaterally in adolescence ADHD participants in the caudate (p < 0.05 FWE corrected across the whole brain) at age 20-24. Working memory was poorer in adolescence ADHD participants, with associated failure to show normal load-dependent caudate activation. Young adults diagnosed with ADHD in adolescence have structural and functional deficits in the caudate associated with abnormal working memory function. These findings are not secondary to stimulant treatment, and emphasise the importance of taking a wider perspective on ADHD outcomes than simply whether or not a particular patient meets diagnostic criteria at any given point in time.
Deroche, Chelsea B; Holland, Margaret M; McDermott, Suzanne; Royer, Julie A; Hardin, James W; Mann, Joshua R; Salzberg, Deborah; Ozturk, Orgul; Ouyang, Lijing
There is a need for research that focuses on the correlation between self-perceived quality of life (QoL) and the health outcomes of adolescents with disability transitioning to adulthood. To better understand the transition experience of adolescents and young adults with disability, we developed a questionnaire to assess the impact of disability on QoL. We recruited 174 participants who were 15-24 years old and diagnosed with Fragile X syndrome (FXS), spina bifida (SB) or muscular dystrophy (MD) and conducted an exploratory factor analysis to identify factors that characterize QoL. Five factors emerged: emotional health, physical health, independence, activity limitation, and community participation. To validate the tool, we linked medical claims and other administrative data records and examined the association of the factor scores with health care utilization and found the questionnaire can be utilized among diverse groups of young people with disability.
Deroche, Chelsea B.; Holland, Margaret M.; McDermott, Suzanne; Royer, Julie A.; Hardin, James W.; Mann, Joshua R.; Salzberg, Deborah; Ozturk, Orgul; Ouyang, Lijing
There is a need for research that focuses on the correlation between self-perceived quality of life (QoL) and the health outcomes of adolescents with disability transitioning to adulthood. To better understand the transition experience of adolescents and young adults with disability, we developed a questionnaire to assess the impact of disability on QoL. We recruited 174 participants who were 15–24 years old and diagnosed with Fragile X syndrome (FXS), spina bifida (SB) or muscular dystrophy (MD) and conducted an exploratory factor analysis to identify factors that characterize QoL. Five factors emerged: emotional health, physical health, independence, activity limitation, and community participation. To validate the tool, we linked medical claims and other administrative data records and examined the association of the factor scores with health care utilization and found the questionnaire can be utilized among diverse groups of young people with disability. PMID:25577179
Poe, Elizabeth Ann
Applying reader response theory, a study explored the responses of 19 pregnant adolescents and teenage mothers to two dissimilar young adult novels, one about teenage pregnancy and one about adolescent alcoholism. Quantitative analysis, using a modified version of the Purves-Rippere (1968) system, and qualitative analysis of written answers to…
Dawson, Jeffrey D.; Sonka, Milan; Blecha, Mary Beth; Lin, Wenjiao; Davis, Patricia H.
Objectives To determine whether cardiovascular risk factors are associated with aortic and carotid intimal-medial thickness (aIMT and cIMT) in adolescents and young adults. Background Atherosclerotic lesions begin developing in youth, first in the distal abdominal aorta and later in the carotid arteries. Knowledge of how risk factors relate to aIMT and cIMT may help in the design of early interventions to prevent cardiovascular disease. Methods Participants were 635 members of the Muscatine Offspring cohort. The mean aIMT and cIMT were measured using an automated reading program. Results The means (SDs) of aIMT and cIMT were 0.63 (0.14) mm and 0.49 (0.04) mm, respectively. In adolescents (ages 11 to 17), aIMT was associated with triglycerides, systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), and waist/hip ratio, after adjusting for age, gender, and height. In young adults (ages 18 to 34), aIMT was associated with those same five risk factors, plus HDL-cholesterol and pulse pressure. In adolescents, cIMT was associated with SBP, pulse pressure, heart rate, BMI, and waist/hip ratio. In young adults, cIMT was associated total cholesterol, LDL-cholesterol, triglycerides, SBP, .DBP, BMI, waist/hip ratio, and HbA1C. In both age groups, aIMT and cIMT were significantly correlated with the PDAY coronary artery risk score. Conclusions Both aIMT and cIMT are associated with cardiovascular risk factors. Using aIMT in adolescents gives information beyond that obtained from cIMT alone. Measurement of aIMT and cIMT may help identify those at risk for premature cardiovascular disease. PMID:19520251
Reyna, Valerie F.; Estrada, Steven M.; DeMarinis, Jessica A.; Myers, Regina M.; Stanisz, Janine M.; Mills, Britain A.
Predictions of fuzzy-trace theory and neurobiological approaches are examined regarding risk taking in a classic decision-making task--the framing task--as well as in the context of real-life risk taking. We report the 1st study of framing effects in adolescents versus adults, varying risk and reward, and relate choices to individual differences,…
Davis, Cheryl; Leonard, Annette
Guiding deaf and hard of hearing students in making important decisions about their adult careers can be a difficult task. Twenty years after its inception, the TCB, as adapted for deaf and hard of hearing students, may help. The TCB is a unique assessment tool designed to measure the transition skills of deaf high school adolescents and young…
Harris, Sion K; Aalsma, Matthew C; Weitzman, Elissa R; Garcia-Huidobro, Diego; Wong, Charlene; Hadland, Scott E; Santelli, John; Park, M Jane; Ozer, Elizabeth M
We reviewed research regarding system- and visit-level strategies to enhance clinical preventive service delivery and quality for adolescents and young adults. Despite professional consensus on recommended services for adolescents, a strong evidence base for services for young adults, and improved financial access to services with the Affordable Care Act's provisions, receipt of preventive services remains suboptimal. Further research that builds off successful models of linking traditional and community clinics is needed to improve access to care for all youth. To optimize the clinical encounter, promising clinician-focused strategies to improve delivery of preventive services include screening and decision support tools, particularly when integrated into electronic medical record systems and supported by training and feedback. Although results have been mixed, interventions have moved beyond increasing service delivery to demonstrating behavior change. Research on emerging technology-such as gaming platforms, mobile phone applications, and wearable devices-suggests opportunities to expand clinicians' reach; however, existing research is based on limited clinical settings and populations. Improved monitoring systems and further research are needed to examine preventive services facilitators and ensure that interventions are effective across the range of clinical settings where youth receive preventive care, across multiple populations, including young adults, and for more vulnerable populations with less access to quality care.
Kim, Mimi S.; Dao-Tran, Anh; Davidowitz, Elana; Tseng, Teresa; Gilsanz, Vicente; Ryabets-Lienhard, Anna; Nguyen, Eugene; Geffner, Mitchell E.
Background/Aims Youth with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency develop cardiovascular disease (CVD) risk factors of obesity and hypertension. Carotid intima-media thickness (CIMT), a marker of CVD risk, is increased in CAH young adults. We examined CIMT and its relationship with androgens and obesity in adolescents/young adults with CAH. Methods Twenty CAH subjects (16 ± 3.3 yr, 50% female) and 20 matched controls were studied cross-sectionally. Eight additional obese CAH were included in within-group comparisons. CIMT by high-resolution ultrasound, androgens, anthropometry, bone age (BA), and metabolic/inflammatory markers were assessed. Results Within CAH, CIMT correlated with 17-hydroxyprogesterone (r = 0.48, P < 0.05) and androstenedione (r = 0.46, P < 0.05), and was greater in obese subjects. CIMT was greater in CAH males than females, but similar among CAH females with advanced BA, CAH males with normal BA, and control males. There was no difference in CIMT between CAH and controls, although HDL was inversely correlated with CIMT in both groups. Conclusion CIMT is associated with increased androgens in CAH adolescents and young adults, with loss of sex differences in CAH females with excess androgen exposure. Our findings highlight the importance of hormonal control for CVD prevention in CAH. PMID:26933879
Alvarado, Steven Elías
Previous research suggests that youth who grow up in socioeconomically disadvantaged neighborhoods face higher odds of becoming obese. Neighborhood effects scholars, meanwhile, have suggested that contextual influences may increase in strength as children age. This is the first study to examine whether developmental epochs moderate the effect of neighborhood disadvantage on obesity over time. I use thirteen waves of new restricted and geo-coded data on children ages 2-18 from the National Longitudinal Survey of Youth, Children and Young Adults. Bivariate and pooled logistic regression results suggest that neighborhood disadvantage has a stronger impact on adolescents' likelihood of becoming obese. Fixed effects models reveal that after adjusting for observed and unobserved confounders, adolescents continue to face higher odds of becoming obese due to the conditions associated with living in disadvantaged neighborhoods. Moreover, as research on adults suggests, girls experience larger impacts of neighborhood disadvantage than boys.
Edwards, Melinda; Lawson, Caron; Rahman, Safiyyah; Conley, Kerry; Phillips, Hannah; Uings, Rebecca
It is widely recognised that developmentally appropriate services for adolescents and young people improve both healthcare experience and health outcomes. However, there is limited evidence of using young people's expertise to evaluate services, or of young people participating in service developments or design to meet their healthcare needs. This report covers both the process and outcomes of a collaborative project with a group of young people (aged 17-25 years) who are 'experts by experience'. We used qualitative mixed methodology to derive themes from narrative accounts of these young people's healthcare experiences to develop an assessment framework that they identified as being relevant to evaluating services. Informing young people about other assessment measures currently in use (including the Department of Health's You're Welcome quality criteria) enabled the group to further develop their views and refine their proposed assessment framework. This paper is co-authored with young people, enabling them to directly voice their views about healthcare services. Reflections on this process and recommendations for working more collaboratively with young people to evaluate healthcare services are also given.
This author acknowledges that teachers agree that "adolescents aren't always interested in the topics adults consider important for them to learn." It is easy for adults who have forgotten the wonder and uncertainty of the adolescent years to declare that students today are more uninterested in school and undisciplined in life than…
Hoeve, Machteld; Stams, Geert Jan J. M.; van der Zouwen, Marion; Vergeer, Margaretha; Jurrius, Kitty; Asscher, Jessica J.
Financial debt in young people has increased in recent years. Because debt may have severe consequences, and it may enhance criminal behavior, insight into the prevalence and determinants of debt and its association with crime is important. We conducted a systematic review and meta-analysis of 36 manuscripts to examine the prevalence of financial debt (k = 23), correlates and risk factors of debt (k = 16), and associations between debt and criminal behavior in adolescents and young adults (k = 8). Findings revealed that the prevalence of debt is substantial among young people; on average, 49% reported to have at least some debt, 22% had financial problems. Older participants and ethnic minorities were found to have higher levels of debt than younger and indigenous counterparts. Females had more financial problems and higher student loans. Low self-esteem, a pro-debt attitude (of young people and their parents), lack of perceived control towards financial management, poor social functioning, financial stress and external locus of control were found to have the strongest associations with debt. Studies reported strong associations between debt and crime. Particularly, strong associations were found between serious and persistent crime in young people and later (young adult) debt or financial problems. PMID:25136797
Day, Steven M.; Wu, Yvonne W.; Strauss, David J.; Shavelle, Robert M.; Reynolds, Robert J.
This study aimed to determine the probability that a child with cerebral palsy (CP) will lose or gain ambulatory ability through adolescence and young adulthood. We analyzed retrospectively data from 1987 to 2002 on Californians with CP initially aged 10 years (SD 0.9y; n=7550 [4304 males, 3246 females]) and 25 years (SD 0.8y; n=5721 [3261 males,…
Urbano, Maria; Okwara, Leonore; Manser, Paul; Hartmann, Kathrin; Deutsch, Stephen I
Autism spectrum disorders are difficult for older adolescents and young adults as impaired social communication affects the transition to adult life. d-Cycloserine, a partial glycine agonist at the N-methyl-d-aspartic acid receptor, was tested in a double-blind randomized trial in 20 older adolescents and young adults with autism spectrum disorders using two dosing strategies (50 mg daily versus 50 mg weekly) for 8 weeks with a 2-week follow-up after discontinuation. d-Cycloserine caused statistically and clinically significant improvement with no differentiation between dosing strategies on the Social Responsiveness Scale and the Aberrant Behavior Checklist before and after d-cycloserine administration.
Tanner-Smith, Emily E.; Risser, Mark D.
Background Brief alcohol interventions are one approach for reducing drinking among youth, but may vary in effectiveness depending on the type of alcohol assessments used to measure effects. Objectives To conduct a meta-analysis that examined the effectiveness of brief alcohol interventions for adolescents and young adults, with particular emphasis on exploring variability in effects across outcome measurement characteristics. Method Eligible studies were those using an experimental or quasi-experimental design to examine the effects of a brief alcohol intervention on a post-intervention alcohol use measure for youth ages 11–30. A comprehensive literature review identified 190 unique samples that were included in the meta-analysis. Taking a Bayesian approach, we used random-effects multilevel models to estimate the average effect and model variability across outcome measurement types. Results Brief alcohol interventions led to significant reductions in self-reported alcohol use among adolescents ( g¯ = 0.25, 95% CrI [0.13, 0.37]) and young adults ( g¯ = 0.15, 95% CrI [0.12, 0.18]). These results were consistent across outcomes with varying reference periods, but varied across outcome construct type and assessment instruments. Among adolescents, effects were larger when measured using the Timeline Followback; among young adults, effects were smaller when measured using the Alcohol Use Disorders Identification Test. Conclusion The strength of the beneficial effects of brief alcohol interventions on youth’s alcohol use may vary depending upon the outcome measure utilized. Nevertheless, significant effects were observed across measures. Although effects were modest in size, they were clinically significant and show promise for interrupting problematic alcohol use trajectories among youth. PMID:26905387
Baer, Tamara E.; Milliren, Carly E.; Walls, Courtney; DiVasta, Amy D.
Study Objectives To review the clinical presentation, evaluation and management of normal-weight, overweight and obese adolescent and young adult women with PCOS over 2-year follow-up. Design Retrospective chart review Participants 173 adolescent and young adult women, aged 12–22 years, diagnosed with PCOS Interventions Demographic, health data, and laboratory measures were abstracted from 3 clinic visits: baseline and 1- and 2- year follow-up. Subjects were classified as normal-weight (NW), overweight (OW) or obese (OB). Longitudinal data were analyzed using repeated measures ANOVA. Main Outcome Measures BMI, self-reported concerns, lifestyle changes. Results Most patients (73%) were OW or OB. Family history of type II diabetes was greater in OW (38%) and OB (53%) as compared to NW (22%) patients (p=0.002). Acanthosis nigricans was identified in OW (62%) and OB (21%) patients, but not NW patients (0%; p <0.001). OW and OB patients had higher fasting insulin (p<0.001) and lower HDL cholesterol (p=0.005) than NW patients, although screening rates were low. BMI Z-scores decreased in both OW and OB patients over time (0.07 units/year; p<0.001). Conclusions Most patients with PCOS were OW/OB. Substantial clinical variability existed in CVD screening; among those screened, OW and OB patients had greater CVD risk factors. Despite self-reported concerns about weight and diabetes risk among OW/OB patients, no clinically significant change in BMI percentile occurred. Evidence-based interventions and recommendations for screening tests are needed to address CVD risk in adolescents and young adults with PCOS. PMID:26081478
Shah, Amy S.; Gao, Zhiqian; Dolan, Lawrence M.; Dabelea, Dana; D'Agostino, Ralph B.; Urbina, Elaine M.
Background Microvascular dysfunction is a key event in the development of atherosclerosis, which predates the clinical manifestations of vascular disease including stroke and myocardial infarction. Dysfunction of the microvasculature can be measured as a decreased microperfusion in response to heat. Objective We sought to evaluate the microvasculature using heat among adolescents and young adults with type 1 diabetes (T1D) compared to healthy non-diabetic controls. We hypothesized that youth with T1D would have impaired microvascular function measured as decreased perfusion. Methods We studied 181 adolescents and young adults with T1D and 96 age-, race-, and sex-matched healthy controls (mean age 19 yr). Patients were seen at an in-person study visit where demographics, anthropometrics, and laboratory data was obtained. Skin microvascular perfusion was measured on the volvar surface of the right forearm using a standard laser flow Doppler. Measurements were taken at baseline and after heating to 44° C. Results Youth with T1D had decreased microvascular perfusion as measured by lower percent change of perfusion units (1870 ± 945 vs. 2539 ± 1255, p < 0.01) and percent change in area under the curve (1870 ± 945 vs. 2539 ± 1255, p < 0.01) compared to controls. Glycosylated hemoglobin A1c (HbA1c) was found to be an independent determinant of microvascular function (p < 0.05). Conclusions Adolescents and young adults with T1D have evidence of microvascular dysfunction that can be detected using heat, a non-invasive physiologic stimulus. HbA1c appears to play an independent role in determining microvascular perfusion suggesting tight glycemic control is probably important for the development of vascular disease. PMID:25082568
Berking, Matthias; Ebert, David D; Lehr, Dirk; Riper, Heleen; Sieland, Bernhard; Wiencke, Carmen
Epidemiological findings indicate that up to 18.5 % of the German adolescents suffer from depressive symptoms and that younger adults display the highest risk for relevant symptoms of depression (9.9 %) within the German adult population. Internet-based interventions have been shown to be useful for preventing and treating depression and are more easily disseminated in internet-savvy generations. Available programs are usually based on principles of cognitive behavioural therapy. They differ significantly with regard to target groups, structure, content, degree of guidance provided by online-coaches and evidence for their efficacy. Whereas some studies could not prove the use of the trainings there are others that show large effect sizes (up to d = 0.84) for the reduction of depressive symptoms. In Germany there are some online counseling programs for children and adolescents in (acute) crises available. However, at this point no structured intervention program for the treatment of depression exists.
Macpherson, Catherine Fiona; Hooke, Mary C; Friedman, Debra L; Campbell, Kristin; Withycombe, Janice; Schwartz, Cindy L; Kelly, Kara; Meza, Jane
Fatigue is a significant problem for adolescent and young adult (AYA) Hodgkin lymphoma (HL) survivors. The relationship between exercise and fatigue is complex. This study explored the trajectory of and the relationship between exercise and fatigue over 36 months post-therapy in a cohort of 103 AYA-aged HL survivors treated on Children's Oncology Group (COG) study AHOD0031. Descriptive statistics and generalized estimating equations were used in this secondary data analysis. Exercise and fatigue improved over time but were unrelated; amount of exercise at end of therapy predicted amount of exercise at 12 (p = 0.02) and 36 (p = 0.0008) months post-therapy.
Kopp, Lisa M; Gastelum, Zachary; Guerrero, Christian H; Howe, Carol L; Hingorani, Pooja; Hingle, Melanie
Childhood, adolescent, and young adult cancer survivors demonstrate increased cardio-metabolic risk factors, which are amenable to lifestyle changes. The use of technology to impact lifestyle change expands previously limited intervention access, yet little is known about its use. We summarized lifestyle interventions for survivors delivered using technology, finding six studies, primarily targeting physical activity. Study samples were small and durations ranged from 5 to 16 weeks and outcomes modest. Participants were older, white, survivors of leukemia or brain tumors, and the majority received Web-based interventions. Study quality was moderate. Few technology-based interventions have been developed, suggesting an area of opportunity for survivors.
Baker, Rachel B; Fargo, Jamison D; Shambley-Ebron, Donna; Sommers, Marilyn S
Differences in anogenital injury resulting from rape may occur because of racial or skin color differences in adult women. It is critical to determine if these differences also are associated with differences in injury prevalence and frequency in adolescents and young adults. In a retrospective review of medical records, we examined whether Black adolescent/young adult females had different anogenital injuries as compared to White females following rape. Next, we examined whether skin color differences explained a significant amount of the racial difference in injuries. We reviewed charts of 234 female victims of rape ages 14 to 29. Overall injury prevalence was 62.8%. Race was significantly associated with frequency of injuries in several anatomical locations, with White victims having a higher frequency of injuries than Black victims. Skin color was significantly associated with injury frequency in many anatomical locations, with victims with light skin sustaining more injuries than victims with dark skin. Even when skin color was included in the relationship, race remained a statistically significant factor, suggesting that the relationship between race and injuries may be more complicated than merely a skin color difference that has been mislabeled a racial difference.
McNaughton, David B., Ed.; Beukelman, David R., Ed.
To make a smooth transition to a fulfilling, self-determined adult life, young people who use Augmentative-Alternative Communication (AAC) need effective services that meet their individual needs and make the most of advances in technology. Professionals will provide these critical supports with the help of this book, the first complete guide to…
Sulzer, Mark A.; Thein, Amanda Haertling
Courses on teaching young adult literature (YAL) often encourage preservice English language arts teachers to consider their future students as they evaluate texts for classroom use. In this study, Sulzer and Thein analyzed preservice teachers' responses to familiar questions used to frame discussions of YAL--questions that ask them to read on…
Sung, Lillian; Stark, Daniel; Frazier, A. Lindsay; Rosenberg, Abby R.
Purpose Peripheral neuropathy is an important, yet poorly studied, side effect of pediatric cancer treatment. There are many measures of patient-reported peripheral neuropathy in adults but very few in children. We aimed to systematically review and summarize reliable and valid patient-reported peripheral neuropathy scales used in pediatrics. Methods Four major electronic databases (Medline, Embase, EBSCO Host in Cumulative Index to Nursing and Allied Health Literature, and PsycINFO) were reviewed for studies that measured peripheral neuropathy in pediatric patients. Studies eligible for inclusion were those that described use of any patient-reported scale of peripheral neuropathy among children, adolescents, and young adults with any underlying diagnosis (not limited to cancer). Results From a total of 765 articles retrieved, 5 met eligibility criteria and were included. One was a neuropathy symptom score used in patients with diabetes, and the remaining four were in oncology patients and all were based on the total neuropathy score. All involved objective assessments conducted by trained professionals; none relied purely on patient report. Conclusions There are no validated instruments that consist solely of a patient-reported outcome measure of neuropathy in pediatrics and adolescents. Because the clinical evaluation of neuropathy requires specialized training, it is not generalizable in large studies conducted in many diverse institutions. Future studies should validate adult patient-reported neuropathy scales in pediatric and adolescent populations, or develop novel instruments designed for this population. PMID:27037813
Baiocco, Roberto; Chirumbolo, Antonio; Bianchi, Dora; Ioverno, Salvatore; Morelli, Mara; Nappa, Maria R.
Selfies are self-portrait photos shared on Social Networks. Previous literature has investigated how personality traits, and specifically narcissism, are associated with selfie-posting behaviors. In this contribution we investigated how selfie-posting behaviors are predicted by the six HEXACO personality traits, controlling for age, gender and sexual orientation. The Kinsey scale, three questions about the frequency of own selfies, group selfies and selfies with partner, and 60-item HEXACO Personality Inventory-Revised were administered to 750 young people from 13 to 30 years. Females, adolescents and not-exclusively heterosexual people posted more own selfies, and adolescents posted also more group selfies and selfies with partner. Moreover, lower Honesty/Humility, lower Conscientiousness, higher Emotionality and higher Extraversion significantly predict own selfies and group selfies. Finally, only lower Honesty/Humility and higher Emotionality predict selfies with partner. Theoretical and practical implications are provided. PMID:28119662
Lerner, Matthew D; Haque, Omar Sultan; Northrup, Eli C; Lawer, Lindsay; Bursztajn, Harold J
As the prevalence of autism spectrum disorders (ASDs) has increased, attention has shifted toward consideration of ASDs in adolescence and adulthood, as well as public health repercussions for this population. Since the social and emotional deficits within ASDs may be salient during incidents of unintended criminal or violent behavior, one area of focus is involvement of adolescents and young adults with ASD in the criminal justice system. Without a thorough understanding of how and why individuals with ASDs may exhibit criminal behavior, judicial and legislative state systems have begun to develop policies lacking a substantial evidence base. In this article, we attempt to synthesize the literature on one type of ASD (high functioning) and criminal behavior. Three specific deficits characteristic of individuals with ASDs (theory of mind, emotion regulation, and moral reasoning) are examined as potential confluent forces leading to criminal behavior among individuals with ASDs. Legal and policy recommendations are presented.
Garcia, Danilo; Nima, Ali A; Archer, Trevor
The present study investigated the relationship between personality and Subjective Well-Being in a sample of 135 Salvadorian adolescents and young adults (age mean = 21.88 sd. = 4.70). Personality was assessed through self-reports using the Temperament and Character Inventory-Revised. Subjective Well-Being was also self-reported using the Positive Affect Negative Affect Schedule and the Satisfaction With Life Scale. Structural equation modeling was used to determine relationships between personality and Subjective Well-Being. Regarding temperament dimensions, Harm Avoidance was positively associated to negative affect and negatively associated to positive affect, while Persistence was positively associated to positive affect. Regarding character dimensions, only Self-directedness was related to Subjective Well-Being: positively related to life satisfaction and positive affect. The results presented here mirror findings using the temperament and character model of personality among European and North American adolescents.
Hao, Jian; Yang, Yue; Wang, Zhiwen
Young adolescents are generally considered to be self-absorbed. Studies indicate that they lack relevant general cognitive abilities, such as impulse control, that mature in early adulthood. However, their idealism may cause them to be more intolerant of unfair treatment to others and thus result in their engaging in more altruistic behavior. The present study aimed to clarify whether young adolescents are more altruistic than adults and thus indicate whether altruistic competence is domain-specific. One hundred 22 young adolescents and adults participated in a face-to-face, two-round, third-party punishment experiment. In each interaction group, a participant served as an allocator who could share money units with a stranger; another participant who knew the allocator could punish the acquaintance for the stranger. Participants reported their emotions after the first round, and at the end of the experiment, the participants justified their behavior in each round. The results indicated that the young adolescents both shared more and punished more than did the adults. Sharing was associated with a reference to fairness in the justifications, but altruistic punishment was associated with subsequent positive emotion. In sum, greater altruism in young adolescents compared to adults with mature cognitive abilities provides evidence of domain-specificity of altruistic competence. Moreover, sharing and altruistic punishment are related to specific cognitive and emotional mechanisms, respectively. PMID:27752246
Hao, Jian; Yang, Yue; Wang, Zhiwen
Young adolescents are generally considered to be self-absorbed. Studies indicate that they lack relevant general cognitive abilities, such as impulse control, that mature in early adulthood. However, their idealism may cause them to be more intolerant of unfair treatment to others and thus result in their engaging in more altruistic behavior. The present study aimed to clarify whether young adolescents are more altruistic than adults and thus indicate whether altruistic competence is domain-specific. One hundred 22 young adolescents and adults participated in a face-to-face, two-round, third-party punishment experiment. In each interaction group, a participant served as an allocator who could share money units with a stranger; another participant who knew the allocator could punish the acquaintance for the stranger. Participants reported their emotions after the first round, and at the end of the experiment, the participants justified their behavior in each round. The results indicated that the young adolescents both shared more and punished more than did the adults. Sharing was associated with a reference to fairness in the justifications, but altruistic punishment was associated with subsequent positive emotion. In sum, greater altruism in young adolescents compared to adults with mature cognitive abilities provides evidence of domain-specificity of altruistic competence. Moreover, sharing and altruistic punishment are related to specific cognitive and emotional mechanisms, respectively.
Wakefield, Claire E.
Adolescents and young adults (AYAs) with cancer must simultaneously navigate the challenges associated with their cancer experience, whilst striving to achieve a number of important developmental milestones at the cusp of adulthood. The disruption caused by their cancer experience at this critical life-stage is assumed to be responsible for significant distress among AYAs living with cancer. The quality and severity of psychological outcomes among AYAs remain poorly documented, however. This review examined the existing literature on psychological outcomes among AYAs living with cancer. All psychological outcomes (both distress and positive adjustment) were included, and AYAs were included across the cancer trajectory, ranging from newly-diagnosed patients, to long-term cancer survivors. Four key research questions were addressed. Section 1 answered the question, “What is the nature and prevalence of distress (and other psychological outcomes) among AYAs living with cancer?” and documented rates of clinical distress, as well as evidence for the trajectory of this distress over time. Section 2 examined the individual, cancer/treatment-related and socio-demographic factors that have been identified as predictors of these outcomes in this existing literature. Section 3 examined current theoretical models relevant to explaining psychological outcomes among AYAs, including developmental models, socio-cognitive and family-systems models, stress-coping frameworks, and cognitive appraisal models (including trauma and meaning making models). The mechanisms implicated in each model were discussed, as was the existing evidence for each model. Converging evidence implicating the potential role of autobiographical memory and future thinking systems in how AYAs process and integrate their cancer experience into their current sense of self and future goals are highlighted. Finally, Section 4 addressed the future of psycho-oncology in understanding and conceptualizing
Moon, Eun-Kyeong; Park, Hyeon Jin; Oh, Chang-Mo; Jung, Kyu-Won; Shin, Hee Young; Park, Byung Kiu; Won, Young-Joo
Background In Korea, cancer is the third leading cause of death among adolescents and young adults (AYAs). However, cancer incidence and survival trends among AYAs (15–29 years) have never been studied in Korea. Therefore, this study aimed to investigate the incidence and relative survival rates and their trends among AYAs in Korea. Materials and Methods Cancer incidence data from 1999–2010 were obtained from the Korea Central Cancer Registry (KCCR). Each cancer was classified into subgroups according to the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) AYA site recode. Percent distributions, age-specific incidence rates, age-standardized incidence rates per million, and annual percent changes (APCs) were calculated for AYAs according to sex. Five-year relative survival rates were estimated for cases diagnosed between 1993 and 2010 and followed up to 2011. Results The age-standardized incidence rates of all cancers combined were 196.4 and 367.8 per million for males and females, respectively (male-to-female (M/F) ratio: 0.5). The age-standardized incidence rates increased from 208.7 per million in 1999 to 396.4 per million in 2010, and the APC was 6.3% (P<0.001). The five most common cancers among AYAs were thyroid carcinoma, non-Hodgkin lymphoma, stomach carcinoma, breast carcinoma, and acute myeloid leukemia. In males, the 5-year relative survival rate improved, from 46.5% in 1993–1995 to 75.9% in 2006–2010. In females, the 5-year relative survival rate also improved, from 66.7% in 1993–1995 to 89.1% in 2006–2010. Conclusions Our study showed increases in cancer incidence and improvements in the 5-year relative survival rate among Korean AYAs. This study also provides additional data regarding temporal and geographic trends in cancer that may enhance future efforts to identify factors affecting cancer incidence and responses to treatment among AYAs. PMID:24789075
Goldschmidt, Andrea B.; Wall, Melanie M.; Choo, Tse-Hwei J.; Larson, Nicole I.; Neumark-Sztainer, Dianne
Depression may be a risk factor for overweight status, but mechanisms involved in this relationship are unclear. This study explored behavioral factors involved in the relationship between adolescent depression symptoms and adult overweight status. A population-based cohort of female participants in Project EAT (n=1,035) was followed over 10 years and reported on psychological functioning, weight status, and eating and activity patterns in early/middle adolescence (1999=Time 1; T1), middle adolescence/early young adulthood (2004=Time 2; T2), and early/middle young adulthood (2009=Time 3; T3). Structural equation models were fit which included T1 depression scores predicting overweight status at T3, with T2 fruit and vegetable consumption, moderate-to-vigorous physical activity, and binge eating examined as mediators. There were small but significant effects of T1 depression scores predicting an increased likelihood of T3 overweight status (standardized estimate=0.038; p=.007), and of T2 binge eating mediating the relation between T1 depression and T3 overweight status (standardized indirect effect estimate=.036; p=.009). Binge eating may be one pathway to overweight among depressed females, suggesting that recognition and treatment of eating pathology in individuals with depression may help prevent overweight. Examination of other behavioral (and non-behavioral) factors explaining the relationship between depression and overweight is warranted. PMID:25640769
Boegen, Anne, Ed.
Designed to offer guidelines, ideas and help to those who provide library service to young adults, this manual includes information about the provision of young adult (YA) services in six sections. The first section, which addresses planning and administration, includes a definition of a young adult and a checklist for determining community needs…
Lou, Chaohua; Cheng, Yan; Gao, Ersheng; Zuo, Xiayun; Emerson, Mark R.; Zabin, Laurie S.
Background Evidence in western countries indicates that the media have associations with adolescents’ and young people’ sexual behavior that may be as important as family, school and peers. In this new study of Asian adolescents and young adults in the three cities of Hanoi, Shanghai and Taipei, the associations between exposure to sexual content in the media and adolescents’ and young adults’ sex-related knowledge, attitudes and behaviors are explored in societies with traditional Confucian culture, but at different stages in the process of modernization. Method The data are from a questionnaire-based cross-sectional study conducted from 2006 to 2007 where a sample of 17,016 adolescents and young adults aged 15–24 years from Shanghai, Hanoi and Taipei completed face-to-face interviews coupled with computer-assisted self-interviews (CASI) for sensitive questions. For the objectives of this paper, analysis was restricted to the 16,554 unmarried respondents. Exposure to sexual content in the mass media (including the Internet and traditional media), pornographic videos, and a preference for western/Asian movies/videos were the main media influence measures. Sex-related knowledge, premarital sexual permissiveness, and sex-related behaviors were the main outcome measures. The impact of each of four contexts including family, peer, school and media on sex-related knowledge, attitudes and behaviors were assessed using multiple linear regression stratified by gender and city, controlling for age, urban/rural residence, education and economic status. The change in adjusted R2 from the multiple linear regression analysis was adopted to indicate the contribution of family, peer, school and media variables to respondents’ sex-related knowledge, attitudes and behaviors. Results The contextual factors, including family, peer, school and media, explained 30–50% of the variance in sex-related knowledge, 8–22% of the variance in premarital sexual permissiveness and
Jiwani, Alisha; Ketchum, Norma S.; Cornell, John; Williams, Ronald; Heim-Hall, Josefine; Hung, Jaclyn Y.; Langevin, Anne-Marie
Background: Osteosarcoma is the most common bone malignancy in children, adolescents, and young adults. Most study cohorts have 10% to 15% Hispanic patients that encompass many different Hispanic backgrounds. This study characterizes the effect of mainly Mexican American ethnicity on the outcome of children, adolescents, and young adults with osteosarcoma. Methods: A retrospective analysis of demographics, tumor characteristics, response to treatment, and survival outcome of all localized osteosarcoma of the extremity patients below 30 years of age was performed. A Kaplan-Meier estimates with log-rank tests and Cox proportional hazard regression models were used. Results: Fifty patients (median age, 15; range, 2 to 28 y) with localized high-grade osteosarcoma of the extremity were diagnosed between January 2000 and December 2010. The cohort was 70% Mexican Americans. With a median follow-up of 39 months (range, 5 to 142 mo), patients had a 5-year overall survival and event-free survival of 65% and 48%, respectively. We observed a significantly decreased 5-year event-free survival in patients diagnosed before age 12 relative to patients diagnosed between ages 12 and 29 (11% vs. 57%, P<0.001). We also found that tumor necrosis was not predictive of outcome in our patients. Conclusions: The preadolescent patients of predominately Mexican American ethnicity had an increased rate of relapse when compared with previous studies. Tumor necrosis is not directly predictive of outcome in this population. PMID:24487915
Lin, Ashleigh; Yung, Alison R; Wigman, Johanna T W; Killackey, Eoin; Baksheev, Gennady; Wardenaar, Klaas J
The Mood and Anxiety Symptoms Questionnaire (MASQ) was developed to measure the symptom-dimensions of the tripartite model of anxiety and depression. A 30-item short adaptation of the MASQ (MASQ-D30) was previously developed and validated in adult psychiatric outpatients. The aim of the present study was to evaluate the validity and reliability of the MASQ-D30 in a sample of adolescents and young adults. Help-seeking adolescents from Australia (N=147; mean age: 17.7 years; 58.8% female) completed the original, 90-item MASQ. Confirmatory Factor Analysis (CFA) was used to evaluate the construct validity (a 3-factor structure) of the original MASQ and the MASQ-D30. Internal consistencies and correlations with other instruments were calculated and compared between versions. CFA showed that the intended 3-factor structure fit adequately to the MASQ-D30 data (CFI=0.95; RMSEA=0.08). Internal consistencies ranged from 0.85 to 0.92 across the scales and patterns of correlations with the Center for Epidemiological Studies-Depression (CES-D) indicated adequate convergent/divergent properties. Importantly, the observed psychometric characteristics were comparable with the original MASQ and alternative short-forms. Results indicated that the MASQ-D30 is a valid and reliable instrument in young people, allowing for quick assessment of the tripartite dimensions of depression and anxiety.
Finestack, Lizbeth H.; Abbeduto, Leonard
Purpose: This study examined the expressive language abilities of a subset of highly verbally expressive adolescents and young adults with Down syndrome (DS) and those with fragile X syndrome (FXS) for evidence of syndrome-related differences. FXS gender differences were also examined in an exploratory fashion. Method: We evaluated 24 adolescents and young adults with DS, 17 of those with FXS, and 21 children with typical development (TD), with the groups matched on nonverbal mental age. Language ability was examined using the Oral and Written Language Scales (OWLS; Carrow-Woolfolk, 1995) and Developmental Sentence Scoring (DSS; Lee, 1974) scores derived from an oral narrative language sample. Results: Study analyses revealed the following group differences: the FXS group outperformed the DS and TD groups on the OWLS measure; the TD group outperformed both other groups on some of the DSS measures; the FXS group outperformed the DS group on the DSS Sentence Point measure; and females with FXS outperformed males with FXS on several measures. Conclusions: The study results contribute to the ongoing construction of the language phenotypes of individuals with DS and individuals with FXS and support the conclusion that there are quantitative rather than qualitative differences in their expressive language profiles. PMID:20643789
Lin, Chien-Yu; Chen, Pau-Chung; Hsieh, Chia-Jung; Chen, Chao-Yu; Hu, Anren; Sung, Fung-Chang; Lee, Hui-Ling; Su, Ta-Chen
Phthalate has been used worldwide in various products for years. Little is known about the association between phthalate exposure and biomarkers of oxidative stress in adolescents and young adults. Among 886 subjects recruited from a population-based cohort during 2006 to 2008, 751 subjects (12–30 years) with complete phthalate metabolites and oxidation stress measurement were enrolled in this study. Nine urine phthalate metabolites, 8-hydroxydeoxyguanosine (8-OHdG), and 8-iso prostaglandin F2α (8-isoPGF2α) were measured in urine to assess exposure and oxidative stress to DNA and lipid, respectively. Multiple linear regression analysis revealed that an ln-unit increase in mono-methyl phthalate (MMP) concentration in urine was positively associated with an increase in urine biomarkers of oxidative stress (in μg/g; creatinine of 0.098 ± 0.028 in 8-OHdG; and 0.253 ± 0.051 in 8-isoPGF2α). There was no association between other eight phthalate metabolite concentrations and oxidative stress. In conclusion, a higher MMP concentration in urine was associated with an increase in markers of oxidative stress to DNA and lipid in this cohort of adolescents and young adults. Further studies are warranted to clarify the causal relationship between exposure to phthalate and oxidative stress. PMID:28290483
Murphy, Jeremy W; Foxe, John J; Molholm, Sophie
The ability to attend to one among multiple sources of information is central to everyday functioning. Just as central is the ability to switch attention among competing inputs as the task at hand changes. Such processes develop surprisingly slowly, such that even into adolescence, we remain slower and more error prone at switching among tasks compared to young adults. The amplitude of oscillations in the alpha band (~8-14 Hz) tracks the top-down deployment of attention, and there is growing evidence that alpha can act as a suppressive mechanism to bias attention away from distracting sensory input. Moreover, the amplitude of alpha has also been shown to be sensitive to the demands of switching tasks. To understand the neural basis of protracted development of these executive functions, we recorded high-density electrophysiology from school-aged children (8-12 years), adolescents (13-17), and young adults (18-34) as they performed a cued inter-sensory selective attention task. The youngest participants showed increased susceptibility to distracting inputs that was especially evident when switching tasks. Concordantly, they showed weaker and delayed onset of alpha modulation compared to the older groups. Thus the flexible and efficient deployment of alpha to bias competition among attentional sets remains underdeveloped in school-aged children.
Lin, Chien-Yu; Chen, Pau-Chung; Hsieh, Chia-Jung; Chen, Chao-Yu; Hu, Anren; Sung, Fung-Chang; Lee, Hui-Ling; Su, Ta-Chen
Phthalate has been used worldwide in various products for years. Little is known about the association between phthalate exposure and biomarkers of oxidative stress in adolescents and young adults. Among 886 subjects recruited from a population-based cohort during 2006 to 2008, 751 subjects (12–30 years) with complete phthalate metabolites and oxidation stress measurement were enrolled in this study. Nine urine phthalate metabolites, 8-hydroxydeoxyguanosine (8-OHdG), and 8-iso prostaglandin F2α (8-isoPGF2α) were measured in urine to assess exposure and oxidative stress to DNA and lipid, respectively. Multiple linear regression analysis revealed that an ln-unit increase in mono-methyl phthalate (MMP) concentration in urine was positively associated with an increase in urine biomarkers of oxidative stress (in μg/g creatinine of 0.098 ± 0.028 in 8-OHdG; and 0.253 ± 0.051 in 8-isoPGF2α). There was no association between other eight phthalate metabolite concentrations and oxidative stress. In conclusion, a higher MMP concentration in urine was associated with an increase in markers of oxidative stress to DNA and lipid in this cohort of adolescents and young adults. Further studies are warranted to clarify the causal relationship between exposure to phthalate and oxidative stress.
Wickström, Anette; Hasselblad, Tove; Dahllöf, Göran
Patients with Amelogenesis imperfecta (AI) can present with rapid tooth loss or fractures of enamel as well as alterations in enamel thickness, color, and shape; factors that may compromise aesthetic appearance and masticatory function. The aim was to explore the experiences and perceptions of adolescents and young adults living with AI and receiving early prosthetic therapy. Seven patients with severe AI aged 16 to 23 years who underwent porcelain crown therapy participated in one-to-one individual interviews. The interviews followed a topic guide consisting of open-ended questions related to experiences of having AI. Transcripts from the interviews were analyzed using thematic analysis. The analysis process identified three main themes: Disturbances in daily life, Managing disturbances, and Normalization of daily life. These themes explain the experiences of patients living with enamel disturbances caused by AI and receiving early crown therapy. Experiences include severe pain and sensitivity problems, feelings of embarrassment, and dealing with dental staff that lack knowledge and understanding of their condition. The patients described ways to manage their disturbances and to reduce pain when eating or drinking, and strategies for meeting other people. After definitive treatment with porcelain crown therapy, they described feeling like a normal patient. In conclusion the results showed that adolescents and young adults describe a profound effect of AI on several aspects of their daily life. PMID:27359125
Popovici, Ioana; Homer, Jenny F.; Fang, Hai; French, Michael T.
Background A positive relationship between alcohol use and criminal activity has been well documented among adults, but fewer studies explore this relationship among adolescents. Methods Using data from four waves of the National Longitudinal Study of Adolescent Health (Add Health), we examine alcohol use patterns and criminal activity from adolescence to young adulthood. Fixed-effects models partially address the potential endogeneity of alcohol use, and, because numerous studies indicate that males are more likely than females to engage in drinking and criminal activity, the analyses are segmented by gender. Results We find a strong positive relationship between alcohol consumption, the commission of crimes, and criminal victimization for both genders. Various sensitivity analyses and robustness checks support this core finding. Conclusions Our results have important policy implications, as public policy tools that aim to reduce drinking among adolescents could also reduce criminal activity. Moreover, effective alcohol abuse treatment may indirectly reduce delinquency and thus have greater long-term economic benefits than previously estimated. PMID:22168924
Ding, Yingying; He, Na; Detels, Roger
We examined the association between adolescent sexual debut and age at new-type drug initiation among a sample of young adult new-type drug users. A total of 276 participants were recruited using respondent-driven sampling (RDS) in Shanghai, China. The analyses were restricted to a total of 201 participants aged between 18 and 30 years. The average age at sexual debut and age at first new-type drug use were 18.8 and 20.9 years, respectively. About 94% of participants reported having sexual experience (n=188); of those, 137 (72.9%) had sexual debut before they first used new-type drugs, while 32 (17.0%) initiated both events at the same age. After adjustment for age, income, education, and sexual orientation, adolescent sexual debut was independently associated with younger age at new-type drug initiation. Adolescent sexual debut is associated with early onset of new-type drug use. Our findings underscore the importance of implementing sex-education programs for adolescents in schools in China.
Calling, Susanna; Palmér, Karolina; Jönsson, Lena; Sundquist, Jan; Winkleby, Marilyn; Sundquist, Kristina
Aim Preterm birth is associated with a number of physical and mental health issues. The aim of this study was to find out if there was also any association between individuals born preterm in Sweden between 1984 and 2006 and the risk of unintentional injuries during childhood, adolescence and young adulthood. Methods The study followed 2,297,134 individuals, including 5.9% born preterm, from 1985 to 2007 for unintentional injuries leading to hospitalisation or death (n=244,021). The males and females were divided into four age groups: 1–5 years, 6–12 years, 13–18 years and 19–23 years. Hazard ratios were calculated for falls, transport injuries and other injuries. Results After adjusting for a comprehensive set of covariates, some of the preterm subgroups demonstrated slightly increased risks of unintentional injuries, while others showed slightly decreased risks. However, most of the estimates were borderline or non-significant in both males and females. In addition, the absolute risk differences between individuals born preterm and full term were small. Conclusion Despite the association between preterm birth and a variety of physical and mental health consequences, this study shows that there is no consistent risk pattern between preterm birth and unintentional injuries in childhood, adolescence and young adulthood. PMID:23181809
Kavanaugh, Megan L.; Frohwirth, Lori; Jerman, Jenna; Popkin, Ronna; Ethier, Kathleen
Study objective To describe and explore provider- and patient-level perspectives regarding long-acting reversible contraception (LARC) for teens and young adults (ages 16-24). Methods Data collection occurred between June – December 2011. We first conducted telephone interviews with administrative directors at 20 publicly funded facilities that provide family planning services. At six of these sites, we conducted a total of six focus group discussions (FGDs) with facility staff and forty-eight in-depth interviews (IDIs) with facility clients ages 16-24. Results Staff in the FGDs did not generally equate being a teen with ineligibility for IUDs. In contrast to staff, one quarter of the young women did perceive young age as rendering them ineligible. Clients and staff agreed that the “forgettable” nature of the methods and their duration were some of LARC’s most significant advantages. They also agreed that fear of pain associated with both insertion and removal and negative side effects were disadvantages. Some aspects of IUDs and implants were perceived as advantages by some clients but disadvantages by others. Common challenges to providing LARC-specific services to younger patients included extra time required to counsel young patients about LARC methods, outdated clinic policies requiring multiple visits to obtain IUDs, and a perceived higher removal rate among young women. The most commonly cited strategy for addressing many of these challenges was securing supplementary funding to support the provision of these services to young patients. Conclusion Incorporating young women’s perspectives on LARC methods into publicly funded family planning facilities’ efforts to provide these methods to a younger population may increase their use among young women. PMID:23287602
Bathgate, Katherine E.; Sherriff, Jill L.; Leonard, Helen; Dhaliwal, Satvinder S.; Delp, Edward J.; Boushey, Carol J.; Kerr, Deborah A.
Technology-based methods for assessing diet in those with disability remains largely unexplored. The aim was to assess the feasibility of assessing diet with an image-based mobile food record application (mFR) in 51 adolescents and young adults with Down syndrome (PANDs). Adherence was also assessed with the instruction to include a fiducial marker object in the before and after eating images. The PANDs sample completed a four-day mFR and results were compared with a sample of young adults from the Connecting Health and Technology study (CHAT, n = 244). Compared to the CHAT sample, PANDs participants reported more fruit (2.2 ± 1.8 versus 1.0 ± 0.9 serves respectively) and vegetables (2.4 ± 1.3 versus 1.9 ± 1.0 serves, respectively), but no differences in energy-dense nutrient-poor (EDNP) foods and beverages were observed. Compared to CHAT, PANDs participants captured fewer images with the mFR (4.9 ± 2.3 versus 4.0 ± 1.5 images, respectively). Adherence to the instruction to include the fiducial marker in images was lower for PANDs compared with the CHAT sample (90.3% versus 96.5%). Due to the quality of information captured in images and the high acceptability of the fiducial marker, the mFR shows great promise as a feasible method of assessing diet in adolescents and young adults with Down syndrome. PMID:28335382
Schmidt-Grimminger, Delf; Frerichs, Leah; Black Bird, Arlene E; Workman, Karen; Dobberpuhl, Mitchell; Watanabe-Galloway, Shinobu
Native American women in the Northern Plains have a high prevalence of human papillomavirus (HPV) and high incidence of cervical disease and cervical cancer. HPV vaccination coverage is shown to be lower among nonwhite populations and disparity populations. We assessed HPV knowledge, attitudes, and beliefs towards HPV and HPV vaccination during a community-based participatory research project among tribal youth, young adults, parents, and health professionals. In 2009, we recruited a total of 73 individuals to participate in four tribal focus groups: tribal health providers, (n=10), Indian Health Service providers (n=7), young adult women ages 19-26 (n=22), girls (14-18) (n=18), and parents (n=16). Of these, 62 (84.93 %) completed a survey, which included 10 healthcare providers, 22 young adults, 14 teens, and 16 parents. We employed a qualitative thematic analysis of focus group transcript data and conducted frequency analysis of survey data, which were both reviewed and triangulated by a Community Advisory Board. Based on the results of this study, the tribal community advisory board identified local tribal settings for interventions to increase HPV vaccination coverage through health education classes and a school-based vaccination clinic. In addition to tribal community-wide education events to increase awareness of HPV disease, the HPV vaccine, provider-specific training was identified as a potential intervention. These community-based focus group findings underscore the importance of locally and cultural tailored educational interventions to further increase HPV knowledge and HPV vaccination among disparate populations like American Indian adolescent and young adult women.
Weiss, Aaron R; Nichols, Craig R; Freyer, David R
Adolescent and Young Adult Oncology (AYAO, including patients 15-39 years of age) is an emerging discipline in the field of cancer treatment and research. Poorer survival outcomes for this population and characteristic age-related challenges in care have called attention to the need for increased AYAO research. This chapter outlines pressing questions and reviews recent progress in AYAO research within the current organizational structure of the federal clinical trials enterprise, emphasizing how the United States National Cancer Institute's National Clinical Trials Network (NCTN) has created novel opportunities for collaborative AYAO research among the pediatric and adult NCTN groups. Potential strategies for expanding AYAO research, both within the NCTN and with other partners in the federal and advocacy domains are identified.
Skehan, Brian; Davis, Maryann
Transitional age youth (TAY) are in a discrete developmental stage, different from both adolescents and mature adults. Serious mental illness can result in their delayed psychosocial development and morbidity. Systemic, provider, and individual barriers result in poor access to care for these youth, potentially impeding their transition to mature adulthood. Current strategies for TAY treatment include patient centered care, vocational and educational support, and shared decision making. There is a paucity of evidence-based practices to effectively treat this population or provide practice guidelines. The research required to do so should be a priority.
Hooven, Carole; Snedker, Karen A.; Thompson, Elaine Adams
Young adult suicide is an important social problem, yet little is known about how risk for young adult suicide develops from earlier life stages. In this study the authors report on 759 young adults who were potential high school dropouts as youth. At both adolescence and young adulthood, measures of suicide risk status and related suicide risk…
Chondronikola, Maria; Sidossis, Labros S; Richardson, Lisa M; Temple, Jeff R; van den Berg, Patricia A; Herndon, David N; Meyer, Walter J
Burn injury deformities and obesity have been associated with social integration difficulty and body image dissatisfaction. However, the combined effects of obesity and burn injury on social integration difficulty and body image dissatisfaction are unknown. Adolescent and young adult burn injury survivors were categorized as normal weight (n = 47) or overweight and obese (n = 21). Burn-related and anthropometric information were obtained from patients' medical records, and validated questionnaires were used to assess the main outcomes and possible confounders. Analysis of covariance and multiple linear regressions were performed to evaluate the objectives of this study. Obese and overweight burn injury survivors did not experience increased body image dissatisfaction (12 ± 4.3 vs 13.1 ± 4.4; P = .57) or social integration difficulty (17.5 ± 6.9 vs 15.5 ± 5.7; P = .16) compared with normal weight burn injury survivors. Weight status was not a significant predictor of social integration difficulty or body image dissatisfaction (P = .19 and P = .24, respectively). However, mobility limitations predicted greater social integration difficulty (P = .005) and body image dissatisfaction (P < .001), whereas higher weight status at burn was a borderline significant predictor of body image dissatisfaction (P = .05). Obese and overweight adolescents and young adults, who sustained major burn injury as children, do not experience greater social integration difficulty and body image dissatisfaction compared with normal weight burn injury survivors. Mobility limitations and higher weight status at burn are likely more important factors affecting the long-term social integration difficulty and body image dissatisfaction of these young people.
van der Meijden, Wisse P.; Van Someren, Jamie L.; te Lindert, Bart H.W.; Bruijel, Jessica; van Oosterhout, Floor; Coppens, Joris E.; Kalsbeek, Andries; Cajochen, Christian; Bourgin, Patrice; Van Someren, Eus J.W.
Study Objectives: Individual differences in sleep timing have been widely recognized and are of particular relevance in adolescents and young adults who often show mild to severely delayed sleep. The biological mechanisms underlying the between-subject variance remain to be determined. Recent human genetics studies showed an association between sleep timing and melanopsin gene variation, but support for functional effects on downstream pathways and behavior was not demonstrated before. We therefore investigated the association between the autonomic (i.e., pupil diameter) and behavioral (i.e., sleep timing) readouts of two different downstream brain areas, both affected by the same melanopsin-dependent retinal phototransduction: the olivary pretectal nucleus (OPN) and the suprachiasmatic nucleus (SCN). Methods: Our study population included 71 healthy individuals within an age range with known vulnerability to a delayed sleep phase (16.8–35.7 y, 37 males, 34 females). Pupillometry was performed to estimate functionality of the intrinsic melanopsin-signaling circuitry based on the OPN-mediated post-illumination pupil response (PIPR) to blue light. Sleep timing was quantified by estimating the SCN-mediated mid-sleep timing in three different ways in parallel: using a chronotype questionnaire, a sleep diary, and actigraphy. Results: All three measures consistently showed that those individuals with a later mid-sleep timing had a more pronounced PIPR (0.03 < P < 0.05), indicating a stronger blue-light responsiveness of the intrinsic melanopsin-based phototransduction circuitry. Conclusions: Trait-like individual differences in the melanopsin phototransduction circuitry contribute to individual differences in sleep timing. Blue light-sensitive young individuals are more prone to delayed sleep. Citation: van der Meijden WP, Van Someren JL; te Lindert BH, Bruijel J, van Oosterhout F, Coppens JE, Kalsbeek A, Cajochen C, Bourgin P, Van Someren EJ. Individual differences in
Green, Kerry M.; Musci, Rashelle J.; Johnson, Renee M.; Matson, Pamela A.; Reboussin, Beth A.; Ialongo, Nicholas S.
Objective This study identifies and compares outcomes in young adulthood associated with longitudinal patterns of alcohol and marijuana use during adolescence among urban youth. Method Data come from a cohort of 678 urban, predominantly Black children followed from ages 6–25 (1993–2012). Analyses are based on the 608 children who participated over time (53.6% male). Longitudinal patterning of alcohol and marijuana use were based on annual frequency reports from grades 8–12 and estimated through latent profile analysis. Results We identified four classes of alcohol and marijuana use including Non-Use (47%), Moderate Alcohol Use (28%), Moderate Alcohol/Increasing Marijuana Use (12%) and High Dual Use (13%). A marijuana only class was not identified. Analyses show negative outcomes in adulthood associated with all three adolescent substance use classes. Compared to the non-use class, all use classes had statistically significantly higher rates of substance dependence. Those in the ‘High Dual Use’ class had the lowest rate of high school graduation. Comparing classes with similar alcohol but different marijuana patterns, the ‘Moderate Alcohol/Increasing Marijuana Use’ class had a statistically significant increased risk of having a criminal justice record and developing substance use dependence in adulthood. Conclusion Among urban youth, heterogeneous patterns of alcohol and marijuana use across adolescence are evident, and these patterns are associated with distinct outcomes in adulthood. These findings suggest a need for targeted education and intervention efforts to address the needs of youth using both marijuana and alcohol, as well as the importance of universal early preventive intervention efforts. PMID:26517712
Ritterman Weintraub, Miranda Lucia; Fernald, Lia C.; Goodman, Elizabeth; Guendelman, Sylvia; Adler, Nancy E.
Highlights Different measures of social position capture unique dimensions of relative rank among youth. Youth-specific measures of social position may be important in identifying the most at-risk for obesity. Lower social status youth are more likely to be at-risk for obesity-related behaviors compared to those with a higher rank. This cross-sectional study examines multiple dimensions of social position in relation to obesity-related behaviors in an adolescent and young adult population. In addition to using conventional measures of social position, including parental education and household expenditures, we explore the usefulness of three youth-specific measures of social position – community and society subjective social status and school dropout status. Data are taken from a 2004 house-to-house survey of urban households within the bottom 20th percentile of income distribution within seven states in Mexico. A total of 5,321 Mexican adolescents, aged 12–22 years, provided information on obesity-related behaviors (e.g., diet, physical activity, sedentary behavior) and indicators of subjective and objective social position. A parent in each household provided information on socioeconomic status of the parent and household. Ordinal logistic regressions are used to estimate the associations of parental, household and adolescent indicators of social position and obesity-related risk behaviors. Those adolescents with the highest odds of adopting obesity risk behaviors were the ones who perceived themselves as lower in social status in reference to their peer community and those who had dropped out of school. We found no significant associations between parental education or household expenditures and obesity-related risk behaviors. Immediate social factors in adolescents’ lives may have a strong influence on their health-related behaviors. This study provides evidence for the usefulness of two particular measures, both of which are youth
García-Romero, Maria T; Geller, Alan C; Kawachi, Ichiro
Skin cancer represents an important public health problem, and it is associated with ultraviolet radiation exposure, particularly at early ages. Unhealthy sun exposure and intentional tanning continue to be the trend among young people. Multiple interventions to raise awareness of the risks of sun exposure have been implemented, without necessarily translating into decreased unhealthy behaviors or skin cancer incidence rates. Behavioral economics adds a set of concepts and tools to potentially boost the efficacy of existing approaches to decrease unhealthy sun exposure. This paper reviews public health interventions that have been based in behavioral economics concepts and their results, and provides examples of new and creative ways physicians and health professionals can actively apply insights from behavioral economics to counsel teenagers and young adults about skin cancer prevention.
The Bookmark, 1985
Eight articles in this Spring 1985 issue of The Bookmark focus on young adult library services. In addition to these thematic articles, an introduction and three reports are presented. The issue contains: (1) "In Perspective" (E. J. Josey); (2) "Young Adult Literature in the 1980's--Awesome!" (Ellin Chu); (3) "Young Adult…
Mann, Joshua R.; Royer, Julie A.; Turk, Margaret A.; McDermott, Suzanne; Holland, Margaret M.; Ozturk, Orgul D.; Hardin, James W.; Thibadeau, Judy K.
Objective To compare emergency room (ER) and inpatient hospital (IP) use rates for persons with spina bifida (SB) to peers without SB, when transition from pediatric to adult health care is likely to occur; and to analyze those ER and IP rates by age, race, socioeconomic status, gender, and type of residential area. Design A retrospective cohort study. Setting Secondary data analysis in South Carolina. Participants We studied individuals who were between 15 and 24 years old and enrolled in the State Health Plan (SHP) or state Medicaid during the 2000–2010 study period. Methods Individuals with SB were identified using ICD-9 billing codes (741.0, 741.9) in SHP, Medicaid, and hospital uniform billing (UB) data. ER and IP encounters were identified using UB data. Multivariable Generalized Estimating Equation (GEE) Poisson models were estimated to compare rates of ER and IP use among the SB group to the comparison group. Main Outcome Measures Total ER rate and IP rate, in addition to cause-specific rates for ambulatory care sensitive conditions (ACSC) and other condition categories. Results We found higher rates of ER and IP use in persons with SB compared to the control group. Among individuals with SB, young adults (those 20–24 years old) had higher rates of ER use due to all ACSC (P = .023), other ACSC (P = .04), and urinary tract infections (UTI; P = .002) compared to adolescents (those 15–19 years old). Conclusions Young adulthood is associated with increased ER use overall, as well as in specific condition categories (most notably UTI) in individuals 15–24 years old with SB. This association may be indicative of changing healthcare access as people with SB move from adolescent to adult health care, and/or physiologic changes during the age range studied. PMID:25511690
Ziermans, Tim B.
Working memory (WM) impairment is a common feature in individuals with schizophrenia and high-risk for psychosis and a promising target for early intervention strategies. However, it is unclear to what extent WM impairment parallels specific behavioral symptoms along the psychosis continuum. To address this issue, the current study investigated the relation of WM capacity with psychotic-like experiences (PLEs) in a large Swedish population sample (N = 1012) of adolescents and young adults (M = 24.4 years, range 12–35). WM was assessed with two online computer tasks: a task where participants had to identify and remember the location of an odd shape and a task of remembering and following instructions. PLE scores were derived from a translated symptom questionnaire (Community Assessment of Psychic Experiences), which includes positive, negative, and depressive symptom scales. Positive and negative symptom scales were further subdivided into symptom clusters based on factor analyses. The results showed that low WM capacity was modestly associated with increased reports of bizarre experiences (BE) and depressive symptoms, after controlling for age, gender, and global symptom scores. Interestingly, when analyses were repeated for separate age groups, low WM was exclusively associated with a higher frequency of BE for young adults (20–27 years) and with depressive symptoms for older adults (28–35 years). These findings suggest that specific PLEs can be indicative of reduced WM capacity in early adulthood, which in turn may reflect an increased risk for psychosis and a greater need for targeted intervention. In contrast, during adolescence individual differences in cognitive development may influence the strength of the relationships and thereby mask potential vulnerabilities for psychopathology. PMID:24348432
Reingle, Jennifer M; Maldonado-Molina, Mildred M
The purpose of this article is to evaluate the victim-offender overlap among a nationally representative sample of Native American adolescents and young adults. Data for this study were obtained from 338 Native American youth who participated in the National Longitudinal Study of Adolescent Health (Add Health) Waves I-IV. Group-based trajectory modeling was used to estimate trajectories of violence and victimization separately. Bivariate tests were used to assess the overlap between victimization and violent trajectory groups. Multinomial regression procedures were used to assess the predictors of victimization, offending, and the overlap category of both victimization and offending. Three trajectory groups were found for violence (nonviolent, escalators, and desistors) and victimization (nonvictim, decreasing victimization, and increasing victimization). We found substantial evidence of an overlap between victimization and offending among Native Americans, as 27.5% of the sample reported both victimization and offending. Those in the overlap group had greater number of risk factors present at baseline. These results suggest that the victim-offender overlap is present in Native American adolescents. Explanations and implications are discussed.
Braams, Barbara R.; Peper, Jiska S.; van der Heide, Dianne; Peters, Sabine; Crone, Eveline A.
During adolescence there is a normative increase in risk-taking behavior, which is reflected in, for example, increases in alcohol consumption. Prior research has demonstrated a link between testosterone and alcohol consumption, and between testosterone and neural responses to rewards. Yet, no study to date tested how testosterone levels and neural responses to rewards relate to and predict individual differences in alcohol use. The current study aimed to investigate this by assessing alcohol use, testosterone levels and neural responses to rewards in adolescents (12–17 years old) and young adults (18–26 years old). Participants were measured twice with a two-year interval between testing sessions. Cross-sectional analysis showed that at the second time point higher neural activity to rewards, but not testosterone levels, explained significant variance above age in reported alcohol use. Predictive analyses showed that, higher testosterone level at the first time point, but not neural activity to rewards at the first time point, was predictive of more alcohol use at the second time point. These results suggest that neural responses to rewards are correlated with current alcohol consumption, and that testosterone level is predictive of future alcohol consumption. These results are interpreted in the context of trajectory models of adolescent development. PMID:26771250
Braams, Barbara R; Peper, Jiska S; van der Heide, Dianne; Peters, Sabine; Crone, Eveline A
During adolescence there is a normative increase in risk-taking behavior, which is reflected in, for example, increases in alcohol consumption. Prior research has demonstrated a link between testosterone and alcohol consumption, and between testosterone and neural responses to rewards. Yet, no study to date tested how testosterone levels and neural responses to rewards relate to and predict individual differences in alcohol use. The current study aimed to investigate this by assessing alcohol use, testosterone levels and neural responses to rewards in adolescents (12-17 years old) and young adults (18-26 years old). Participants were measured twice with a two-year interval between testing sessions. Cross-sectional analysis showed that at the second time point higher neural activity to rewards, but not testosterone levels, explained significant variance above age in reported alcohol use. Predictive analyses showed that, higher testosterone level at the first time point, but not neural activity to rewards at the first time point, was predictive of more alcohol use at the second time point. These results suggest that neural responses to rewards are correlated with current alcohol consumption, and that testosterone level is predictive of future alcohol consumption. These results are interpreted in the context of trajectory models of adolescent development.
Nilsen, Alleen Pace; Donelson, Kenneth L.
Reflecting the rapid changes that have occurred in young adult literature, this second edition provides teachers with the history and background needed to stay current with what adolescents are reading and how such literature can be taught. The book is organized much as a literature course is taught: first, an introduction to young adults and…
Capone, George T.; Aidikoff, Jenna M.; Goyal, Parag
Caretakers of adolescents and young adults with Down syndrome (DS) may report the onset of a depressive illness in previously mentally well individuals. However, the behavioral phenomenology of these conditions has not been well characterized. We ascertained a cohort of DS patient-subjects presenting to a specialty clinic with medical and/or…
Estévez Gutiérrez, Ana; Herrero Fernández, David; Sarabia Gonzalvo, Izaskun; Jáuregui Bilbao, Paula
The way emotions are regulated might affect the engagement on risk behaviors in adolescents and young adults. Therefore, studying the relationship between these variables could be of great importance. Some of the less studied risky behaviors are pathological gambling, and Internet and videogame abuse. This research aims to analyze the existing relationship between such risky behaviors, emotion regulation, and dysfunctional psychological symptomatology (depression, anxiety, phobic anxiety, somatization, obsessive-compulsive behavior, interpersonal sensitivity, hostility, paranoid ideation, and psychoticism). In addition, it also looks to assess whether emotional regulation plays a mediating role between pathological gambling, and Internet and videogame abuse, and psychological symptomatology. The sample was composed of 1312 young adults and adolescents, aged between 12 and 30, recruited from scholar centers, universities and free time groups, and from associations and centers associated with FEJAR (Spanish Federation of Rehabilitated Gamblers). Participants completed measurements of impulsive behavior, emotion regulation, and dysfunctional symptomatology. Results showed that there is generally a positive and significant relation between these variables. Moreover, it has been pointed out that emotion regulation mediates the association between impulsive behavior and dysfunctional symptomatology among those young adults and adolescents who engage in these impulsive behaviors, except for the relation between videogame abuse and depressive symptomatology. Training in emotional regulation skills could be useful in dealing with and treating this type of behaviors in adolescents and young adults.
Bullis, Michael; And Others
This report describes the development and testing of two measures of job-related social behavior of adolescents and young adults, ages 14-21, with behavior disorders (BD). Following an introduction of the concept of job-related social behavior, detailed descriptive information and data are provided on development and field testing of the…
Rockers, K.; Ousley, O.; Sutton, T.; Schoenberg, E.; Coleman, K.; Walker, E.; Cubells, J. F.
Background: Approximately one-third of individuals with 22q11.2 deletion syndrome (22q11DS), a common genetic disorder highly associated with intellectual disabilities, may develop schizophrenia, likely preceded by a mild to moderate cognitive decline. Methods: We examined adolescents and young adults with 22q11DS for the presence of executive…
Afifi, Tamara D.; Schrodt, Paul
Tests the degree to which adolescents and young adults felt caught between their parents as a mediator between divorce and children's avoidance and satisfaction with them. Reveals that divorce was largely associated with avoidance and satisfaction through children's feelings of being caught, which were a function of their parents' demand-withdraw…
Lambert, M; Bock, T; Naber, D; Löwe, B; Schulte-Markwort, M; Schäfer, I; Gumz, A; Degkwitz, P; Schulte, B; König, H H; Konnopka, A; Bauer, M; Bechdolf, A; Correll, C; Juckel, G; Klosterkötter, J; Leopold, K; Pfennig, A; Karow, A
Numerous birth-control studies, epidemiological studies, and observational studies have investigated mental health and health care in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, treatment delay and course of illness. Moreover, the impact of the burden of illness, of deficits of present health care systems, and the efficacy and effectiveness of early intervention services on mental health were evaluated. According to these data, most mental disorders start during childhood, adolescence and early adulthood. Many children, adolescents and young adults are exposed to single or multiple adversities, which increase the risk for (early) manifestations of mental diseases as well as for their chronicity. Early-onset mental disorders often persist into adulthood. Service use by children, adolescents and young adults is low, even lower than for adult patients. Moreover, there is often a long delay between onset of illness and first adequate treatment with a variety of linked consequences for a poorer psychosocial prognosis. This leads to a large burden of illness with respect to disability and costs. As a consequence several countries have implemented so-called "early intervention services" at the interface of child and adolescent and adult psychiatry. Emerging studies show that these health-care structures are effective and efficient. Part 1 of the present review summarises the current state of mental health in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, and treatment delay with consequences.
Wedow, Robbee; Briley, Daniel A; Short, Susan E; Boardman, Jason D
In this paper, we investigate the possibility that genetic variation contributes to self-perceived weight status among adolescents and young adults in the U.S. Using samples of identical and fraternal twins across four waves of the National Longitudinal Study of Adolescent to Adult Health (Add Health) study, we calculate heritability estimates for objective body mass index (BMI) that are in line with previous estimates. We also show that perceived weight status is heritable (h(2) ∼ 0.47) and most importantly that this trait continues to be heritable above and beyond objective BMI (h(2) ∼ 0.25). We then demonstrate significant sex differences in the heritability of weight identity across the four waves of the study, where h(2)women = 0.39, 0.35, 0.40, and 0.50 for each wave, respectively, and h(2)men = 0.10, 0.10, 0.23, and 0.03. These results call for a deeper consideration of both identity and gender in genetics research.
Weintraub, Amy; Mellins, Claude A; Warne, Patricia; Dolezal, Curtis; Elkington, Katherine; Bucek, Amelia; Leu, Cheng-Shiun; Bamji, Mahrukh; Wiznia, Andrew; Abrams, Elaine J
Similar to same-age peers, perinatally HIV-infected (PHIV+) youth in the US are engaging in sex, including condomless sex. Understanding decisions about serostatus disclosure to sexual partners is important to domestic and global HIV prevention efforts, since large numbers of PHIV+ children are entering adolescence and becoming sexually active. Using Social Action Theory (SAT) to inform variable selection, we examined correlates of disclosure among 98 PHIV+ adolescents/young adults in New York City. Over half of these youth reported not disclosing to any casual partners (59 %) or to any partners when using condoms (55 %). In bivariate analyses, increased disclosure was associated with older age; being female; earlier age of learning one's serostatus; and increased STD knowledge, disclosure intentions, and parent-child communication. Multiple regression analyses revealed a strong fit with the SAT model. As with adults, disclosure to sexual partners is difficult for PHIV+ youth and challenges prevention efforts. Effective interventions that help youth with disclosure decisions are needed to curb the epidemic.
Upchurch, Dawn M; Wexler Rainisch, Bethany K
This study describes complementary and alternative medicine use among a national sample of young adults, with an emphasis on characterizing racial and ethnic differences, highlighting variation across subgroups of Hispanics. The authors examined young adults ages 18 to 27 years (n = 14 128) from wave III (2001-2002) of the National Longitudinal Study of Adolescent Health. Prevalence estimates and logistic regression results were weighted and adjusted for complex sample design. The study examined recent complementary and alternative medicine use in the past 12 months, recent use for each of 15 specific complementary and alternative medicine modalities, and the 5 most commonly used modalities (herbs, massage, chiropractic, relaxation, and vitamins). Results showed that 29% of young adults aged 18 to 27 years recently used complementary and alternative medicine. Prevalence was highest among Cuban Americans (42%) and lowest among blacks (22%). Young adults used a diversity of complementary and alternative medicine modalities and there were substantial differences in use across racial and ethnic groups.
Sharma, Kirti; Kathait, Atul; Jain, Asha; Kujur, Karmila; Raghuwanshi, Shirish; Bharti, Alok Chandra; Saklani, Asha Chandola; Das, Bhudev Chandra
Background Despite high prevalence of human papillomavirus (HPV) infection and cervical cancer in Indian women, no study has been done in tribal populations whose socio-sexual lifestyle is different. Therefore, HPV screening has been carried out in pre-adolescent, adolescent and young adult tribal girls using self-collected urine samples. Methods 20–35 ml self-collected midstream urine samples were obtained from a total of 2278 healthy tribal girls (9–25 years) comprising pre-adolescent, adolescent and young adults from three Indian states: Madhya Pradesh, Jharkhand and Chhattisgarh. β-globin positive 2034 samples were employed for HPV detection and genotyping. Results The overall prevalence of HPV infection in tribal girls was 12.9% (262/2034). More than 65% (172/262) of them were infected with HR-HPV types of which HPV16 was the most predominant type (54%). Young adult girls aged 18–25 years showed a significantly higher prevalence of HPV infection (19.2%; OR = 3.36; 95% CI 2.97–6.34, P<0.001) as compared to that in adolescent (11.4%; OR = 1.82; 95% CI 1.20–2.76, P<0.01) or pre-adolescent girls (6.6%). Conclusion This is a first study showing significantly a very high prevalence of HPV infection in adolescent and young adult tribal girls possibly due to different socio-sexual behavior, indicating a serious health concern for Indian tribal women. PMID:25954813
Radon, Katja; Fürbeck, Barbara; Thomas, Silke; Siegfried, Wolfgang; Nowak, Dennis; von Kries, Rüdiger
One component of the recent obesity epidemic is the sedentary behaviour of children and adolescents e.g., use of video games consoles. The new generation of video games requires body movements and might thus increase activity. The aim of this study was to evaluate whether such games could have an effect on physical activity in obese adolescents in a clinical setting. Between March and May 2007 activity-promoting video games ("apvg") were offered to all 84 inpatients (aged 13-28 years) registered in a long-term rehabilitation programme on a voluntary base. Reasons for (non-)attendance were assessed. Frequency and duration of use of the activity-promoting video game sessions were documented. Furthermore, heart rate and activity counts during use of "apvg", endurance training, and strength training were measured. Of 84 inpatients, 51 used the "apvg" at least once (69%) over the study period. The median weekly use of the intervention was 27 min during the first week (range 0-182 min), declining to zero (range 0-74 min) in week four. Mean heart rate during the sessions (mean 115 bpm; 95% confidence interval 108-122 bpm) was similar to the heart rate during strength training (106 bpm; 101-112 bpm). The results indicate that the video games could have an impact on the activity of obese adolescents and young adults. However, as the interest in the devices seems to be too low the suitability of them for weight reduction programmes in young people cannot be ensured.
Ziv, Ido; Kiasi, Mali
Studies of correlations between general internet use and psychological well-being have shown mixed results. The present study aimed to elucidate the relationship between Facebook use and psychological well-being, with mental resilience expected to moderate the relationship. Two hundred Israeli adolescents and young adults completed questionnaires assessing their Facebook use, mental resilience, and psychological well-being. Results showed that Facebook use was positively correlated with psychological well-being, and that this relationship was particularly strong for participants with low mental resilience. The findings support a positive effect of Facebook use as providing a virtual supportive community for individuals who may lack the social skills needed to develop social capital and confidence through traditional communication paths.
Karp, Sharon M; Gesell, Sabina B
The rise in the rate of obesity in school-aged children, adolescents, and young adults in the last 30 years is a clear healthcare crisis that needs to be addressed. Despite recent national reports in the United States highlighting positive downward trends in the rate of obesity in younger children, we are still faced with approximately 12.7 million children struggling with obesity. Given the immediate and long-term health consequences of obesity, much time and effort has been expended to address this epidemic. Yet, despite these efforts, we still only see limited, short-term success from most interventions. Without changes to how we address childhood obesity, we will continue to see inadequate improvements in the health of our children. Clinicians and researchers need to be lobbying for evidence-based policy changes, such as those identified by systems science, in order to improve the nation's health.
Nagel, Kim; Wizowski, Lindsay; Duckworth, JoAnn; Cassano, Jane; Hahn, Shirley Ann; Neal, Michael
Writing in plain language makes it easier for patients to read, understand, and make informed decisions about sperm banking. Greater attention to the issue and properly designed educational brochures for use by nurses in oncology and reproductive health is of evident importance but of unknown impact. A multidisciplinary clinical team followed an evidence-based, patient-centered approach to develop "plain language" patient education materials about sperm banking for adolescent and young adult (AYA) males with cancer. A patient education booklet was produced and implemented as part of the planned patient education for AYA male oncology patients at McMaster Children's Hospital, Hamilton Health Sciences, in Hamilton, Ontario, Canada. The patient education booklet for use by health professionals as a teaching tool to facilitate discussion with AYA males has been produced with the hope that it will contribute to better informed decision making regarding sperm banking and increased use of this technology for fertility preservation.
Soneji, Samir; Ambrose, Bridget K.; Lee, Won; Sargent, James; Tanski, Susanne
Objective We assess exposure to direct-to-consumer tobacco marketing and its association with ever having tried smoking, smoking within past 30 days (‘current’), and smoking ≥100 cigarettes in lifetime (‘established’) among adolescents and young adults. Methods We surveyed a U.S. telephone sample of 3,342 15–23 year olds and 2,541 respondents subsequently completed a web-based survey. Among respondents completing both the telephone and web-based surveys (N=2,541 [75%]), we assessed their exposure to direct-to-consumer tobacco marketing (receiving direct mail from tobacco companies and seeing tobacco company websites) and their associations with ever having tried smoking, current smoking, and established smoking. Results Overall, 12% of 15–17 year olds and 26% of 18–23 year olds were exposed to direct-to-consumer tobacco marketing. Racial/ethnic minority non-smoking respondents were more likely to see tobacco websites than non-smoking Whites. Respondents exposed to either form of direct-to-consumer tobacco marketing were more likely to currently smoke (adjusted odds ratio[AOR]: 2.2; 95% CI 1.3–3.8), while those exposed to both forms of marketing experienced even higher odds of currently smoking (AOR: 2.7; 95% CI 1.1–6.6). We observed similar relationships for ever having tried smoking and established smoking. Conclusions Direct-to-consumer tobacco marketing reaches adolescent and young adult non-smokers and is associated with smoking behavior. PMID:24661738
Schtscherbyna, Annie; Gouveia, Carla; Pinheiro, Maria Fernanda Miguens Castelar; Luiz, Ronir Raggio; Farias, Maria Lucia Fleiuss; Machado, Elizabeth Stankiewicz
The purpose was to determine the prevalence and related factors of vitamin D (VitD) insufficiency in adolescents and young adults with perinatally acquired human immunodeficiency virus. A cohort of 65 patients (17.6 ± 2 years) at the Federal University of Rio de Janeiro, Brazil, were examined for pubertal development, nutrition, serum parathormone and serum 25-hydroxyvitamin D [s25(OH)D]. s25(OH)D levels < 30 ng/mL (< 75 nmol/L) were defined as VitD insufficiency. CD4+ T-cell counts and viral load, history of worst clinical status, immunologic status as nadir, current immunologic status, and antiretroviral (ART) regimen were also evaluated as risk factors for VitD insufficiency. Mean s25(OH)D was 37.7 ± 13.9 ng/mL and 29.2% had VitD insufficiency. There was no difference between VitD status and gender, age, nutritional status, clinical and immunological classification, and type of ART. Only VitD consumption showed tendency of association with s25(OH)D (p = 0.064). Individuals analysed in summer/autumn season had a higher s25(OH)D compared to the ones analysed in winter/spring (42.6 ± 14.9 vs. 34.0 ± 11.9, p = 0.011). Although, the frequency of VitD insufficiency did not differ statistically between the groups (summer/autumn 17.9% vs. winter/spring 37.8%, p = 0.102), we suggest to monitor s25(OH)D in seropositive adolescents and young adults, especially during winter/spring months, even in sunny regions.
García-Cabrerizo, Rubén; García-Fuster, M Julia
While hippocampus is a brain region particularly susceptible to the effects of MDMA, the cellular and molecular changes induced by MDMA are still to be fully elucidated, being the dosage regimen, the species and the developmental stage under study great variables. This study compared the effects of one and four days of MDMA administration following a binge paradigm (3×5 mg/kg, i.p., every 2 h) on inducing hippocampal neurochemical changes in adolescent (PND 37) and young adult (PND 58) rats. The results showed that chronic MDMA caused hippocampal protein deficits in adolescent and young adult rats at different levels: (1) impaired serotonergic (5-HT2A and 5-HT2C post-synaptic receptors) and GABAergic (GAD2 enzyme) signaling, and (2) decreased structural cytoskeletal neurofilament proteins (NF-H, NF-M and NF-L). Interestingly, these effects were not accompanied by an increase in apoptotic markers. In fact, chronic MDMA inhibited proteins of the apoptotic pathway (i.e., pro-apoptotic FADD, Bax and cytochrome c) leading to an inhibition of cell death markers (i.e., p-JNK1/2, cleavage of PARP-1) and suggesting regulatory mechanisms in response to the neurochemical changes caused by the drug. The data, together with the observed lack of GFAP activation, support the view that chronic MDMA effects, regardless of the rat developmental age, extends beyond neurotransmitter systems to impair other hippocampal structural cell markers. Interestingly, inhibitory changes in proteins from the apoptotic pathway might be taking place to overcome the protein deficits caused by MDMA.
Hawkins, Amy; Evangeli, Michael; Sturgeon, Kate; Le Prevost, Marthe; Judd, Ali
ABSTRACT Due to the success of antiretroviral (ART) medications, young people living with perinatally acquired HIV (PHIV+) are now surviving into adolescence and young adulthood. Understanding factors influencing ART non-adherence in this group is important in developing effective adherence interventions. Most studies of ART adherence in HIV-positive populations assess differences in adherence levels and adherence predictors between participants, over a period of time (global adherence). Many individuals living with HIV, however, including PHIV+ young people, take medication inconsistently. To investigate this pattern of adherence, a within-participants design, focussing on specific episodes of adherence and non-adherence, is suitable (episodic adherence). A within-participants design was used with 29 PHIV+ young people (17 female, median age 17 years, range 14–22 years), enrolled in the UK Adolescents and Adults Living with Perinatal HIV cohort study. Participants were eligible if they could identify one dose of medication taken and one dose they had missed in the previous two months. For each of the two episodes (one adherent, one non-adherent), behavioural factors (whom they were with, location, routine, day, reminders) and psychological factors at the time of the episode (information about medication, adherence motivation, perceived behavioural skills to adhere to medication – derived from the Information-Motivation-Behavioural Skills (IMB) Model – and affect) were assessed in a questionnaire. Non-adherence was significantly associated with weekend days (Friday to Sunday versus Monday to Thursday, p = .001), lack of routine (p = .004), and being out of the home (p = .003), but not with whom the young person was with or whether they were reminded to take medication. Non-adherence was associated with lower levels of behavioural skills (p < .001), and lower positive affect (p = .005). Non-adherence was not significantly associated with
Kröner-Herwig, Birgit; Gorbunova, Anastasia; Maas, Jennifer
The aim of the current study was to identify predictors of recurrent headache and back pain in young adults (aged 18–27 years) from data assessed in childhood or adolescence, i.e., 9 years before the final survey. Our interest was whether psychological characteristics contribute to the risk of pain prevalence in adult age when controlling for already empirically supported risk factors such as parental pain, pediatric pain and sex. The study was part of a five-wave epidemiological investigation of >5000 families with children aged between 7 and 14 years when addressed first. In a multiple hierarchical regression analysis, the abovementioned three variables (Block-I variables) were entered first followed by five psychological trait variables (Block-II variables: internalizing, anxiety sensitivity, somatosensory amplification, catastrophizing and dysfunctional stress coping) to find out the extent of model improvement. The multivariable hierarchical regression analysis confirmed the hypothesis that the Block-I variables significantly enhance the risk of future pain at young adult age. None of the psychological variables did so. Thus, the hypothesis of a significant surplus predictive effect was not confirmed. The amount of total explained variance differed strongly between headache and back pain. In particular, a valid prediction of back pain was not possible. When analyzed separately in simple regression analysis, psychological variables turned out to be significant predictors, however, of very low effect size. The inclusion of Block-I variables in the model clearly reduced the impact of the psychological variables. This risk profile is discussed in the context of the different trajectories of headache and back pain from childhood to adult age, which were proposed by various studies. We propose that a biopsychological characteristic denoted as emotional negativity, especially regarding self-reference, might be a common factor behind all selected variables. Risk
LaVeist, Thomas A.; Zeno, Tia L.; Fesahazion, Ruth G.
This article explores the effects of being raised by married parents during childhood on health and well-being in adolescence and young adulthood in a longitudinal sample of African Americans. This study aims to address the following three questions: Does childhood with married parents lead to better health and well-being during adolescence? Does…
Dawson, Laura H; Shih, Mei-Chiung; de Moor, Carl; Shrier, Lydia
This study examined associations of psychological characteristics and sexual behavior with types of reasons for episodes of sexual intercourse among youth. After completing a baseline assessment, 62 adolescents (47 female) used a handheld computer to report when they had sex as soon as possible after the event as well as in response to random signals. Youth indicated for each sex event the main reason, categorized as intimacy/desire, external, affect management, and other; analyses were restricted to sex with a main partner (234 events). Baseline sexual behavior was not related to reasons for sex. Higher anxiety was associated with external reasons for sex; younger age and lower self-esteem were associated with affect management reasons. Female youth with higher impulsiveness reported more external reasons and fewer intimacy/desire reasons. Among male youth, lower self-esteem was associated with intimacy/desire reasons, but lower depression was associated with affect management reasons. These findings may aid health care providers and researchers in understanding the differences in young people's motivations for sex.
García-Baltazar, J; Figueroa-Perea, J G; Reyes-Zapata, H; Brindis, C; Pérez-Palacios, G
This article presents the preliminary findings of the Survey on Teenagers and Youth Reproductive Behavior in the Metropolitan Area of Mexico City, which contains information on 1,010 teenagers and young adults from 10 to 25 years of age interviewed in 1987. The average age was 17 years; 51.7 per cent of those interviewed were male and 48.3 per cent were female. A total of 14.6 per cent were married, being the average age at marriage 19.2 years for males and 17.8 years for females. Menarche occurred at an average age of 12.4 years, and spermarche at 14. Of those interviewed, 32.7 per cent have had sexual intercourse at least once in their lives. The average age at which sexual activity had begun, in the case of males, was 16 years and for females, 17 years. Of this group, 33.8 per cent stated that they had used some form of contraception during the first sexual intercourse; the contraceptive methods used most often were rhythm and withdrawal. The main source of supply of other methods is the pharmacy, in 67 per cent. 18.4 per cent of women had been pregnant, and 20.4 per cent of men's partners had presented this same condition. The first pregnancy occurred at 17.8 years for women and 18.7 for men. Of those men and women with a pregnancy experience 66.1 per cent and 57.3 per cent, respectively, stated that their first pregnancy was an unplanned one. Also, first pregnancy was related to their first marriage in 48.1 per cent of women and 82.4 per cent of male. The data presented here will reinforce current knowledge and will enable us to obtain a profile of the reproductive behavior of teenagers and young adults in the metropolitan area of Mexico City.
Spoth, Richard; Mason, W. Alex; Randall, G. Kevin; Redmond, Cleve; Schainker, Lisa
Depression symptoms are associated with impairments in functioning and have substantial health and economic consequences. Universal substance misuse prevention programs have shown effects on non-targeted mental health-related symptoms, but long-term effects are understudied. This cluster randomized controlled trial examined effects of both the LifeSkills Training (LST) and Strengthening Families Program: For Parents and Youth 10–14 (SFP 10–14) interventions, delivered during seventh grade, on age 22 young adult depression symptoms. The study was conducted in US rural Midwestern communities with a randomly-selected sample from a larger study (N= 670). Experimental conditions were LST+SFP 10–14, LST-only, and a control condition. Effects on age 22 depression symptoms were hypothesized as mediated through effects on age 21 relationship problems and illicit use of substances. Structural equation modeling with manifest and latent variables was conducted to test hypotheses; the intervention conditions were combined and compared with the control condition because analyses indicated a comparable pattern of effects between intervention conditions. Significant indirect intervention effects were found on age 22 depression symptoms via effects on the mediating variables (indirect effect: β=−0.06, 95 % CI [−0.10, −0.01], p=0.011). Effect sizes for the young adult variables were between d=0.17 and 0.29, which can be considered small, but nontrivial, especially in the context of public health benefits. Results support scaled-up implementation of school-based and family-focused universal substance misuse preventive interventions. PMID:25795013
Freixas Sepúlveda, Alejandra; Díaz Narváez, Víctor Patricio; Durán Agüero, Samuel; Gaete Verdugo, María Cristina
In order to analyze the usual consumption of vitamins in an adolescent population and young adult in the Metropolitan Region, were 213 food fortified with vitamins of the Chilean market. A survey of consumption and nutrient intake was calculated. The result added vitamins added to food. The normality of the variables of the intake was assessed and data were subjected to analysis of descriptive statisticians and percentiles are determined. Estimated percentages of subjects whose values exceed those fixed for DDR and UL listed for each vitamin and percentage of excess for each case. Discriminant analysis was performed using the M Box test. The correlation canonical and the Statisticians Wilks were estimated. Finally it was estimated the percentage of correctly classified data. Data were processed by the program SPSS 20.0 with a significance level of α ≤ 0.05. The results indicate that you for all the studied vitamins, the percentage of subjects who more than the DDR is for total folate (96.4%) and the lowest percentage is given for the vitamin E and B12 in young adult women. The percentage of subjects who exceed the UL values is greatest for the vitamin B3 (91.9%). According to the canonical correlation, there are differences in behavior between the groups. It is recommended to monitor the behavior and consumption of food fortified with vitamins, especially of the complex B and A.
This study undertook to assess the degree to which a person's sense of interconnectedness with others may have a mediating effect on whether one reacts to the consciousness of nuclear threat with feelings of despair (helplessness and hopelessness) or with a sense of empowerment (hope, efficacy, and action for change). Subjects included 119 public high school students and 14 Friends' school students, ranging from 12-18 years of age; 58 university students ranging from 18-25 years of age; and 24 parents of public school students, 10 adult Friends, and 38 members of Physicians for Social Responsibility, ranging from 20-83 years of age. A self-rating questionnaire was administered to assess subjects' conscious level of concern about nuclear issues, feelings of connectedness with others in general and about nuclear concerns, feelings of hope and efficacy in general and with regard to nuclear issues, and participation in activities reflecting concerns about nuclear threat. Correlational analyses (multiple regression, Spearman Rho, Kendall's Tau) showed that general feelings of hope, level of activity, and feelings of connectedness about nuclear concerns were the best predictors of hope about nuclear concerns. Conscious level of concern and feelings of connectedness about nuclear concerns, along with age and SES were the best predictors of an active response to nuclear threat; additionally, parents' level of concern about nuclear issues was predictive of their children's degree of activity in response to nuclear threat. Adolescents' level of concern and degree of connectedness with others was predicted by their parents' degree of connectedness.
Carpentier, Melissa Y; Fortenberry, J Dennis
This review presents a summary of existing knowledge regarding the effect of testicular cancer along four broad domains, including romantic and sexual relationships, body image, and fertility. A total of 37 studies were reviewed. Of note, most research consists of older adult testicular cancer survivors, with very little research attention afforded to adolescent and young adult survivorship. Relationship status (i.e., partnered versus unpartnered) appears to play an important role as it relates to adjustment outcomes in testicular cancer survivors. In addition, sexual function (and thereby fertility) and body image are also frequently compromised. Implications regarding a lack of developmentally focused research on adolescent and young adult testicular cancer survivorship are discussed, along with recommendations for new research.
Peres, Marco A.; Peres, Karen G.; Cascaes, Andreia M.; Correa, Marcos B.; Demarco, Flávio F.; Hallal, Pedro C.; Horta, Bernardo L.; Gigante, Denise P.; Menezes, Ana B.
Background Most studies comparing prevalence of periodontal disease and risk factors by using partial protocols were performed in adult populations, with several studies being conducted in clinical settings. The aim of this study is to assess the accuracy of partial protocols in estimating the prevalence of periodontal outcomes in adolescents and young adults from two population-based birth cohorts from Pelotas, Brazil, and to assess differences in the estimation and strength of the effect measures when partial protocols are adopted compared to full-mouth examination. Methods Gingival bleeding at probing among adolescents (n = 339) and young adults (n = 720) and dental calculus and periodontal probing depth among young adults were assessed using full-mouth examinations and four partial protocols: Ramfjord teeth (RT), community periodontal index (CPI), and two random diagonal quadrants (1 and 3, 2 and 4). Socioeconomic, demographic, and periodontal health-related variables were also collected. Sensitivity, absolute and relative bias, and inflation factors were calculated. Prevalence ratio for each periodontal outcome for the risk factors was estimated. Results Two diagonal quadrants showed better accuracy; RT had the worst, whereas CPI presented an intermediate pattern when compared to full-mouth examination. For bleeding assessment in adolescence, RT and CPI underestimated by 18.4% and 16.2%, respectively, the true outcome prevalence, whereas among young adults, all partial protocols underestimated the prevalence. All partial protocols presented similar magnitude of association measures for all investigated periodontal potential risk factors. Conclusion Two diagonal quadrants protocol may be effective in identifying the risk factors for the most relevant periodontal outcomes in adolescence and in young adulthood. PMID:21859320
Kahana, Shoshana Y.; Jenkins, Richard A.; Bruce, Douglas; Fernandez, Maria I.; Hightow-Weidman, Lisa B.; Bauermeister, Jose A.
Background The authors examined associations between structural characteristics and HIV disease management among a geographically diverse sample of behaviorally and perinatally HIV-infected adolescents and young adults in the United States. Methods The sample included 1891 adolescents and young adults living with HIV (27.8% perinatally infected; 72.2% behaviorally infected) who were linked to care through 20 Adolescent Medicine Trials Network for HIV/AIDS Interventions Units. All completed audio computer–assisted self-interview surveys. Chart abstraction or blood draw provided viral load data. Geographic-level variables were extracted from the United States Census Bureau (e.g., socioeconomic disadvantage, percent of Black and Latino households, percent rural) and Esri Crime (e.g., global crime index) databases as Zip Code Tabulation Areas. AIDSVu data (e.g., prevalence of HIV among youth) were extracted at the county-level. Using HLM v.7, the authors conducted means-as-outcomes random effects multi-level models to examine the association between structural-level and individual-level factors and (1) being on antiretroviral therapy (ART) currently; (2) being on ART for at least 6 months; (3) missed HIV care appointments (not having missed any vs. having missed one or more appointments) over the past 12 months; and (4) viral suppression (defined by the corresponding assay cutoff for the lower limit of viral load at each participating site which denoted nondetectability vs. detectability). Results Frequencies for the 4 primary outcomes were as follows: current ART use (n = 1120, 59.23%); ART use for ≥6 months (n = 861, 45.53%); at least one missed HIV care appointment (n = 936, 49.50); and viral suppression (n = 577, 30.51%). After adjusting for individual-level factors, youth living in more disadvantaged areas (defined by a composite score derived from 2010 Census indicators including percent poverty, percent receiving public assistance, percent of female, single
Roek, Marion A E; Spijkerman, Renske; Poelen, Evelien A P; Lemmers, Lex; Engels, Rutger C M E
Attitudes toward alternative behaviors, such as drinking soda instead of alcohol, might contribute to the prediction of young people's drinking behavior. The current study explored the associations between late adolescents' and young adults' attitudes toward alcoholic and non-alcoholic drinks and their alcohol consumption, and whether these associations were moderated by participants' sex, age and education level. Cross-sectional data were collected among 1012 15 to 25-year-olds. Participants completed an online questionnaire on attitudes toward alcoholic and non-alcoholic drinks, binge drinking and monthly alcohol consumption. Data were analyzed by employing structural equation modeling in Mplus. After controlling for the shared variance in both attitudes, attitudes toward alcoholic drinks were positively related and attitudes toward non-alcoholic drinks were negatively related to participants' monthly alcohol use and binge drinking. Relations between attitudes towards alcoholic drinks and monthly alcohol consumption were stronger for boys than for girls and stronger for participants with intermediate education background. Relations between both attitudes and binge drinking were strongest for high educated participants. According to our data, non-alcohol attitudes provide a unique contribution to the prediction of alcohol use.
Ramo, Danielle E.; Liu, Howard; Prochaska, Judith J.
Tobacco (TOB) and marijuana (MJ) are the most widely used drugs among adolescents and young adults. The literature on their co-use, however, has not been systematically reviewed. We identified 163 English language articles published from 1999-2009 examining TOB and MJ co-use, correlates or consequences of co-use, or interventions for prevention or cessation of couse with participants age 13-25 years. Most studies (n = 114, 70%) examined TOB and MJ couse, and 85% of relationships studied indicated a significant association. Fifty-nine studies (36%) examined correlates or consequences of co-use. Factors consistently associated with increased likelihood of co-use, defined as significant associations in at least four studies, were African-American ethnicity, mental and physical health characteristics (e.g., high-intensity pleasure temperament), and school characteristics (e.g., good grades). The only consistent consequence of co-use was exacerbation of mental health symptoms. Few studies examined prevention (n = 3) or cessation (n = 2) interventions for TOB and MJ co-use, and the findings were stronger for prevention efforts. A sufficient literature base has documented that TOB and MJ use are strongly related in young people, yet few consistent correlates and consequences of co-use have been identified to inform intervention targets. PMID:22245559
Guided internet-administered self-help to reduce symptoms of anxiety and depression among adolescents and young adults diagnosed with cancer during adolescence (U-CARE: YoungCan): a study protocol for a feasibility trial
Ander, Malin; Wikman, Anna; Ljótsson, Brjánn; Grönqvist, Helena; Ljungman, Gustaf; Woodford, Joanne; Lindahl Norberg, Annika; von Essen, Louise
Introduction A subgroup of adolescents and young adults diagnosed with cancer during adolescence reports elevated levels of anxiety and depressive symptoms and unmet needs for psychological support. Evidence-based psychological treatments tailored for this population are lacking. This protocol describes a feasibility study of a guided-internet-administered self-help programme (YoungCan) primarily targeting symptoms of anxiety and depression among young persons diagnosed with cancer during adolescence and of the planned study procedures for a future controlled trial. Methods/analysis The study is an uncontrolled feasibility trial with a pre-post and 3-month follow-up design. Potential participants aged 15–25 years, diagnosed with cancer during adolescence, will be identified via the Swedish Childhood Cancer Registry. 30 participants will be included. Participants will receive YoungCan, a 12-week therapist-guided, internet-administered self-help programme consisting primarily of cognitive–behavioural therapy organised into individually assigned modules targeting depressive symptoms, worry and anxiety, body dissatisfaction and post-traumatic stress. Interactive peer support and psychoeducative functions are also available. Feasibility outcomes include: recruitment and eligibility criteria; data collection; attrition; resources needed to complete the study and programme; safety procedures; participants' and therapists' adherence to the programme; and participants' acceptability of the programme and study methodology. Additionally, mechanisms of impact will be explored and data regarding symptoms of anxiety, depression, post-traumatic stress, body dissatisfaction, reactions to social interactions, quality of life, axis I diagnoses according to the Mini International Neuropsychiatric Interview and healthcare service use will be collected. Exploratory analyses of changes in targeted outcomes will be conducted. Ethics/dissemination This feasibility protocol was
Manzi, Alberto; Nessler, Doreen; Czernochowski, Daniela; Friedman, David
To investigate the development of advance task-set updating and reconfiguration, behavioral and event-related potential (ERP) data were recorded in children (9-10 years), adolescents (13-14 years), and young adults (20-27 years) in a cued task-switching paradigm. In pure blocks, the same task was repeated. In mixed blocks, comprised of stay and switch trials, two tasks were intermixed. Age differences were found for stay-pure performance (mixing costs) in the 600-ms but not in the 1200-ms cue-target interval (CTI). Children showed larger reaction time mixing costs than adults. The ERPs suggested that the larger costs were due to delayed anticipatory task-set updating in children. Switch-stay performance decrements (switch costs) were age-invariant in both CTIs. However, ERP data suggested that children reconfigured the task-set on some stay trials, rather than only on switch trials, suggesting the continued maturation of task-set reconfiguration processes.
Seynnaeve, Brittani; Lee, Seungjae; Borah, Sumit; Park, Yongseok; Pappo, Alberto; Kirkwood, John M.; Bahrami, Armita
Progression of melanoma to distant sites in adolescents and young adults (AYAs) is not reliably predicted by clinicopathologic criteria. TERT promoter mutations when combined with BRAF/NRAS mutations correlate with adverse outcome in adult melanoma. To determine the prognostic value of TERT alterations in AYA melanoma, we investigated the association of TERT promoter mutations, as well as promoter methylation, an epigenetic alteration also linked to TERT upregulation, with TERT mRNA expression and outcome using a well-characterized cohort of 27 patients with melanoma (ages 8–25, mean 20). TERT mRNA expression levels were significantly higher in tumors harboring TERT promoter mutation and/or hypermethylation than those without either aberration (P = 0.046). TERT promoter mutations alone did not predict adverse outcomes (P = 0.50), but the presence of TERT promoter methylation, alone or concurrent with promoter mutations, correlated with reduced recurrence-free survival (P = 0.001). These data suggest that genetic and epigenetic alterations of TERT are associated with TERT upregulation and may predict clinical outcomes in AYA melanoma. A more exhaustive understanding of the different molecular mechanisms leading to increased TERT expression may guide development of prognostic assays to stratify AYA melanoma patients according to clinical risk. PMID:28378855
Kreuzer, Martin; Prüfe, Jenny; Oldhafer, Martina; Bethe, Dirk; Dierks, Marie-Luise; Müther, Silvia; Thumfart, Julia; Hoppe, Bernd; Büscher, Anja; Rascher, Wolfgang; Hansen, Matthias; Pohl, Martin; Kemper, Markus J.; Drube, Jens; Rieger, Susanne; John, Ulrike; Taylan, Christina; Dittrich, Katalin; Hollenbach, Sabine; Klaus, Günter; Fehrenbach, Henry; Kranz, Birgitta; Montoya, Carmen; Lange-Sperandio, Bärbel; Ruckenbrodt, Bettina; Billing, Heiko; Staude, Hagen; Heindl-Rusai, Krisztina; Brunkhorst, Reinhard; Pape, Lars
Abstract Transition from child to adult-oriented care is widely regarded a challenging period for young people with kidney transplants and is associated with a high risk of graft failure. We analyzed the existing transition structures in Germany and Austria using a questionnaire and retrospective data of 119 patients transferred in 2011 to 2012. Most centers (73%) confirmed agreements on the transition procedure. Patients’ age at transfer was subject to regulation in 73% (18 years). Median age at transition was 18.3 years (16.5–36.7). Median serum creatinine increased from 123 to 132 μmol/L over the 12 month observation period before transfer (P = 0.002). A total of 25/119 patients showed increased creatinine ≥20% just before transfer. Biopsy proven rejection was found in 10/119 patients. Three patients lost their graft due to chronic graft nephropathy. Mean coefficient of variation (CoV%) of immunosuppression levels was 0.20 ± 0.1. Increased creatinine levels ≥20% just before transfer were less frequently seen in patients with CoV < 0.20 (P = 0.007). The majority of pediatric nephrology centers have internal agreements on transitional care. More than half of the patients had CoV of immunosuppression trough levels consistent with good adherence. Although, 20% of the patients showed increase in serum creatinine close to transfer. PMID:26632907
Schmitz, Jane; Pillion, Joseph P; LeClerq, Steven C; Khatry, Subarna K; Wu, Lee S-F; Prasad, Rakesh; Karna, Sureswor L; Shrestha, Sharada R; West, Keith P
A cross-sectional survey was conducted among 3646 persons, 15 to 23 years of age, in the southern plains District of Sarlahi, Nepal, to assess the prevalence and severity of hearing loss and middle-ear dysfunction, and adverse effects of hearing loss on social integration. Between 2006 and 2008, subjects were enumerated and underwent otoscopic, tympanometric, and audiometric evaluations at central sites in villages. Hearing loss was diagnosed in subjects who failed a hearing screening and exhibited an average air conduction threshold value greater than or equal to 30 dBHL in the worse ear. Clinically, 32.8% of subjects exhibited a dull or retracted tympanic membrane, and 18% had abnormal tympanometry. Nearly 12% failed the hearing screening test, among whom more than half, or 6.1% overall, had hearing loss. Hearing-impaired subjects were six- to eight-fold (ORs, with 95% CIs excluding 1.0) more likely to report problems in hearing usual sounds or communicating with other people. Among young adults living in southern Nepal, hearing loss is common, and associated with social disability.
Kemler, E; Vriend, I; Paulis, W D; Schoots, W; van Middelkoop, M; Koes, B
Physical activity and sports participation are promoted to counteract the increased prevalence of overweight and obesity in children and young adults. Both high body mass index and physical activity level have been associated with an increased risk of sports injuries. The objective is to determine the relationship between sports injuries and overweight in sports participants (4-24 years), taking physical activity into account. Data were obtained from the 2006-2011 "Injuries and Physical Activity in the Netherlands" survey. Analyses were based on a representative sample of 3846 sports participants (4-24 years). Univariate and multiple logistic regression analyses were applied to investigate the association between sports injury and weight status. Of all the sports participants, 14.7% were overweight. Compared with normal-weight sports participants, the odds of sustaining a sports injury was 0.73 [confidence interval (CI): 0.53-1.00, P = 0.050] for overweight sports participants; the odds for underweight sports participants was 0.80 (CI: 0.56-1.15, P = 0.226). There is some evidence that overweight sports participants (4-24 years) do not have an increased injury risk compared with normal-weight sports participants, even when the level of physical activity is taken into account. Additional research is recommended regarding overweight people who start to participate in a physically active lifestyle.
Bato, Angelica A.; Blair, Melanie A.; DeRosse, Pamela; Szeszko, Philip R.; Malhotra, Anil K.
Predicting which individuals may engage in aggressive behavior is of interest in today’s society; however, there is little data on the neural basis of aggression in healthy individuals. Here, we tested whether regional differences in white matter (WM) microstructure were associated with later reports of aggressive tendencies. We recontacted healthy young adults an average of 3 years after they underwent research MRI scans. Via electronic survey, we administered the Buss Perry Aggression Questionnaire. We divided aggression into Aggressive Thoughts (Anger and Hostility subscales) and Aggressive Acts (Verbal and Physical subscales) and used Tract-Based Spatial Statistics to test the relationship of those measures to WM microstructure. In 45 individuals age 15–30 at baseline, we observed significant relationships between Aggressive Acts and fractional anisotropy (FA) in a parietal region consistent with the superior longitudinal fasciculus (SLF). As the SLF has an established relationship to executive function, we performed an exploratory analysis in a subset of individuals with working memory data. Decreased FA in executive network regions, as well as working memory performance, were associated with later self-reported aggressive tendencies. This has implications for our healthy behavior understanding of as well as that of patient populations known to have executive dysfunction. PMID:25691778
Horn, Stacey S.
Reports on the school climate for gay and lesbian students in the United States suggest that negative attitudes toward gay and lesbian individuals are quite common in adolescence. Very little research, however, has investigated adolescents' sexual prejudice from a developmental perspective. In this study, 10th- (N = 119) and 12th- (N = 145) grade…
Meiselman, Karin C.
In late adolescence and early adulthood, an ideally developing woman learns to cope with the world outside her family of origin and acquires a sense of identity that is stable and largely positive. Individuals with severe early trauma may have difficulty completing adolescence. Incest is one childhood trauma that can either be mastered in late…
Nabors, Laura A.; Brubaker, Michael D.; Hoffman, Sarah; Shipley, Halley; Pangallo, Jordan; Strong, Amanda
Adolescent substance use is a serious problem often invoking negative reactions. The current study extends the literature in this area. A total of 425 college students read one of five vignettes, each of which described an adolescent who used marijuana, hard liquor, or drank an occasional beer (control) and who had received or not received…
Steinhausen, Hans-Christoph; Haslimeier, Claudia; Metzke, Christa Winkler
Using a large longitudinal representative community sample, this study identified three groups of subjects who were depressed either in pre-adolescence, late adolescence or early adulthood, and matched by age and gender to controls without depression. The 90th percentile on one or two self-reported symptom scales [i. e. the Center for…
Merenda, Lisa A.; Rutter, Laure; Curran, Kimberly; Kozin, Scott H.
Background: Tendon transfer surgery can restore elbow extension in approximately 70% of persons with tetraplegia and often results in antigravity elbow extension strength. However, we have noted an almost 15% rupture/attenuation rate. Objective: This investigation was conducted to analyze potential causes in adolescents/young adults with spinal cord injury (SCI) who experienced tendon rupture or attenuation after biceps-to-triceps transfer. Methods: Medical charts of young adults with SCI who underwent biceps-to-triceps transfer and experienced tendon rupture or attenuation were reviewed. Data collected by retrospective chart review included general demographics, surgical procedure(s), use and duration of antibiotic treatment, time from tendon transfer surgery to rupture/attenuation, and method of diagnosis. Results: Twelve subjects with tetraplegia (mean age, 19 years) who underwent biceps-to-triceps reconstruction with subsequent tendon rupture or attenuation were evaluated. Mean age at time of tendon transfer was 18 years (range, 14-21 years). A fluoroquinolone was prescribed for 42% (n=5) of subjects. Tendon rupture was noted in 67% (n=8), and attenuation was noted in 33% (n=4). Average length of time from surgery to tendon rupture/attenuation was 5.7 months (range, 3-10 months). Conclusion: Potential contributing causes of tendon rupture/attenuation after transfer include surgical technique, rehabilitation, co-contraction of the transfer, poor patient compliance, and medications. In this cohort, 5 subjects were prescribed fluoroquinolones that have a US Food and Drug Administration black box concerning tendon ruptures. Currently, all candidates for upper extremity tendon transfer reconstruction are counseled on the effects of fluoroquinolones and the potential risk for tendon rupture. PMID:23459326
Zhang, Yang; Lorenzi, Maria F; Goddard, Karen; Spinelli, John J; Gotay, Carolyn; McBride, Mary L
To estimate the risk of late morbidity leading to hospitalization among young adult cancer 5-year survivors compared to the general population and to examine the long-term effects of demographic and disease-related factors on late morbidity, a retrospective cohort of 902 five-year survivors of young adult cancer diagnosed between 1981 and 1999 was identified from British Columbia (BC) Cancer Registry. A matched comparison group (N = 9020) was randomly selected from the provincial health insurance plan. All hospitalizations until the end of 2006 were determined from the BC health insurance plan hospitalization records. The Poisson regression model was used to estimate the rate ratios for late morbidity leading to hospitalization except pregnancy after adjusting for sociodemographic and clinical risk factors. Overall, 455 (50.4%) survivors and 3,419 (37.9%) individuals in the comparison group had at least one type of late morbidity leading to hospitalization. The adjusted risk of this morbidity for survivors was 1.4 times higher than for the comparison group (95% CI = 1.22-1.54). The highest risks were found for hospitalization due to blood disease (RR = 4.2; 95% CI = 1.98-8.78) and neoplasm (RR = 4.3; 95% CI = 3.41-5.33). Survivors with three treatment modalities had three-fold higher risk of having any type of late morbidity (RR = 3.22; 95% CI = 2.09-4.94) than the comparators. These findings emphasize that young adult cancer survivors still have high risks of a wide range of late morbidities.
Epstein, Connie C.
Considers the similarities between science fiction writing and young adult literature, and points out that several well-known authors, such as Robert Heinlein and Jane Yolen, write in both genres. (NKA)
Life stage is an important risk factor for toxicity. Children and aging adults, for example, are more susceptible to certain chemicals than are young adults. In comparison to children, relatively little is known about susceptibility in older adults. Additionally, few studies have...
Humphrey, Lisa; Dell, Mary Lynn
Using a case study, in this article we seek to highlight how the distinct developmental needs of adolescent and young adult patients facing a life-threatening condition require a different approach to patient care by pediatric health care workers. The case underscores pitfalls in using a pediatric construct of care in areas of pain management, social stressors, and advanced care planning, and suggests programs to implement for improvement, including partnership with psychiatry, substance abuse, and palliative care specialists.
1) To identify, enroll and collect blood specimens from 368 adolescents and young adults 18 years of age or older at the time of participation... Young Adult Hodgkin Lymphoma PRINCIPAL INVESTIGATOR: Wendy Cozen, Victoria Cortessis...COVERED 1 Sep 2007 – 31 Aug 2008 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Immune Response Genotypes and Risk of Young Adult Hodgkin Lymphoma 5b
Brown, Larry K.; Kennard, Betsy D.; Emslie, Graham J.; Mayes, Taryn L.; Whiteley, Laura B.; Bethel, James; Xu, Jiahong; Thornton, Sarah; Tanney, Mary R.; Hawkins, Linda A.; Garvie, Patricia A.; Subramaniam, Geetha A.; Worrell, Carol J.; Stoff, Laura W.
Objective Preliminary test of a manualized, measurement-guided treatment for depression for adolescents and young adults in care at four sites of the Adolescent Trials Network for HIV/AIDS Interventions (ATN). Design The U.S. sites were randomly assigned to either a 24-week, combination cognitive behavioral therapy and medication management algorithm (COMB) tailored for youth living with HIV (YLWH) or to treatment as usual (TAU). Methods Youth at TAU sites had access to therapists and medication management as needed. COMB site clinicians were trained in the manualized intervention and participated in supervision calls to monitor intervention fidelity. Results Over the course of the study with 44 participants, those in COMB, compared to those in TAU, reported fewer depressive symptoms, p<0.01 (as measured by the Quick Inventory for Depression Symptomatology) and were more likely to be in remission, p<0.001, (65% vs.10% at week 24 end of treatment, and 71% vs. 7% at week 48 final follow-up). A greater proportion of COMB participants received psychotherapy (95% vs. 45%, p<0.001) and attended more sessions (12.6 vs. 5, p<0.001) than those in TAU. Viral load decreased in both groups and was associated (p<0.05) with reduction in depressive symptoms. Conclusions A 24-week manualized, measurement-guided psychotherapy and medication management algorithm tailored for YLWH was more effective in achieving and sustaining remission from depression than treatment as usual at HIV care clinic sites. Given observed treatment efficacy, this structured combination treatment could be disseminated to medical clinics in order to successfully treat YLWH, who are at particular risk for depression. PMID:26761270
Nutakki, Kavitha; Varni, James W; Steinbrenner, Sheila; Draucker, Claire B; Swigonski, Nancy L
Health-related quality of life (HRQOL) is arguably one of the most important measures in evaluating effectiveness of clinical treatments. At present, there is no disease-specific outcome measure to assess the HRQOL of children, adolescents and young adults with Neurofibromatosis Type 1 (NF1). This study aimed to develop the items and support the content validity for the Pediatric Quality of Life Inventory™ (PedsQL™) NF1 Module for children, adolescents and young adults. The iterative process included multiphase qualitative methods including a literature review, survey of expert opinions, semi-structured interviews, cognitive interviews and pilot testing. Fifteen domains were derived from the qualitative methods, with content saturation achieved, resulting in 115 items. The domains include skin, pain, pain impact, pain management, cognitive functioning, speech, fine motor, balance, vision, perceived physical appearance, communication, worry, treatment, medicines and gastrointestinal symptoms. This study is limited because all participants are recruited from a single-site. Qualitative methods support the content validity for the PedsQL™ NF1 Module for children, adolescents and young adults. The PedsQL™ NF1 Module is now undergoing national multisite field testing for the psychometric validation of the instrument development.
Gattis, Maurice N; Larson, Andrea
There is a dearth of empirical evidence that addresses how racial minority, sexual minority, and homeless statuses, with their accompanying experiences of stigma and discrimination, are related to mental health in adolescent and young adult populations. The current study addresses this gap by examining the associations between multiple forms of discrimination, depressive symptoms, and suicidality in a sample of 89 Black adolescents and young adults (52% female; 47% nonheterosexual, ages 16-24) experiencing homelessness. Results from a series of ordinary least squares and logistic regressions suggested that perceived homelessness stigma and racial discrimination were associated with higher levels of depressive symptoms, controlling for gender, age, and other types of discrimination, while perceived sexual identity discrimination showed no association. Having ever spent a homeless night on the street, an indicator of homelessness severity, accounted for a substantial amount of the association between homelessness stigma and depressive symptoms. In contrast, suicidality was not significantly associated with any measure of discrimination, homelessness severity, or personal characteristics. We also found no indication that the associations between perceived discrimination targeted at racial and homelessness statuses and mental health differed by sexual minority status. Our results suggest that depressive symptoms and suicidality are prevalent among Black homeless youth, and that depressive symptoms are particularly associated with racial discrimination and indicators of homelessness. The roles of discrimination and a lack of safe housing may be taken into account when designing programs and policies that address the mental health of Black adolescents and young adults experiencing homelessness.
Hennessy, Emily A.; Tanner-Smith, Emily E.; Steinka-Fry, Katarzyna T.
This meta-analysis synthesizes studies of brief interventions (BIs) that targeted alcohol consumption and reported both alcohol and tobacco outcomes. It examines whether BIs reduce alcohol and tobacco use for adolescents and young adults among interventions that (1) directly targeted tobacco and alcohol use, or (2) did not target tobacco use but measured it as a secondary outcome. Multiple databases and grey literature sources were searched (1980–2012) resulting in the identification of 18 randomized or controlled quasi-experimental studies (5949 participants). Analyses were conducted using random effects inverse-variance weighted three-level models. BIs were associated with a significant reduction in alcohol consumption relative to control groups (ḡ = 0.11, 95% CI [0.04, 0.17]) but not with a significant decrease in tobacco use (ḡ = 0.07, 95% CI [−0.01, 0.16]). Directly addressing tobacco was not a significant moderator affecting tobacco use outcomes. Post-hoc exploratory analysis revealed potential questions to address with future research. PMID:26130030
A growing literature suggests that personality traits may be endophenotype markers for psychiatric illnesses. Although the phenotypic relationships between obsessive-compulsive disorder (OCD) and high neuroticism and low extraversion have been well documented, underlying genetic and environmental contributions to these associations have not been explored previously. Five hundred and twenty-four monozygoitc (MZ) and 228 dizygotic (DZ) pairs of adolescent and young adult twins (aged 13-24 years) drawn from the South Korean Twin Registry completed the Maudsley Obsessive Compulsive Inventory (MOCI) and the Neuroticism and Extraversion scale of the Eysenck Personality Scale by mail. The total score of MOCI (MOCIT) was significantly and positively correlated with Neuroticism (r = .44), but only weakly and negatively related to Extraversion (r = -.10). A trivariate Cholesky model was applied to the data. The additive genetic correlations in the best-fitting model were .51 between Neuroticism and MOCIT and -.17 between Extraversion and MOCIT, suggesting that additive genetic factors that lead to high neuroticism and low extraversion overlap with those genetic factors influencing high OC symptoms. These findings add to the cumulative evidence of the shared genetic etiology for the associations between a personality profile of high neuroticism and low extraversion and mental illnesses.
Hullmann, Stephanie E; Eddington, Angelica R; Molzon, Elizabeth S; Mullins, Larry L
The current study sought to: 1) assess differences in levels of physical and mental health-related quality of life (HRQOL), illness uncertainty, and intrusiveness in adolescents and young adults (AYAs) with allergies and asthma, as well as 2) examine the effect of illness appraisals on HRQOL. Participants were undergraduate students with self-reported allergies (n=74) and asthma (n=74) who completed the Mishel Uncertainty in Illness Scale (MUIS), the Illness Intrusiveness Scale (IIS), and the SF-36 Health Survey Questionnaire. Paired t-tests indicated that AYAs with allergies reported higher levels of illness uncertainty and poorer mental HRQOL than AYAs with asthma; the groups did not differ on reported levels of illness intrusiveness or physical HRQOL. Hierarchical regressions were conducted to examine the relationship between illness appraisals and HRQOL. Results revealed that poorer mental HRQOL was associated with higher illness uncertainty in AYAs with allergies and higher illness intrusiveness in AYAs with asthma. Poorer physical HRQOL was associated with higher illness uncertainty in AYAs with asthma and higher illness intrusiveness in AYAs with allergies and asthma. The current examination suggests that illness appraisals may be differentially related to HRQOL in AYAs with allergies compared to those with asthma.
Yi, Jaehee; McClellan, Jessica; Kim, Jonghee; Tian, Tian; Grahmann, Bridget; Kirchhoff, Anne C.; Holton, Avery; Wright, Jennifer
Purpose: This study uses qualitative methods to identify barriers to and facilitators of exercise and healthy eating among adolescent and young adult (AYA) cancer survivors (survivors currently aged 18–39 years and diagnosed with cancer anytime in their lives), as reported by survivors and their primary supporters. Methods: Survivors (Mage = 27.6 years, SD = 6.6 years) had completed active cancer therapy. Survivors and supporters (i.e., nominated by survivors as someone who was a main source of support) attended separate focus group sessions (five survivor focus groups, five supporter focus groups) and were asked to complete a self-reported questionnaire assessing demographic and cancer history and engagement in exercise and healthy eating. Results: In total, 25 survivors and 19 supporters participated. The three overarching themes identified were barriers to exercise and healthy eating (e.g., lack of resources, negative thoughts and feelings, negative social and environmental influences), facilitators of exercise and healthy eating (e.g., cognitive motivators, tools for health behavior implementation, social relationships), and intervention implications (e.g., informational needs, desire for social support). Conclusion: AYA cancer survivors and their supporters identified barriers to and facilitators of healthy lifestyle behaviors, which should be considered when designing interventions to improve the long-term health of survivors. PMID:26697268
Hampson, Elizabeth; Rovet, Joanne F
Females with the classic form of congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency are said to perform better than unaffected female controls on tests of mental rotation or other visuospatial abilities, but findings are conflicting. We studied 31 adolescents and young adults with CAH and 19 unaffected sibling controls, who were given standardized spatial tests and tests of other sexually differentiated cognitive functions (verbal fluency, perceptual speed). The possible role of CAH subtype (salt-wasting or simple-virilizing) was evaluated. Only females with the more severe, salt-wasting form of CAH, but not females with the simple-virilizing form, performed significantly better than sex-matched sibling controls on measures of mental rotation. Subtype differences were not significant for verbal fluency or perceptual speed. Severity of prenatal genital virilization, but not postnatal age when medication was started, predicted accuracy on the Mental Rotations Test. Results are consistent with the possibility of an organizational effect of androgens in the central nervous system that impacts the development of spatial abilities. Implications for the timing of the hypothetical critical period are discussed.
Martin, Staci; Wolters, Pamela L; Baldwin, Andrea; Roderick, Marie Claire; Toledo-Tamula, Mary Anne; Gillespie, Andrea; Widemann, Brigitte
Youth with neurofibromatosis type 1 (NF1) have multiple, complex symptoms associated with physical, social-emotional, and cognitive difficulties. In addition, caring for a child with NF1 can be extremely challenging for parents. Since research with other chronic illness populations suggests that social support, including internet support groups (ISGs), can be beneficial, this survey study aimed to determine the attitudes and preferences of adolescents and young adults with NF1 and parents of a child with NF1 regarding ISGs. Thirty patients and 30 caregivers completed a 24-item survey about ISGs. Many patients and parents are not aware of any ISGs for NF1, but are interested in using one in the future for a variety of reasons, including to get answers to their questions about NF1, to find out about research studies, and to discuss problems and concerns about NF1. Specific concerns of interest include physical, social-emotional, and cognitive aspects of NF1. ISGs have potential as a social support intervention within the NF1 community. ISGs for the NF1 population should include patients with NF1 (or parents of children with NF1) as well as a health professional, and both chat rooms and discussion boards likely would be well-received.
Murphy, Devin; Klosky, James L; Reed, Damon R; Termuhlen, Amanda M; Shannon, Susan V; Quinn, Gwendolyn P
Visions for the future are a normal developmental process for adolescents and young adults (AYAs) with and without cancer, and these visions often include expectations of sexual and romantic relationships. AYA cancer survivors indicate reproductive health is an issue of great importance and more attention is needed in the health care setting throughout the cancer experience, beginning at diagnosis. Various practice guidelines are predominately focused on fertility; are intended to influence survivorship care plans; and do not encompass the broad scope of reproductive health that includes romantic partnering, friendships, body image, sexuality, sexual identity, fertility, contraception, and more. Although interventions to reduce reproductive health-related sequelae from treatment are best approached as an evolving process, practitioners are not certain of the priorities of these various reproductive health content areas. Strategies incongruent with the reproductive health priorities of AYAs will likely thwart adequate follow-up care and foster feelings of isolation from the treatment team. Research is needed to identify these priorities and ensure discussions of diverse content areas. This review explored various domains of reproductive health and emphasized how understanding the priorities of the AYA cancer cohort will guide future models of care.
Gipson, Debbie S.; Massengill, Susan A.; Dooley, Mary Anne; Primack, William A.; Ferris, Maria A.; Hogan, Susan L.
Background and objectives: The prevalence and significance of remission and relapse in children, adolescents, and young adults with lupus nephritis in the United States are poorly understood. Patterns and predictors of disease progression in a southeastern U.S. pediatric cohort with severe lupus nephritis are presented. Design, settings, participants, & measurements: Individuals age 21 or less with kidney biopsy-proven lupus nephritis followed in the Glomerular Disease Collaborative Network were included. Cox regression models were used to evaluate predictors of relapse and end stage kidney disease (ESKD). Results: Seventy-three subjects with a mean age of 15.6 ± 3.4 yr were included. Five-year kidney survival was 77%. Complete and partial remission rates within 1 yr of induction therapy were 25 and 64%, respectively. Relapse and ESKD rates were similar between complete and partial responders. Relapse occurred in 35% of responders (complete or partial) in 45 ± 32 mo. Disease relapse was a predictor of ESKD (HR = 10.12, P < 0.0001). Treatment resistance was documented in African Americans more often than non-African Americans (eight versus 0; P = 0.03). ESKD HR associated with treatment resistance was 6.25, P < 0.002. Conclusions: Remission whether complete or partial is associated with improved kidney survival in children with lupus nephritis. Nephritis relapse is a strong predictor of progression to ESKD. Treatment resistance portends a high risk of ESKD and disproportionately affects African American children with lupus nephritis. PMID:19820130
Vadaparampil, Susan T; Hutchins, Nicole M; Quinn, Gwendolyn P
In 2008, approximately 69,200 adolescents and young adults (AYAs) were diagnosed with cancer, second only to heart disease for males in this age group. Despite recent guidelines from professional organizations and clinical research that AYA oncology patients want information about reproductive health topics and physician support for nurses to address these issues with patients, existing research finds few oncology nurses discuss this topic with patients due to barriers such as lack of training. This article describes an innovative eLearning training program, entitled Educating Nurses about Reproductive Issues in Cancer Healthcare. The threefold purpose of this article is to: (1) highlight major reproductive health concerns relevant to cancer patients, (2) describe the current status of reproductive health and oncology communication and the target audience for the training, and (3) present a systematic approach to curriculum development, including the content analysis and design stages as well as the utilization of feedback from a panel of experts. The resulting 10-week curriculum contains a broad-based approach to reproductive health communication aimed at creating individual- and practice-level change.
Rosipal, Nicole C; Mingle, Lindsay; Smith, Janet; Morris, G Stephen
This pilot study sought to examine the exercise behavior and preferences among adolescent and young adult (AYA) hematopoietic stem cell transplant (HSCT) recipients. Eighteen patients aged 19 to 25 years were recruited to engage in unsupervised exercise activities lasting at least 60 minutes/week during hospitalization for HSCT. Enrolled patients had access to standard exercise activities (walking, resistance training, and basketball) and active video gaming equipment. Physical function (6-Minute Walk Test and Timed-Up-and-Go test) and quality of life (Behavioral, Affective, and Somatic Experiences Scale) were assessed at different time points during admission. Participants exercised an average of 76% of the days during admission and spent an average of 36.5 minutes per day exercising. The Nintendo Wii was the preferred active video gaming equipment, but standard exercises accounted for 73% of all exercise time. Neither functional capacity nor quality of life improved. Results suggest that AYAs voluntarily exercise during HSCT admission, prefer to use standard exercise activities, and may require supervision in order to derive maximum benefits from their efforts. These results provide guidance for developing rehabilitation interventions for AYA HSCT recipients.
Männikkö, Niko; Billieux, Joël; Kääriäinen, Maria
Background and Aims The aim of this study was to identify problematic gaming behavior among Finnish adolescents and young adults, and evaluate its connection to a variety of psychological, social, and physical health symptoms. Methods This cross-sectional study was conducted with a random sample of 293 respondents aged from 13 to 24 years. Participants completed an online survey. Problematic gaming behavior was measured with the Game Addiction Scale (GAS). Self-reports covered health measures such as psychological health (psychopathological symptoms, satisfaction with life), social health (preferences for social interaction), and physical health (general health, Body Mass Index [BMI], body discomfort, physical activity). Results Problematic gaming behavior was found to relate to psychological and health problems, namely fatigue, sleep interference, depression and anxiety symptoms. Multiple linear regression indicated that the amount of weekly gaming, depression and a preference for online social interaction predicted increased problematic gaming symptoms. Conclusions This research emphasized that problematic gaming behavior had a strong negative correlation to a variety of subjective health outcomes. PMID:26690623
Perez-Andreu, Virginia; Roberts, Kathryn G; Xu, Heng; Smith, Colton; Zhang, Hui; Yang, Wenjian; Harvey, Richard C; Payne-Turner, Debbie; Devidas, Meenakshi; Cheng, I-Ming; Carroll, William L; Heerema, Nyla A; Carroll, Andrew J; Raetz, Elizabeth A; Gastier-Foster, Julie M; Marcucci, Guido; Bloomfield, Clara D; Mrózek, Krzysztof; Kohlschmidt, Jessica; Stock, Wendy; Kornblau, Steven M; Konopleva, Marina; Paietta, Elisabeth; Rowe, Jacob M; Luger, Selina M; Tallman, Martin S; Dean, Michael; Burchard, Esteban G; Torgerson, Dara G; Yue, Feng; Wang, Yanli; Pui, Ching-Hon; Jeha, Sima; Relling, Mary V; Evans, William E; Gerhard, Daniela S; Loh, Mignon L; Willman, Cheryl L; Hunger, Stephen P; Mullighan, Charles G; Yang, Jun J
Acute lymphoblastic leukemia (ALL) in adolescents and young adults (AYA) is characterized by distinct presenting features and inferior prognosis compared with pediatric ALL. We performed a genome-wide association study (GWAS) to comprehensively identify inherited genetic variants associated with susceptibility to AYA ALL. In the discovery GWAS, we compared genotype frequency at 635 297 single nucleotide polymorphisms (SNPs) in 308 AYA ALL cases and 6,661 non-ALL controls by using a logistic regression model with genetic ancestry as a covariate. SNPs that reached P ≤ 5 × 10(-8) in GWAS were tested in an independent cohort of 162 AYA ALL cases and 5,755 non-ALL controls. We identified a single genome-wide significant susceptibility locus in GATA3: rs3824662, odds ratio (OR), 1.77 (P = 2.8 × 10(-10)) and rs3781093, OR, 1.73 (P = 3.2 × 10(-9)). These findings were validated in the replication cohort. The risk allele at rs3824662 was most frequent in Philadelphia chromosome (Ph)-like ALL but also conferred susceptibility to non-Ph-like ALL in AYAs. In 1,827 non-selected ALL cases, the risk allele frequency at this SNP was positively correlated with age at diagnosis (P = 6.29 × 10(-11)). Our results from this first GWAS of AYA ALL susceptibility point to unique biology underlying leukemogenesis and potentially distinct disease etiology by age group.
Gfeller, Kate; Driscoll, Virginia; Smith, Rachel See; Scheperle, Christina
The purpose of this study was to examine the musical engagement (participation and attitude) of pediatric CI recipients who were implanted during early childhood and who have reached age 15 or older. A questionnaire was administered to a group of 31 prelingually deaf CI users who receive annual follow up services and assessment in a clinical research center. The questionnaire was used to examine involvement in and attitudes toward music in school, the community, and in the home; social affiliation (hearing, Deaf, both) and mode of communication (oral, manual, both) were also examined. Despite the technical limitations of cochlear implants in transmitting pitch, melody, and tone quality, over two thirds of this sample described music as being important or very important in their lives. A high level of past and present familial involvement in music was associated with higher levels of current involvement and importance of music in the lives of adolescent and young adult CI users. Comparisons were noted with data from prior studies of persons with hearing loss who were non-CI users. PMID:23565029
Harper, Gary W; Lemos, Diana; Hosek, Sybil G
This article describes the influence of a group-based behavioral intervention for adolescents and young adults newly diagnosed with HIV (Project ACCEPT) on four dimensions of HIV-related stigma-personalized stigma, disclosure concerns, negative self-image, and concern with public attitudes about people with HIV-as measured by the Berger HIV Stigma Scale. Stigma was addressed in a holistic manner during the intervention by providing HIV/AIDS-related information, facilitating the acquisition of coping skills, and providing contact with other youth living with HIV in order to improve social support. Fifty youth (28 male, 22 female; mean age=19.24 years) newly diagnosed with HIV from four geographically diverse clinics participated in a one-group pretest-posttest design study whereby they received the intervention over a 12-week period, and completed assessments at baseline, post-intervention, and 3-month follow-up. Results from the combined sample (males and females) revealed overall reductions in stigma in three dimensions: personalized stigma, disclosure concerns, and negative self-image, although only the combined-sample effects for negative self-image were maintained at 3-month follow-up. Gender-specific analyses revealed that the intervention reduced stigma for males across all four dimensions of stigma, with all effects being maintained to some degree at the 3-month follow-up. Only personalized stigma demonstrated a decrease for females, although this effect was not maintained at the 3-month follow-up; while the other three types of stigma increased at post-intervention and 3-month follow-up. Findings are discussed in terms of gender specific outcomes and the need for a different type of intervention to reduce stigma for young women.
Lemos, Diana; Hosek, Sybil G.
Abstract This article describes the influence of a group-based behavioral intervention for adolescents and young adults newly diagnosed with HIV (Project ACCEPT) on four dimensions of HIV-related stigma—personalized stigma, disclosure concerns, negative self-image, and concern with public attitudes about people with HIV—as measured by the Berger HIV Stigma Scale. Stigma was addressed in a holistic manner during the intervention by providing HIV/AIDS-related information, facilitating the acquisition of coping skills, and providing contact with other youth living with HIV in order to improve social support. Fifty youth (28 male, 22 female; mean age=19.24 years) newly diagnosed with HIV from four geographically diverse clinics participated in a one-group pretest-posttest design study whereby they received the intervention over a 12-week period, and completed assessments at baseline, post-intervention, and 3-month follow-up. Results from the combined sample (males and females) revealed overall reductions in stigma in three dimensions: personalized stigma, disclosure concerns, and negative self-image, although only the combined-sample effects for negative self-image were maintained at 3-month follow-up. Gender-specific analyses revealed that the intervention reduced stigma for males across all four dimensions of stigma, with all effects being maintained to some degree at the 3-month follow-up. Only personalized stigma demonstrated a decrease for females, although this effect was not maintained at the 3-month follow-up; while the other three types of stigma increased at post-intervention and 3-month follow-up. Findings are discussed in terms of gender specific outcomes and the need for a different type of intervention to reduce stigma for young women. PMID:25216106
Arnon, Sara; Shamai, Shmuel; Ilatov, Zinaida
Research examined the relative importance of peer groups for young adolescents as compared with diverse adult socialization agents--family, school, and community. The factors involved were teenagers' activities, preferences, feelings, and thoughts as to how they spend their leisure time, their preferences for help providers, and their sense of…
Seiffge-Krenke, Inge; Persike, Malte
The transition to adulthood is a critical juncture in the course of psychopathology. This study examined the ways in which earlier capacity to deal with relationship stress during adolescence contributed to an adaptive outcome in emerging adulthood. In a prospective study of 145 individuals, relationship stress, individual coping capacities, and…
Liu, Guodong; Pearl, Amanda M.; Kong, Lan; Leslie, Douglas L.; Murray, Michael J.
There has been an increase in utilization of the Emergency Department (ED) in individuals with autism spectrum disorder (ASD) which may reflect a deficit of services (Green et al., "Journal of the American Academy of Child and Adolescent Psychiatry" 40(3):325-332, 2001; Gurney et al., "Archives of Pediatric and Adolescent…
Linker, Julie; Gillespie, Nathan A.; Maes, Hermine; Eaves, Lindon; Silberg, Judy L.
The co-occurrence of suicidal ideation, depression, and conduct disturbance is likely explained in part by correlated genetic and environmental risk factors. Little is known about the specific nature of these associations. Structured interviews on 2,814 twins from the Virginia Twin Study of Adolescent Behavioral Development (VTSABD) and Young…
Goldman, S. E.; Malow, B. A.; Newman, K. D.; Roof, E.; Dykens, E. M.
Background: Sleep disorders are common in individuals with neurodevelopmental disorders and may adversely affect daytime functioning. Children with Williams syndrome have been reported to have disturbed sleep; however, no studies have been performed to determine if these problems continue into adolescence and adulthood. Methods: This study…
Kaushansky, Daniel; Cox, Jarad; Dodson, Chaka; McNeeley, Miles; Kumar, Sinthu; Iverson, Ellen
Objectives This qualitative study examines how and why adolescents living with visible and invisible chronic illnesses choose to share their condition with individuals within their social environments. Methods A sample of 25 adolescents were recruited from five subspecialty services: Spina bifida, rheumatology, cardiology, cystic fibrosis, and renal transplant/dialysis. Recruits completed a semi-structured interview designed to explore: (1) to whom adolescents disclose their conditions, (2) motivation and conditions under which they disclose, (3) content of disclosure, and (4) barriers to disclosure. Results Family members closely connected to treatment or management are most likely to be primary targets of disclosure. Regardless of social network size, respondents disclosed their illness to few peers. Common reasons for disclosure were perceived trust and shared experience with illness and disability. Reasons for withholding disclosure include perceived fear of rejection, pity, and perceptions of being seen as vulnerable or different. Discussion Disclosure was found to be influenced by (a) the visibility of a condition, (b) the anticipated response from the recipient, (c) practical needs, and (d) a decision that disclosure is justified. These findings inform clinical practice, warrant the need for further study, and insinuate practical solutions to combat the socio-emotional impact of nondisclosure among adolescents.
Locke, Thomas F.; Newcomb, Michael D.; Duclos, Alisa; Goodyear, Rodney K.
This study determined how multiple ecodevelopmental domains influenced dysphoria in a community sample of Latina adolescents. Risk factors tested include childhood maltreatment, parental alcohol-related problems, and polysubstance problems. Protective factors include general self-efficacy, social conformity, and family connection. Female…
Daniel, Stephanie S.; Goldston, David B.; Erkanli, Alaattin; Franklin, Joseph C.; Mayfield, Andrew M.
Previous studies of the relationship between anger, anger expression, and suicidal behavior have been largely cross-sectional and have yielded mixed findings. In a prospective, naturalistic study, we examined how trait anger and anger expression influenced the likelihood of suicide attempts among 180 adolescents followed for up to 13.3 years after…
Uecker, Jeremy E
Marriage is widely thought to confer mental health benefits, but little is known about how this apparent benefit may vary across the life course. Early marriage, which is nonnormative, could have no, or even negative, mental health consequences for young adults. Using survey data from waves 1 and 3 of the National Longitudinal Study of Adolescent Health (n = 11,695), I find that married young adults exhibit levels of psychological distress that are similar to those of young adults in any kind of romantic relationship. Married and engaged young adults also report lower frequency of drunkenness than those who are not in a romantic relationship. Married young adults, especially those who first married at ages 22 to 26, report higher life satisfaction than those in other type of romantic relationships,those in no romantic relationship, and those who married prior to age 22. Explanations for these findings are examined, and their implications are discussed.
Carceller, Fernando; Fowkes, Lucy A; Khabra, Komel; Moreno, Lucas; Saran, Frank; Burford, Anna; Mackay, Alan; Jones, David T W; Hovestadt, Volker; Marshall, Lynley V; Vaidya, Sucheta; Mandeville, Henry; Jerome, Neil; Bridges, Leslie R; Laxton, Ross; Al-Sarraj, Safa; Pfister, Stefan M; Leach, Martin O; Pearson, Andrew D J; Jones, Chris; Koh, Dow-Mu; Zacharoulis, Stergios
Pseudoprogression (PsP) is a treatment-related phenomenon which hinders response interpretation. Its prevalence and clinical impact have not been evaluated in children/adolescents. We assessed the characteristics, risk factors and prognosis of PsP in children/adolescents and young-adults diagnosed with non-brainstem high grade gliomas (HGG) and diffuse intrinsic pontine gliomas (DIPG). Patients aged 1-21 years diagnosed with HGG or DIPG between 1995 and 2012 who had completed radiotherapy were eligible. PsP was assessed according to study-specific criteria and correlated with first-line treatment, molecular biomarkers and survival. Ninety-one patients (47 HGG, 44 DIPG) were evaluable. Median age: 10 years (range, 2-20). Eleven episodes of PsP were observed in 10 patients (4 HGG, 6 DIPG). Rates of PsP: 8.5 % (HGG); 13.6 % (DIPG). Two episodes of PsP were based on clinical findings alone; nine episodes had concurrent radiological changes: increased size of lesions (n = 5), new focal enhancement (n = 4). Temozolomide, MGMT methylation or H3F3A mutations were not found to be associated with increased occurrence of PsP. For HGG, 1-year progression-free survival (PFS) was 41.9 % no-PsP versus 100 % PsP (p = 0.041); differences in 1-year overall survival (OS) were not significant. For DIPG, differences in 1-year PFS and OS were not statistically significant. Hazard ratio (95 %CI) of PsP for OS was 0.551 (0.168-1.803; p = 0.325) in HGG; and 0.308 (0.107-0.882; p = 0.028) in DIPG. PsP occurred in both pediatric HGG and DIPG patients at a comparable rate to adult HGG. PsP was associated with improved 1-yr PFS in HGG patients. PsP had a protective effect upon OS in DIPG patients.
Duckham, Rachel L; Baxter-Jones, Adam D G; Johnston, James D; Vatanparast, Hassanali; Cooper, David; Kontulainen, Saija
The long-term benefits of habitual physical activity during adolescence on adult bone structure and strength are poorly understood. We investigated whether physically active adolescents had greater bone size, density, content, and estimated bone strength in young adulthood when compared to their peers who were inactive during adolescence. Peripheral quantitative computed tomography (pQCT) was used to measure the tibia and radius of 122 (73 females) participants (age mean ± SD, 29.3 ± 2.3 years) of the Saskatchewan Pediatric Bone Mineral Accrual Study (PBMAS). Total bone area (ToA), cortical density (CoD), cortical area (CoA), cortical content (CoC), and estimated bone strength in torsion (SSIp ) and muscle area (MuA) were measured at the diaphyses (66% tibia and 65% radius). Total density (ToD), trabecular density (TrD), trabecular content (TrC), and estimated bone strength in compression (BSIc ) were measured at the distal ends (4%). Participants were grouped by their adolescent physical activity (PA) levels (inactive, average, and active) based on mean PA Z-scores obtained from serial questionnaire assessments completed during adolescence. We compared adult bone outcomes across adolescent PA groups in each sex using analysis of covariance followed by post hoc pairwise comparisons with Bonferroni adjustments. When adjusted for adult height, MuA, and PA, adult males who were more physically active than their peers in adolescence had 13% greater adjusted torsional bone strength (SSIp , p < 0.05) and 10% greater adjusted ToA (p < 0.05) at the tibia diaphysis. Females who were more active in adolescence had 10% larger adjusted CoA (p < 0.05), 12% greater adjusted CoC (p < 0.05) at the tibia diaphysis, and 3% greater adjusted TrC (p < 0.05) at the distal tibia when compared to their inactive peers. Benefits to tibia bone size, content, and strength in those who were more active during adolescence seemed to persist into young adulthood
Stephens, T; Braithwaite, R L; Taylor, S E
Currently little attention has been directed, with the exception of peer education efforts, to constructively develop new and innovative ways to promote HIV/AIDS primary prevention among African American (AA) adolescents and young adults. With this in mind, the aim of this conceptual effort is to present a HIV/AIDS preventive counseling protocol developed for use with AA young adults that makes use of hip-hop music, a form of music popularized by young AAs. The author contend that an increased understanding of the relationships that many AA young adults have with hip-hop music may be used by disease prevention personnel to educate these populations about protective factors for HIV. Making use of hip-hop music is one strategy for integrating counseling in prevention and health maintenance. The overall implications of using hip-hop music in health promotion are unlimited. First, this method makes use of cultural relevant materials to address the educational and health needs of the target community. Second, it is grounded in an approach that serves to stimulate cooperative learning based on peer developed content. Moreover, the use of this medium can be applied to other health promotion activities such as violence/harm reduction and substance abuse prevention, upon reviews of songs for appropriate content. The authors contend that such an approach holds heuristic value in dealing with HIV/AIDS prevention among AA young adults. Additional testing of the intervention is warranted in the refinement of this innovative intervention.
Christie-Mizell, C. Andre; Peralta, Robert L.
We utilize data from the National Longitudinal Survey of Youth young adult sample (N = 1,488) to investigate whether gender role attitudes and the occupation of and transition to three adult roles (i.e., employment, marriage, and parenthood) contribute to the maintenance of the gender gap in the frequency and quantity of alcohol use. Our results…
Jugert, Philipp; Eckstein, Katharina; Noack, Peter; Kuhn, Alexandra; Benbow, Alison
Levels of civic engagement are assumed to vary according to numerous social and psychological characteristics, but not much is known about online civic engagement. This study aimed to investigate differences and similarities in young people's offline and online civic engagement and to clarify, based on Ajzen's theory of planned behavior (TPB),…
Learning about global problems, such as climate change, is not only a cognitive endeavor, but also involves emotions evoked by the seriousness and complexity of these problems. Few studies, however, have explored how young people cope with emotions related to climate change. Since coping strategies could be as important as the emotions themselves…
Johnson, Gregory R.; Krug, Etienne G.; Potter, Lloyd B.
Reports on survey about suicide among 15- to 24-year-olds (N=15,555) in 34 of the wealthiest nations. Finland led in total and firearm-related suicides. An association was found between divorce rates and youth suicide rates, firearm-related suicide, and suicide rates among young males. An association was found between firearm availability and…
Chenoweth, Meghan J.; Sylvestre, Marie-Pierre; Contreras, Gisele; Novalen, Maria; O’Loughlin, Jennifer; Tyndale, Rachel F.
Background Smoking is influenced by genetic factors including variation in CYP2A6 and CYP2B6, which encode nicotine-metabolizing enzymes. In early adolescence, CYP2A6 slow nicotine metabolism was associated with higher dependence acquisition, but reduced cigarette consumption. Here we extend this work by examining associations of CYP2A6 and CYP2B6 with tobacco dependence acquisition in a larger sample of smokers followed throughout adolescence. Methods White participants from the Nicotine Dependence in Teens cohort that had ever inhaled (n=421) were followed frequently from age 12–18 years. Cox’s proportional hazards models compared the risk of ICD-10 tobacco dependence acquisition (score 3+) for CYP2A6 and CYP2B6 metabolism groups. Early smoking experiences, as well as amount smoked at end of follow-up, was also computed. At age 24 (N=162), we assessed concordance between self-reported cigarette consumption and salivary cotinine. Results In those who initiated inhalation during follow-up, CYP2A6 slow (vs. normal) metabolizers were at greater risk of dependence (hazards ratio (HR)=2.3; 95% CI=1.1, 4.8); CYP2B6 slow (vs. normal) metabolizers had non-significantly greater risk (HR=1.5; 95% CI=0.8, 2.6). Variation in CYP2A6 or CYP2B6 was not significantly associated with early smoking symptoms or cigarette consumption at end of follow-up. At age 24, neither gene was significantly associated with dependence status. Self-reported consumption was associated with salivary cotinine, a biomarker of tobacco exposure, acquired at age 24 (B=0.37; P<0.001). Conclusions Our findings extend previous work indicating that slow nicotine metabolism mediated by CYP2A6, and perhaps CYP2B6, increases risk for tobacco dependence throughout adolescence. PMID:26644138
Graff, Mariaelisa; Ngwa, Julius S; Workalemahu, Tsegaselassie; Homuth, Georg; Schipf, Sabine; Teumer, Alexander; Völzke, Henry; Wallaschofski, Henri; Abecasis, Goncalo R; Edward, Lakatta; Francesco, Cucca; Sanna, Serena; Scheet, Paul; Schlessinger, David; Sidore, Carlo; Xiao, Xiangjun; Wang, Zhaoming; Chanock, Stephen J; Jacobs, Kevin B; Hayes, Richard B; Hu, Frank; Van Dam, Rob M; Crout, Richard J; Marazita, Mary L; Shaffer, John R; Atwood, Larry D; Fox, Caroline S; Heard-Costa, Nancy L; White, Charles; Choh, Audrey C; Czerwinski, Stefan A; Demerath, Ellen W; Dyer, Thomas D; Towne, Bradford; Amin, Najaf; Oostra, Ben A; Van Duijn, Cornelia M; Zillikens, M Carola; Esko, Tõnu; Nelis, Mari; Nikopensius, Tit; Metspalu, Andres; Strachan, David P; Monda, Keri; Qi, Lu; North, Kari E; Cupples, L Adrienne; Gordon-Larsen, Penny; Berndt, Sonja I
Genetic loci for body mass index (BMI) in adolescence and young adulthood, a period of high risk for weight gain, are understudied, yet may yield important insight into the etiology of obesity and early intervention. To identify novel genetic loci and examine the influence of known loci on BMI during this critical time period in late adolescence and early adulthood, we performed a two-stage meta-analysis using 14 genome-wide association studies in populations of European ancestry with data on BMI between ages 16 and 25 in up to 29 880 individuals. We identified seven independent loci (P < 5.0 × 10⁻⁸) near FTO (P = 3.72 × 10⁻²³), TMEM18 (P = 3.24 × 10⁻¹⁷), MC4R (P = 4.41 × 10⁻¹⁷), TNNI3K (P = 4.32 × 10⁻¹¹), SEC16B (P = 6.24 × 10⁻⁹), GNPDA2 (P = 1.11 × 10⁻⁸) and POMC (P = 4.94 × 10⁻⁸) as well as a potential secondary signal at the POMC locus (rs2118404, P = 2.4 × 10⁻⁵ after conditioning on the established single-nucleotide polymorphism at this locus) in adolescents and young adults. To evaluate the impact of the established genetic loci on BMI at these young ages, we examined differences between the effect sizes of 32 published BMI loci in European adult populations (aged 18-90) and those observed in our adolescent and young adult meta-analysis. Four loci (near PRKD1, TNNI3K, SEC16B and CADM2) had larger effects and one locus (near SH2B1) had a smaller effect on BMI during adolescence and young adulthood compared with older adults (P < 0.05). These results suggest that genetic loci for BMI can vary in their effects across the life course, underlying the importance of evaluating BMI at different ages.
Graff, Mariaelisa; Ngwa, Julius S.; Workalemahu, Tsegaselassie; Homuth, Georg; Schipf, Sabine; Teumer, Alexander; Völzke, Henry; Wallaschofski, Henri; Abecasis, Goncalo R.; Edward, Lakatta; Francesco, Cucca; Sanna, Serena; Scheet, Paul; Schlessinger, David; Sidore, Carlo; Xiao, Xiangjun; Wang, Zhaoming; Chanock, Stephen J.; Jacobs, Kevin B.; Hayes, Richard B.; Hu, Frank; Van Dam, Rob M.; Crout, Richard J.; Marazita, Mary L.; Shaffer, John R; Atwood, Larry D.; Fox, Caroline S.; Heard-Costa, Nancy L.; White, Charles; Choh, Audrey C.; Czerwinski, Stefan A.; Demerath, Ellen W.; Dyer, Thomas D.; Towne, Bradford; Amin, Najaf; Oostra, Ben A.; Van Duijn, Cornelia M.; Zillikens, M. Carola; Esko, Tõnu; Nelis, Mari; Nikopensius, Tit; Metspalu, Andres; Strachan, David P.; Monda, Keri; Qi, Lu; North, Kari E.; Cupples, L. Adrienne; Gordon-Larsen, Penny; Berndt, Sonja I.
Genetic loci for body mass index (BMI) in adolescence and young adulthood, a period of high risk for weight gain, are understudied, yet may yield important insight into the etiology of obesity and early intervention. To identify novel genetic loci and examine the influence of known loci on BMI during this critical time period in late adolescence and early adulthood, we performed a two-stage meta-analysis using 14 genome-wide association studies in populations of European ancestry with data on BMI between ages 16 and 25 in up to 29 880 individuals. We identified seven independent loci (P < 5.0 × 10−8) near FTO (P = 3.72 × 10−23), TMEM18 (P = 3.24 × 10−17), MC4R (P = 4.41 × 10−17), TNNI3K (P = 4.32 × 10−11), SEC16B (P = 6.24 × 10−9), GNPDA2 (P = 1.11 × 10−8) and POMC (P = 4.94 × 10−8) as well as a potential secondary signal at the POMC locus (rs2118404, P = 2.4 × 10−5 after conditioning on the established single-nucleotide polymorphism at this locus) in adolescents and young adults. To evaluate the impact of the established genetic loci on BMI at these young ages, we examined differences between the effect sizes of 32 published BMI loci in European adult populations (aged 18–90) and those observed in our adolescent and young adult meta-analysis. Four loci (near PRKD1, TNNI3K, SEC16B and CADM2) had larger effects and one locus (near SH2B1) had a smaller effect on BMI during adolescence and young adulthood compared with older adults (P < 0.05). These results suggest that genetic loci for BMI can vary in their effects across the life course, underlying the importance of evaluating BMI at different ages. PMID:23669352
Kahana, Shoshana Y; Rohan, Jennifer; Allison, Susannah; Frazier, Thomas W; Drotar, Dennis
The relationship between adherence to antiretroviral therapy (ART) and virologic outcomes in HIV+ children, adolescents, and young adults has been notably understudied, with much of the extant research focused on specific sub-literatures, such as resource-limited regions, specific clinical outcomes and time frames. The authors sought to better characterize the relationship between adherence to ART and virologic functioning along various sample and methodological factors. The authors conducted a meta-analysis of thirty-seven studies and utilized a random effects model to generate weighted mean effect sizes. In addition, the authors conducted meta-ANOVAs to examine potential factors influencing the relationship between adherence and three categories of clinical outcomes, specifically Viral Load (VL) <100, VL < 400, and continuously measured VL. The analyses included 5,344 HIV+ children, adolescents, and young adults. The relationship between adherence behaviors and virologic outcomes varied across different methods of measurement and analysis. The relationship between adherence and continuously measured VL was significantly larger than for dichotomously-coded VL < 400 at Qb (20.69(1), p < .0005). Caregiver self-report indices elicited very small to small magnitude effects across both VL < 100 and VL < 400 outcomes and combined informant reporting (youth/adolescent and parent) produced significantly larger effects than caregiver report alone with adherence and VL < 400 outcomes at Qb (9.28(1), p < .005). More recently published trials reported smaller relationships between adherence and categorical clinical outcomes, such that year of publication significantly negatively correlated with VL < 100 (r = -.71(14), p < .005) and VL < 400 (r = -.43(26), p < .02). The data suggest that the magnitude of the relationship between ART adherence and virologic outcomes among heterogeneous samples of HIV+ children, adolescents and young adults varies across virologic outcomes and
Burke, Jeffrey D.; Loeber, Rolf; Lahey, Benjamin B.
Unfortunately, very little research has examined the link between antisocial personality traits in childhood and adult psychopathy. This study used data from a clinic-referred sample of 177 boys, assessed annually from recruitment (ages 7 to 12) through age 19. Parent and teacher ratings of interpersonal callousness (IC) were tested at predictors…
Killoren, Sarah E; De Jesús, Sue A Rodríguez; Updegraff, Kimberly A; Wheeler, Lorey A
We examined profiles of sibling relationship qualities in 246 Mexican-origin families living in the United States using latent profile analyses. Three profiles were identified: Positive, Negative and Affect-Intense. Links between profiles and youths' familism values and adjustment were assessed using longitudinal data. Siblings in the Positive profile reported the highest familism values, followed by siblings in the Affect-Intense profile and, finally, siblings in the Negative profile. Older siblings in the Positive and Affect-Intense profiles reported fewer depressive symptoms than siblings in the Negative profile. Further, in the Positive and Negative profiles, older siblings reported less involvement in risky behaviors than younger siblings. In the Negative profile, younger siblings reported greater sexual risk behaviors in late adolescence than older siblings; siblings in opposite-sex dyads, as compared to same-sex dyads, engaged in riskier sexual behaviors. Our findings highlight sibling relationship quality as promotive and risky, depending on sibling characteristics and adjustment outcomes.
Daniel, Stephanie S; Goldston, David B; Erkanli, Alaattin; Franklin, Joseph C; Mayfield, Andrew M
Previous studies of the relationship between anger, anger expression, and suicidal behavior have been largely cross-sectional and have yielded mixed findings. In a prospective, naturalistic study, we examined how trait anger and anger expression influenced the likelihood of suicide attempts among 180 adolescents followed for up to 13.3 years after discharge from an inpatient psychiatry unit. Results showed that higher trait anger and anger expressed outwardly over the follow-up was related to increased likelihood of suicide attempts among boys. For girls, trait anger and both the inward and outward expression of anger moderated the risk for suicide attempts associated with major depression. These results are interpreted in light of theory regarding behavioral activation and behavioral inhibition systems.
Zebrack, Brad; Kwak, Minyoung; Salsman, John; Cousino, Melissa; Meeske, Kathleen; Aguilar, Christine; Embry, Leanne; Block, Rebecca; Hayes-Lattin, Brandon; Cole, Steve
Objective Theories of posttraumatic growth suggest that some degree of distress is necessary to stimulate growth; yet investigations of the relationship between stress and growth following trauma are mixed. This study aims to understand the relationship between posttraumatic stress symptoms and posttraumatic growth in adolescent and young adult (AYA) cancer patients. Method 165 AYA patients aged 14–39 years at diagnosis completed standardized measures of posttraumatic stress and posttraumatic growth at 12 months following diagnosis. Locally weighted scatterplot smoothing and regression were used to examine linear and curvilinear relationship between posttraumatic stress and posttraumatic growth. Results No significant relationships between overall posttraumatic stress severity and posttraumatic growth were observed at 12-month follow-up. However, curvilinear relationships between re-experiencing (a posttraumatic stress symptom) and two of five posttraumatic growth indicators (New possibilities, Personal strengths) were observed. Conclusion Findings suggest that re-experiencing is associated with some aspects of posttraumatic growth but not others. Although re-experiencing is considered a symptom of post-traumatic stress disorder, it also may represent a cognitive process necessary to achieve personal growth for AYAs. Findings call into question the supposed psychopathological nature of re-experiencing and suggest that re-experiencing, as a cognitive process, may be psychologically adaptive. Opportunities to engage family, friends, cancer survivors, or health care professionals in frank discussions about fears, worries, or concerns may help AYAs re-experiencing cancer in a way that enhances their understanding of what happened to them and contributes to positive adaptation to life after cancer. PMID:24916740
Roth, Michael E.; O’Mara, Ann M.; Seibel, Nita L.; Dickens, David S.; Langevin, Anne-Marie; Pollock, Brad H.
Purpose: Stagnant outcomes for adolescents and young adults (AYAs; 15 to 39 years old) with cancer are partly attributed to poor enrollment onto clinical trials. The National Cancer Institute (NCI) Community Clinical Oncology Program (CCOP) was developed to improve clinical trial participation in the community setting, where AYAs are most often treated. Further, many CCOP sites had pediatric and medical oncologists with collaborative potential for AYA recruitment and care. For these reasons, we hypothesized that CCOP sites enrolled proportionately more AYAs than non-CCOP sites onto Children’s Oncology Group (COG) trials. Methods: For the 10-year period 2004 through 2013, the NCI Division of Cancer Prevention database was queried to evaluate enrollments into relevant COG studies. The proportional enrollment of AYAs at CCOP and non-CCOP sites was compared and the change in AYA enrollment patterns assessed. All sites were COG member institutions. Results: Although CCOP sites enrolled a higher proportion of patients in cancer control studies than non-CCOP sites (3.5% v 1.8%; P < .001), they enrolled a lower proportion of AYAs (24.1% v 28.2%, respectively; P < .001). Proportional AYA enrollment at CCOP sites decreased during the intervals 2004 through 2008 and 2009 through 2013 (26.7% v 21.7%; P < .001). Conclusion: Despite oncology practice settings that might be expected to achieve otherwise, CCOP sites did not enroll a larger proportion of AYAs in clinical trials than traditional COG institutions. Our findings suggest that the CCOP (now the NCI Community Oncology Research Program) can be leveraged for developing targeted interventions for overcoming AYA enrollment barriers. PMID:27026648
Kitsune, Glenn L; Cheung, Celeste H M; Brandeis, Daniel; Banaschewski, Tobias; Asherson, Philip; McLoughlin, Gráinne; Kuntsi, Jonna
Elevated theta or theta/beta ratio is often reported in attention deficit hyperactivity disorder (ADHD), but the consistency across studies and the relation to hypoarousal are increasingly questioned. Reports of elevated delta related to maturational lag and of attenuated beta activity are less well replicated. Some critical inconsistencies could relate to differences in recording context. We examined if resting-state EEG power or global field synchronization (GFS) differed between recordings made at the beginning and end of a 1.5 h testing session in 76 adolescents and young adults with ADHD, and 85 controls. In addition, we aimed to examine the effect of IQ on any potential group differences. Both regional and midline electrodes yielded group main effects for delta, trends in theta, but no differences in alpha or theta/beta ratio. An additional group difference in beta was detected when using regions. Group by time interactions in delta and theta became significant when controlling for IQ. The ADHD group had higher delta and theta power at time-1, but not at time-2, whereas beta power was elevated only at time-2. GFS did not differ between groups or condition. We show some ADHD-control differences on EEG spectral power varied with recording time within a single recording session, with both IQ and electrode selection having a small but significant influence on observed differences. Our findings demonstrate the effect of recording context on resting-state EEG, and highlight the importance of accounting for these variables to ensure consistency of results in future studies.
Rytting, Michael E; Thomas, Deborah A; O'Brien, Susan M; Ravandi-Kashani, Farhad; Jabbour, Elias J; Franklin, Anna R; Kadia, Tapan M; Pemmaraju, Naveen; Daver, Naval G.; Ferrajoli, Alessandra; Garcia-Manero, Guillermo; Konopleva, Marina Y; Cortes, Jorge E; Borthakur, Gautham; Garris, Rebecca; Cardenas-Turanzas, Maria; Schroeder, Kurt; Jorgensen, Jeffrey L; Kornblau, Steven M; Kantarjian, Hagop M.
Background Various trials report improved outcomes for adolescents and young adults (AYA) with acute lymphoblastic leukemia (ALL) treated with pediatric- based regimens. This prompted the investigation of the pediatric Augmented Berlin-Frankfurt-Münster (ABFM) regimen in AYA patients. Results were compared with the hyper–fractionated cyclophosphamide, vincristine, Adriamycin and dexamethasone (hyper-CVAD) regimen in a similar population. Methods Eighty-five patients age 12 to 40 years with Philadelphia chromosome- (Ph) negative ALL were treated with ABFM from 10/2006 through 4/2012. Their outcome was compared to 71 historical AYA patients treated with hyper-CVAD from our institution. Patient and disease characteristics, as well as status of minimal residual disease (MRD), were analyzed for their impact on outcomes. Results The complete remission (CR) rate with ABFM was 94%. The 3-year complete remission duration (CRD) and overall survival (OS) rates were 70% and 74%, respectively. The 3-year CRD and OS were 72% and 85%, respectively, with age ≤ 21 years, and 69% and 60%, respectively, with age 21-40 years. Initial white blood cell count was an independent predictive factor of OS and CRD. The MRD status on Day 29 and Day 84 of therapy were also predictive of long-term outcomes. Severe regimen toxicities included transient hepatotoxicity in 35-39%, pancreatitis in 11%, osteonecrosis in 11%, and thrombosis in 22%. The 3-year OS rate was 74% with ABFM versus 71% with hyper-CVAD; the 3-year CRD rate was 70% with ABFM versus 66% with hyper-CVAD. Conclusion ABFM was tolerable in AYA patients with ALL but was not associated with significant improvements in CRD and OS compared with hyper-CVAD. PMID:25042398
Jennings, Jacky M; Hensel, Devon J; Tanner, Amanda E; Reilly, Meredith L; Ellen, Jonathan M
This study explored the relationship between the social organization of neighborhoods including informal social control and social cohesion and a current bacterial sexually transmitted infection (STI) among adolescents and young adults in one U.S. urban setting. Data for the current study were collected from April 2004 to April 2007 in a cross-sectional household study. The target population included English-speaking, sexually-active persons between the ages of 15 and 24 years who resided in 486 neighborhoods. The study sample included 599 participants from 63 neighborhoods. A current bacterial STI was defined as diagnosis of a chlamydia and/or gonorrhea infection at the time of study participation. Participants reported on informal social control (i.e. scale comprised of 9 items) and social cohesion (i.e. scale comprised of 5 items) in their neighborhood. In a series of weighted multilevel logistic regression models stratified by gender, greater informal social control was significantly associated with a decreased odds of a current bacterial STI among females (AOR 0.53, 95% CI 0.34, 0.84) after controlling for individual social support and other factors. The association, while in a similar direction, was not significant for males (AOR 0.73, 95% CI 0.48, 1.12). Social cohesion was not significantly associated with a current bacterial STI among females (OR 0.85, 95% CI 0.61, 1.19) and separately, males (OR 0.98, 95% CI 0.67, 1.44). Greater individual social support was associated with an almost seven-fold increase in the odds of a bacterial STI among males (AOR 6.85, 95% CI 1.99, 23.53), a finding which is in contrast to our hypotheses. The findings suggest that neighborhood social organizational factors such as informal social control have an independent relationship with sexual health among U.S. urban youth. The causality of the relationship remains to be determined.
Ameringer, Suzanne; Erickson, Jeanne M; Macpherson, Catherine Fiona; Stegenga, Kristin; Linder, Lauri A
Adolescents and young adults (AYAs) with cancer experience multiple distressing symptoms during treatment. Because the typical approach to symptom assessment does not easily reflect the symptom experience of individuals, alternative approaches to enhancing communication between the patient and provider are needed. We developed an iPad-based application that uses a heuristic approach to explore AYAs' cancer symptom experiences. In this mixed-methods descriptive study, 72 AYAs (13-29 years old) with cancer receiving myelosuppressive chemotherapy used the Computerized Symptom Capture Tool (C-SCAT) to create images of the symptoms and symptom clusters they experienced from a list of 30 symptoms. They answered open-ended questions within the C-SCAT about the causes of their symptoms and symptom clusters. The images generated through the C-SCAT and accompanying free-text data were analyzed using descriptive, content, and visual analyses. Most participants (n = 70) reported multiple symptoms (M = 8.14). The most frequently reported symptoms were nausea (65.3%), feeling drowsy (55.6%), lack of appetite (55.6%), and lack of energy (55.6%). Forty-six grouped their symptoms into one or more clusters. The most common symptom cluster was nausea/eating problems/appetite problems. Nausea was most frequently named as the priority symptom in a cluster and as a cause of other symptoms. Although common threads were present in the symptoms experienced by AYAs, the graphic images revealed unique perspectives and a range of complexity of symptom relationships, clusters, and causes. Results highlight the need for a tailored approach to symptom management based on how the AYA with cancer perceives his or her symptom experience.
Maher, Ossama M; Khatua, Soumen; Mukherjee, Devashis; Olar, Adriana; Lazar, Alexander; Luthra, Raja; Liu, Diane; Wu, Jimin; Ketonen, Leena; Zaky, Wafik
There is a paucity of literature reporting the outcome of intracranial sarcomas (IS) in children, adolescents, and young adults (CAYA). A multimodal therapeutic approach is commonly used, with no well-established treatment consensus. We conducted a retrospective review of CAYA with IS, treated at our institution, to determine their clinical findings, treatments, and outcomes. Immunohistochemistry (PDGFRA and EGFR) and DNA sequencing were performed on 5 tumor samples. A literature review of IS was also conducted. We reviewed 13 patients (median age, 7 years) with a primary diagnosis of IS between 1990 and 2015. Diagnoses included unclassified sarcoma (n = 9), chondrosarcoma (n = 2), and rhabdomyosarcoma (n = 2). Five patients underwent upfront gross total resection (GTR) of the tumor. The 5-drug regimen (vincristine, doxorubicin, cyclophosphamide, etoposide, and ifosfamide) was the most common treatment used. Nine patients died due to progression or recurrence (n = 8) or secondary malignancy (n = 1). The median follow-up period of the 4 surviving patients was 1.69 years (range 1.44-5.17 years). The 5-year progression-free survival and overall survival rates were 21 and 44 %, respectively. BRAF, TP53, KRAS, KIT, ERBB2, MET, RET, ATM, and EGFR mutations were detected in 4 of the 5 tissue samples. All 5 samples were immunopositive for PDGFRA, and only 2 were positive for EGFR. IS remain a therapeutic challenge due to high progression and recurrence rates. Collaborative multi-institutional studies are warranted to delineate a treatment consensus and investigate tumor biology to improve the disease outcome.
Aubin, Sylvie; Perez, Samara
Introduction Adolescents and young adults aged 15–39 years who have been diagnosed with cancer (AYAC) have unique medical and psychosocial needs. Following their cancer treatments, AYAC must learn to manage the sometimes irreversible general side effects of cancer treatments including side effects that impact their sexuality. These side effects include but are not limited to: infertility, altered body/physical appearance, and sexual dysfunction. Such effects may hinder AYAC efforts to date and experiment sexually, limiting sexual maturation and confidence, as well as the formation or maintenance of meaningful couple and sexual relationships. It is clear that we need to tailor our clinical approaches to ensure that we assess the unique needs and concerns faced by AYAC. Aims Based on consistent study findings substantiating the distinctive needs of AYAC, the main objective of this article is to present the core clinical components involved in assessing sexuality among AYAC. Methods The clinical recommendations are based on the authors and experts' clinical experiences coupled with a thorough examination of the literature related to AYAC sexuality. Main Outcome Measures This article first describes the three components (clinical interview, review of chart notes, and self-report questionnaires) of a sexuality assessment and the seven core domains that highlight target areas of focus. Results A detailed outline of each of the core domains of assessment (socio-demographics; medical history; fertility and sexually transmitted infection; sexual functioning; sexual coping style; body and self-image; and sexual history and dating/couple experience) is presented. A “toolbox” table containing useful resources for clinicians (e.g., questionnaires and red flags) and direct resources for AYAC patients are included. Conclusion Cancer can have a significant impact on numerous domains of AYAC sexuality. The assessment of and attention to the impact of sexuality on AYAC is
Husson, Olga; Zebrack, Brad J; Block, Rebecca; Embry, Leanne; Aguilar, Christine; Hayes-Lattin, Brandon; Cole, Steve
Purpose To examine changes in health-related quality of life (HRQoL) and its predictors during the first 2 years after initial cancer diagnosis in adolescent and young adult (AYA) patients with cancer. Patients and Methods A multicenter, longitudinal, prospective study was conducted among a diverse sample of AYA patients with cancer ages 15 to 39 years. One hundred seventy-six patients (75% response) completed a self-report measure of HRQoL (Short Form-36 [SF-36]) within the first 4 months after diagnosis and again 12 and 24 months later. Linear mixed models with random intercepts and slopes estimated changes in QoL. Results Recently diagnosed AYA patients with cancer had significantly worse physical component scale (PCS) scores (38.7 v 52.8; P < .001) and mental component scale (MCS) scores (42.9 v 48.9; P < .001) when compared with population norms. Significant improvements in PCS and MCS scores from baseline to 24-month follow-up were observed; however, these increases were largest during the first 12 months. At the 24-month follow-up, AYA patients still had significantly lower PCS scores (48.0 v 52.8; P < .001) and MCS scores (45.8 v 48.9; P = .002) when compared with population norms. Multivariable analyses revealed that improvements in PCS and MCS scores were primarily a function of being off-treatment and being involved in school or work. PCS but not MCS scores were worse for AYA patients diagnosed with cancers with poorer prognoses. Conclusion Although HRQoL improved over time, it was still compromised 24 months after primary diagnosis. Given relatively little observed improvement in HRQoL during the 12- to 24-month period after diagnosis, AYA patients may benefit from supportive care interventions administered during the second year after diagnosis.
Zepf, F.D.; Sungurtekin, I.; Glass, F.; Elstrodt, L.; Peetz, D.; Hintereder, G.; Kratzsch, J.; Biskup, C.S.; Poustka, F.; Wöckel, L.
Background Evidence from animal studies suggests that leptin metabolism is associated with zinc (Zn) status. However, research investigating this relationship in adolescents and young adults with anorexia nervosa (AN) is scarce; the present study aims to fill that gap. Methods Serum concentrations of leptin, the soluble leptin receptor (sOB-R) and the free leptin index (FLI) were obtained in healthy control subjects (n=19), acutely ill individuals (n=14) and recovered patients with AN (n=15). Serum Zn concentrations noted in previous research data were also incorporated for all groups. Results Leptin, FLI and Zn concentrations were higher in recovered subjects with AN when compared with acutely ill AN patients. Remitted patients showed higher sOB-R concentrations but no difference in FLI compared with the control group. Leptin and FLI were lower in the acutely ill patients compared with the control subjects, who showed no differences in Zn concentrations. Zn concentrations were not correlated with leptin, sOB-R or FLI concentrations in any of the three investigated subgroups. Conclusions The present investigation does not entirely support an association between Zn, Leptin and FLI concentrations in subjects with AN, possibly due to limited statistical power. Further research and replication of the present findings related to the interaction between leptin and Zn is warranted. However, with respect to serum leptin levels the data of the present investigation indicate that acutely ill and remitted patients with AN differ as regards serum leptin concentrations and FLI, which is in line with previous research. PMID:22393314
Troop, Nick A.; Sullivan, Keith R.; Hart, Daniel P.
Introduction haemophilia is an inherited bleeding disorder caused by a deficiency in one of the blood coagulation factors. For people affected by severe haemophilia, the deficiency can cause spontaneous internal bleeding. Most young people with severe haemophilia in the UK follow a preventative treatment regimen (prophylaxis) consisting of several intravenous injections of factor concentrate each week. There is good evidence that prophylaxis reduces bleeds whilst also improving quality of life. However, levels of adherence among young people with haemophilia reported in the existing literature vary widely and are predominately based on estimations made by healthcare professionals and parents. Additionally, drivers of (non)adherence among young people specifically have not been evidenced. Aim to assess self-reported adherence among young people with haemophilia, provide evidence of psychosocial predictors of adherence, and to establish the associations between non-adherence and number of bleeds and hospital visits. Methods 91 participants were recruited during outpatient appointments in 13 haemophilia centres across England and Wales, and invited to complete a questionnaire assessing self-reported adherence (VERITAS-Pro), Haemophilia-related pain and impact of pain, Illness Perceptions, Beliefs about Medications, Self-efficacy, Outcome expectations, Positive and Negative Affect, and Social support. Number of hospital visits and bleeds during the previous six months were collected from medical files. Results Of 78 participants with complete data, just 18% had scores indicating non-adherence. Psychosocial predictors differed between intentional (skipping) and un-intentional (forgetting) non-adherence. Overall, however, better adherence was reported where participants perceived the need for prophylaxis was greater than their concern over taking it as well as having a positive expectancy of its effectiveness, good social support and a stronger emotional reaction to
Brüll, Phil; Ruiter, Robert A. C.; Wiers, Reinout W.; Kok, Gerjo
Young people are especially vulnerable to sexually transmitted infections (STIs). The triad of deliberate and effective safer sex behavior encompasses condom use, combined with additional information about a partner’s sexual health, and the kind of sex acts usually performed. To identify psychosocial predictors of young people’s intentions to have safer sex, as related to this triad, we conducted an online study with 211 sexually active participants aged between 18 and 24 years. Predictors [i.e., perceived behavioral control (PBC), subjective norms, and intention] taken from Fishbein and Ajzen’s Reasoned Action Approach (RAA), were combined with more distal variables (e.g., behavioral inhibition, sensation seeking, parental monitoring, and knowledge about STIs). Beyond the highly predictive power of RAA variables, additional variance was explained by the number of instances of unprotected sexual intercourse (SI) during the last 12 months and reasons for using barrier protection during first SI. In particular, past condom non-use behavior moderated PBC related to intended condom use. Further, various distal variables showed significant univariate associations with intentions related to the three behaviors of interest. It may, therefore, be helpful to include measures of past behavior as well as certain additional distal variables in future safer sex programs designed to promote health-sustaining sexual behavior. PMID:27148520
Suisman, Jessica L.; Thompson, J. Kevin; Keel, Pamela K.; Burt, S. Alexandra; Neale, Michael; Boker, Steven; Sisk, Cheryl; Klump, Kelly L.
Objective Mean-levels of thin-ideal internalization increase during adolescence and pubertal development, but it is unknown whether these phenotypic changes correspond to developmental changes in etiological (i.e., genetic and environmental) risk. Given the limited knowledge on risk for thin-ideal internalization, research is needed to guide the identification of specific types of risk factors during critical developmental periods. The present twin study examined genetic and environmental influences on thin-ideal internalization across adolescent and pubertal development. Method Participants were 1,064 female twins (ages 8–25 years) from the Michigan State University Twin Registry. Thin-ideal internalization and pubertal development were assessed using self-report questionnaires. Twin moderation models were used to examine if age and/or pubertal development moderate genetic and environmental influences on thin-ideal internalization. Results Phenotypic analyses indicated significant increases in thin-ideal internalization across age and pubertal development. Twin models suggested no significant differences in etiologic effects across development. Nonshared environmental influences were most important in the etiology of thin-ideal internalization, with genetic, shared environmental, and nonshared environmental accounting for approximately 8%, 15%, and 72%, respectively, of the total variance. Discussion Despite mean-level increases in thin-ideal internalization across development, the relative influence of genetic versus environmental risk did not differ significantly across age or pubertal groups. The majority of variance in thin-ideal internalization was accounted for by environmental factors, suggesting that mean-level increases in thin-ideal internalization may reflect increases in the magnitude/strength of environmental risk across this period. Replication is needed, particularly with longitudinal designs that assess thin-ideal internalization across key
Flerlage, Jamie E; Kelly, Kara M; Beishuizen, Auke; Cho, Steve; De Alarcon, Pedro A; Dieckmann, Ute; Drachtman, Richard A; Hoppe, Bradford S; Howard, Scott C; Kaste, Sue C; Kluge, Regine; Kurch, Lars; Landman-Parker, Judith; Lewis, Jocelyn; Link, Michael P; McCarten, Kathleen; Punnett, Angela; Stoevesandt, Dietrich; Voss, Stephan D; Wallace, William Hamish; Mauz-Körholz, Christine; Metzger, Monika L
International harmonization of staging evaluation and response criteria is needed for childhood, adolescence, and young adulthood Hodgkin lymphoma. Two Hodgkin lymphoma protocols from cooperative trials in Europe and North America were compared for areas in need of harmonization, and an evidence-based approach is currently underway to harmonize staging and response evaluations with a goal to enhance comparisons, expedite identification of effective therapies, and aid in the approval process for new agents by regulatory agencies.
Stewart, H; Noble, G; Seeger, B R
This research was undertaken to determine the best wheelchair driving method for clients with cerebral palsy who were experiencing difficulties using displacement joysticks. The hypothesis was that adolescents with cerebral palsy would perform better in a tracking task using an isometric joystick (which has no moving parts) than a displacement joystick of the type used in commercial wheelchair controllers. A series of single subject case studies was performed in which the activating force of the isometric joystick was individualised for each subject. Comparative evaluation of the isometric joystick and a displacement joystick was then carried out. Results indicate that performance using the displacement joystick was superior to performance with the isometric joystick for the able-bodied subject and four of the five subjects with cerebral palsy. One of the subjects showed significantly better performance on the displacement joystick using his hand, and no significant difference between joysticks using his foot. The remaining subject, who used his foot, showed no significant difference between joysticks. These findings suggest that subjects with cerebral palsy with prior experience using a displacement joystick do not appear to benefit by the use of an isometric joystick compared to a displacement joystick. No difference in the use of the two joysticks was found for subjects with cerebral palsy who had no prior experience using a joystick. This suggests that an isometric joystick is an option for people beginning to learn to drive an electric wheelchair.
Crowe, Chris, Ed.
Outlines some of the many confusions about young adult literature. Sheds some light on what young adult literature is (defining it as all genres of literature published since 1967 that are written for and marketed to young adults). Discusses briefly how it can be used in schools. Offers a list of the author's 20 favorite books for teenagers. (SR)
Cerrato, Felecia E; Pruthi, Sandhya; Boughey, Judy C; Simmons, Patricia S; Salje, Barbara; Nuzzi, Laura C; Lemaine, Valerie; Labow, Brian I
Giant fibroadenomas (5 cm or greater) are benign breast masses that often present in adolescence and require surgical excision. Long-term outcomes, recurrence rates, and the need for additional reconstructive surgery in this population are unknown. Patients aged 11-25 years whose pathology reports indicated the presence of a giant fibroadenoma were eligible for this study. Medical records were reviewed for presentation, treatment, and outcomes. A subset of patients completed an investigator-designed long-term outcome survey to measure additional outcomes and the desire or need for subsequent reconstructive surgery. Forty-six patients with at least one giant fibroadenoma (mean size 7.4 ± 2.8 cm) were identified. Most patients underwent excision with a periaroeolar incision (n = 31), and an enucleation technique (n = 41), and four patients underwent immediate breast reconstruction. Thirty-three patients had complete medical records with a mean follow-up time of 2.2 ± 4.1 years and no complaints of asymmetry, additional breast deformities, or reconstructive surgery procedures documented. In addition, nine patients completed the investigator-designed survey with a mean follow-up time of 10.1 ± 8.7 years (range 1.5-27.0). Three of these patients reported postoperative breast asymmetry and the desire to pursue reconstructive surgery. Aesthetic outcomes of giant fibroadenoma excision may be satisfactory for many patients without immediate reconstruction, but for others, the need for reconstructive surgery may arise during development. Providers should address this potential need prior to discussing treatment options and during postoperative follow-up. Caution should be exercised before recommending immediate reconstruction.
Jugert, Philipp; Eckstein, Katharina; Noack, Peter; Kuhn, Alexandra; Benbow, Alison
Levels of civic engagement are assumed to vary according to numerous social and psychological characteristics, but not much is known about online civic engagement. This study aimed to investigate differences and similarities in young people's offline and online civic engagement and to clarify, based on Ajzen's theory of planned behavior (TPB), associations between motivation for civic engagement, peer and parental norms, collective efficacy, and civic engagement. The sample consisted of 755 youth (native German, ethnic German Diaspora, and Turkish migrants) from two age groups (16-18 and 19-26; mean age 20.5 years; 52 % female). Results showed that ethnic group membership and age moderated the frequency of engagement behavior, with Turkish migrants taking part more than native Germans, who were followed by ethnic German Diaspora migrants. Analyses based on TPB showed good fit for a model relating intention for offline and online civic engagement to motivation for civic engagement, peer and parental norms, and collective efficacy. Ethnic group moderated the findings for offline civic engagement and questioned the universality of some model parameters (e.g., peer and parental norms). This study showed the utility of the TPB framework for studying civic engagement but also reveals that the predictive utility of peer and parental norms seems to vary depending on the group and the behavior under study. This study highlights the importance of including minority samples in the study of civic engagement in order to identify between-group similarities and differences.
Background A cancer diagnosis is 2.9 times more likely to occur during the adolescent and young adult years than in younger children. This spike in incidence coincides with a life stage characterised by psychological vulnerability as young people strive to attain numerous, critical developmental milestones. The distress young people experience after cancer treatment seriously jeopardises their ability to move into well-functioning adulthood. Methods/Design This article presents the protocol of the Recapture Life study, a phase II three-arm randomised controlled trial designed to evaluate the feasibility and efficacy of a new intervention in reducing distress and improving quality of life for adolescent and young adult cancer survivors. The novel intervention, “ReCaPTure LiFe” will be compared to a both a wait-list, and a peer-support group control. Ninety young people aged 15–25 years who have completed cancer treatment in the past 1–6 months will be recruited from hospitals around Australia. Those randomised to receive Recapture Life will participate in six, weekly, 90-minute online group sessions led by a psychologist, involving peer-discussion around cognitive-behavioural coping skills (including: behavioural activation, thought challenging, communication and assertiveness skills training, problem-solving and goal-setting). Participants randomised to the peer-support group control will receive non-directive peer support delivered in an identical manner. Participants will complete psychosocial measures at baseline, post-intervention, and 12-months post-intervention. The primary outcome will be quality of life. Secondary outcomes will include depression, anxiety, stress, family functioning, coping, and cancer-related identity. Discussion This article reviews the empirical rationale for using group-based, online cognitive-behavioural therapy in young people after cancer treatment. The potential challenges of delivering skills-based programs in an online
Jennings, Larissa; Mathai, Muthoni; Linnemayr, Sebastian; Trujillo, Antonio; Mak'anyengo, Margaret; Montgomery, Brooke E E; Kerrigan, Deanna L
Urban slum adolescents and young adults have disproportionately high rates of HIV compared to rural and non-slum urban youth. Yet, few studies have examined youth's perceptions of the economic drivers of HIV. Informed by traditional and behavioral economics, we applied a scarcity theoretical framework to qualitatively examine how poverty influences sexual risk behaviors among adolescents and young adults. Focus group discussions with one hundred twenty youth in Kenyan's urban slums were transcribed, coded, and analyzed using interpretive phenomenology. Results indicated that slum youth made many sexual decisions considered rational from a traditional economics perspective, such as acquiring more sex when resources were available, maximizing wealth through sex, being price-sensitive to costs of condoms or testing services, and taking more risks when protected from adverse sexual consequences. Youth's engagement in sexual risk behaviors was also motivated by scarcity phenomena explained by behavioral economics, such as compensating for sex lost during scarce periods (risk-seeking), valuing economic gains over HIV risks (tunneling, bandwidth tax), and transacting sex as an investment strategy (internal referencing). When scarcity was alleviated, young women additionally described reducing the number of sex partners to account for non-economic preferences (slack). Prevention strategies should address the traditional and behavioral economics of the HIV epidemic.
Beaty, Lee A.
In this paper, development during the adolescent period is considered from a counseling perspective. Although many of the issues of young adults continue to confront older adults, this paper discusses the issues that are special to this age group. It suggests that the emotional and social domain is best represented by the theory of Erikson, which…
Vorstman, Jacob AS; Kon, Moshe; Mink van der Molen, Aebele B
Background Speech problems are a common clinical feature of the 22q11.2 deletion syndrome. The objectives of this study were to inventory the speech history and current self-reported speech rating of adolescents and young adults, and examine the possible variables influencing the current speech ratings, including cleft palate, surgery, speech and language therapy, intelligence quotient, and age at assessment. Methods In this cross-sectional cohort study, 50 adolescents and young adults with the 22q11.2 deletion syndrome (ages, 12-26 years, 67% female) filled out questionnaires. A neuropsychologist administered an age-appropriate intelligence quotient test. The demographics, histories, and intelligence of patients with normal speech (speech rating=1) were compared to those of patients with different speech (speech rating>1). Results Of the 50 patients, a minority (26%) had a cleft palate, nearly half (46%) underwent a pharyngoplasty, and all (100%) had speech and language therapy. Poorer speech ratings were correlated with more years of speech and language therapy (Spearman's correlation= 0.418, P=0.004; 95% confidence interval, 0.145-0.632). Only 34% had normal speech ratings. The groups with normal and different speech were not significantly different with respect to the demographic variables; a history of cleft palate, surgery, or speech and language therapy; and the intelligence quotient. Conclusions All adolescents and young adults with the 22q11.2 deletion syndrome had undergone speech and language therapy, and nearly half of them underwent pharyngoplasty. Only 34% attained normal speech ratings. Those with poorer speech ratings had speech and language therapy for more years. PMID:25276637
Wang, Daoyang; Hu, Mingming; Zheng, Chanjin; Liu, Zhengguang
Introduction: The original 89-item Zuckerman–Kuhlman Personality Questionnaire (form III Revised, ZKPQ-III-R) is a widely accepted and used self-report measure for personality traits. This study assessed the reliability and construct validity of the Chinese short 46-item version of the ZKPQ-III-R in a sample of adolescents and young adults. Methodology: A total of 1,019 Chinese adolescents and young adults completed the Chinese version of the original 89-item version ZKPQ-III-R and short 46-item version ZKPQ-III-R, self-report measures of depression, life satisfaction, and subjective health complaints (SHC), the Big Five personality traits, and a substance use risk profile. We explored the internal consistency of five dimensions of the short 46-item version ZKPQ-III-R and compared it with observations in previous studies of Chinese and other populations. The structure of the questionnaire was analyzed by confirmatory factor analysis and exploratory structural equation modeling. Results: The short 46-item version ZKPQ-III-R had adequate internal reliability for all five dimensions, with Cronbach’s α coefficients of 0.63 to 0.84. The concurrent validity of the short 46-item version ZKPQ-III-R was supported by significant correlations with depression, life satisfaction, and SHC. The short 46-item version ZKPQ-III-R had better fit, similar reliability coefficients, and slightly better construct and convergent validity than the 89-item version. Conclusion: The Chinese version of the 46-item ZKPQ-III-R presented reliability and validity in measuring personality in Chinese adolescents and young adults. PMID:28326057
Boyer, Cherrie B; Greenberg, Lauren; Chutuape, Kate; Walker, Bendu; Monte, Dina; Kirk, Jennifer; Ellen, Jonathan M
The goal of this research was to examine associations among sociodemographic factors, HIV risk, and community context (e.g., economic insecurity, job training, housing instability, crime victimization, and perceived community norms) in adolescents and young adults who ever exchanged sex for drugs or money. Anonymous survey data were collected using ACASIs at community venues where adolescents and young adults congregate in resource-challenged, STI prevalent, urban, US neighborhoods. Conventional descriptive statistics, Fisher's exact tests, and generalized estimating equations approaches were used to examine associations. Participants (1818, 95.5 % of those screened eligible) were, on average, aged 21.0 years; 42.2 % were males, and 4.6 % were transgender. Almost one-third (32.1 %) identified as gay or lesbian, 18.1 % identified as bisexual; 66.2 % were Black and 21.0 % were Hispanic; 1.3 % was 'living on the street'. A sizeable proportion reported HIV-related risk: 16.3 % exchanged sex, 12.6 % had sex with someone they knew to be HIV-infected, 7.8 % had sex with someone who injected drugs, and 1.3 % injected drugs. Multivariate comparisons identified a number of variables (e.g., being male or transgender, homelessness, sex with a partner who has HIV, STI history, unemployment, job training access, housing instability, crime victimization, perceived community norms) that were significantly associated with exchange of sex (p < 0.05). This research contributes to the knowledge-base regarding exchange of sex among adolescents and young adults, particularly as it relates to community context. Longitudinal studies to describe the trajectory of social, health, and physical risks and consequences are needed for development of effective evidence-based prevention strategies.
Hawk, Jane Ward; Lester, Virda K.
One of the most effective means of achieving a successful program in reading is the use of the young adult novel to stimulate the adolescent's interest in free reading or even to instill an interest where there is none. A novel which provides pleasurable reading experiences with interesting material at the proper level (such as novels by Judy…
Bach, Jacqueline; Choate, Laura Hensley; Parker, Bruce
As the body of high quality young adult literature (YAL) continues to grow, what role might these texts play in professional development for educators? This article describes ways in which schools can develop book study programs that use this literature to promote meaningful dialogue and understanding of contemporary adolescent issues. Based on…
Attacks the trend in recent young adult novels to focus on individual adolescents and their self-centered concerns without having these characters confront the consequences of their actions and their effects on other people. Specifically examines the novels of Judy Blume and Alice Bach. (RBW)
Eaves, Linda C.; Ho, Helena H.
To learn about the lives of young adults with ASD, families with children born 1974-1984, diagnosed as preschoolers and followed into adolescence were contacted by mail. Of 76 eligible, 48 (63%) participated in a telephone interview. Global outcome scores were assigned based on work, friendships and independence. At mean age 24, half had good to…
Akhtar, Saad; Rauf, Shahzad M; Elhassan, Tusneem A M; Maghfoor, Irfan
High-dose chemotherapy (HDC) and autologous stem cell transplantation (auto-SCT) can salvage many patients with relapsed or refractory Hodgkin's lymphoma (HL). We are reporting the outcome of HDC auto-SCT and the impact of 21 prognostic factors in relapsed and refractory adolescent (14-21 years) and young adult (>21-30 years) (AYA) HL patients. We used Fine and Gray's competing risk analysis method and regression model for outcome analysis. From 1996 to 2013, 290 consecutive patients with biopsy-proven HL underwent HDC auto-SCT for relapsed/refractory HL; 216 patients (74.5 %) were AYA at the time of auto-SCT. Male/female were equal, median age at auto-SCT was 22.4 years, and there were 94 adolescent (43.5 %) and 122 young adults (56.5 %). There was refractory disease in 121 (56 %) patients, relapsed in 95 (44 %). Median follow-up was 72.6 months. The Kaplan-Meier method estimated that 5-year overall survival is 62.7 % (adolescents (63.5 %), young adults (62 %)) and event-free survival was 51.3 %. Five-year cumulative incidence of disease-specific death (DS-death) is 33 % and that of DS-event is 45 %. For DS-death, the multivariate analysis identified complete remission (CR) duration of <12 months (hazard ratio (HR) 3.61, P = 0.0009), no CR after salvage (HR: 3.93, P = 0.0002), and nodular sclerosis pathology (HR 3.3, P = 0.016) and positive B symptoms (HR 2, P = 0.028) as negative factors. For DS-event, CR duration of <12 months (HR 1.88, P = 0.02), no CR after salvage (HR 3.47, P = 0.000005) and nodular sclerosis pathology (HR 1.88, P = 0.02) were found significant. The Kaplan-Meier method estimated overall survival (OS) at 36 months with 0-2:3:4 factors being 93.6:54:21 %, respectively (P value <0.001). Kaplan-Meier estimated event-free survival (EFS) at 36 months with 0-1:2:3 factors being 84.6:65:31 %, respectively (P value <0.001). Clinically, adolescents have similar outcomes as young adults.
Maeng, Daniel D; Snyder, Susan R; Davis, Thomas W; Tomcavage, Janet F
Adolescents and young adults with special care and health needs in the United States-many of whom have Medicaid coverage-at the transition phase between pediatric and adult care often experience critical care gaps. To address this challenge, a new model-referred to as Comprehensive Care Clinic (CCC)-has been developed and implemented by Geisinger Health System since 2012. CCC comprises a care team, consisting of a generalist physician, advanced practitioner, pharmacist, and a nurse case manager, that develops and closely follows a coordinated care plan. This study examines the CCC impact on total cost of care and utilization by analyzing Geisinger Health Plan claims data obtained from 83 Medicaid patients enrolled in CCC. A set of multivariate regression models with patient fixed effects was estimated to obtain adjusted differences in cost and acute care utilization between the months in which the patients were enrolled and the months not enrolled in CCC. The results indicate that CCC enrollment was associated with a 28% reduction in per-member-per-month total cost ($3931 observed vs. $5451 expected; P = 0.028), driven by reductions in hospitalization and emergency department visits. This finding suggests a clinical redesign focused on adolescent and young adults with complex care needs can potentially reduce total cost and acute care utilization among such patients.
Geldhof, John; Little, Todd D.; Hawley, Patricia H.
In this paper we present domain-specific measures of academic and social self-regulation in young adults. We base our scales on Baltes and colleagues' Selection, Optimization, and Compensation (SOC) model, and establish the factor structure of our new measures using data collected from a sample of 152 college students. We then compare the…
Multicultural children's and young adult literature provides readers with various opportunities: to mirror their lives and reflect the meanings of their own experiences; to gain insight on social issues as well as personal issues; and to enhance cross-cultural awareness. How might Korean/Korean American youth cope with everyday life as a minority…
Cederlund, Mats; Hagberg, Bibbi; Gillberg, Christopher
Descriptive and comparative follow-up studies of young adult males with Asperger syndrome (AS) diagnosed in childhood, using both interview, self- and parent assessment instruments for the study of aspects of emotional well-being, social functioning, and cognitive-practical skills have not been performed in the past. One-hundred males with AS…
Harrison, Allyson G.; Green, Paul; Flaro, Lloyd
It is almost self-evident that test results will be unreliable and misleading if those undergoing assessments do not make a full effort on testing. Nevertheless, objective tests of effort have not typically been used with young adults to determine whether test results are valid or not. Because of the potential economic and/or recreational benefits…
Polirstok, Susan Rovet; Dana, Lawrence; Buono, Serafino; Mongelli, Vita; Trubia, Grazia
A study evaluated a therapeutic intervention program for young adults with severe autism at the Oasi Institute in Troina, Sicily. The program, which integrates gentle teaching, humanistic applied behavior analysis, and functional communication training, provides opportunities to acquire functional skills through errorless learning activities.…
Scholes-Balog, Kirsty E; Hemphill, Sheryl A; Evans-Whipp, Tracy J; Toumbourou, John W; Patton, George C
This study aimed to identify distinct developmental trajectories (sub-groups of individuals who showed similar longitudinal patterns) of cannabis use among Australian adolescents, and to examine associations between trajectory group membership and measures of social and behavioural adjustment in young adulthood. Participants (n=852, 53% female) were part of the International Youth Development Study. Latent class growth analysis was used to identify distinct trajectories of cannabis use frequency from average ages 12 to 19, across 6 waves of data. Logistic regression analyses and analyses of covariance were used to examine relationships between trajectory group membership and young adult (average age: 21) adjustment, controlling for a range of covariates. Three trajectories were identified: abstainers (62%), early onset users (11%), and late onset occasional users (27%). The early onset users showed a higher frequency of antisocial behaviour, violence, cannabis use, cannabis-related harms, cigarette use, and alcohol harms, compared to the abstinent group in young adulthood. The late onset occasional users reported a higher frequency of cannabis use, cannabis-related harms, illicit drug use, and alcohol harms, compared to the abstinent group in young adulthood. There were no differences between the trajectory groups on measures of employment, school completion, post-secondary education, income, depression/anxiety, or alcohol use problems. In conclusion, early onset of cannabis use, even at relatively low frequency during adolescence, is associated with poorer adjustment in young adulthood. Prevention and intervention efforts to delay or prevent uptake of cannabis use should be particularly focussed on early adolescence prior to age 12.
Bechtold, Jordan; Simpson, Theresa; White, Helene R.; Pardini, Dustin
Some evidence suggests that youth who use marijuana heavily during adolescence may be particularly prone to health problems in later adulthood (e.g., respiratory illnesses, psychotic symptoms). However, relatively few longitudinal studies have prospectively examined the long-term physical and mental health consequences associated with chronic adolescent marijuana use. The present study used data from a longitudinal sample of Black and White young men to determine whether different developmental patterns of marijuana use, assessed annually from early adolescence to the mid-20s, were associated with adverse physical (e.g., asthma, high blood pressure) and mental (e.g., psychosis, anxiety disorders) health outcomes in the mid-30s. Analyses also examined whether chronic marijuana use was more strongly associated with later health problems in Black men relative to White men. Findings from latent class growth curve analysis identified four distinct subgroups of marijuana users: early-onset chronic users, late increasing users, adolescence-limited users, and low/nonusers. Results indicated that the four marijuana use trajectory groups were not significantly different in terms of their physical and mental health problems assessed in the mid-30s. The associations between marijuana group membership and later health problems did not vary significantly by race. Findings are discussed within the context of a larger body of work investigating the potential long-term health consequences of early-onset chronic marijuana use, as well as the complications inherent in studying the possible link between marijuana use and health effects. PMID:26237286
Lord, Sarah; Marsch, Lisa
One in four youths aged 12 to 17 years and more than half of young adults aged 18 to 25 years in the United States have used an illicit drug in their lifetime. A significant number progress to problematic use, and only 1 in 10 young people who meet criteria for dependence or abuse receive some form of treatment. Despite advances in the field, effectively intervening along the continuum of drug use involvement remains a challenge. In this article, we review the current epidemiology of illicit drug use by young people; describe recent advances in assessment, intervention and treatment; and highlight how technology can help overcome barriers to effective management of drug use among young people. PMID:22423469
Halkitis, Perry N.; Siconolfi, Daniel; Fumerton, Megan; Barlup, Kristin
We sought to consider the phenomenon of intentional unprotected intercourse, known colloquially as barebacking, with regard to identities that gay men develop as barebackers and the developmental bases which may predispose some men to this identity. As part of a larger study, we analyzed the life history interviews of 12 diverse HIV-negative men in early adulthood, using thematic coding procedures to identify events, conditions, and emotional states in childhood and adolescence that might help to explain why uninfected young men might place themselves at risk for HIV seroconversion. These analyses elicited various risk bases in childhood and adolescence, including early sexual experiences, pronounced experimentation with and abuse of drugs and alcohol, feelings of loneliness, a lack of love relationships despite sexual activity, and early experiences of loss. These findings suggest a complex interplay between emotional factors and life events, which may help to explain these men as sexual risk takers. PMID:19946573
Adam, Emma K.; Chyu, Laura; Hoyt, Lindsay; Doane, Leah D.; Boisjoly, Johanne; Duncan, Greg; Chase-Lansdale, Lindsay; McDade, Thomas W.
Purpose To examine the associations between adverse interpersonal relationship histories experienced during adolescence and health in young adulthood in a large, nationally representative sample. Methods Using data from Waves I, II and III of the National Longitudinal Study of Adolescent Health, multiple adverse relationship experiences are examined, including high loneliness, low perceived parental support, frequent transitions in romantic relationships (relationship instability), exposure to intimate partner violence, and loss by death of important relationship figures. These histories are assessed, both individually and in a relationship risk index, as predictors of self-reported general health and depressive symptoms at Wave III (ages 18 to 27), controlling for baseline (Wave I) health and for demographic and health behavior covariates. Results Net of baseline health and covariates, each type of relationship risk (experienced between Wave I and Wave III) was related to either depression or general health at Wave III, with the strongest effects seen for exposure to intimate partner violence. In addition, a cumulative relationship risk index examining the extent to which youth experienced high levels of multiple relationship risk factors revealed that each additional adverse relationship experience increased the odds of reporting poor mental and general health at Wave III, with increases occurring in an additive manner. Conclusions Multiple types of adverse relationship experiences predicted increases in poor general health and depressive symptoms from adolescence to early adulthood. Consistent with a cumulative risk hypothesis, the more types of adverse relationship experiences a youth experienced, the worse their young adult health outcomes. PMID:21856520
Sanders, Peter W; Allen, G E Kawika; Fischer, Lane; Richards, P Scott; Morgan, David T; Potts, Richard W
We investigated the relationships between religiousness and spirituality and various indicators of mental health and positive psychosocial functioning in three separate samples of college students. A total of 898 students at Brigham Young University participated in the three studies. The students ranged in age from 17 to 26 years old, with the average age of 20.9 across all three samples. Our results indicate that intrinsic religiousness, spiritual maturity, and self-transcendence were significantly predictive of better mental health and positive functioning, including lower levels of depression, anxiety, and obsessive-compulsiveness, and higher levels of global self-esteem, identity integration, moral self-approval, and meaning in life. Intrinsic religiousness was not predictive of shame, perfectionism, and eating disorder symptoms. These findings are consistent with many prior studies that have found religiousness and spirituality to be positively associated with better mental health and positive psychosocial functioning in adolescents and young adults.
This study aimed at investigating the effects of individualistic-collectivistic value orientations on non-fatal suicidal behavior and attitudes in Turkish adolescents and young adults. A questionnaire containing measures of individualism, collectivism (INDCOL), non-fatal suicidal behaviors and suicidal attitudes was used to collect the data. The results showed that both suicidal ideation and attempts were significantly more frequent in participants classified as individualist than those who were classified as collectivist on the basis of INDCOL scale scores. Participants with individualistic tendencies displayed more permissive attitudes toward suicide than those with collectivistic tendencies but collectivists believed to a greater extent than the individualists that people should communicate suicidal problems to others. Participants with collectivistic tendencies showed more accepting and helping reactions to an imagined suicidal friend than those with individualistic tendencies. Suicidal ideation and attempts were more common among adolescents than young adults. The findings suggest that individualistic and collectivistic value orientations and developmental status specific stressors play a role in the distribution of nonfatal suicidal behavior and the nature of suicidal attitudes.
Romonath, Roswitha; Wahn, Claudia; Gregg, Noel
The present study addressed the question whether there is a relationship between phonological and orthographic processes of reading and spelling in adolescents and young adults with and without dyslexia in German and English. On the evidence of the Linguistic Coding Differences Hypothesis and results of the latest research in foreign language learning the hypothesis is tested if there is a relationship between phonological and orthographic knowledge on the one hand and decoding and spelling performance on the other hand in German adolescents and young adults reading and spelling German and English words. This hypothesis was tested with the statistical method of structural equation modeling and therefore the research population was divided into the following groups: group 1 with dyslexia in reading (n = 93), group 2 with dyslexia in spelling (n = 93), group 3 without dyslexia in reading (n = 95), and group 4 without dyslexia in spelling (n = 95). Results of data analysis show that the postulated prediction model fits only the data of the dyslexia group for reading and spelling, but not for the control group. Also the model for both groups does not fit. The results of the pilot study show that it is necessary to modify diagnostic instruments of measurement and to separate scales of phonological and orthographic processes.
Lang, Michael J; David, Victoria; Giese-Davis, Janine
This scoping review was conducted to understand the extent, range, and nature of current research on adolescents and young adults (AYA) with cancer and distress, depression, and anxiety (DDA). This information is necessary to find and aggregate valuable data on the AYA population embedded in generalized studies of DDA. Keyword searches of six relevant electronic databases identified 2156 articles, with 316 selected for abstract review and 40 for full text review. Full-text reviews and data extraction resulted in 34 studies being included, which ranged widely in design, sample size, age-range categorization, analysis methods, DDA measurement tool, overall study rigor, and quality of evidence. Studies very seldom reported using theory to guide their age categorization, with only four studies giving any rationale for their age-group definitions. All 34 studies found a significant association between at least one DDA construct and the younger age group relative to the older age groups at some point along the cancer trajectory. However, age as an independent risk factor for DDA is still unclear, as the relationship could be confounded by other age-related factors. Despite the wide range of definitions and effect sizes in the studies included in this review, one thing is clear: adolescents and young adults, however defined, are a distinct group within the cancer population with an elevated risk of DDA. Widespread adoption of a standard AYA age-range definition will be essential to any future meta-analytical psycho-oncology research in this population.
David, Victoria; Giese-Davis, Janine
This scoping review was conducted to understand the extent, range, and nature of current research on adolescents and young adults (AYA) with cancer and distress, depression, and anxiety (DDA). This information is necessary to find and aggregate valuable data on the AYA population embedded in generalized studies of DDA. Keyword searches of six relevant electronic databases identified 2156 articles, with 316 selected for abstract review and 40 for full text review. Full-text reviews and data extraction resulted in 34 studies being included, which ranged widely in design, sample size, age-range categorization, analysis methods, DDA measurement tool, overall study rigor, and quality of evidence. Studies very seldom reported using theory to guide their age categorization, with only four studies giving any rationale for their age-group definitions. All 34 studies found a significant association between at least one DDA construct and the younger age group relative to the older age groups at some point along the cancer trajectory. However, age as an independent risk factor for DDA is still unclear, as the relationship could be confounded by other age-related factors. Despite the wide range of definitions and effect sizes in the studies included in this review, one thing is clear: adolescents and young adults, however defined, are a distinct group within the cancer population with an elevated risk of DDA. Widespread adoption of a standard AYA age-range definition will be essential to any future meta-analytical psycho-oncology research in this population. PMID:26697266
Background The purpose of this study is to evaluate the relationship between glycemic control and the factors of knowledge about diabetes, resilience, depression and anxiety among Brazilian adolescents and young adults with type 1 diabetes. Methods This cross-sectional study included 85 adolescents and young adults with type 1 diabetes, aged between 11–22 years, with an average age of 17.7 ± 3.72 years. Glycemic control degree was evaluated through HbA1c. To assess psychosocial factors, the following questionnaires were used: resilience (Resilience Scale, RS) and anxiety and depression (Hospital Anxiety and Depression Scale, HADS). The Diabetes Knowledge Assessment Scale (DKNA) was used to assess knowledge about diabetes. Results Significant correlations were found between HbA1c and resilience, anxiety and depression. Multiple linear regression analysis revealed that the only variable which presented significant association with the value of HbA1c was depression. Conclusions Depression has a significant association with higher HbA1c levels, as demonstrated in a regression analysis. The results suggest that depression, anxiety and resilience should be considered in the design of a multidisciplinary approach to type 1 diabetes, as these factors were significantly correlated with glycemic control. Glycemic control was not correlated with knowledge of diabetes, suggesting that theoretical or practical understanding of this disease is not by itself significantly associated with appropriate glycemic control (HbA1c ≤ 7.5%). PMID:24289093
Saxvig, Ingvild W; Wilhelmsen-Langeland, Ane; Pallesen, Ståle; Vedaa, Oystein; Nordhus, Inger H; Sørensen, Eli; Bjorvatn, Bjørn
Delayed sleep phase disorder is characterized by a delay in the timing of the major sleep period relative to conventional norms. The sleep period itself has traditionally been described as normal. Nevertheless, it is possible that sleep regulatory mechanism disturbances associated with the disorder may affect sleep duration and/or architecture. Polysomnographic data that may shed light on the issue are scarce. Hence, the aim of this study was to examine polysomnographic measures of sleep in adolescents and young adults with delayed sleep phase disorder, and to compare findings to that of healthy controls. A second aim was to estimate dim light melatonin onset as a marker of circadian rhythm and to investigate the phase angle relationship (time interval) between dim light melatonin onset and the sleep period. Data from 54 adolescents and young adults were analysed, 35 diagnosed with delayed sleep phase disorder and 19 healthy controls. Results show delayed timing of sleep in participants with delayed sleep phase disorder, but once sleep was initiated no group differences in sleep parameters were observed. Dim light melatonin onset was delayed in participants with delayed sleep phase disorder, but no difference in phase angle was observed between the groups. In conclusion, both sleep and dim light melatonin onset were delayed in participants with delayed sleep phase disorder. The sleep period appeared to occur at the same circadian phase in both groups, and once sleep was initiated no differences in sleep parameters were observed.
TECHNICAL OBJECTIVES 1) To identify, enroll and collect blood specimens from 368 adolescents and young adults 18-to 45 years old diagnosed with Hodgkin... Young Adult Hodgkin Lymphoma PRINCIPAL INVESTIGATOR: Wendy Cozen Victoria Cortessis, Ph.D. David Conti, Ph.D. David...Genotypes and Risk of Young Adult Hodgkin Lymphoma 5b. GRANT NUMBER W81XWH-06-1-0683 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Wendy Cozen
Background Although childhood sexual and/or physical abuse (CSA/CPA) is known to have severe psychopathological consequences, there is little evidence on psychotherapeutic interventions for adolescents and young adults suffering from post-traumatic stress disorder (PTSD). Equally sparse are data on moderators of treatment response on PTSD-related epigenetic changes, health care costs and loss of productivity, alterations in cognitive processing, and on how successful interventions affect all of these factors. Early treatment may prevent later (co)morbidity. In this paper, we present a study protocol for the evaluation of a newly developed psychotherapeutic manual for PTSD after CSA/CPA in adolescents and young adults – the Developmentally Adapted Cognitive Processing Therapy (D-CPT). Methods/design In a multicenter randomized controlled trial (RCT) D-CPT is compared to treatment as usual (TAU). A sample of 90 adolescent outpatients aged 14 to 21 years will be randomized to one of these conditions. Four assessments will be carried out at baseline, at end of treatment, and 3 and 6 months after end of therapy. Each time, patients will be assessed via clinical interviews and a wide range of questionnaires. In addition to PTSD symptoms and comorbidities, we will evaluate moderators of treatment response, epigenetic profiles, direct and indirect costs of this disorder, and neurophysiological processing of threat cues in PTSD and their respective changes in the course of these two treatments (D-CPT and TAU). Discussion The study will provide new insights in the understudied field of PTSD in adolescents and young adults. A newly developed intervention will be evaluated in this therapeutically underserved population. Results will provide data on treatment efficacy, direct and indirect treatment costs, as well as on associations of treatment outcome and PTSD intensity both to epigenetic profiles and to the neurobiological processing of threat cues. Besides, they will
International Reading Association, Newark, DE.
Designed to make the job of encouraging adolescents to read less of a challenge, this book provides descriptions of all of the approximately 150 examples of young adult literature that were selected "Young Adults' Choices" in the yearly voting by teenagers conducted from 1987 to 1992. Each entry in the book includes bibliographic…
KENT, ERIN E.; PARRY, CARLA; MONTOYA, MICHAEL J.; SENDER, LEONARD S.; MORRIS, REBECCA A.; ANTON-CULVER, HODA
Adolescent and young adult cancer survivors face unique challenges not systematically addressed by cancer clinicians. Four focus groups and two individual interviews were conducted with 19 survivors to profile experiences and identify key concerns for future interventions. The resultant themes reflect cancer care continuum challenges (such as delays in diagnosis, problems with adherence), psychosocial concerns (such as infertility and reproductive concerns, changing social relationships, financial burden), and the paradox of being diagnosed with cancer as a young adult. Future intervention development for adolescent and young adult survivors should involve patient voices at each stage of the research process. PMID:22416959
McDaniel, Larry W.; Jackson, Allen; Gaudet, Laura
Participation in strength training is important for older children or young adolescences who wish to improve fitness or participate in sports. When designing strength training programs for our youth this age group is immature anatomically, physiologically, and psychologically. For the younger or inexperienced group the strength training activities…
The emotional, social, intellectual, and physical needs of young people from 10 to 15 years old are being increasingly recognized in the schools, but the activities of these students after school are just beginning to be considered in terms of their effects on adolescents' academic and personal growth. Early in 1985, the University of North…
Gordon-Messer, Deborah; Bauermeister, Jose Arturo; Grodzinski, Alison; Zimmerman, Marc
Purpose Sexting has stirred debate over its legality and safety, but few researchers have documented the relationship between sexting and health. We describe the sexting behavior of young adults in the United States, and examine its association with sexual behavior and psychological well-being. Methods Using an adapted web version of Respondent-Driven Sampling (webRDS) we recruited a sample of U.S. young adults (ages 18 to 24; N=3447). We examined participant sexting behavior using 4 categories of sexting: 1) Non-Sexters, 2) Receivers, 3) Senders, and 4) Two-way Sexters. We then assessed the relationships between sexting categories and sociodemographic characteristics, sexual behavior and psychological well-being. Results Over half (57%) of respondents were Non-Sexters, 28.2% of the sample were Two-way Sexters, 12.6% were Receivers, and 2% were Senders. Males were more likely to be Receivers than females. Sexually active respondents were more likely to be Two-way Sexters than non-sexually active respondents. Among participants who were sexually active in the past 30 days, we found no differences across sexting groups in number of sexual partners, or number of unprotected sex partners in the past 30 days. We also found no relationship between sexting and psychological well-being. Conclusions Our results suggest that sexting is not related to sexual risk behavior or psychological well-being. We discuss the findings of this study and propose directions for further research on sexting. PMID:23299018
Kendig, Michael D; Boakes, Robert A; Rooney, Kieron B; Corbit, Laura H
Although increasing consumption of sugar drinks is recognized as a significant public health concern, little is known about (a) the cognitive effects resulting from sucrose consumption; and (b) whether the long-term effects of sucrose consumption are more pronounced for adolescents. This experiment directly compared performance on a task of spatial learning and memory (the Morris Water Maze) and sensitivity to outcome devaluation following 28 days of 2-h/day access to a 10% sucrose solution in adolescent and young-adult Wistar rats. Sucrose groups developed elevated fasting blood glucose levels after the diet intervention, despite drawing <15% of calories from sucrose and gaining no more weight than controls. In subsequent behavioral testing, sucrose groups were impaired on the Morris Water Maze, with some residual deficits in spatial memory observed more than 6 weeks after the end of sucrose exposure. Further, results from outcome devaluation testing indicated that in the older cohort of rats, those fed sucrose showed reduced sensitivity to devaluation of the outcome, suggestive of differences in instrumental learning following sucrose exposure. Data provide strong evidence that sucrose consumption can induce deficits in spatial cognition and reward-oriented behavior at levels that resemble patterns of sugar drink consumption in young people, and which can remain long after exposure.
Mason, W. Alex; Hitch, Julia E.; Kosterman, Rick; McCarty, Carolyn A.; Herrenkohl, Todd I.; Hawkins, J. David
Background: This study examined adolescent delinquency and alcohol use in relation to young adult crime, alcohol use disorders (AUDs), and risky sex. Analyses further examined the influences of late childhood involvement in these problem behavior outcomes, with mediation through teen delinquency and alcohol use, and examined differences in the…
Windle, Michael; Zucker, Robert A.
Forty years ago, when the National Institute on Alcohol Abuse and Alcoholism (NIAAA) was founded, alcoholism was considered an adult disease driven principally by physiological determinants. As NIAAA expanded its research portfolio, new data and insights were obtained that led to an increased focus on underage and young adult drinking. Fostered by interdisciplinary research, etiologic models were developed that recognized the multiplicity of relevant genetic and environmental influences. This shift in conceptualizing alcohol use disorders also was based on findings from large-scale, national studies indicating that late adolescence and early young adulthood were peak periods for the development of alcohol dependence and that early initiation of alcohol use (i.e., before age 15) was associated with a fourfold increase in the probability of subsequently developing alcohol dependence. In recent years, developmental studies and models of the initiation, escalation, and adverse consequences of underage and early young adult drinking have helped us to understand how alcohol use may influence, and be influenced by, developmental transitions or turning points. Major risk and protective factors are being identified and integrated into screening, prevention, and treatment programs to optimize interventions designed to reduce drinking problems among adolescents and young adults. In addition, regulatory policies, such as the minimum drinking age and zero-tolerance laws, are being implemented and evaluated for their impact on public health. PMID:23579934
Gillmore, Mary Rogers; Chen, Angela Chia-Chen; Haas, Steven A.; Kopak, Albert M.; Robillard, Alyssa G.
Studies show that positive family factors help protect adolescents from engaging in risky sexual activities, but do they continue to protect adolescents as they transition to late adolescence/early adulthood? Using data from the National Longitudinal Study of Adolescent Health, we examined whether family support, parent-child closeness, parental…
Donelson, Kenneth L.; Nilsen, Alleen Pace
Defining young adult literature to include any book freely chosen for reading by a person between the ages of 12 and 20, this book is intended to help educate professionals in related fields about the growing body of such literature. The first section of the book provides an introduction to young adult literature, including a discussion of the…
This study explores the role of informal mentoring (i.e., developing an important relationship with a non-parental adult) in the transition to full time employment among young adults (age 23-28). Multivariate analysis of the Add Health data reveals that mentoring is positively related to the likelihood of full time employment, and the relationship involves both selection and causation processes. Entrance into the world of work facilitates the development of mentoring relationships, especially among youth who identify work-related mentors after adolescence. These relationships have the potential for promoting attachment to the labor force. Mentoring relationships that develop outside of work settings and during adolescence have a positive impact on the odds of full time employment. The receipt of guidance and advice from mentors, as well as access to weak-tied mentoring relationships, teacher mentors, and friend mentors all contribute to the increased odds of employment in young adulthood. However, adolescent mentoring may be less effective among young women than it is among young men. PMID:19050736
Khazal, Sajad; Abdel-Azim, Hisham; Kapoor, Neena; Mahadeo, Kris M
Adolescents/young adults (AYAs) afflicted with cancer face unique barriers to potentially standard curative therapies, such as blood and marrow transplantation (BMT). Transgender AYAs face additional barriers and there is a dearth of published literature regarding their oncology-related experience. We present the case of an AYA male-to-female (MTF) transgender patient on cross-sex hormone therapy, with a history of Chronic Myelogenous Leukemia (CML) and significant psychosocial barriers, which initially served as a barrier to BMT at two different centers; we modified our standard consent and education process and was able to successfully proceed with BMT and subsequently cure her CML. Despite unique challenges, AYA and transgender patients with significant psychosocial barriers may achieve successful outcomes with BMT. Research is needed regarding guidelines for cross-sex hormone therapy administration for patients undergoing BMT and other issues, which may be unique to the transgender experience.
Laing, Catherine M; Moules, Nancy J; Estefan, Andrew; Lang, Mike
The purpose of this philosophical hermeneutic study was to understand the effects on health care providers (HCPs) of watching digital stories made by (past and present) pediatric and adolescent/young adult (AYA) oncology patients. Twelve HCPs participated in a focus group where they watched digital stories made by pediatric/AYA oncology patients and participated in a discussion related to the impact the stories had on them personally and professionally. Findings from this research revealed that HCPs found digital stories to be powerful, therapeutic, and educational tools. Health care providers described uses for digital stories ranging from education of newly diagnosed families to training of new staff. Digital stories, we conclude, can be an efficient and effective way through which to understand the patient experience, implications from which can range from more efficient patient care delivery to decision making. Recommendations for incorporating digital storytelling into healthcare delivery are offered.
Do predisposing and family background characteristics modify or confound the relationship between drinking frequency and alcohol-related aggression? A study of late adolescent and young adult drinkers.
Wells, Samantha; Graham, Kathryn; Speechley, Mark; Koval, John J
The present study examined whether predisposing and family background characteristics confounded (common cause/general deviance theory) or modified (conditional/interactive theory) the association between drinking frequency and alcohol-related aggression. A secondary analysis of the US National Longitudinal Survey of Youth was conducted using a composite sample of drinkers, ages 17 to 21, from the 1994, 1996, and 1998 Young Adult surveys (n=602). No evidence of confounding of the relationship between drinking frequency and alcohol-related aggression was found. In addition, predisposing characteristics did not modify the association between drinking frequency and alcohol-related aggression. However, family background variables (mother's education and any poverty) were important explanatory variables for alcohol-related aggression among males, whereas recent aggression (fights at school or work) was an important predictor for females. Overall, lack of support for the conditional/interactive and common cause theories of the alcohol and aggression relationship suggests that alcohol has an independent explanatory role in alcohol-related aggression. In addition, the gender differences found in the present study highlight the need for more gender-focussed research on predictors of alcohol-related aggression, especially among adolescents and young adults.
Background Particularly in groups of adolescents with lower educational level the smoking prevalence is still high and constitutes a serious public health problem. There is limited evidence of effective smoking cessation interventions in this group. Individualised text messaging (SMS) based interventions are promising to support smoking cessation and could be provided to adolescents irrespective of their motivation to quit. The aim of the current paper is to outline the study protocol of a trial testing the efficacy of an SMS based intervention for smoking cessation in apprentices. Methods/Design A two-arm cluster-randomised controlled trial will be conducted to test the efficacy of an SMS intervention for smoking cessation in adolescents and young adults compared to an assessment only control group. A total of 910 daily or occasional (≥ 4 cigarettes in the preceding month and ≥ 1 cigarette in the preceding week) smoking apprentices will be proactively recruited in vocational school classes and, using school class as a randomisation unit, randomly assigned to an intervention group (n = 455) receiving the SMS based intervention or an assessment only control group (n = 455). Individualised text messages taking into account demographic data and the individuals' smoking behaviours will be sent to the participants of the intervention group over a period of 3 months. Participants will receive two text messages promoting smoking cessation per week. Program participants who intend to quit smoking have the opportunity to use a more intensive SMS program to prepare for their quit day and to prevent a subsequent relapse. The primary outcome measure will be the proportion of participants with 7-day point prevalence smoking abstinence assessed at 6-months follow-up. The research assistants conducting the baseline and the follow-up assessments will be blinded regarding group assignment. Discussion It is expected that the program offers an effective and inexpensive way to
Improving Access to Standardized Fertility Preservation Information for Older Adolescents and Young Adults with Cancer: Using a User-Centered Approach with Young Adult Patients, Survivors, and Partners to Refine Fertility Knowledge Transfer.
Tam, Seline; Puri, Natasha; Stephens, Derek; Mitchell, Laura; Giuliani, Meredith; Papadakos, Janet; Gupta, Abha A
Adolescent and young adult (AYA) cancer patients under 40 should be made aware of their fertility risks and preservation options throughout their care. However, discussions on fertility preservation (FP) do not routinely occur. With a dearth of FP resources, oncology providers may lack knowledge around FP. Thus, informational needs can be unmet, leading to anxiety and distress in patients. Provision of pertinent and timely information can help patients cope better with their diagnosis. FP pamphlets were developed for men and women with cancer. A cross-sectional in-house survey, using convenience sampling, evaluated the pamphlets' effectiveness and measured ease of understanding, acceptability, and perceived utility. Patients and partners were also asked to provide recommendations and complete the Short Test of Functional Health Literacy in Adults (S-TOFHLA) measuring health literacy level. This helps determine if health literacy influences perception of pamphlet effectiveness. All participants (n = 56) reviewed both pamphlets. Fifty-four participants (96 %) found the pamphlet for men useful, while 29 participants (52 %) improved their male fertility knowledge. The pamphlet for women was useful for 52 participants (93 %) and improved knowledge in 35 (63 %) of them. Although the majority of participants had adequate health literacy (98 %), there was insufficient sample diversity to determine if health literacy influenced the pamphlet's effectiveness. Participants indicated preference in receiving verbal (73 %) and written (66 %) information over watching videos or in-class education. They recommended including fertility clinics, financial resources, and statistics in the brochures. These FP pamphlets were concluded as effective in supporting patients in making FP decisions.
Jones, Krista; Eathington, Patricia; Baldwin, Kathleen; Sipsma, Heather
Despite the increased use of social media and text messaging among adolescents, it is unclear how effective education transmitted via these mechanisms is for reducing sexual risk behavior. Accordingly, we conducted a systematic review of the literature to examine the effectiveness of social media and text messaging interventions designed to increase sexually transmitted disease (STD) knowledge, increase screening/testing, decrease risky sexual behaviors, and reduce the incidence of STDs among young adults aged 15 through 24 years. Eleven studies met our inclusion criteria. Most of the included studies used a control group to explore intervention effects and included both young men and women. Sample sizes ranged from 32 to 7606 participants, and follow-up periods ranged between 4 weeks and 12 months. These studies provide preliminary evidence indicating that social media and text messaging can increase knowledge regarding the prevention of STDs. These interventions may also affect behavior, such as screening/testing for STDs, sexual risk behaviors, and STD acquisition, but the evidence for effect is weak. Many of these studies had several limitations that future research should address, including a reliance on self-reported data, small sample sizes, poor retention, low generalizability, and low analytic rigor. Additional research is needed to determine the most effective and engaging approaches for young men and women.
The aim of our study was to evaluate the utility and diagnostic accuracy of the ossification grade of medial clavicular epiphysis on chest radiographs for identifying Korean adolescents and young adults under the age of majority. Overall, 1,151 patients (age, 16-30) without any systemic disease and who underwent chest radiography were included for ossification grading. Two radiologists independently classified the ossification of the medial clavicular epiphysis from chest radiographs into five grades. The age distribution and inter-observer agreement on the ossification grade were assessed. The diagnostic accuracy of the averaged ossification grades for determining whether the patient is under the age of majority was analyzed by using receiver operating characteristic (ROC) curves. Two separate inexperienced radiologists assessed the ossification grade in a subgroup of the patients after reviewing the detailed descriptions and image atlases developed for ossification grading. The median value of the ossification grades increased with increasing age (from 16 to 30 years), and the trend was best fitted by a quadratic function (R-square, 0.978). The inter-observer agreements on the ossification grade were 0.420 (right) and 0.404 (left). The area under the ROC curve (AUC) was 0.922 (95% CI, 0.902-0.942). The averaged ossification scores of 2.62 and 4.37 provided 95% specificity for a person < 19 years of age and a person ≥ 19 years of age, respectively. A preliminary assessment by inexperienced radiologists resulted in an AUC of 0.860 (95% CI, 0.740-0.981). The age of majority in Korean adolescents and young adults can be estimated using chest radiographs. PMID:27550480
Berkemeyer, Shoma; Remer, Thomas
The role of elevated net endogenous acid production (NEAP) in the causation of osteoporosis, muscle wasting, and kidney stones is currently under discussion. The aim of this study was to examine whether urinary organic acid anion excretion, a major component of NEAP, is predicted primarily by anthropometric- (OA(anthro)) or diet- (OA(diet)) based estimates. Dietary intakes, anthropometric data, and 24-h urinary excretion rates of organic acids (24h-OA(urine)) were determined cross sectionally in healthy children (6-7 y; n = 217), adolescents (13-14 y; n = 91), and young adults (18-22 y; n = 82). OA(anthro) was computed from body surface area and OA(diet) calculated using a published algorithm based on dietary intakes of mineral anions and cations. There was a significant increase (P < 0.0001) in 24h-OA(urine) across the age groups that was no longer discernible after correction for body surface area. In almost all sex-stratified subsamples, OA(anthro) had a higher correlation with 24h-OA(urine) than OA(diet). Multiple regression analyses, using energy-corrected diet variables, revealed that OA(anthro) was consistently the primary predictor of 24h-OA(urine) (R(2) varying from 0.15 to 0.39) and dietary fat and protein were sporadic predictors. In accordance with the observed age independency of 24h-OA(urine) after body surface area correction, our findings indicate that OA(anthro) is a better estimate of 24h-OA(urine) in healthy children, adolescents, and young adults than OA(diet). This further confirms that the (principally diet-dependent) NEAP comprises a component, i.e., organic acid anions, that is reasonably predictable by anthropometrics. Consequently, the other component, i.e., the potential renal acid load, appears to be the primary parameter that characterizes the diet-induced acid load.
Klingensmith, Georgeanna J; Aisenberg, Javier; Kaufman, Francine; Halvorson, Mary; Cruz, Eric; Riordan, Mary Ellen; Varma, Chandrasekhar; Pardo, Scott; Viggiani, Maria T; Wallace, Jane F; Schachner, Holly C; Bailey, Timothy
The purpose of this study was to assess the performance and acceptability of a blood glucose meter coupled with a gaming system for children, adolescents, and young adults with type 1 diabetes. During an in-clinic visit, duplicate blood samples were tested by subjects (N = 147; aged 5-24 yr) and health care providers (HCPs) to evaluate the accuracy and precision of the Didget® system. Subjects' meter results were compared against Yellow Springs Instruments (YSI) reference results and HCP results using least squares regression and error grid analyses. Precision was measured by average within-subject and within-HCP coefficient of variation (CV). During the home-use component of this study, subjects (n = 58) tested their blood glucose at least two to three times daily for 3-5 d to evaluate routine use of the system. Subjects' meter results showed significant correlations with both YSI (r(2) = 0.94; p < 0.001 for regression slope) and HCP results (r(2) = 0.96; p < 0.001). Average within-subject and within-HCP CVs were 5.9 and 7.2%, respectively. Overall satisfaction was assessed by subjects, their parents or guardians, and HCP surveys. Subject satisfaction with the Didget® system was good to excellent; most subjects found the system easy to use, motivating, and helpful for building good blood glucose monitoring habits. Most HCPs agreed that the system fulfilled a need in diabetes management. In conclusion, the Didget® system was precise and clinically accurate in the hands of children, adolescents, and young adults with type 1 diabetes.
Ritter, Philipp S; Höfler, Michael; Wittchen, Hans-Ulrich; Lieb, Roselind; Bauer, Michael; Pfennig, Andrea; Beesdo-Baum, Katja
There is ample data suggesting that individuals with bipolar disorder more frequently suffer from disturbed sleep even when euthymic. Since sleep is a process that is crucial for affective homeostasis, disturbed sleep in healthy individuals may be a risk factor for the subsequent onset of bipolar disorder. Utilizing data from a large cohort of adolescents and young adults, this study tests the hypothesis that disturbed sleep constitutes a risk factor for the later onset of bipolar disorder. A representative community sample of N = 3021 adolescents and young adults (baseline age 14-24) was assessed using the standardized Composite International Diagnostic Interview and followed-up prospectively up to 3 times over up to 10 years. Disturbed sleep at baseline was quantified utilizing the corresponding items from the self-report inventory SCL-90-R. The compound value (insomnia-score) as an ordinal parameter for the severity of sleep disturbances was used to assess associations with the incidence of bipolar disorder among participants free of major mental disorder at baseline (N = 1943) using odds ratios (OR) from logistic regressions. Analyses were adjusted for age, gender, parental mood disorder and lifetime alcohol or cannabis dependence. Poor sleep quality significantly increased the risk for the subsequent development of bipolar disorder (OR = 1.75; p = 0.001). Regarding individual sleep items, trouble falling asleep and early morning awakening were predictive for the subsequent onset of bipolar disorder. Disturbed sleep in persons otherwise free of major mental disorders appears to confer an increased risk for the subsequent onset of bipolar disorder.
Pisula, Ewa; Lukowska, Ewa; Fudalej, Piotr S
Objectives : To evaluate self-esteem, coping styles, and health-related quality of life and their relationships in Polish adolescents and young adults with unilateral complete cleft lip and palate and related sex differences. Design and Participants : Self-report questionnaires measuring self-esteem (Multidimensional Self-Esteem Inventory), coping styles (Coping Inventory for Stressful Situations), and health-related quality of life (WHOQOL-BREF) were completed by 48 participants with cleft lip and palate (age, 16 to 23 years; 31 males, 17 females) and 48 controls without cleft lip and palate (age, 16 to 23 years; 28 males, 20 females) matched for age, place of residence, and socioeconomic status. Results : Regarding self-esteem, individuals with cleft lip and palate scored higher on body functioning (P < .01) and defensive self-enhancement (P < .05). Self-control showed an interaction effect: Females with cleft lip and palate scored higher than controls, but males did not differ between groups (P < .05). Males with cleft lip and palate scored lower than controls in personal power but higher in body functioning (P < .05); females showed no differences between groups. The groups did not differ with regard to coping styles or quality of life, but several correlations were found between self-esteem and coping styles, and quality of life (P < .01). Conclusions : Late adolescents and young adults with and without cleft lip and palate differed little in terms of psychological adjustment measures. The higher scores in defensive self-enhancement of individuals with cleft lip and palate suggest the need for instruments measuring social approval in psychosocial adjustment research involving this group.
Adair, Linda S; Pisa, Pedro T; Griffiths, Paula L; Pettifor, John M; Norris, Shane A
Objective Social epidemiology models suggest that socioeconomic status (SES) mobility across the life course affects blood pressure. The aim of this study was to investigate the association between SES change between infancy and adolescence, and blood pressure, in young adults, and the impact of early growth on this relationship. Setting Data for this study were obtained from a ‘Birth to Twenty’ cohort in Soweto, Johannesburg, in South Africa. Participants The study included 838 Black participants aged 18 years who had household SES measures in infancy and at adolescence, anthropometry at 0, 2, 4 and 18 years of age and blood pressure at the age of 18 years. Methods We computed SES change using asset-based household SES in infancy and during adolescence as an exposure variable, and blood pressure and hypertension status as outcomes. Multivariate linear and logistic regressions were used to investigate the associations between SES change from infancy to adolescence, and age, height and sex-specific blood pressure and hypertension prevalence after adjusting for confounders. Results Compared to a persistent low SES, an upward SES change from low to high SES tertile between infancy and adolescence was significantly associated with lower systolic blood pressure (SBP) at the age of 18 years (β=−4.85; 95% CI −8.22 to −1.48; p<0.01; r2=0.1804) after adjusting for SES in infancy, small-for-gestational-age (SGA) and weight gain. Associations between SES change and SBP were partly explained by weight gain between birth and the age of 18 years. There was no association between SES mobility and diastolic blood pressure, mean arterial pressure or hypertension status. Conclusions Our study confirms that upward SES change has a protective effect on SBP by the time participants reach young adulthood. Socioeconomic policies and interventions that address inequality may have the potential to reduce cardiovascular disease burden related to BP in later life. PMID
Roberts, Linda K.
Young adults read not only to experience real-life problems, but also to "escape" from those problems. The two most popular types of novels available to teens are the contemporary realistic problem novel and the formula romance novel. A study examined the incidence of specific adolescent developmental tasks (adolescent problems/concerns)…
Background A range of innovative websites, mobile technologies, eHealth and mHealth platforms have emerged to support adolescents and young adults (AYAs) with cancer. Previous reviews have identified these various applications and solutions, but no review has summarized the quality, feasibility, and efficacy of existing patient platforms (inclusive of websites, mobile technologies, mHealth and eHealth platforms) developed specifically for young people with cancer. Objective This paper describes the design of a protocol to conduct a review of published studies or reports which describe or report on an existing platform designed specifically for AYAs who have had a cancer diagnosis. Methods A search string was developed using a variety of key words and Medical Subject Heading and applied to bibliographic databases. General data (sample characteristics, patient platform development, design and, if applicable, pilot testing outcomes) will be extracted from reports and studies. Drawing on a previously developed coding schematic, the identified patient platforms will be coded for mode of delivery into (1) automated functions, (2) communicative functions, and (3) use of supplementary modes. An adapted version of the Mobile App Rating Scale (MARS) will be used to assess the of quality of each identified patient platform. The methodological quality of included studies will be assessed using the Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields (QualSyst). Both authors will independently screen eligible studies for final inclusion and will both be responsible for data extraction and appraisal. Data will be synthesized narratively to provide an overview of identified patient platforms. Results The review began in October 2016 and is currently in progress. The review paper will be submitted for peer-review and publication in the summer of 2017. Conclusions This review will be unique in its focus on assessing, where possible, the
Cruickshank, J Kennedy; Silva, Maria J; Molaodi, Oarabile R; Enayat, Zinat E; Cassidy, Aidan; Karamanos, Alexis; Read, Ursula M; Faconti, Luca; Dall, Philippa; Stansfield, Ben; Harding, Seeromanie
Early determinants of aortic stiffness as pulse wave velocity are poorly understood. We tested how factors measured twice previously in childhood in a multiethnic cohort study, particularly body mass, blood pressure, and objectively assessed physical activity affected aortic stiffness in young adults. Of 6643 London children, aged 11 to 13 years, from 51 schools in samples stratified by 6 ethnic groups with different cardiovascular risk, 4785 (72%) were seen again at aged 14 to 16 years. In 2013, 666 (97% of invited) took part in a young adult (21-23 years) pilot follow-up. With psychosocial and anthropometric measures, aortic stiffness and blood pressure were recorded via an upper arm calibrated Arteriograph device. In a subsample (n=334), physical activity was measured >5 days via the ActivPal. Unadjusted pulse wave velocities in black Caribbean and white UK young men were similar (mean±SD 7.9±0.3 versus 7.6±0.4 m/s) and lower in other groups at similar systolic pressures (120 mm Hg) and body mass (24.6 kg/m(2)). In fully adjusted regression models, independent of pressure effects, black Caribbean (higher body mass/waists), black African, and Indian young women had lower stiffness (by 0.5-0.8; 95% confidence interval, 0.1-1.1 m/s) than did white British women (6.9±0.2 m/s). Values were separately increased by age, pressure, powerful impacts from waist/height, time spent sedentary, and a reported racism effect (+0.3 m/s). Time walking at >100 steps/min was associated with reduced stiffness (P<0.01). Effects of childhood waist/hip were detected. By young