Weight loss intervention for young adults using mobile technology: design and rationale of a randomized controlled trial - Cell Phone Intervention for You (CITY).

BACKGROUND: The obesity epidemic has spread to young adults, leading to significant public health implications later in adulthood. Intervention in early adulthood may be an effective public health strategy for reducing the long-term health impact of the epidemic. Few weight loss trials have been conducted in young adults. It is unclear what weight loss strategies are beneficial in this population. PURPOSE: To describe the design and rationale of the NHLBI-sponsored Cell Phone Intervention for You (CITY) study, which is a single center, randomized three-arm trial that compares the impact on weight loss of 1) a behavioral intervention that is delivered almost entirely via cell phone technology (Cell Phone group); and 2) a behavioral intervention delivered mainly through monthly personal coaching calls enhanced by self-monitoring via cell phone (Personal Coaching group), each compared to 3) a usual care, advice-only control condition. METHODS: A total of 365 community-dwelling overweight/obese adults aged 18-35 years were randomized to receive one of these three interventions for 24 months in parallel group design. Study personnel assessing outcomes were blinded to group assignment. The primary outcome is weight change at 24 [corrected] months. We hypothesize that each active intervention will cause more weight loss than the usual care condition. Study completion is anticipated in 2014. CONCLUSIONS: If effective, implementation of the CITY interventions could mitigate the alarming rates of obesity in young adults through promotion of weight loss. ClinicalTrial.gov: NCT01092364.

Posture and cognition interfere in later adulthood even without concurrent response production

We investigated adult age differences in dual-task costs in cognitive-sensorimotor settings without concurrent response production and with individually adjusted resource demands for the cognitive task. Twenty-four young adults (M=25.42 years, SD=3.55) and 23 older adults (M=68 years, SD=4.46) performed a cognitive task and two postural control tasks (standing on a stable and moving platform) both separately (single-task context) and concurrently (dual-task context). The cognitive task did not require response production during posture data collection and its difficulty was individually adjusted to 80% correct performance under single-task conditions. Results showed pronounced age differences in postural control in the moving platform condition, which increased further under dual-task conditions. Our findings support the assumption of increased cognitive resource demands for postural control in older adults. They extend existing work by taking two shortcomings of previous studies into account. We discuss cognitive and posture task constraints in this and previous studies as factors determining multi-tasking and its changes in later adulthood.

Executive functioning deficits in young adult survivors of bronchopulmonary dysplasia

Purpose: To assess long-term impairments of executive functioning in adult survivors of bronchopulmonary dysplasia (BPD). 
Method: Participants were assessed on measures of executive functioning, health-related quality of life (HRQoL) and social functioning. Survivors of BPD (n = 63; 34 males; mean age 24.2 years) were compared with groups comprising preterm (without BPD) (<1500 g; n = 45) and full-term controls (n = 63). Analysis of variance was used to explore differences among groups for outcome measures. Multiple regression analyzes were performed to identify factors predictive of long-term outcomes. 
Results: Significantly more BPD adults, compared with preterm and term controls, showed deficits in executive functioning relating to problem solving (OR: 5.1, CI: 1.4–19.3), awareness of behavior (OR: 12.7, CI: 1.5–106.4) and organization of their environment (OR: 13.0, CI: 1.6–107.1). Birth weight, HRQoL and social functioning were predictive of deficits in executive functioning. 
Conclusions: This study represents the largest sample of survivors into adulthood of BPD and is the first to show that deficits in executive functioning persist. Children with BPD should be assessed to identify cognitive impairments and allow early intervention aimed at ameliorating their effects.

Young People’s Offending Careers and Criminal Justice Contact: A Case for Social Justice

This article draws on an analysis of young people’s offending careers. The research was initiated against a backdrop of changing discourse around youth justice in Ireland with a shift towards prevention of offending and diversion from the criminal justice system. Locating crime and criminal justice contact within a biographical context indicated that participants’ offending, and lives generally, was bound up in marginalized transitions to adulthood, and embedded within social and economic environments characterized by high deprivation. The findings support a further shift in focus towards addressing social injustice as a necessary prerequisite to tackle the origins of youth offending.

Alcohol consumption in late adolescence and early adulthood - where is the problem?

Risky single-occasion drinking (RSOD) is more common in late adolescence and early adulthood (approximately between the ages of 16 and 30) than in any other period in life. This is also the age when young people in Switzerland and many other European countries are legally allowed to buy and drink alcohol, but they usually do not yet have adult responsibilities. This paper reviews evidence from the international literature and provides examples of studies conducted in Switzerland demonstrating that (a) RSOD is by far most prevalent on Saturday evenings followed by Friday evenings, usually because young people go out and do not have any work or study responsibilities the next day; (b) RSOD results from drinking in private before going out ("predrinking") and accelerating the pace of drinking (i.e. increasing the number of drinks consumed per hour); (c) RSOD is often not accidental but purposeful,. to seek excitement, to have fun and to feel the effects of alcohol; (d) RSOD occurs predominantly outside the home, mostly in bars, pubs, discos or at special events and festivals; (e) RSOD often results in intended and unintended injuries and other acute consequences, which are leading risk factors for mortality and morbidity in this age group. Effective prevention strategies should include attempts to reduce opportunities to engage in heavy drinking as well as strategies to reduce its harmful consequences.

Bringing Zombies Back to Life: An Autoethnographical Exploration of Alienation and Political Dis/Engagement in Emerging Adulthood Within Late-Stage Capitalism

In this thesis, by employing an autoethnographic methodology, I am exploring why certain understandings, or assemblages, of political engagement come to have greater meaning in my life and why other assemblages may be more hidden and thus fail to contribute substantially to the meaning of political in my life. Using immanent, Marxist and post-Marxist theories, as well as a zombie narrative, the study will contextualize the movement of assemblages in my life within late-stage capitalism which is juxtaposed with the zombie apocalypse. The placement and displacement of certain understandings of the political within my life will be theorized within the crisis of constituent power that is revealed in an immanent framework. Furthermore, the crisis of the constituent in late-stage capitalism creates new forms of radical alienation which will also be examined. By exploring my own struggles in becoming political I will theorize why political disengagement in emerging adulthood appears to be increasing, as well as possibilities for new forms of political engagement in a late-stage capitalist context.

The Impact of Labeling in Childhood on the Sense of Self of Young Adults

Research studies on labeling of children have either focused on the effects of formal labels on the lives of children with exceptionalities and mental health issues, or the effect of informal labeling by parents, peers and teachers on teenagers. The effects of informal labeling in childhood and its implications in later life or for one’s career choice have not yet been examined. This study adds to the growing research on informal labeling. The purpose of this qualitative study was to determine what negative effects informal labeling of children as deviant had on their lives. Data were gathered through semi-structured interviews conducted with seventeen young adults, between the ages of sixteen and thirty years, from a post-secondary institution and an organization for homeless youth. The results showed an initial negative impact on the lives of the young adults during their childhood and early teenage years but as they progressed into their late teens and early adulthood, most were able to overcome their negative labels suggesting resilience. There were no significant gender differences in the impact of the labels. The implications of the study for policy makers and parents are discussed as well as some recommendations for parents and practitioners are offered.

Reference values for handgrip strength in among healthy young adults

Background: Isometric grip strength, evaluated with a handgrip dynamometer, is a marker of current nutritional status and cardiometabolic risk and future morbidity and mortality. We present reference values for handgrip strength in healthy young Colombian adults (aged 18 to 29 years). Methods: The sample comprised 5.647 (2.330 men and 3.317 women) apparently healthy young university students (mean age, 20.6±2.7 years) attending public and private institutions in the cities of Bogota and Cali (Colombia). Handgrip strength was measured two times with a TKK analogue dynamometer in both hands and the highest value used in the analysis. Sex- and age-specific normative values for handgrip strength were calculated using the LMS method and expressed as tabulated percentiles from 3 to 97 and as smoothed centile curves (P3, P10, P25, P50, P75, P90 and P97). Results: Mean values for right and left handgrip strength were 38.1±8.9 and 35.9±8.6 kg for men, and 25.1±8.7 and 23.3±8.2 kg for women, respectively. Handgrip strength increased with age in both sexes and was significantly higher in men in all age categories. The results were generally more homogeneous amongst men than women. Conclusions: Sex- and age-specific handgrip strength normative values among healthy young Colombian adults are defined. This information may be helpful in future studies of secular trends in handgrip strength and to identify clinically relevant cut points for poor nutritional and elevated cardiometabolic risk in a Latin American population. Evidence of decline in handgrip strength before the end of the third decade is of concern and warrants further investigation

The experiences and priorities of young people who care for their siblings in Tanzania and Uganda

This report presents key findings from a small-scale pilot research project that explored the experiences and priorities of young people caring for their siblings in sibling-headed households affected by AIDS in Tanzania and Uganda. Qualitative and participatory research was conducted with 33 young people living in sibling-headed households and 39 NGO staff and community members in rural and urban areas of Tanzania and Uganda. The report analyses the ways that young people manage transitions to caring for their younger siblings following their parents’ death and the impacts of caring on their family relations, education, emotional wellbeing and health, social lives and their transitions to adulthood. The study highlights gendered- and age-related differences in the nature and extent of young people’s care work and discusses young people’s needs and priorities for action, based on the views of young people, NGO staff and community members. Meeting the basic needs of young people living in sibling-headed households, listening to young people’s views, fostering peer support and relationships of trust with supportive adults, raising awareness and advocacy emerge as key priorities to safeguard the rights of children and young people living in sibling-headed households and challenge the stigma and marginalisation they sometimes face.

Making an effort to feel positive: insecure attachment in infancy predicts the neural underpinnings of emotion regulation in adulthood

Background: Animal research indicates that the neural substrates of emotion regulation may be persistently altered by early environmental exposures. If similar processes operate in human development then this is significant, as the capacity to regulate emotional states is fundamental to human adaptation. Methods: We utilised a 22-year longitudinal study to examine the influence of early infant attachment to the mother, a key marker of early experience, on neural regulation of emotional states in young adults. Infant attachment status was measured via objective assessment at 18-months, and the neural underpinnings of the active regulation of affect were studied using fMRI at age 22 years. Results: Infant attachment status at 18-months predicted neural responding during the regulation of positive affect 20-years later. Specifically, while attempting to up-regulate positive emotions, adults who had been insecurely versus securely attached as infants showed greater activation in prefrontal regions involved in cognitive control and reduced co-activation of prefrontal cortex and nucleus accumbens, consistent with relative inefficiency in the neural regulation of positive affect. Conclusions: Disturbances in the mother-infant relationship may persistently alter the neural circuitry of emotion regulation, with potential implications for adjustment in adulthood.

Computerised therapies for anxiety and depression in children and young people: a systematic review and meta-anaylsis

One quarter of children and young people (CYP) experience anxiety and/or depression before adulthood, but treatment is sometimes unavailable or inadequate. Self-help interventions may have a role in augmenting treatment and this work aimed to systematically review the evidence for computerised anxiety and depression interventions in CYP aged 5–25 years old. Databases were searched for randomised controlled trials and 27 studies were identified. For young people (12–25 years) with risk of diagnosed anxiety disorders or depression, computerised CBT (cCBT) had positive effects for symptoms of anxiety (SMD −0.77, 95% CI −1.45 to −0.09, k = 6, N = 220) and depression (SMD −0.62, 95% CI −1.13 to −0.11, k = 7, N = 279). In a general population study of young people, there were small positive effects for anxiety (SMD −0.15, 95% CI −0.26 to −0.03; N = 1273) and depression (SMD −0.15, 95% CI −0.26 to −0.03; N = 1280). There was uncertainty around the effectiveness of cCBT in children (5–11 years). Evidence for other computerised interventions was sparse and inconclusive. Computerised CBT has potential for treating and preventing anxiety and depression in clinical and general populations of young people. Further program development and research is required to extend its use and establish its benefit in children.

Insecure attachment during infancy predicts greater amygdala volumes in early adulthood

Background The quality of the early environment is hypothesized to be an influence on morphological development in key neural areas related to affective responding, but direct evidence to support this possibility is limited. In a 22-year longitudinal study, we examined hippocampal and amygdala volumes in adulthood in relation to early infant attachment status, an important indicator of the quality of the early caregiving environment. Methods Participants (N = 59) were derived from a prospective longitudinal study of the impact of maternal postnatal depression on child development. Infant attachment status (24 Secure; 35 Insecure) was observed at 18 months of age, and MRI assessments were completed at 22 years. Results In line with hypotheses, insecure versus secure infant attachment status was associated with larger amygdala volumes in young adults, an effect that was not accounted for by maternal depression history. We did not find early infant attachment status to predict hippocampal volumes. Conclusions Common variations in the quality of early environment are associated with gross alterations in amygdala morphology in the adult brain. Further research is required to establish the neural changes that underpin the volumetric differences reported here, and any functional implications.

Caring responsibilities, change and transitions in young people's family lives in Zambia

Despite diversity in family dynamics within and between societies, globally, it is adults who are usually relied upon to care for family members who are sick, disabled or have other care needs. Young people in Zambia and other African countries affected by the HIV epidemic are under increasing pressure to obtain a good education and employment to support their families, whilst some also have to cope with the loss of parents and care for relatives with little external support. This article discusses the findings of qualitative research that explored the experiences of young people (aged 14-30) who had significant family caring responsibilities and those without such responsibilities in Zambia. Interviews and life-mapping methods were conducted with a total of 35 young people living in rural and urban areas, 12 parents and relatives and 12 professionals. We analyse young people's experiences and perceptions of socially expected transitions, such as completing education and earning an income to support themselves and their families, in addition to more unpredictable changes in young people's family lives. ‘Critical moments’ (Thomson et al, 2002), such as bereavement and loss of parents and other family members, disinheritance of assets and property grabbing, migration and mobility between different relatives homes, parental divorce and separation, often had significant impacts on young people’s ability to navigate their pathways to adulthood according to wider social norms and expectations. A more relational conceptualisation of youth transitions is needed that takes account of young people's caring responsibilities and changing family dynamics.

Pulmonary and systemic vascular dysfunction in young offspring of mothers with preeclampsia

Adverse events in utero may predispose to cardiovascular disease in adulthood. The underlying mechanisms are unknown. During preeclampsia, vasculotoxic factors are released into the maternal circulation by the diseased placenta. We speculated that these factors pass the placental barrier and leave a defect in the circulation of the offspring that predisposes to a pathological response later in life. The hypoxia associated with high-altitude exposure is expected to facilitate the detection of this problem.