Movies and the Enchanted Mind : Emotional Comprehension and Spiritual Meaning Making Among Young Adults in Contemporary Sweden

The outcome of an empirical audience study in Sweden including questionnaires, focus groups and ten in-depth individual interviews discussing favorite films supports claims about viewers as active and playful (cf. Frampton 2006, Hoover 2006, Plantinga 2009). The soft side of mediatization processes is illustrated showing young adults experiencing enchantment through films (Jerslev 2006, Partridge 2008, Klinger 2008, Oliver & Hartmann 2010). The outcome is in line with a growing number of empirical case studies which support conclusions that both thinking and behavior are affected by film watching (Marsh 2007, Suckfüll 2010, Oliver & Hartmann 2010, Axelson 2014). The results of the interviews exploring specific scenes of idiosyncratic relevance support theories about fiction films as important sources for moral and spiritual reflection (Partridge 2004, Zillman 2005, Lynch 2007, Plantinga 2009).  The concept thick viewing is proposed for capturing these moments of film experience when profound and enchanted emotional interpretations take place.

Economic competence and financial literacy of young adults. Status and challenges

This book will concentrate on economic competence and financial literacy of young adults in the US, Europe and South America. The subjects of the research are mainly individuals who have begun an apprenticeship or university education. Economic competence and financial literacy are of special interest for this group because they are usually in the unique position of being responsible for managing their own financial affairs autonomously, often for the first time. Furthermore, economic competence is key to social participation and active citizenship. (DIPF/Orig.)

THE HEALTH OF YOUNG ADULTS WITH DISABILITIES IN THE UNITED STATES: THE COLLECTIVE ROLES OF RISK FACTORS IN SOCIAL ECOLOGIC FRAMEWORK

Background: Over the last few decades, the prevalence of young adults with disabilities (YAD) has steadily risen as a result of advances in medicine, clinical treatment, and biomedical technologythat enhanced their survival into adulthood. Despite investments in services, family supports, and insurance, they experience poor health status and barriers to successful transition into adulthood. Objectives: We investigated the collective roles of multi-faceted factors at intrapersonal, interpersonal and community levels within the social ecological framework on health related outcome including self-rated health (SRH) of YAD. The three specific aims are: 1) to examine sociodemographic differences and health insurance coverage in adolescence; 2) to investigate the role of social skills in relationships with family and peers developed in adolescence; and 3) to collectively explore the association of sociodemographic characteristics, social skills, and community participation in adolescence on SRH. Methods: Using longitudinal data (N=5,020) from the National Longitudinal Transition Study (NLTS2), we conducted multivariate logistic regression analyses to understand the association between insurance status as well as social skills in adolescence and YAD’s health related outcomes. Structural equation modeling (SEM) assessed the confluence of multi-faceted factors from the social ecological model that link to health in early adulthood. Results: Compared with YAD who had private insurance, YAD who had public health insurance in adolescence are at higher odds of experiencing poorer health related outcomes in self-rated health [adjusted odds ratio (aOR=2.89, 95% confidence interval (CI): 1.16, 7.23), problems with health (aOR=2.60, 95%CI: 1.26, 5.35), and missing social activities due to health problems (aOR=2.86, 95%CI: 1.39, 5.85). At the interpersonal level, overall social skills developed through relationship with family and peers in adolescence do not appear to have association with health related outcomes in early adulthood. Finally, at the community level, community participation in adolescence does not have an association with SRH in early adulthood. Conclusions: Having public health insurance coverage does not equate to good health. YAD need additional supports to achieve positive health outcomes. The findings in social skills and community participation suggest other potential factors may be at play for health related outcomes for YAD and the need for further investigation.

Heart failure in young adults

Heart failure (HF) is a major health concern affecting 15 million people in Europe and around 900 000 people in the U.K. HF predominantly affects the elderly, with the mean age of patients with a diagnosis of HF between 70 and 80 years. Most previous HF studies have accordingly focused on older patients. Although HF is less common in younger adults (<65 years), 15% to 20% of patients hospitalised with HF are younger than 60 years of age. Very few studies have described the characteristics of younger adults with HF and its outcome. The aims of this thesis are to describe the clinical characteristics of younger adults with HF, explore the epidemiology of HF in younger adults and determine their short- and long-term outcomes. This was made possible by access multiple databases consisting of large patient cohorts with HF. The first chapter is a systematic literature review of younger adults with HF. Gaps in the current literature were identified and the thesis focused on some of these. The CHARM study allows detail characterisations of younger adults with HF. It recorded characteristics of patients with HF, including symptoms and signs of HF, electrocardiographic changes, chest radiographic findings, and also left ventricular ejection fraction. HF hospitalisations and its precipitating factors were also recorded systematically. Younger adults were more likely to have a third heart sound and hepatomegaly, but less likely to have pulmonary crackles and peripheral oedema. Similarly, radiological findings in younger adults were less likely to show interstitial pulmonary oedema or pleural effusion. Interestingly, younger adults aged <40 years not only have similar HF hospitalisation rate to older patients, however during their presentation with decompensated HF, they were less likely to have clinical pulmonary oedema and radiological signs of HF. Physicians managing younger adults with HF need to be aware of this. Younger adults were also less compliant with medications and lifestyle restriction resulting in hospitalisation with decompensated HF. Fortunately, despite these challenges, mortality rates in younger adults with HF were lower compared to older patients. To further substantiate the findings from the CHARM study, the MAGGIC study, a meta-analysis consists of over 40 000 patients with HF from large observational studies and randomised controlled trials, was examined. In both databases, the commonest aetiology of HF in younger adults was dilated cardiomyopathy. The ejection fraction was the lowest in younger adults. Similar to the CHARM study, mortality rates in younger adults were lower compared to older patients. However, in the MAGGIC study, by stratifying mortality into patients with preserved ejection fraction and with reduced ejection fraction, younger patients with preserved ejection fraction have a much lower mortality rate compared to patients with reduced ejection fraction. Findings from clinical trials are not always reflective of the real life clinical practice. The U.K. Clinical Practice Research Datalink (CPRD), a large and well-validated primary care database with 654 practices contributing information into the database representing approximated 8% of the U.K. population, is a rich dataset offering a unique opportunity to examine the characteristics, treatments, and outcomes of younger adults with HF in the community. In contrast to the CHARM and MAGGIC studies, younger adults aged <40 years were stratified into 20-29 and 30-39 years in the CPRD analysis. This is possible due to the larger number of younger adults with HF. Further stratifying the younger age groups demonstrated heterogeneity among younger adults with HF. In contrast to previous data showing younger adults have lower co-morbidities, the proportions of depression, chronic kidney disease, asthma, and any connective tissue disease were high among patients aged 20-29 years in the analysis from the CPRD. Surprisingly, the treatment rates for angiotensin converting enzyme (ACE) inhibitor, and aldosterone antagonist were the lowest in patients aged 20-29 years. With the exception of patients aged ≥80 years, treatment rate with beta-blocker was also the lowest in patients aged 20-29 years. With over two decades of follow up, long-term mortality rates in younger adults with HF can be determined. The mortality rates continued to decline from 1988 to 2011. Physicians managing younger adults with HF can now use this contemporary data to provide prognostic information to patients and their family. A hospital administrative database is the logical next platform to explore younger adults with HF. The Alberta Ministry of Health database links an outpatient database to a hospitalisation database providing ample data to examine the relationship between outpatient clinic visits and hospital admissions in younger adults with HF. Following a diagnosis of HF in the outpatient setting, younger adults were admitted to the hospital with decompensated HF much sooner than older patients. Younger adults also presented to emergency department more frequently following their first hospitalisation for HF. In conclusion, this thesis presented the characteristics and outcomes of younger adults with HF, and helped to extend our current understanding on this important topic. I hope the data presented here will benefit not only physicians looking after younger adults with HF, but also patients and their family.

Prevalence of Barrett Esophagus in Adolescents and Young Adults With Esophageal Atresia

International audience

Aerobic endurance in HIV-positive young adults and HIV-negative controls in Malawi

Background Aerobic endurance is an important aspect of physical fitness that enables individuals living with HIV to endure in the work place as well as in agricultural operations in order to earn a living and improve their quality of life. However, despite high HIV prevalence rates, the aerobic endurance status of young Malawians living with HIV remains unknown. The objective of this study was to determine the difference in VO2max between HIV-negative and HIV-positive individuals in Blantyre, Malawi. Methods Fifty five participants (17 males and 38 females) who have HIV and were not taking antiretroviral medication and 78 HIV-negative participants (45 males and 33 females) performed the Rockport submaximal treadmill exercise test. Measures of body weight, post-exercise heart rate and time to walk one mile were obtained and used to predict VO2max. Comparisons between groups were adjusted for age differences using analysis of covariance (ANCOVA). Results VO2max was significantly lower in HIV-positive subjects [31.1, 28.7 - 33.5mL.kg-1.min-1(mean, 95% CI)] compared with HIV-negative subjects [56.2, 54.3 - 58.1mL.kg-1.min-1]. Conclusion Aerobic endurance was markedly reduced in HIV-positive participants compared with HIV-negative participants. Findings of the current study implicate factors associated with the HIV infection as contributors to a decreased aerobic endurance in people living with HIV.

Vitamin D status in a Brazilian cohort of adolescents and young adults with perinatally acquired human immunodeficiency virus infection

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.

Transition into adulthood : the impact of the great recession in schooling and financial choices of young adults

Mestrado em Finanças

Nutrients can modulate the adiponectin concentrations in apparently healthy young adults

Introduction: Adiponectin, an adipocyte derived peptide, has anti-inflammatory and antiatherogenic effects, and improves insulin sensitivity. However, little is known about dietary predictors and their interactions with lifestyle on adiponectin concentrations, in apparently healthy young adults. Objective: To evaluate the associations between plasma concentrations of adiponectin with dietary components and lifestyle in apparently healthy young adults. Methods: Anthropometric and body composition, systolic and diastolic blood pressure, diet and lifestyle data of 157 healthy young adults, aged 18 and 35, were collected and analyzed. Blood samples were collected after fasting for 12 hours to determine adiponectin concentrations. Dietary and anthropometric indexes were calculated and analyzed. Results: Adiponectin concentrations were significantly higher for women compared to men; and there was an indirect and significant correlation between adiponectin concentrations with BMI. There was a significant association between adiponectin concentrations with the healthy eating index, calories, lipids, proteins, fibers, riboflavin, and phosphorus, among others; and a tendency with carbohydrates and niacin. In multiple linear regression analysis, fiber and riboflavin (r² = 0.0928; p = 0.0013) and carbohydrates and phosphorus were associated with the concentrations of adiponectin. The association with carbohydrates and phosphorus suffered interaction with gender (r²= 0.2400; p < 0.0001), as well as the association with phosphorus also suffered interaction with physical activity (r²= 0.1275; p = 0.0003). Conclusion: Plasma concentrations of adiponectin, in healthy young adults, seem to be modulated by components of diet depending on gender and physical activity.

MIGRATION PATTERNS AMONG YOUNG ADULTS IN THE UNITED STATES: ENVIRONMENTAL, SOCIAL, AND ECONOMIC EXPLANATIONS

Young adult migration is a key factor in community development. The goal of this paper is to study what kinds of places attract young adults and what kinds are losing them. Linear regression is conducted to analyze what place-specific factors explain migration patterns among young adults. These factors include economic, social, and environmental variables. This study finds that social and environmental factors are just as important as economic ones. Specifically, employment in the arts increases young adult net migration. Environmental variables, for example, natural amenities and protected federal lands are particularly important in rural settings in attracting young adults. These findings suggest that policy makers interested in attracting and retaining young adults should pay closer attention to social and environmental factors and consider creating more opportunities for arts employment in general. For rural areas, improving the attractiveness of natural amenities and better protection of federal lands is also recommended.

The Impact of Social Comparison Processes on Hoped-For Possible Selves, Self-Regulatory Processes, and Mental Health Outcomes in Young Adults

In exploring the role of social influences in the development of the self, the current study evaluated whether young adults use social comparisons in developing their hoped-for possible selves and, if so, whether their developmental process correlates with self-regulatory processes and positive mental health outcomes. The current study found the following: (1) the domains of hoped-for possible selves among young adults were related to the gender of the social comparison target, (2) the direction of young adults’ social comparison processes (upward or downward) did not significantly influence self-regulatory processes (self-efficacy and outcome expectancy) toward achieving their hoped-for possible selves, (3) strong masculine gender identification related to greater outcome expectancy, while strong feminine gender identification related to both greater self-efficacy and outcome expectancy, and (4) self-efficacy related to less state anxiety, trait anxiety, and depression, while outcome expectancy related only to less trait anxiety. Males and females were found to use traditional gender role identification in forming their hoped-for possible selves.

Making life choices : facilitating identity formation in young adults

This dissertation makes a contribution to the growing literature on identity formation by formulating, implementing, and testing the effectiveness of a psychosocial intervention, the Making Life Choices (MLC) Workshops, designed to facilitate the process of identity formation. More specifically, the MLC Workshops were designed to foster the development and use of critical cognitive and communicative skills and competencies in choosing and fulfilling life goals and values. The MLC Workshops consist of a psychosocial group intervention that includes both didactic and group experiential exercises. The primary research question for this study concerned the effectiveness of the MLC Workshop relative to a control condition. Effectiveness was evaluated on two levels: skills development and reduction of distress. First, the effectiveness of MLC in fostering the development of critical competencies was evaluated relative to a control condition, and no statistically significant differences were found. Second, the effectiveness of MLC in decreasing life distress was also evaluated relative to the control condition. While participants in the MLC workshop had no significant decrease in distress, they did have statistically significant improvement in life satisfaction in the Personal Domain.

Intraexaminer repeatability and agreement in stereoacuity measurements made in young adults

·AIM: To determine the repeatability and agreement of stereoacuity measurements made using some of the most widely used clinical tests: Frisby, TNO, Randot and Titmus. ·METHODS: Stereoacuity was measured in two different sessions separated by a time interval of at least 24h but no longer than 1wk in 74 subjects of mean age 20.6y using the four methods. The study participants were divided into two groups: subjects with normal binocular vision and subjects with abnormal binocular vision. ·RESULTS: Best repeatability was shown by the Frisby and Titmus [coefficient of repeatability (COR): 依13 and 依12s arc respectively] in the subjects with normal binocular vision though a clear ceiling effect was noted. In the subjects with abnormal binocular vision, best repeatability was shown by the Frisby (COR: 依69s arc) and Randot (COR: 依72s arc). In both groups, the TNO test showed poorest agreement with the other tests. ·CONCLUSION: Therepeatabilityof stereoacuitymeasures was low in subjects with poor binocular vision yet fairly good in subjects with normal binocular vision with the exception of the TNO test. The reduced agreement detected between the tests indicates they cannot be used interchangeably.

Risk of repeated self-harm and associated factors in children, adolescents and young adults

Background: Repeated self-harm represents the single strongest risk factor for suicide. To date no study with full national coverage has examined the pattern of hospital repeated presentations due to self-harm among young people. Methods: Data on consecutive self-harm presentations were obtained from the National Self-Harm Registry Ireland. Socio-demographic and behavioural characteristics of individuals aged 10–29 years who presented with self-harm to emergency departments in Ireland (2007–2014) were analysed. Risk of long-term repetition was assessed using survival analysis and time differences between the order of presentations using generalised estimating equation analysis. Results: The total sample comprised 28,700 individuals involving 42,642 presentations. Intentional drug overdose was the most prevalent method (57.9%). Repetition of self-harm occurred in 19.2% of individuals during the first year following a first presentation, of whom the majority (62.7%) engaged in one repeated act. Overall, the risk of repeated self-harm was similar between males and females. However, in the 20–24-year-old age group males were at higher risk than females. Those who used self-cutting were at higher risk for repetition than those who used intentional drug overdose, particularly among females. Age was associated with repetition only among females, in particular adolescents (15–19 years old) were at higher risk than young emerging adults (20–24 years old). Repeated self-harm risk increased significantly with the number of previous self-harm episodes. Time differences between first self-harm presentations were detected. Time between second and third presentation increased compared to time between first and second presentation among low frequency repeaters (patients with 3 presentations only within 1 year following a first presentation). The same time period decreased among high frequency repeaters (patients with at least 4 to more than 30 presentations). Conclusion: Young people with the highest risk for repeated self-harm were 15–19-year-old females and 20–24-year-old males. Self-cutting was the method associated with the highest risk of self-harm repetition. Time between first self-harm presentations represents an indicator of subsequent repetition. To prevent risk of repeated self-harm in young people, all individuals presenting at emergency departments due to self-harm should be provided with a risk assessment including psychosocial characteristics, history of self-harm and time between first presentations.