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.

Correlates of Vitamin D Status in Healthy Older Adults Living in Miami-Dade and its Association with Non-Skeletal Outcomes: A Cross-Sectional Study

Examining factors that affect vitamin D status in the fast-growing elderly population of Miami-Dade, Florida, is needed. Vitamin D deficiency in older adults has been linked to correlates of disability, including falls and fractures, and cardiovascular disease. The purpose of this study was to determine the proportion of vitamin D insufficient individuals and their relationship with vitamin D insufficiency in older adults (n=97) living in Miami-Dade. We evaluated the association between vitamin D status and 1) dual task physical performance to understand the link between vitamin D and cognition in the context of mobility; and 2) cardiometabolic risk, measured by galvanic skin response, pulse oximetry, and blood pressure to create a composite score based on autonomic nervous system and endothelial function. Participants completed baseline assessments that included serum levels of vitamin D, anthropometrics, body composition, dual task physical performance and cardiometabolic risk. Surveys to evaluate vitamin D intake, sun exposure, physical activity, and depressive symptoms were completed. Spearman’s correlations, independent t-tests, paired t-tests, repeated measures ANOVAs, and multiple logistic and linear regressions were used to examine the relationship of vitamin D insufficiency (25(OH)D /ml) and sufficiency (25(OH)D ≥30 ng/ml) with determinants of vitamin D status, dual task physical performance variables and cardiometabolic risk scores. Although the proportion of vitamin D insufficient individuals was lower when compared to the prevalance of the general United States elderly population, it was still common in healthy community-dwelling older adults living in Miami-Dade County, especially among Hispanics. Factors that affected skin synthesis (ethnicity, and sun exposure), and bioavailability/metabolism (obesity) were significant predictors of vitamin D status. Vitamin D insufficiency was not significantly correlated with worse dual task physical performance; however, cognitive performance was worse in the vitamin D insufficient group. Our results suggest a relationship of vitamin D insufficiency with executive dysfunction, and support an association with cardiometabolic risk using an innovative electro-sensor complex, possibly by modulating autonomic nervous system activity and vascular function, thus affecting cardiac performance.

Association of depression and anxiety status with 10-year cardiovascular disease incidence among apparently healthy Greek adults:the ATTICA study

Background: Chronic stress frequently manifests with anxiety and/or depressive symptomatology and may have detrimental cardiometabolic effects over time. As such, recognising the potential links between stress-related psychological disorders and cardiovascular disease (CVD) is becoming increasingly important in cardiovascular epidemiology research. The primary aim of this study was to explore prospectively potential associations between clinically relevant depressive symptomatology and anxiety levels and the 10-year CVD incidence among apparently healthy Greek adults. Design: A population-based, health and nutrition prospective survey. Methods: In the context of the ATTICA Study (2002–2012), 853 adult participants without previous CVD history (453 men (45 ± 13 years) and 400 women (44 ± 18 years)) underwent psychological evaluations through validated, self-reporting depression and anxiety questionnaires. Results: After adjustment for multiple established CVD risk factors, both reported depression and anxiety levels were positively and independently associated with the 10-year CVD incidence, with depression markedly increasing the CVD risk by approximately fourfold (adjusted odds ratio (95% confidence interval) 3.6 (1.3, 11) for depression status; 1.03 (1.0, 1.1) for anxiety levels). Conclusions: Our findings indicate that standardised psychological assessments focusing on depression and anxiety should be considered as an additional and distinct aspect in the context of CVD preventive strategies that are designed and implemented by health authorities at the general population level.

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.

Determination of metabolic equivalents during low-and high-intensity resistance exercise in healthy young subjects and patients with type 2 diabetes

The purpose of this study was to quantify the metabolic equivalents (METs) of resistance exercise in obese patients with type 2 diabetes (T2DM) and healthy young subjects and to evaluate whether there were differences between sessions executed at low- versus high-intensity resistance exercise. Twenty obese patients with T2DM (62.9±6.1 years) and 22 young subjects (22.6±1.9 years) performed two training sessions: one at vigorous intensity (80% of 1-repetition maximum (1RM)) and one at moderate intensity (60% of 1RM). Both groups carried out three strength exercises with a 2-day recovery between sessions. Oxygen consumption was continuously measured 15 min before, during and after each training session. Obese T2DM patients showed lower METs values compared with young healthy participants at the baseline phase (F= 2043.86; P<0.01), during training (F=1140.59; P<0.01) and in the post-exercise phase (F=1012.71; P<0.01). No effects were detected in the group x intensity analysis of covariance. In this study, at both light-moderate and vigorous resistance exercise intensities, the METs value that best represented both sessions was 3 METs for the obese elderly T2DM patients and 5 METs for young subjects.

Young adults’ perceptions of and affective bonds to a rural tourism community

Many rural areas, in Sweden and worldwide, experience population decline where the young leave for education and work in urban areas. Employment has declined in several rural industries, such as agriculture, forestry, and fishing, while growing in other industries are often located in urban areas. Politicians and organizations have put much hope in tourism as a tool of rural development, but can tourism help reverse the rural out-migration trend among young adults? This paper explores how tourism affects young inhabitants’ perceptions of and affective bonds to a rural area in Sweden, the ski resort of Sälen. Students from the 1993–1995 elementary school graduating classes were interviewed about their migration history, childhood, and view of and ties to Sälen. The respondents experience that tourism contributes to a more vital community incorporating influences from elsewhere, but without eliminating the positive aspects of rural life. The regular flow of people – tourists, seasonal workers, and entrepreneurs – passing through Sälen presents opportunities to extend one’s social network that are widely appreciated by respondents. The high in and out mobility constitutes a key part of Sälen’s character. Contributions from tourism – such as employment, entertainment, leisure, and opportunities to forge new social relationships – are available during the adult transition, the life phase when rural areas are often perceived as least attractive. Even though out-migration occurs in Sälen, and some respondents still find Sälen too small, tourism has clearly increased the available opportunities and contributed significantly to making Sälen more attractive to young adults.

Young adults in rural tourism areas

This thesis examines how tourism affects conditions for young adults in rural areas. Such a study lies at the intersection of research about tourism impacts, adult transition, and rural areas. The aim is to examine how largescale tourism affects the opportunities for young adults living in rural areas; their perception of place and the perceived opportunities and obstacles that tourism provides. The thesis utilizes a mixed method approach. A quantitative study based on micro-data on individuals identifies the patterns and magnitudes of the mechanisms by which tourism affects population change among young adults. Interview methods are used in the case study area, Sälen, to investigate these mechanisms in depth. Finally, the rural–urban dichotomy is explored in a conceptual study that asks how tourism affects the perception of a local village as either rural or urban. Young inhabitants in rural areas are rarely considered in tourism research; therefore, the main contribution of this thesis is that it illuminates how tourism affects conditions for young adults in rural areas. The thesis reveals a substantial impact on the adult transition, mainly due to easier access to the labor market and a good supply of jobs during the high season. Further, the large number of people passing through creates flows of opportunities to make friends, get a job, or just meet people. All of these factors contribute to high mobility in these places, and to the perception of them as places where things happen. The high mobility in Sälen implies that fixed migrant categories (such as stayers and leavers) are largely insufficient. The tourism environment creates a space that is always under construction and continually producing new social relations mainly perceived as opportunities. Conceptualizing this as a modern rurality is a way to move beyond the often implicit notions of urban as modern and rural as traditional.

Social participation and interventions supporting teenagers and young adults living with developmental coordination disorder (DCD): results from a Scoping Review

Background: The impact of Developmental Coordination Disorder (DCD) on teenagers’ and young adults’ participation is not well documented. This article aims to synthesize the current knowledge on social participation, which is the performance of an individual in realizing his daily activities and social roles within its life environment. Strategies and interventions to support youths (15-25 years old) with DCD were also synthesized. Methods: A scoping review interrogating three databases and using ‘snowballing techniques’ was performed to identify both scientific and grey literature published between 2004 and 2014. Over 1000 documents were screened and 57 were read in full; 28 met inclusion criteria. A charting form based on 12 life habits described in the Disability Creation Process (DCP) and developed by two reviewers was used to extract data and report the results. Results: All life habits were reported to be affected for teenagers and young adults with DCD, with education and interpersonal relationships being the most frequently discussed. During adolescence and adulthood, new tasks and subsequent difficulties emerge, such as driving. Mental health difficulties emerged as a key theme. Few strategies and interventions were described to support social participation of youths with DCD. Conclusion: Many life habits are challenging for youths with DCD, but few evidence-based strategies and interventions have been designed to help them to increase their social participation.

Parental Rejection, Personality, and Depression in the Prediction of Suicidality in a Sample of Nonclinical Young Adults

This study tested a prediction model of suicidality in a sample of young adults. Predictor variables included perceived parental rejection, self-criticism, neediness, and depression. Participants (N 5 165) responded to the Depressive Experiences Questionnaire,theInventoryforAssessingMemoriesofParentalRearingBehavior, theCenterforEpidemiologicalStudiesDepressionScale,andtheSuicideBehaviors Questionnaire—Revised. Perceived parental rejection, personality, and depression wereassessedinitiallyatTime1,anddepressionagainandsuicidalitywereassessed 5 months later at Time 2. The proposed structural equation model fit the observed data well in a sample of young adults. Parental rejection demonstrated direct and indirect relationships with suicidality, and self-criticism and neediness each had indirect associations with suicidality. Depression was directly related to suicidality. Implications for clinical practice are discussed.

Anxiety, stress and depression in young adults with type 1 Diabetes

Introdução: A vida dos jovens adultos com diabetes tipo 1 (DM1) tem muitas exigências e as consequências psicológicas da adesão contínua aos aspetos do tratamento pode afetar a qualidade de vida. Objetivos: Conhecer o suporte social, satisfação com a vida, ansiedade, stresse e depressão nos jovens adultos com DM1. Material e Métodos: Estudo quantitativo realizado com 278 jovens adultos com DM1 (18 - 35 anos). Resultados: Os jovens consideram ter bom suporte social. A média de satisfação com a vida é 6,6 ±1,7 (escala 0-10). A maior parte dos jovens não apresenta estados persistentes de ansiedade e de excitação e tensão (stresse), pelo que têm resistência à frustração e desilusão. A maioria dos jovens não apresenta sintomas de depressão, revelando auto-estima, sentimentos positivos, motivação, entusiasmo e perceção da probabilidade de alcançar objetivos de vida que sejam significativos. A análise fatorial das escalas de ansiedade, stresse e depressão permitiu encontrar 3 fatores que explicam 50% da variância total: stresse (36%), ansiedade (8%), depressão (6%). Conclusões: Os jovens adultos com DM1 têm bom suporte social e satisfação com a vida. A maior parte dos jovens não revela sintomas de ansiedade, stresse e depressão. O suporte social e a satisfação com a vida poderão contribuir para uma boa saúde mental.

El futuro es femenino: un approccio transfemminista alla traduzione nella letteratura per l’infanzia e young adults

La letteratura per l’infanzia e young adults (YA) ha un ruolo fondamentale nello sviluppo della personalità umana e su di essa grava ancora più responsabilità quando si tratta di tematiche come l’eguaglianza di genere, la decostruzione di stereotipi e l’inclusività. In questo elaborato viene esposto inizialmente il quadro generale dell’offerta di letteratura per l’infanzia e YA di taglio di genere da parte dell’editoria attuale. In seguito, un quadro teorico e pratico per l’adozione di un approccio transfemminista e inclusivo alla traduzione per il giovane pubblico, mettendo a confronto le tecniche implementate dalla traduzione più tradizionalista con quelle della traduzione transfemminista. Segue una riflessione sulla responsabilità che grava sulla figura del traduttore quando si approccia alla traduzione per l’infanzia e YA, soprattutto se dà una dimensione politico-ideologica alle proprie scelte traduttive. Infine, nell’elaborato è presente una proposta di traduzione di due degli otto racconti del libro El futuro es femenino di Sara Cano Fernández, seguito dal commento di tutte le scelte traduttive adottate basate sui princìpi esposti nella prima parte di questa tesi.

Age-related difference on weight transfer during unconstrained standing

The ability to transfer weight from one lower limb to the other is essential for the execution of daily life activities and little is known about how weight transfer during unconstrained natural standing is affected by age. This study examined the weight transfer ability of elderly individuals during unconstrained standing (for 30 mill) in comparison to young adults. The subjects (19 healthy elderly adults, range 65-80 years, and 19 healthy young adults, range 18-30 years) stood with each foot on a separate force plate and were allowed to change their posture freely at any time. The limits of stability and base of support width during standing, measures of mobility (using the timed up and go and the preferred walking speed tests), and fear of falling were also measured. In comparison to the young adults, during unconstrained standing the elderly adults produced four times fewer weight transfers of large amplitude (greater than,half of their body weight). The limits of stability and base of support width were significantly smaller for the elderly adults but there were no significant differences in the measures of mobility and in the fear of falling score compared to young adults. The observed significant age-related decrease in the use of weight transfer during unconstrained standing, despite any difference in the measured mobility of the subjects, suggests that this task reveals unnoticed and subtle differences in postural control, which may help to better understand age related impairments in balance that the elderly population experiences. (C) 2010 Elsevier B.V. All rights reserved.

Joint forces and torques when walking in shallow water

This study reports for the first time an estimation of the internal net joint forces and torques on adults` lower limbs and pelvis when walking in shallow water, taking into account the drag forces generated by the movement of their bodies in the water and the equivalent data when they walk on land. A force plate and a video camera were used to perform a two-dimensional gait analysis at the sagittal plane of 10 healthy young adults walking at comfortable speeds on land and in water at a chest-high level. We estimated the drag force on each body segment and the joint forces and torques at the ankle, knee, and hip of the right side of their bodies using inverse dynamics. The observed subjects` apparent weight in water was about 35% of their weight on land and they were about 2.7 times slower when walking in water. When the subjects walked in water compared with walking on land, there were no differences in the angular displacements but there was a significant reduction in the joint torques which was related to the water`s depth. The greatest reduction was observed for the ankle and then the knee and no reduction was observed for the hip. All joint powers were significantly reduced in water. The compressive and shear joint forces were on average about three times lower during walking in water than on land. These quantitative results substantiate the use of water as a safe environment for practicing low-impact exercises, particularly walking. (C) 2011 Elsevier Ltd. All rights reserved.

Surface electromyographic assessment of patients with long lasting temporomandibular joint disorder pain

The normalized electromyographic characteristics of masticatory muscles in patients with temporomandibular joint disorders (TMD) and healthy controls were compared. Thirty TMD patients (15 men, 15 women, mean age 23 years) with long lasting pain (more than 6 months), and 20 control subjects matched for sex and age were examined. All patients had arthrogenous TMD according to the Research Diagnostic Criteria for TMD (RDC/TMD). Surface electromyography of masseter and temporal muscles was performed during maximum teeth clenching either on cotton rolls or in intercuspal position. Standardized EMG indices and the median power frequency were obtained, and compared between the two groups and sexes using ANOVAs. During clenching, the TMD patients had larger asymmetry in their temporalis muscles, larger temporalis activity relative to masseter, and reduced mean power frequencies than the control subjects (p < 0.05, ANOVA). In both groups, the mean power frequencies of the temporalis muscles were larger than those of the masseter muscles (p < 0.001). No sex related differences, and no sex x group interactions were found. In conclusion, young adult patients with long lasting TMD have an increased and more asymmetric standardized activity of their temporalis anterior muscle, and reduced mean power frequencies, relative to healthy controls. (C) 2011 Elsevier Ltd. All rights reserved.