Introduction
How to communicate effectively with adolescent and young adults with cancer (AYACs) is a research priority. In a UK‐wide survey of young people with cancer's research priorities, ...communication was a striking cross‐cutting theme. It is increasingly recognised that AYACs have experiences and communication needs that differ significantly from those of younger children and older adults. The purpose of this review is to explore the features of effective clinical communication with AYACs.
Methods
A literature search was undertaken to identify and map the available evidence using a broad scope to get an overview of the pertinent literature, identify knowledge gaps and clarify concepts. The searches yielded 5825 records, generating 4040 unique articles. These were screened and 71 full articles were read by four researchers with disagreements resolved by discussion leaving 29 included articles. Narrative synthesis was undertaken in relation to each of the research questions.
Results
Three key themes were identified: being an adolescent/young adult, supporters, and healthcare professionals (HCPs). AYACs need to feel that HCPs understand their unique perspective. They want to be involved, this changes over time and in different contexts. Supporters are a central tenet, are most often parents and undertake several roles which are not always universally supportive. HCPs enable involvement of AYACs, and this needs to be actively promoted. AYACs preference for their level of involvement requires continual assessment. The three themes are interlinked and exist within the wider scope of the triadic encounter and cancer experience.
Conclusion
Supporters, most often parents were a key feature across the data and were seemingly paradoxical in nature. Triadic communication, the presence of a third person, is a central tenet of communication with AYACs and we propose a conceptual model to represent the nuances, components, and facets of this complex communication.
Adolescents and young adults with and without chronic illnesses partake in risk‐taking behavior. Clinicians in transplant clinics should be aware of the prevalence of risk‐taking behavior in their ...adolescent and young adult solid organ transplant patients in order to provide complete care. Creating an environment where teens and young adults feel comfortable discussing risky behavior is important and includes creating a privacy policy and increasing comfort of the healthcare provider in asking sensitive questions. This review is intended to help the providers in the transplant clinic screen for and counsel about risk‐taking behaviors with their adolescent and young adult patients, specifically around sexual and reproductive health.
Lung cancer is traditionally more prevalent in the elderly patients, men, and smokers. However, as low-dose computed tomography (LDCT) is increasingly popular, we hypothesized the disease spectrum ...might change.
LDCT was performed as a part of regular health examinations in 8392 of 15,686 employees from 6 hospitals in different regions of China in 2012 to 2018. Clinicopathologic characteristics, including age, sex, smoking status, radiologic features, tumor histology, and pathologic stage, were retrospectively analyzed.
LDCT incidentally detected lung cancer (pathologically confirmed) in a total of 179 (2.1%) hospital employees. The lung cancer detection rate was significantly greater in female than male (2.5% vs 1.3%, P = .001) patients. There was also a greater detection rate among nonsmokers than smokers, although statistical significance was not reached (2.2% vs 1.4%, P = .092). The lung cancer detection rate was 1.0% in the “age ≤40 years” group, 2.6% in the “40 < age ≤55 years” group, and 2.9% in the “age >55 years” group (P < .001). Among the hospital employees with lung cancer, 171 (95.5%) presented as ground-glass opacity, 177 (98.9%) were lung adenocarcinoma, 170 (95.0%) were early stage 0/IA, and 177 (98.9%) received curative surgical resection as the initial treatment. After a median follow-up of 38 months, no disease recurrence or death was observed among these patients.
LDCT detected lung cancer in a significant proportion of young, female, and nonsmoking employees. The vast majority of these lung cancers were early stage, with extremely good prognosis.
The methods, results, and implications of this study. We analyzed the results of low-dose computed tomography (LDCT) as a regular health examination in 8392 of 15,686 employees from 6 hospitals in different regions of China. We found LDCT detected lung cancer in a significant proportion of young, female, and nonsmoking employees. The vast majority of these lung cancers were early stage with an extremely good prognosis. There are challenges and opportunities for better understanding and management of this disease. Display omitted
Recent trends have identified increasing number of young individuals with rectal and colon cancers. These individuals, who are younger than 50 years old, in most instances would not meet screening ...guidelines. We aimed to report the characteristics and trend of the rising proportion of young individuals being diagnosed with rectal and colon cancers at our institutions.
This study included 3381 rectal and colon cancer patients from the Mayo Clinic cancer registry from 1972 to 2017 who were diagnosed with rectal or colon cancer and who were < 50 years old. Patient and cancer characteristics are described. The Cochran-Armitage trend test was used to see if the change in percentage diagnosed at age < 50 years had a significant trend over the years. A linear regression model was fit to estimate the percentage change per year when the trend was approximately linear.
The percentage of patients diagnosed with rectal or colon cancer in different age categories over the years showed a rising trend for individuals aged < 50. Most of these tumors were distal (rectum, left-sided colon, and right-sided colon were 49.8%, 28.8%, and 21.4%, respectively). This was more so for patients < 50 diagnosed with rectal cancer, which showed a linear increase at a rate of 0.26% per year (P < .001).
Our study affirms the rising proportion of colorectal cancers found in young individuals, with a linear ongoing rise of rectal cancers in particular. This may have implications for the current screening recommendations for colorectal cancers, which are already being revised.
We noticed an increased number of patients diagnosed with colorectal cancer (CRC) in their 20s, 30s, and 40s. We analyzed all CRC patients aged < 50 at our institutions from 1972 to 2017 and found increasing trends as well as a propensity for more distal location—findings that are hypothesis generating, given the embryologic origin of these tumors. This finding may have implications for screening guidelines.
Objective
Personality changes are related to successfully performing adult occupational roles which require teamwork, duty, and managing stress. However, it is unclear how personality development ...relates to specific job characteristics that vary across occupations.
Method
We investigated whether 151 objective job characteristics, derived from the Occupational Information Network (O*NET), were associated with personality levels and changes in a 12‐year longitudinal sample followed over the school to work transition. Using cross‐validated regularized modeling, we combined two Icelandic longitudinal datasets (total N = 1054) and constructed an individual‐level, aggregated job characteristics score that maximized prediction of personality levels at baseline and change over time.
Results
The strongest association was found for level of openness (0.25), followed by conscientiousness (0.16) and extraversion (0.14). Overall, aggregated job characteristics had a stronger prediction for personality intercepts (0.14) than slopes (0.10). These results were subsequently replicated in a U.S. sample using levels of the Big Five as the dependent variable. This indicates that associations between job characteristics and personality are generalizable across life stages and nations.
Conclusions
Our findings suggest that job titles are a valuable resource that can be linked to personality to better understand factors that influence psychological development. Further work is needed to document the prospective validity of job characteristics across a wider range of occupations and age.
Objective
Lifestyle variables such as drug use and excessive weight gain contribute to adult morbidity and mortality. This study was designed to determine whether participation in a preventive ...intervention designed to enhance supportive parenting can reduce drug use and body mass index (BMI) in young Black adults from disadvantaged neighborhoods.
Method
This study was conducted in the rural southeastern United States. Black parents and their 11‐year‐old children (517 families) were assigned randomly to the Strong African American Families (SAAF) prevention trial or a control condition. Data assessing neighborhood socioeconomic status and supportive parenting were obtained when the youths were ages 11 and 16. When youths were ages 19–21 and 25, drug use and BMI were measured.
Results
As hypothesized, significant three‐way interactions were detected among neighborhood disadvantage, prevention condition, and gender for BMI (B = 3.341, p = .009, 95% CI 0.832, 5.849) and substance use (B = −0.169, p = .049, 95% CI −0.337, −0.001). Living in a disadvantaged neighborhood during adolescence was associated with increased drug use among young men in the control group (simple‐slope = 0.215, p < .003) but not among those in the SAAF condition (simple‐slope = 0.030, p = .650). Neighborhood disadvantage was associated with elevated BMI among young women in the control group (simple‐slope = 3.343, p < .001), but not in the SAAF condition (simple‐slope = 0.204, p = .820).
Conclusions
The results suggest that participation during childhood in a preventive intervention to enhance supportive parenting can ameliorate the effects of life in a disadvantaged neighborhood on men's drug use and women's BMI across ages 19–25 years. These findings suggest a possible role for parenting enhancement programs in narrowing health disparities.
Abstract
Introduction
Neural replay occurs during sleep to strengthen individual memories. Non-invasive methods of sensory stimulation during sleep have been developed to enhance this process. A ...widely used method known as targeted memory reactivation (TMR) involves classical conditioning of an auditory cue paired with task performance during initial skill acquisition, followed by cue replay during sleep. Our previous work demonstrated that TMR throughout the first two slow wave cycles of overnight sleep, but not daytime wakefulness, enhanced non-dominant arm throwing accuracy. The purpose of the current study was to determine whether TMR throughout a one hour afternoon nap is sufficient to enhance non-dominant arm throwing accuracy.
Methods
The protocol involved repetitive non-dominant arm throwing to unique visuospatial targets, and auditory cues distinctively paired with each target. For participants receiving TMR, these same auditory cues were repetitively replayed either during napping or wakefulness. The primary and secondary outcomes of absolute and variable throwing error distance, respectively, were collected at four time points (baseline, post initial training session, post one-hour nap, and post second training session). Healthy adults were divided into groups based on the inter-training interval: Wakefulness+NoTMR (n=12), Wakefulness+TMR (n=12), Napping+NoTMR (n=12), Napping+TMR (n=10).
Results
A between-group difference was found in absolute error change score ratios between the end of the first session and beginning of the second session (p=0.038), with Napping+TMR demonstrating greater error reduction than Wakefulness+NoTMR (p=0.025). Between sessions, variable error increased similarly in both waking groups, but decreased similarly in both napping groups (napping vs. wakefulness: p=0.011).
Conclusion
These findings suggest that TMR throughout a nap is sufficient to enhance sensorimotor performance, and that a nap is sufficient to decrease performance variability. Data collection continues, and future analyses will investigate the effects of sleep quality and quantity with and without TMR.
Support (If Any)
The American College of Sports Medicine Foundation.
Abstract
Introduction
Sleep duration has decreased significantly in the US over the past 50 years. Short sleep duration and sleep disruption have been associated with obesity, insulin resistance (IR) ...and increased risk of type 2 diabetes (T2DM). When examining the sleep patterns of obese young adults, obstructive sleep apnea (OSA) with severe blood oxygen desaturation is rare, while respiratory effort-related arousals (RERAs) resulting in sleep disruption are common. However, it is still unclear as to how the presence of RERAs in young adults plays a role in IR. Thus, we hypothesized that RERAs would be associated with decreased slow wave sleep (SWS) duration and higher IR and mediate the association between short SWS and IR.
Methods
21 cognitively normal subjects (age 20 ± 1.4, BMI 34 ± 5.9) completed one night nocturnal polysomnography (NPSG). Apneas were defined as absence of airflow for ≥10’’. Hypopnea (3% or arousal) were defined as a reduction in the amplitude of breathing by 30% or more for ≥10’’ accompanied by ≥3% decline in blood O2Sat or an arousal. Standard QUICKI scores were generated using fasting insulin and glucose. Pearson correlations were performed to study the associations between QUICKI, SWS duration and RERAs (measured as AHI3a).
Results
A significant association was found between QUICKI and SWS r=0.44, p=.046. There was a significant relationship between SWS and RERAs r=-0.46, p=0.034. However, we found no association between QUICKI and RERAs (and therefore no mediation effects).
Conclusion
Our findings suggest a relationship between increased IR and decreased SWS in the young obese. The presence of RERAs had an effect on the duration of SWS, which could be relevant for glucose control, school performance, and quality of life. We weren’t able to show the effects of SWS on IR were mediated by RERAs. One of the limitations was the small sample size and cross-sectional design, which limits the understanding of the directionality of these associations. Future studies on metabolic disorders and sleep are required to better understand the physiological effects of IR on sleep in younger populations.
Support (If Any):
Abstract
Introduction
Research has shown the positive effect of artificial dawn on individuals’ physiology and behavior. However, less scientific consideration has been paid to the effect of dusk ...modality. The aim of the present study was to examine the effects of dusk-simulated light on nocturnal sleep of healthy sleepers using polysomnography (PSG) in a carefully controlled laboratory design and whether this light modality would have an impact on sleep inertia after waking up.
Methods
Fourteen healthy subjects (6 males) with a mean age of 21.41 ± 0.35 years took part in the study. Each subject was instructed to participate for four consecutive weeks and the research design included one week baseline and three different light conditions, dusk simulator, constant light and control dim light. Cognitive tests (psychomotor vigilance task, 3-back, stroop task and facial emotional recognition task) and subjective assessments (alertness and mood) were administered three hours before bedtime and at regular intervals for two hours, starting immediately after awakening in the morning. Sleep quality, sleep duration and sleep timing were concurrently monitored by actigraphy and were treated as potential confounders.
Results
Subjects reported a better sleep quality after dusk simulation light (p<0.05). The sleep latency onset tended to be shorter after the dusk session relative to the dim and constant light. Participants’ alertness and mood were reduced immediately after waking up (p<0.01). Moreover, performance on PVT and 3-back task were found to be worse immediately upon awakening than at wake time (p<0.01). However, no significant influence of sleep inertia on stroop and facial expression recognition task was observed (p>0.05). The lighting conditions had no differential impact on morning sleep inertia in task performance and subjective feelings (p>0.05).
Conclusion
The results indicate that the artificial dusk may be a useful light modality in improving sleep quality and shortening sleep latency in healthy sleepers. While this light setting has no influence on sleep inertia after awakening in the morning. The effect of sleep inertia does vary with cognitive domains.
Support (If Any)
the National Key R&D Program of China (2016YFB0404202)
Myopia incidence and progression has been described extensively in children. However, few data exist regarding myopia incidence and progression in early adulthood.
To describe the 8-year incidence of ...myopia and change in ocular biometry in young adults and their association with the known risk factors for childhood myopia.
The Raine Study is a prospective single-center cohort study. Baseline and follow-up eye assessments were conducted from January 2010 to August 2012 and from March 2018 to March 2020. The data were analyzed from June to July 2021. A total of 1328 participants attended the baseline assessment, and 813 participants attended the follow-up assessment. Refractive information from both visits was available for 701 participants. Participants with keratoconus, previous corneal surgery, or recent orthokeratology wear were excluded.
Participants' eyes were examined at ages 20 years (baseline) and 28 years.
Incidence of myopia and high myopia; change in spherical equivalent (SE) and axial length (AL).
A total of 516 (261 male 50.6%) and 698 (349 male 50.0%) participants without myopia or high myopia at baseline, respectively, were included in the incidences analyses, while 691 participants (339 male 49%) were included in the progression analysis. The 8-year myopia and high myopia incidence were 14.0% (95% CI, 11.5%-17.4%) and 0.7% (95% CI, 0.3%-1.2%), respectively. A myopic shift (of 0.50 diopters D or greater in at least 1 eye) occurred in 261 participants (37.8%). Statistical significance was found in longitudinal changes in SE (-0.04 D per year; P < .001), AL (0.02 mm per year; P <.001), and lens thickness (0.02 mm per year; P < .001). Incident myopia was associated with self-reported East Asian vs White race (odds ratio OR, 6.13; 95% CI, 1.06-35.25; P = .04), female vs male sex (OR, 1.81; 95% CI, 1.02-3.22; P = .04), smaller conjunctival ultraviolet autofluorescence area (per 10-mm2 decrease, indicating less sun exposure; OR, 9.86; 95% CI, 9.76-9.97; P = <.009), and parental myopia (per parent; OR, 1.57; 95% CI, 1.03-2.38; P = <.05). Rates of myopia progression and axial elongation were faster in female participants (estimate: SE, 0.02 D per year; 95 % CI, 0.01-0.02 and AL, 0.007 mm per year, 95 % CI, 0.00.-0.011; P ≤ .001) and those with parental myopia (estimate per parent: SE, 0.01 D per year; 95% CI, 0.00-0.02 and AL, 95% CI, 0.002-0.008; P ≤ .001). Education level was not associated with myopia incidence or progression.
These findings suggest myopia progression continues for more than one-third of adults during the third decade of life, albeit at lower rates than during childhood. The protective effects of time outdoors against myopia may continue into young adulthood.
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