Determining the needs, priorities, and desired rehabilitation outcomes of young adults who have had a stroke

Background. Guidelines state that young adults' (aged 18–55 years) rehabilitation needs and priorities following stroke are different from older adults'. However, there is a lack of evidence regarding young adults' perspectives of their needs and priorities. Aim. To gain an understanding of young adults' experience of stroke and associated rehabilitation needs, priorities, and desired outcomes. Methods. A qualitative approach was adopted, based on the phenomenology of Merleau-Ponty. Longitudinal data were gathered using unstructured interviews and analysed using phenomenological reduction. Results. Ten young adults took part in up to four interviews over two years. An overarching theme, Embodied Disorientation, and three subthemes: Mortal Body, Situated Body, and Embodied Perception of Difference, described the young adults' experience. A subsequent iterative process enabled tabulation of patient-centred rehabilitation needs, priorities, and outcomes. Conclusion. Rehabilitation professionals can use the evidence-based outcomes table to work with young adults to develop meaningful patient-centred goals and select appropriate interventions which align with identified needs and outcomes throughout the stroke recovery trajectory

Investing in The Health and Well-Being of Young Adults

This report was prepared to assist federal, state, and local policy makers and program leaders, as well as employers, nonprofit organizations, and other community partners, in developing and enhancing policies and programs to improve young adults' health, safety, and well-being. The report also suggests priorities for research to inform policy and programs for young adults.Young adulthood - ages approximately 18 to 26 - is a critical period of development with long-lasting implications for a person's economic security, health and well-being. Young adults are key contributors to the nation's workforce and military services and, since many are parents, to the healthy development of the next generation. Although 'millennials' have received attention in the popular media in recent years, young adults are too rarely treated as a distinct population in policy, programs, and research. Instead, they are often grouped with adolescents or, more often, with all adults. Currently, the nation is experiencing economic restructuring, widening inequality, a rapidly rising ratio of older adults, and an increasingly diverse population. The possible transformative effects of these features make focus on young adults especially important. A systematic approach to understanding and responding to the unique circumstances and needs of today's young adults can help to pave the way to a more productive and equitable tomorrow for young adults in particular and our society at large

Mental health among northern New Hampshire young adults: depression and substance problems higher than nationwide

This brief uses data on depressive and substance abuse symptoms from two surveys administered in 2011—the Coös Youth Study and the National Survey on Drug Use and Health—to compare mental health patterns among young adults in Coös County, New Hampshire, to patterns among rural young adults nationwide. The analyses focus on 214 Coös young adults and 1,477 young adult respondents, ages 18 to 21, who were living in non-metropolitan areas in 2011 and who provided usable data on depressive and substance abuse symptoms. Author Karen Van Gundy reports that Coös County young adults are more likely than rural young adults nationwide to suffer from symptoms of depression and substance abuse, and these patterns vary by sex. Coös young women tend to experience more depressive symptoms than their national counterparts, and Coös young men tend to experience more substance abuse symptoms than their national counterparts. Van Gundy concludes that programs fostering community attachment could lessen adult substance abuse in Coös County and that combined or co-occurring symptoms of depression and substance abuse in Coös County require careful consideration

The Lives of Young Adults Who Have Graduated from Residential Children\u27s Mental Health Programs (FULL REPORT)

This report presents the results of a research process in which 59 young adults who had received residential mental health treatment in the past were sorted into descriptive profiles based on the information they shared about their lives and personal functioning with researchers. Five different groups of young adults emerged from this process and represent the clearest categorizations for understanding this particular sample of young adults from across Southern Ontario who received residential treatment. Sorting young adults into distinct groups based on their functioning within key life domains (like education, employment, social connections, personal functioning) is useful to understanding the long term community adaptation of youth previously involved in children’s residential mental health treatment. Through a process of describing the defining characteristics of particular groups of young adults we can begin to think about adapting services and supports to meet the unique needs of distinct groups of youth as they transition into young adulthood

To Have and to Hold: An Analysis of Young Adult Debt

Today's young adults often have been characterized as a generation of borrowers. But are they any different from past generations, or the current generation of adults, in the amount of debt they carry?In this Issue Brief Ngina Chiteji takes a careful look at debt in young adulthood, finding that, contrary to popular perception, most of today's young adults are not carrying an unusual or excessive amount of debt, at least not by historical standards or given their time in life, just starting out. The fraction of indebted young adult households age 25 to 34 has barely changed in 40 years, and while, in general, young households carry more debt than the population at large, this is consistent with the predictions of economic theory and most young adults appear to have manageable debt loads

An Initiative to Educate and Support Young Adults Diagnosed with Hypertension

An Initiative to Educate and Support Young Adults Diagnosed with Hypertension Page Tomlinson, BS, RN, DNPc Background: Hypertension is a common diagnosis in the US with significant long-term effects. While guidelines for optimal hypertension management exist, young adults lag behind older adults in treatment and control3. The young adult is arguably more capable of lifestyle changes, primarily due to fewer physical limitations than older adults. Promotion of disease self-management is the most effective way to engage young adults in seeking control over their blood pressure1,2. Lifestyle modification as a young adult decreases costs of care and risk for cardiovascular events, while lack of guidance and support at this stage of life may increase risk for cardiac events over their lifetime. This project examined disease self-management in young adults aged 18-39 years at a local primary care office. Methods. Patients aged 18-39 years with diagnosis of hypertension were identified. A questionnaire on self-efficacy in hypertension management was sent and preference for lifestyle modification counseling (LMC) was assessed. Follow up calls placed. Semi-structured interviews conducted. Provider survey conducted. Results: Three patients discussed their experience of being diagnosed with hypertension in semi-structured interviews. Fourteen patients were not interested in participating. Provider survey (n=7) response 100%. Patient information handout created. Conclusions. While the literature demonstrates the positive effect of LMC on outcomes in hypertensive young adults, efforts to engage this population proved challenging. Young adults desire consistent guidance and support with lifestyle modification yet are unwilling to engage in lifestyle modification when they are asymptomatic and do not have rapport with the offering provider. Key Words: hypertension, young adult, support, lifestyle modification Word count [246] References: Johnson, H., Olson, A., Lamantia, J., Kind, A., Pandhi, N., Mendonça, E., Craven, M., & Smith, M. (2015). Documented lifestyle education among young adults with incident hypertension. Journal of General Internal Medicine, 30(5), 556-64. Trento, M., & Porta, M. (2012). Structured and Persistently Reinforced Patient Education Can Work. BMJ: British Medical Journal 345, e5100. Zhang, Y. E., & Moran, A. (2017). Trends in the Prevalence, Awareness, Treatment, and Control of Hypertension Among Young Adults in the United States, 1999 to 2014. Hypertension, 70(4), 736-742

Antiretroviral Therapy outcomes among adolescents and youth in rural Zimbabwe

Around 2 million adolescents and 3 million youth are estimated to be living with HIV worldwide. Antiretroviral outcomes for this group appear to be worse compared to adults. We report antiretroviral therapy outcomes from a rural setting in Zimbabwe among patients aged 10-30 years who were initiated on ART between 2005 and 2008. The cohort was stratified into four age groups: 10-15 (young adolescents) 15.1-19 years (adolescents), 19.1-24 years (young adults) and 24.1-29.9 years (older adults). Survival analysis was used to estimate rates of deaths and loss to follow-up stratified by age group. Endpoints were time from ART initiation to death or loss to follow-up. Follow-up of patients on continuous therapy was censored at date of transfer, or study end (31 December 2008). Sex-adjusted Cox proportional hazards models were used to estimate hazard ratios for different age groups. 898 patients were included in the analysis; median duration on ART was 468 days. The risk of death were highest in adults compared to young adolescents (aHR 2.25, 95%CI 1.17-4.35). Young adults and adolescents had a 2-3 times higher risk of loss to follow-up compared to young adolescents. When estimating the risk of attrition combining loss to follow-up and death, young adults had the highest risk (aHR 2.70, 95%CI 1.62-4.52). This study highlights the need for adapted adherence support and service delivery models for both adolescents and young adults

Supraspinal Fatigue Impedes Recovery From a Low-Intensity Sustained Contraction in Old Adults

This study determined the contribution of supraspinal fatigue and contractile properties to the age difference in neuromuscular fatigue during and recovery from a low-intensity sustained contraction. Cortical stimulation was used to evoke measures of voluntary activation and muscle relaxation during and after a contraction sustained at 20% of maximal voluntary contraction (MVC) until task failure with elbow flexor muscles in 14 young adults (20.9 ± 3.6 yr, 7 men) and 14 old adults (71.6 ± 5.4 yr, 7 men). Old adults exhibited a longer time to task failure than the young adults (23.8 ± 9.0 vs. 11.5 ± 3.9 min, respectively, P \u3c 0.001). The time to failure was associated with initial peak rates of relaxation of muscle fibers and pressor response (P \u3c 0.05). Increments in torque (superimposed twitch; SIT) generated by transcranial magnetic stimulation (TMS) during brief MVCs, increased during the fatiguing contraction (P \u3c 0.001) and then decreased during recovery (P = 0.02). The increase in the SIT was greater for the old adults than the young adults during the fatiguing contraction and recovery (P \u3c 0.05). Recovery of MVC torque was less for old than young adults at 10 min post-fatiguing contraction (75.1 ± 8.7 vs. 83.6 ± 7.8% of control MVC, respectively, P = 0.01) and was associated with the recovery of the SIT (r = −0.59, r2 = 0.35, P \u3c 0.001). Motor evoked potential (MEP) amplitude and the silent period elicited during the fatiguing contraction increased less for old adults than young adults (P \u3c 0.05). The greater fatigue resistance with age during a low-intensity sustained contraction was attributable to mechanisms located within the muscle. Recovery of maximal strength after the low-intensity fatiguing contraction however, was impeded more for old adults than young because of greater supraspinal fatigue. Recovery of strength could be an important variable to consider in exercise prescription of old populations