Browsing by Subject "Young Adult"
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Item Bone mineral density reductions after tenofovir disoproxil fumarate initiation and changes in phosphaturia: a secondary analysis of ACTG A5224s(Oxford Academic, 2017-07-01) Gupta, Samir K.; Yeh, Eunice; Kitch, Douglas W.; Brown, Todd T.; Venuto, Charles S.; Morse, Gene D.; Ha, Belinda; Melbourne, Kathleen; McComsey, Grace A.; Medicine, School of MedicineBackground: It is unknown if the greater reductions in bone mineral density (BMD) associated with initiation of tenofovir disoproxil fumarate compared with abacavir in previously untreated HIV-infected participants in the ACTG A5224s clinical trial were associated with potentially worsening tenofovir-related phosphaturia. Methods: We correlated changes in BMD at the hip and spine with changes in phosphaturia [transtubular reabsorption of phosphorus (TRP) and tubular maximum phosphate reabsorption per glomerular filtration rate (TmP/GFR)] from entry through week 96 in those initiating tenofovir ( n = 134) versus abacavir ( n = 135) with efavirenz or atazanavir/ritonavir in A5224s. We also correlated changes in BMD with tenofovir AUC measured between weeks 4 and 24. Results: Changes in TRP and TmP/GFR through week 96 between the tenofovir and abacavir arms were not significantly different (both P ≥ 0.70) and did not differ with use of efavirenz versus atazanavir/ritonavir. There were no significant correlations between changes in either TRP or TmP/GFR and with either hip or spine BMD in the tenofovir arms. Tenofovir AUC was significantly correlated with changes in hip BMD, but not spine BMD, at week 24 ( r = -0.22, P = 0.028) and week 48 ( r = -0.26, P = 0.010), but not at week 96 ( r = -0.14, P = 0.18). Conclusions: Changes in phosphaturia were not different between the tenofovir and abacavir arms in A5224s. Changes in hip and spine BMD with tenofovir were not related to changes in phosphaturia. However, tenofovir exposure was weakly associated with changes in hip BMD through week 48.Item COVID-19 vaccination intention and vaccine characteristics influencing vaccination acceptance: a global survey of 17 countries(BMC, 2021-10) Wong, Li Ping; Li Ping, Haridah; Danaee, Mahmoud; Ahmed, Jamil; Lachyan, Abhishek; Cai, Carla Zi; Lin, Yulan; Hu, Zhijian; Tan, Si Ying; Lu, Yixiao; Cai, Guoxi; Nguyen, Di Khanh; Seheli, Farhana Nishat; Alhammadi, Fatma; Madhale, Milkar D.; Atapattu, Muditha; Quazi-Bodhanya, Tasmi; Mohajer, Samira; Zimet, Gregory D.; Zhao, Qinjian; Pediatrics, School of MedicineBACKGROUND: The availability of various types of COVID-19 vaccines and diverse characteristics of the vaccines present a dilemma in vaccination choices, which may result in individuals refusing a particular COVID-19 vaccine offered, hence presenting a threat to immunisation coverage and reaching herd immunity. The study aimed to assess global COVID-19 vaccination intention, vaccine characteristics influencing vaccination acceptance and desirable vaccine characteristics influencing the choice of vaccines. METHODS: An anonymous cross-sectional survey was conducted between 4 January and 5 March 2021 in 17 countries worldwide. Proportions and the corresponding 95% confidence intervals (CI) of COVID-19 vaccine acceptance and vaccine characteristics influencing vaccination acceptance were generated and compared across countries and regions. Multivariable logistic regression analysis was used to determine the factors associated with COVID-19 vaccine hesitancy. RESULTS: Of the 19,714 responses received, 90.4% (95% CI 81.8-95.3) reported likely or extremely likely to receive COVID-19 vaccine. A high proportion of likely or extremely likely to receive the COVID-19 vaccine was reported in Australia (96.4%), China (95.3%) and Norway (95.3%), while a high proportion reported being unlikely or extremely unlikely to receive the vaccine in Japan (34.6%), the U.S. (29.4%) and Iran (27.9%). Males, those with a lower educational level and those of older age expressed a higher level of COVID-19 vaccine hesitancy. Less than two-thirds (59.7%; 95% CI 58.4-61.0) reported only being willing to accept a vaccine with an effectiveness of more than 90%, and 74.5% (95% CI 73.4-75.5) said they would accept a COVID-19 vaccine with minor adverse reactions. A total of 21.0% (95% CI 20.0-22.0) reported not accepting an mRNA vaccine and 51.8% (95% CI 50.3-53.1) reported that they would only accept a COVID-19 vaccine from a specific country-of-origin. Countries from the Southeast Asia region reported the highest proportion of not accepting mRNA technology. The highest proportion from Europe and the Americas would only accept a vaccine produced by certain countries. The foremost important vaccine characteristic influencing vaccine choice is adverse reactions (40.6%; 95% CI 39.3-41.9) of a vaccine and effectiveness threshold (35.1%; 95% CI 33.9-36.4). CONCLUSIONS: The inter-regional and individual country disparities in COVID-19 vaccine hesitancy highlight the importance of designing an efficient plan for the delivery of interventions dynamically tailored to the local population.Item Cultural stressors experienced by young Latinas with depressive symptoms living in a tumultuous sociopolitical climate in the United States(Elsevier, 2019-08-19) McCord Stafford, Allison; Bigatti, Silvia M.; Burke Draucker, Claire; Social and Behavioral Sciences, School of Public HealthThe purpose of this study is to describe the cultural stressors experienced by Latina young women with depressive symptoms from 2016-2018 in the United States. Twenty-four Latina young women (mean age=16.7 years) participated in this qualitative descriptive study. Content analysis of interviews revealed four cultural stressors: Parental oversight, pressure to succeed, being treated differently, and fears of deportation. Experiences with cultural stressors varied across generational status. Clinicians should provide Latina young women with a safe space for discussing cultural stressors, assess how they are managing their stress, and advocate for policies that will benefit the well-being of Latina young women.Item Differential processing of nociceptive input within upper limb muscles(Public Library of Science, 2018-04-25) Eckert, Nathanial R.; Poston, Brach; Riley, Zachary A.; Kinesiology, School of Physical Education and Tourism ManagementThe cutaneous silent period is an inhibitory evoked response that demonstrates a wide variety of responses in muscles of the human upper limb. Classically, the cutaneous silent period results in a characteristic muscle pattern of extensor inhibition and flexor facilitation within the upper limb, in the presence of nociceptive input. The aims of the current study were: 1) to primarily investigate the presence and characteristics of the cutaneous silent period response across multiple extensor and flexor muscles of the upper limb, and 2) to secondarily investigate the influence of stimulation site on this nociceptive reflex response. It was hypothesized that the cutaneous silent period would be present in all muscles, regardless of role (flexion/extension) or the stimulation site. Twenty-two healthy, university-age adults (14 males; 8 females; 23 ± 5 yrs) participated in the study. Testing consisted of three different stimulation sites (Digit II, V, and II+III nociceptive stimulation) during a low intensity, sustained muscle contraction, in which, 7 upper limb muscles were monitored via surface EMG recording electrodes. Distal muscles of the upper limb presented with the earliest reflex onset times, longest reflex duration, and lowest level of EMG suppression when compared to the more proximal muscles, regardless of extensor/flexor role. Additionally, the greatest overall inhibitory influence was expressed within the distal muscles. In conclusion, the present study provides a new level of refinement within the current understanding of the spinal organization associated with nociceptive input processing and the associated motor control of the upper limb. Subsequently, these results have further implications on the impact of nociception on supraspinal processing.Item Dual Protection Messaging for Adolescents and Young Adults in the Setting of Over-the-Counter Hormonal Contraception: A Human-Centered Design Approach(Elsevier, 2022-12) Wilkinson, Tracey A.; Jenkins, Kelli; Hawryluk, Bridget A.; Moore, Courtney M.; Wiehe, Sarah E.; Kottke, Melissa J.; Pediatrics, School of MedicineStudy Objective To use human-centered design approaches to engage adolescents and young adults in the creation of messages focused on dual method use in the setting of over-the-counter hormonal contraception access Design Baseline survey and self-directed workbooks with human-centered design activities were completed. The workbooks were transcribed and analyzed using qualitative methods to determine elements of the communication model, including sender, receiver, message, media, and environment. Setting Indiana and Georgia Participants People aged 14-21 years in Indiana and Georgia Interventions Self-directed workbooks Main Outcome Measures Elements of the communication model, including sender, receiver, message, media, and environment Results We analyzed 54 workbooks, with approximately half from each state. Stakeholders self-identified as female (60.5%), white (50.9%), Hispanic (10.0%), sexually active (69.8%), and heterosexual (79.2%), with a mean age of 18 years. Most strongly agreed (75.5%) that they knew how to get condoms, but only 30.2% expressed the same sentiment about hormonal contraception. Exploration of the elements of the communication model indicated the importance of crafting tailored messages to intended receivers. Alternative terminology for dual protection, such as “Condom+____,” was created. Conclusion There is a need for multiple and diverse messaging strategies about dual method use in the context of over-the-counter hormonal contraception to address the various pertinent audiences as this discussion transitions outside of traditional clinical encounters. Human-centered design approaches can be used for novel message development.Item Executive functioning and speech-language skills following long-term use of cochlear implants(Oxford University Press, 2014-10) Kronenberger, William G.; Colson, Bethany G.; Henning, Shirley C.; Pisoni, David B.; Department of Medicine, IU School of MedicineNeurocognitive processes such as executive functioning (EF) may influence the development of speech-language skills in deaf children after cochlear implantation in ways that differ from normal-hearing, typically developing children. Conversely, spoken language abilities and experiences may also exert reciprocal effects on the development of EF. The purpose of this study was to identify EF domains that are related to speech-language skills in cochlear implant (CI) users, compared to normal-hearing peers. Sixty-four prelingually deaf, early-implanted, long-term users of CIs and 74 normal-hearing peers equivalent in age and nonverbal intelligence completed measures of speech-language skills and three domains of EF: working memory, fluency-speed, and inhibition-concentration. Verbal working memory and fluency-speed were more strongly associated with speech-language outcomes in the CI users than in the normal-hearing peers. Spatial working memory and inhibition-concentration correlated positively with language skills in normal-hearing peers but not in CI users. The core domains of EF that are associated with spoken language development are different in long-term CI users compared to normal-hearing peers, suggesting important dissociations in neurocognitive development.Item Gene-by-Environment Interactions on Alcohol Use Among Asian American College Freshmen(Rutgers University, Center of Alcohol Studies, 2017-07) Luk, Jeremy W.; Liang, Tiebing; Wall, Tamara L.; Medicine, School of MedicineOBJECTIVE: Among northeast Asians, the variant aldehyde dehydrogenase allele, ALDH2*2 (rs671, A/G, minor/major), has been inversely associated with alcohol dependence. The strength of the associations between ALDH2*2 and drinking behaviors depends on the developmental stage, the phenotype studied, and other moderating variables. This study examined ALDH2 gene status as a moderator of the associations between parental drinking, peer drinking, and acculturation with alcohol use among 222 Chinese American and Korean American college freshmen. METHOD: Negative binomial regressions were used to test the main and interactive effects of ALDH2 with contextual factors on alcohol frequency (drinking days) and quantity (drinks per drinking day) in the past 3 months. RESULTS: ALDH2*2 was associated with more subjective flushing symptoms and longer length of flushing but was unrelated to both alcohol frequency and quantity. Peer drinking was positively associated with both alcohol frequency and quantity, but neither was moderated by ALDH2. We observed a nonsignificant trend for the interaction between parental drinking and ALDH2 on alcohol frequency, where parental drinking was positively associated with alcohol frequency only among participants with ALDH2*2. We found a significant interaction between acculturation and ALDH2 on alcohol frequency, where acculturation was positively associated with alcohol frequency only among those with ALDH2*2. Exploratory analyses stratified by Asian ethnic subgroup indicated that this interaction was driven primarily by the Korean subsample. CONCLUSIONS: Parental drinking and acculturation may facilitate more frequent drinking among those who have more intense reactions to alcohol (i.e., those with ALDH2*2) during the transition from high school to college.Item The Resilience in Illness Model Part 2: Confirmatory Evaluation in Adolescents and Young Adults With Cancer(Wolters Kluwer, 2017-11) Haase, Joan E.; Kintner, Eileen K.; Robb, Sheri L.; Stump, Timothy E.; Monahan, Patrick O.; Phillips, Celeste; Stegenga, Kristin A.; Burns, Debra S.; School of NursingBACKGROUND: Empirically derived and tested models are necessary to develop effective, holistic interventions to improve positive health outcomes in adolescents and young adults (AYA) with cancer, yet few exist. This article is the second of 2 articles reporting on evaluation of the Resilience in Illness Model (RIM) as a predictive model to guide positive health research and practice. OBJECTIVE: The aim of this study was to report the confirmatory model evaluation of the RIM. METHODS: A confirmatory evaluation of RIM was done using baseline data from a sample of 113 AYA aged 11 to 24 years who were undergoing hematopoietic stem cell transplant and enrolled in a randomized controlled trial of a behavioral intervention to enhance resilience. Data were analyzed using latent variable structural equation modeling. RESULTS: Goodness-of-fit indices supported RIM as a confirmed model that accounted for large amounts of variance in the outcomes of self-transcendence (62%) and resilience (72%), and in 3 of 5 mediators, specifically social integration (74%), courageous coping (80%), and hope-derived meaning (87%), as well as small to moderate amounts of variance in the remaining mediators of defensive coping (1%) and family environment (35%). CONCLUSIONS: Findings establish the RIM as a plausible predictive framework for explaining ways AYA with cancer transcend their illness and achieve resilience resolution and for guiding intervention studies in this population. Additional research is needed to explore RIM's transferability based on stage of illness, other chronic diseases, and cultural diversity. IMPLICATIONS FOR PRACTICE: Results support the RIM as an appropriate guide for developing and evaluating interventions to foster positive adjustment in AYA with cancer.Item The resilience in illness model, part 1: exploratory evaluation in adolescents and young adults with cancer(Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins, 2014-05) Haase, Joan E.; Kintner, Eileen K.; Monahan, Patrick O.; Robb, Sheri L.; IU School of NursingBACKGROUND: Resilience is a positive health outcome identified by the Committee on Future Direction for Behavioral and Social Sciences as a research priority for the National Institutes of Health. The Resilience in Illness Model (RIM) was developed from a series of qualitative and quantitative studies, to increase understanding of how positive health protective factors (ie, social integration, family environment, courageous coping, and derived meaning) may influence resilience outcomes. The RIM also includes 2 risk factors: illness-related distress and defensive coping. OBJECTIVE: The purpose of this 2-part article was to report on evaluation of the RIM for adolescents/young adults (AYAs) with cancer. Here, in part 1, our purpose was to describe the exploratory RIM evaluation, and in part 2 we describe the confirmatory RIM evaluation. METHODS: An exploratory evaluation of RIM was done using exploratory latent variable structural equation modeling with a combined sample from 2 studies of preadolescents and AYAs with cancer aged 10 to 26 years (n = 202). RESULTS: Results, including goodness-of-fit indices, support the RIM as a theory with a high level of explained variance for outcomes of resilience (67%) and self-transcendence (63%). Variance explained for proximal outcomes ranged from 18% to 76%. CONCLUSIONS: Findings indicate that, following confirmatory testing, the RIM may be a useful guide to developing targeted interventions that are grounded in the experiences of the AYAs. IMPLICATIONS FOR PRACTICE: Understanding of the AYA cancer experience to improve holistic care is increased.