Adult Life Outcomes Research Articles

Adolescent boys' physical fighting and adult life outcomes: Examining the interplay with intelligence.

Although it is well known that adolescent delinquent behavior is related to poor outcomes in adulthood, longitudinal research on specific acts of delinquency and their interplay with important individual characteristics in predicting future outcomes is scarce. We aimed to examine how physical fighting-one of the most common acts of violent delinquency among adolescent boys-is related to adult life success in several domains, and how intelligence influences these associations. The study used data from 1,083 boys that participated in the population-based longitudinal Young in Norway Study, following adolescents from 1992 to 2015, by combining self-reports at four time points with comprehensive information from registers. Results showed that adolescent boys' physical fighting was associated with poor adult outcomes in the domains of employment, education, and criminal behavior. Associations remained significant even after controlling for conduct problems in general-which isolated the effects of fighting from other delinquent acts-as well as from a variety of other potential confounders. Detailed analyses on the interplay of physical fighting and intelligence showed that some parts of the associations between adolescent boys' fighting and several adverse adult outcomes could be ascribed to lower intelligence among the fighters. Moreover, intelligence moderated the relationship between physical fighting and adult education. Adolescent fighting was not related to educational attainment among boys with high intelligence, whereas boys with lower intelligence experienced detrimental effects of adolescent fighting. The analyses show the importance of considering adolescent boys' physical fighting as a potential risk factor for future social marginalization.

Meditation-Based Interventions for Adults With Dementia: A Scoping Review

Abstract Date Presented 04/05/19 This scoping review investigated how meditation-based interventions improve health and quality of life outcomes for adults with dementia. Improvements in quality of life, mental health, cognition, and functional abilities were found. Gaps in the literature highlight the need for rigorous research in this area. OTs can develop standardized protocol, educate caregivers on the importance of mindfulness-based interventions, and advocate for continued research. Primary Author and Speaker: Lindsey Hoffman Additional Authors and Speakers: Rebecca Hutt, Celine Tsui, Kim Zorokong

Spanish validation of the Delaying Gratification Inventory in adolescents.

Individual differences in the capacity to delay gratification explain considerable variability in adult life outcomes related to health, psychological well-being, and social relationships. Although individual differences in delay of gratification begin to emerge in adolescence, few studies have tried to evaluate this construct in adolescents, especially in Spanish. The goal of this study was to validate the Delaying Gratification Inventory and to analyse its psychometric properties in Spanish adolescents. Using a sample of 695 adolescents (M = 15.18, SD = 1.22) between 13 and 18 years old, the factor structure, internal consistency and reliability were tested. The analyses showed an adequate fit to the original model (χ ² (550) = 1671.59, CFI = .92, TLI = .92, RMSEA = .063, 95% CI [.063, .071]), and appropriate internal consistency (α = .80). The ability to delay gratification was directly and moderately associated with self-control and self-consciousness, and inversely and moderately related with depression and psychological difficulties. This study provides new data on a tool for assessing the ability to delay reward in Spanish adolescents, a key regulatory ability to prevent unhealthy high-risk behaviours that are associated with serious health, psychological, and social problems.

Exercise on quality of life and cancer-related fatigue for lymphoma survivors: a systematic review and meta-analysis.

People treated for lymphoma can experience several significant long-term and late effects, including fatigue and decreased quality of life. This study aimed to systematically review the evidence from randomized controlled trials (RCTs) and to conduct a meta-analysis of the effect of exercise on quality of life and other health outcomes for adults suffering from lymphoma. We searched the following databases and sources: PubMed, Cochrane Library, Embase, Web of Science, and MEDLINE. Such studies would be included if they were RCT designs which focus on observing the evaluated health outcomes of exercise intervention for lymphoma patients or survivors, comparing with non-exercise or wait-list control groups. Two review authors independently screened search results, extracted data, and assessed the quality of trials. We used standardized mean differences for quality of life (QoL), fatigue, sleep quality, and depression. Six publications have met the inclusion criteria and the exercise interventions are short term. Slight improvement can be seen on QoL, fatigue, sleep quality, and depression due to exercise for lymphoma patients. Subgroup analysis was carried out according to the classification of mind-body exercise and aerobic exercise, and significant progress can be seen after mind-body exercise intervention in the area of fatigue and sleep. Short-term exercises do not appear to convey benefits to quality of life and other psychosocial outcomes. Subgroup analysis showed that physical activity together with mental exercise may be more beneficial to lymphoma patients, but it needs more research to verify this finding. The interpretation of this result should be cautious due to the baseline difference, completion efficiency of intervention process, and high heterogeneity.

Randomized Controlled Trial of a Telephone-Delivered Physical Activity and Fatigue Self-management Interventions in Adults With Multiple Sclerosis

ObjectiveTo compare the effectiveness of telephone-delivered interventions on fatigue, physical activity, and quality of life outcomes in adults with multiple sclerosis (MS). DesignA single-blinded, randomized controlled trial. Participants were randomized to contact-control intervention (CC), physical activity–only intervention (PA-only), and physical activity plus fatigue self-management intervention (FM+). Outcomes were measured at baseline (2wk prerandomization), posttest (14wk postrandomization), and follow-up (26wk postrandomization). SettingTelephone-delivered in Midwest and Northeast regions of the United States. ParticipantsInactive adults with MS (N=208) and moderate-to-severe fatigue. InterventionsThree or 6 group teleconferences followed by 4 individually tailored phone calls delivered during 12 weeks. An occupational therapist and research assistant delivered the teleconferences and tailored phone calls, respectively. Main Outcome MeasuresPrimary outcomes were self-report fatigue and physical activity measured with the Fatigue Impact Scale and Godin Leisure-Time Exercise Questionnaire, respectively. Secondary outcomes included quality of life measured with the Multiple Sclerosis Impact Scale and moderate-to-vigorous exercise and step count measured with an accelerometer. ResultsLinear mixed effects models showed FM+ significantly improved self-reported fatigue (β=−11.08; P=.03) and physical activity (β=0.54; P=.01) compared with CC at posttest. However, FM+ had nonsignificant differences compared with PA-only on self-report fatigue (β=−1.08, P=.84) and physical activity (β=0.09; P=.68) at posttest. PA–only had significant improvements compared with CC on moderate-to-vigorous exercise (β=0.38; P=.02) at posttest and step count at posttest (β=1.30; P<.01) and follow-up (β=1.31; P=.01) measured with an accelerometer. FM+ and PA-only had nonsignificant differences compared with CC on quality of life. ConclusionsGroup teleconferences followed by tailored phone calls have a small yet statistically significant effect in promoting physical activity and reducing fatigue impact in people with MS.

A Structured Literature Review of the Epidemiology and Disease Burden of Non-Alcoholic Steatohepatitis (NASH).

IntroductionNon-Alcoholic Steatohepatitis (NASH) is a chronic, progressive disease characterized by fatty liver and liver cell injury, advancing to fibrosis, cirrhosis and hepatocellular carcinoma (HCC). Diagnosis involves liver biopsy; however, as a result of its high cost and invasiveness, NASH remains underdiagnosed, and accurate burden of disease (BoD) data are lacking. Our aim was to understand the epidemiological and BoD landscape in NASH and identify knowledge gaps.MethodsThe Ovid search engine was used to conduct a structured review, following quality systematic principles. It included publications that reported on epidemiology, quality of life (QoL) and BoD outcomes in NASH adults. Searches were limited to English language studies published between January 2007 and September 2017. Additional grey literature searches were conducted. A total of 53 references were selected; 38 were peer-reviewed and 15 were grey literature sources.ResultsNASH is estimated to affect 3–5% of the global population, most suffering from several comorbidities. Advancing fibrosis drives clinical outcomes, with approximately 20% of patients developing cirrhosis and/or HCC, the latter being a leading cause of death in NASH. A recent model predicted the 15-year survival of advanced fibrosis patients at F3 and F4 as 51.0% and 28.4%, respectively. The limited data consistently show that NASH patients experience significantly poorer QoL and higher costs compared to non-NASH patients.ConclusionThis first broad-ranging examination of NASH literature revealed a paucity of evidence, with poor-quality, small studies found. The overwhelming impact of NASH and its patient and healthcare burden is evident. Further evidence is needed to improve our understanding of NASH, especially as fibrosis stages advance.FundingGilead Science Inc.Electronic supplementary materialThe online version of this article (10.1007/s12325-019-00960-3) contains supplementary material, which is available to authorized users.

Assessing socioeconomic inequalities in the reduction of child stunting in sub-Saharan Africa

Health and nutrition in early childhood are essential for survival, growth and adult life outcomes. As such, a number of global and national interventions have been pursued to improve early childhood health and nutrition. However, child malnutrition is pervasive and endemic across the sub Saharan Africa. This paper therefore assesses the nature and trends of socioeconomic inequalities in child stunting. The paper proceeds to decompose the causes of such socioeconomic-related inequalities over the period covered. We used data from Demographic and Health Surveys (DHSs) for ten sub-Saharan African countries conducted between 2000 and 2016. The study employs an extension to the concentration index for binary health outcomes to measure socioeconomic inequalities in stunting and decompose the causes of inequalities in stunting using a generalized decomposition technique based on recentered influence function regressions. The results show substantial pro-rich inequalities in child stunting across sub-Saharan Africa. The incidence of stunting are concentrated among children living in households with low socioeconomic status. In spite of persistent declines in the prevalence of stunting among children under 5 years across the study countries since 2000, trends in socioeconomic inequalities in stunting are mixed. We find significant contributions of child, maternal, and household characteristics to inequalities in child stunting. The results suggest that there is the need to design and target nutrition-based interventions at children in low socioeconomic households. In addition, promoting female education and improving access to health and nutrition information will be key to improving child nutrition across the region.

Abstract 5: Improved Quality of Life With Endovascular Therapy in the DEFUSE 3 Trial

Background: Little is known about the effect of endovascular therapy on patients’ quality of life. Using data from the randomized DEFUSE 3 trial, we aimed to assess if thrombectomy performed in the late (6-16 hour) time window leads to improved quality of life. Methods: Neuro-QoL is a measurement tool designed to assess quality of life (QoL) outcomes in adults with neurologic disorders. In DEFUSE 3, Neuro-QoL short forms were administered at day 90 to assess quality of life in four domains: mobility, ability to participate in social roles and activities, cognitive function, and depression. Raw scores were transformed to T-scores, which calibrates the scores to the distribution in the US general adult population with a mean score of 50 and SD of 10. For consistency among domains, the distribution of depression T-scores was inverted across the mean such that higher scores reflect better outcomes. Quality of life scores were compared between groups using the Wilcoxon rank-sum test (unadjusted) and linear regression (adjusted). Results: In DEFUSE 3, 146 patients were alive at day 90. Of these, 128 completed all four QoL forms, 10 did not complete any of the forms, and 8 completed a subset of the forms. Endovascular therapy compared to medical alone was associated with superior quality of life outcomes in all domains: mobility (p&lt;0.001), social participation (p&lt;0.001), cognition (p=0.013), and depression (p=0.003) (figure). Higher NIHSS at baseline was associated with worse outcomes in mobility, social participation and cognition, older age with worse mobility and depression, and female gender with worse mobility, cognition and depression (multivariable p&lt;0.05). The benefit of endovascular therapy in each quality of life domain remained significant after adjusting for these variables. Conclusion: In addition to improved functional outcomes, endovascular therapy 6 to 16 hours after onset preserves mental health and social capabilities critical to patients’ quality of life.

Abstract 178: Correlation between Modified Rankin Scale and Quality of Life in DEFUSE 3

Background: The relationship between the modified Rankin Scale (mRS) and quality of life in stroke patients treated in late time windows (6-16 hours) has not been explored. Using data from the randomized DEFUSE 3 trial, we aimed to assess the strength of the correlation between mRS at day 90 and quality of life outcomes. Methods: Neuro-QoL is a measurement tool designed to assess quality of life (QoL) outcomes in adults with neurologic disorders. In DEFUSE 3, Neuro-QoL short forms were administered at day 90 to assess quality of life in four domains: mobility, ability to participate in social roles and activities, cognitive function, and depression. Raw scores were transformed to T-scores, which calibrates the scores to the distribution in the US general adult population with a mean score of 50 and SD of 10. For consistency among domains, the distribution of depression T-scores was inverted across the mean such that higher scores reflect better outcomes. We assessed the strength of the correlation between mRS and each domain using the Spearman rank correlation coefficient (Rs 2 ) and tested for unidirectional trend using the Jonckheere-Terpstra test. Results: In DEFUSE 3, 146 patients were alive at day 90. Of these, 128 completed all four quality of life forms, 10 did not complete any of the forms, and 8 completed a subset of the forms. In each domain, quality of life outcomes worsened with increasing mRS (p&lt;0.001 for all; see figure). The mRS accounts for a high degree of the variability in mobility (Rs 2 =0.82) and a moderate degree in social participation (Rs 2 =0.62), yet accounts only for a low degree in cognition (Rs 2 =0.31) and depression (Rs 2 =0.19). Conclusion: The modified Rankin Scale fails to fully capture patients’ mental health and cognitive outcomes, which are critical measures of well-being. These results warrant assessment with quality of life tools focused on mental health and cognition in future stroke trials.

The outcome of adults born with pulmonary atresia: High morbidity and mortality irrespective of repair

ObjectivesTo describe the characteristics and long-term outcome of a large adult cohort with pulmonary atresia. BackgroundPatients with pulmonary atresia (PA) are a heterogeneous population in terms of anatomy, physiology and surgical history, and their management during adulthood remains challenging. MethodsData on all patients with PA followed in our center between January 2000 and March 2015 were recorded. Patients were classified into the following groups: PA with ventricular septal defect (PA-VSD, 1), PA with intact ventricular septum (PA-IVS, 2) and other miscellaneous PA (PA-other, 3). ResultsTwo-hundred twenty-seven patients with PA were identified, 66.1% female, mean age 25.5 ± 8.7 years. Over a median follow-up of 8.8 years, 49 (21.6%) patients had died: heart failure (n = 21, 42.8%) and sudden cardiac death (n = 8, 16.3%) were the main causes. There was no significant difference in mortality between the 3 Groups (p = 0.12) or between repaired and unrepaired patients in Group 1 (p = 0.16). Systemic ventricular dysfunction and resting oxygen saturations were the strongest predictors of mortality. Additionally, 116 (51%) patients were hospitalized, driven mainly by the need for invasive procedures, heart failure and arrhythmias. ConclusionsAdult survivors with pulmonary atresia have a high morbidity and mortality irrespective of underlying cardiac anatomy and previous reparative or palliative surgery. We present herewith predictors of outcome in adult life that may assist with their tertiary adult congenital care.

The Association Between Family Violence in Childhood and Mental Health in Adulthood as Mediated by the Experience of Childhood

Family violence in all of its types and forms, suffered directly or witnessed, is detrimental to healthy child development and increases the odds of poor developmental outcomes, such as impaired adult mental health. Very little knowledge is available about the mechanism that links family violence in childhood with outcomes in adult life. This retrospective study used data collected from 618 students in institutions of higher education in northern Israel (72.2% female, 86.9% Jewish, average age of 25) to test a structural model in which the effects of family violence in childhood on adult mental health are mediated by perceived positive childhood experience. The results show that perceived positive childhood experience fully mediates the effects of family violence (interparental and parent-to-child, physical and verbal) on adult mental health. The results also show that a significant proportion of the variance in adult mental health remains unexplained. These results suggest that in order to better understand the mechanism linking family violence in childhood with developmental outcomes in adulthood, additional mediators might need to be identified. These findings also suggest that some professional interventions be focused on enhancing positive childhood experience, in order to attenuate the harmful, lifelong effects of family violence in childhood.

Protective effect of breastfeeding on recurrent cough in adulthood

RationaleBreastfeeding protects from respiratory infections in early life but its relationship to recurrent cough and other respiratory outcomes in adult life is not well established.MethodsInfant feeding practices were assessed prospectively...

Grandiose-Manipulative, Callous-Unemotional, and Daring-Impulsive: the Prediction of Psychopathic Traits in Adolescence and their Outcomes in Adulthood

There has been much debate about how to measure psychopathic traits in adolescence. One of the main issues is whether one should focus on callous-unemotional (CU) traits alone, or CU traits in combination with Grandiose-Manipulative (GM) and Daring-Impulsive (DI) traits. The current study first investigates the extent to which youth who are high on CU traits are also high on GM and DI traits. In addition, the study investigates if being high on both CU and GM, and high on both CU and DI, identify groups that are particularly characterized by past and future impairments. To investigate this, data from the Cambridge Study in Delinquent Development (CSDD) was analyzed. The CSDD is a prospective longitudinal study of 411 English boys spanning over 50 years. The information available at age 12–14 was coded on the Antisocial Process Screening Device (APSD). Childhood risk factors were measured at age 8–10 and later life outcomes were measured at age 32. The results indicate that being high on CU in combination with DI delineates a clinically interesting group who are characterized by high childhood risk and poorer adult life outcomes. The same applied to the high CU/high GM group, but to a lesser extent.

Effect of maternal anaemia on birth weight of term babies

Background: Low birth weight is the major determinant of mortality, morbidity and disability in infancy and childhood and has a long-term impact on health outcome in adult life. The objectives of this study were to study the relationship between maternal anemia and birth weight of babies and to study anthropometric measures of babies born to anemic and non-anemic mothers and to correlate the timing of anemia with birth weight of babies.Methods: Term babies born in Institute of Maternal and Child Health, Government Medical College, Kozhikode from November 2014 to October 2016 fulfilling the criteria were divided into 2 groups, cases (term babies with birth weight &lt;2500g) and controls (term babies with weight &gt;2500g) and studied and their maternal hemoglobin values were compared.Results: Maternal anaemia in all three trimesters was found to be more in cases compared to controls. Mean 1st trimester hemoglobin of cases was 10.68 g/dl which was significantly lower when compared to controls. Mean 2nd trimester hemoglobin of cases was 10.36 g/dl compared to 11.47 g/dl in controls. Mean 3rd trimester hemoglobin of cases was 10.42 g/dl which was also significantly lower compared to 11.32 g/dl in controls. SGA babies were also found to be more in cases, 89%, compared to 18% in controls. The difference in head circumference between two groups was not statistically significant. Mean length of babies were higher in controls compared to cases. Mothers with anemia at any time during pregnancy was found to have 4.3 times higher risk of giving birth to low birth weight babies compared to non-anemic mothersConclusion: Anemia during pregnancy is a risk factor for low birth weight and SGA, independent of the trimester. Length of babies born to anaemic mothers is also low. But it does not have a significant effect on head circumference of babies.

PT020 - Functional and cosmetic outcomes in adult life of distal and penile hypospadias repaired in childhood

PT020 - Functional and cosmetic outcomes in adult life of distal and penile hypospadias repaired in childhood

Gender Segregation in Education and its Implications for Labour Market Outcomes: Evidence from India

This paper investigates gender-based segregation across different fields of study at the post-secondary level of schooling, and how that affects subsequent labour market outcomes of men and women. Using a nationally representative longitudinal data-set from India, we provide evidence that there is substantial intra-household gender disparity in the choice of study stream at the higher-secondary level of education. A household fixed effects regression shows that girls are 20 percentage points less likely than boys to study in technical streams, namely science (STEM) and commerce, vis-a-vis arts or humanities.This gender disparity is not driven by gender specific differences in mathematical ability, as the gap remains large and significant even after controlling for individuals' past test scores. Our further analysis on working-age individuals suggests that technical stream choice at higher-secondary level significantly affects the gender gap in labour market outcomes in adult life, including labour force participation, nature of employment, and earnings. Thus our findings reveal how gender disparity in economic outcomes at a later stage in the life-course is affected by gendered trajectories set earlier in life, especially at the school level.

Early Life Determinants of Cognitive Ability: A Comparative Study on Madagascar and Senegal

We study the determinants of educational and cognitive outcomes of young adults in Madagascar and Senegal employing a production function approach. Using unique and comparable long-term panel data sets from both countries, we find that cognitive skills measured using test scores in second grade are strong predictors of school attainment and cognitive skills of a cohort of individuals surveyed in their early twenties. The inclusion of early life household wealth, parental education and other household characteristics in the model does not diminish the impact of early cognitive ability on educational and cognitive outcomes in young adult life. Additionally, we find that both early life cognitive ability and health seem to have independent effects on educational attainment and adult cognition. In Senegal, both math and French scores are strong predictors of adult cognitive skills, whereas in Madagascar math plays a relatively stronger role. We find suggestive evidence that the association between early life cognitive ability and later life outcomes is stronger among girls as compared to boys. We also show significant differences in the relationship between early ability and later life test scores for those cohort members according to their height, which we consider a proxy for health status – shorter individuals show a stronger relationship between second grade performance and later life outcomes. These findings highlight the importance of how falling behind in early life may be critical in determining longterm outcomes, particularly for vulnerable groups, that is girls and shorter individuals.

Abdominal Fat by Imaging Methods and Metabolic Syndrome in Young People

Metabolic Syndrome is highlighted in the current health mainly due to its increasing prevalence in the world. Its occurrence among adolescents ranges from 2.2% to 51.7%. This set of diseases, when acquired during childhood/adolescence, tends to persist into adulthood. This study aims to present the results of the latest publications that correlated ultrasonography, computed tomography and magnetic resonance imaging with the components of the Metabolic Syndrome in young people. Nine papers were found. Abdominal adipose accumulation has a strong influence on the metabolic disorders of MS, being measurable by imaging methods. It is of crucial importance to deepen the knowledge of the benefits brought by the imaging tests and their relationship with the components of the syndrome so that clinicians and radiologists can use these exams, especially in young people, where an accurate and early diagnosis allows interventions that will influence reducing the risk unfavorable outcomes in adult life. Keywords: Metabolic syndrome X; Intra-abdominal fat; Computed tomography; Magnetic resonance imaging; Ultrasonography Abbreviations: SM: Metabolic Syndrome; TM: Computer Tomography; RM: Magnetic Resonance Imaging; US: Ultrasonography; BVS: Health Virtual Library; CC: Waist Circumference; IMC: Body Mass Index; GAS: Subcutaneous Abdominal Fat; GAV: Visceral Abdominal Fat

Using Evidence Based Home Visiting for Preventing Intergenerational Adverse Childhood Experiences

A body of literature has amassed in recent years examining risk factors and outcomes for children who have experienced various forms of trauma. Childhood maltreatment in various forms has commonly been termed adverse childhood experiences (ACEs), which are severe enough to negatively impact mental and physical health in both childhood and adulthood, as well as lead to a variety of undesirable life outcomes for affected adults. Less has been studied regarding the cyclical nature of child maltreatment and the effects that parents’ own history of childhood trauma may have on their children’s experience of trauma. Recent research has evaluated intervention strategies such as evidence-based home visiting (EBHV) programs for mothers and infants/toddlers that address this phenomenon and aims to interrupt the cycle of maltreatment. The benefits of home visiting will be reviewed and policy and cost implications related to preventive intervention are discussed.

Before and after: Personality pathology, childhood conditions, and life history outcomes

In this study (N=253), we examined how pathological personality traits are related to (self-reported) childhood conditions and the adult life outcomes of rates of education, socioeconomic status, income, and number of offspring for men and women. We found (1) childhood unpredictability was more strongly associated with pathological personality traits than was harshness; (2) higher levels of psychoticism were associated with a broad-spectrum of adverse life history outcomes; (3) men reported higher levels of detachment, antagonism, disinhibition, and psychoticism than women reported; and (4) moderated-mediational analyses suggested detachment and antagonism differentially mediated the associations between childhood socioecological conditions and adult life outcomes for men and women.