Population-based Study Of Young Adults Research Articles

Self-schemas and information processing biases as mechanisms underlying sexual orientation disparities in depressive symptoms: Results from a longitudinal, population-based study.

Sexual minority individuals experience higher prevalence of major depression and more frequent depressive symptoms compared to heterosexual individuals. Although existing theories have suggested cognitive mechanisms that may explain these disparities, empirical tests are limited by a reliance on cross-sectional designs, self-reported measures, and nonprobability samples. We analyzed data from a longitudinal, population-based study of young adults (N = 1,065; n = 497 sexual minority) who completed validated measures of depressive symptoms over a 3-year period; at Wave 2, participants completed the self-referent encoding task, a behavioral task assessing self-schemas and information processing biases. Self-schemas were measured with the drift rate, which was estimated via the composite of endorsement of positive or negative words as self-referential (or not) and the reaction time for these decisions. Information processing biases were operationalized as the total number of negative words that were both endorsed as self-referential and recalled after the task, divided by the total number of words endorsed and recalled. Compared to heterosexuals, sexual minorities displayed significantly higher negative self-schemas and recalled a significantly higher proportion of negative words endorsed as self-referential, relative to total number of words. In turn, these differences in self-schemas and information processing biases mediated the sexual orientation disparity in depressive symptoms. Moreover, among sexual minorities, perceived discrimination predicted greater negative self-schemas and information processing biases, which mediated the prospective association between discrimination and depressive symptoms. These findings provide the strongest evidence to date for cognitive risk factors that underlie sexual orientation disparities in depression, highlighting potential intervention targets. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Sexual Violence-Related Stigma, Mental Health, and Treatment-Seeking: A Multimodal Assessment in a Population-Based Study of Young Adults.

Sexual violence (SV) is a stigmatized form of trauma, yet the stigma experiences of those reporting SV are often assumed rather than explicitly measured. We adapted a measure that quantified three key features of SV stigma across three levels: negative self-image (individual), disclosure concerns (interpersonal), and concerns about public attitudes (structural). We administered this measure to a population-based sample of Swedish young adults (N = 453) who reported a history of either sexual assault (SA) or intimate partner sexual violence (IPSV). Among both groups, 89% endorsed at least one item on the stigma scale. Experiences of SV-related stigma were associated with significantly higher symptoms of generalized anxiety, depression, and posttraumatic stress disorder, with greater perceived need for mental health treatment, and with more shame (measured implicitly via a reaction-time task). Experiences of stigma were negatively associated with symptoms of alcohol misuse. Results suggest that exposure to SV stigma may be a critical, but often overlooked, correlate of post-assault recovery.

The impact of the initial COVID-19 outbreak on young adults’ mental health: a longitudinal study of risk and resilience factors

Few studies assessing the effects of COVID-19 on mental health include prospective markers of risk and resilience necessary to understand and mitigate the combined impacts of the pandemic, lockdowns, and other societal responses. This population-based study of young adults includes individuals from the Neuroscience in Psychiatry Network (n = 2403) recruited from English primary care services and schools in 2012–2013 when aged 14–24. Participants were followed up three times thereafter, most recently during the initial outbreak of the COVID-19 outbreak when they were aged between 19 and 34. Repeated measures of psychological distress (K6) and mental wellbeing (SWEMWBS) were supplemented at the latest assessment by clinical measures of depression (PHQ-9) and anxiety (GAD-7). A total of 1000 participants, 42% of the original cohort, returned to take part in the COVID-19 follow-up; 737 completed all four assessments [mean age (SD), 25.6 (3.2) years; 65.4% female; 79.1% White]. Our findings show that the pandemic led to pronounced deviations from existing mental health-related trajectories compared to expected levels over approximately seven years. About three-in-ten young adults reported clinically significant depression (28.8%) or anxiety (27.6%) under current NHS guidelines; two-in-ten met clinical cut-offs for both. About 9% reported levels of psychological distress likely to be associated with serious functional impairments that substantially interfere with major life activities; an increase by 3% compared to pre-pandemic levels. Deviations from personal trajectories were not necessarily restricted to conventional risk factors; however, individuals with pre-existing health conditions suffered disproportionately during the initial outbreak of the COVID-19 pandemic. Resilience factors known to support mental health, particularly in response to adverse events, were at best mildly protective of individual psychological responses to the pandemic. Our findings underline the importance of monitoring the long-term effects of the ongoing pandemic on young adults’ mental health, an age group at particular risk for the emergence of psychopathologies. Our findings further suggest that maintaining access to mental health care services during future waves, or potential new pandemics, is particularly crucial for those with pre-existing health conditions. Even though resilience factors known to support mental health were only mildly protective during the initial outbreak of the COVID-19 pandemic, it remains to be seen whether these factors facilitate mental health in the long term.

Substance Use and Performance of Toxicology Screens in the Greater Cincinnati Northern Kentucky Stroke Study.

Though stroke risk factors such as substance use may vary with age, less is known about trends in substance use over time or about performance of toxicology screens in young adults with stroke. Using the Greater Cincinnati Northern Kentucky Stroke Study, a population-based study in a 5-county region comprising 1.3 million people, we reported the frequency of documented substance use (cocaine/marijuana/opiates/other) obtained from electronic medical record review, overall and by race/gender subgroups among physician-adjudicated stroke events (ischemic and hemorrhagic) in adults 20 to 54 years of age. Secondary analyses included heavy alcohol use and cigarette smoking. Data were reported for 5 one-year periods spanning 22 years (1993/1994-2015), and trends over time were tested. For 2015, to evaluate factors associated with performance of toxicology screens, multiple logistic regression was performed. Overall, 2152 strokes were included: 74.5% were ischemic, mean age was 45.7±7.6, 50.0% were women, and 35.9% were Black. Substance use was documented in 4.4%, 10.4%, 19.2%, 24.0%, and 28.8% of cases in 1993/1994, 1999, 2005, 2010, and 2015, respectively (Ptrend<0.001). Between 1993/1994 and 2015, documented substance use increased in all demographic subgroups. Adjusting for gender, comorbidities, and National Institutes of Health Stroke Scale, predictors of toxicology screens included Black race (adjusted odds ratio, 1.58 [95% CI, 1.02-2.45]), younger age (adjusted odds ratio, 0.70 [95% CI, 0.53-0.91], per 10 years), current smoking (adjusted odds ratio, 1.62 [95% CI, 1.06-2.46]), and treatment at an academic hospital (adjusted odds ratio, 1.80 [95% CI, 1.14-2.84]). After adding chart-reported substance use to the model, only chart-reported substance abuse and age were significant. In a population-based study of young adults with stroke, documented substance use increased over time, and documentation of substance use was higher among Black compared with White individuals. Further work is needed to confirm race-based disparities and trends in substance use given the potential for bias in screening and documentation. Findings suggest a need for more standardized toxicology screening.

The Relationship between Cannabis and Tobacco Co-administration and Long-Term Patterns of Cannabis Use in Young Adults Who Use Stimulants: A Prospective Population-Based Study

Background Co-administering cannabis with tobacco (i.e. co-administration of the substances mixed together) is a common practice among cannabis users, but the consequences of this practice are not well understood. This study examines the relationship between co-administering cannabis with tobacco and the long-term frequency of cannabis use in a young adult population group with high rates of cannabis and tobacco use. Methods The data are from an Australian prospective population-based study of young adults who recurrently used amphetamine-type stimulants (ATS). The mean age of participants was 20.8 years at baseline, sample size (n = 277), and 47% were female. We examined the frequency and quantity of cannabis consumption over 4 ½ years. Negative binomial regression analysis was conducted to examine the frequency of cannabis use at 12-month follow-up and at 4 ½ years, with co-administering practices as the predictor. Results At every time interval, participants who always co-administered their cannabis with tobacco used cannabis on more days in the last month than those who only sometimes co-administered, rarely co-administered, or never co-administered these substances (p < 0.001). Sometimes co-administering cannabis with tobacco at baseline predicted more frequent cannabis use at 12-month follow-up (adjusted IRR: 2.25, 95% CI: 1.05, 4.78), independently of the baseline frequency of cannabis use. However, levels of co-administering cannabis with tobacco at 12-month follow-up (rarely, sometimes, and always) did not predict high levels of cannabis use at 4 ½ years follow-up after adjusting for cannabis use at 12-month follow-up. Conclusions Among people who use ATS and cannabis, frequent cannabis use may be a marker of the practice of co-administering cannabis with tobacco, and can be used to target tobacco cessation interventions in these populations.

Co–administering cannabis with tobacco and persistent tobacco smoking after 4½ years in young adults who use stimulants: A prospective population–based study

ABSTRACT Tobacco smoking remains highly prevalent in high-risk groups, including young adults who use cannabis and a variety of other drugs. We examine whether co-administering cannabis with tobacco is associated with heavier and more persistent tobacco smoking compared to separate use of these substances among young adults who use drugs recreationally. Data are from a prospective population-based study of young adults residing in Queensland, Australia, who recurrently used ecstasy or methamphetamine. The mean age was 20.8 years at baseline, and 47% were female. An ordinal regression model was developed (n = 277) with levels of tobacco smoking at 4½ years as the outcome. At baseline, just under half the sample (44.6%) had not co-administered cannabis with tobacco in the last month, 9.5% rarely co-administered, 7.7% sometimes co-administered, and 38.2% always co-administered. Always co-administering cannabis with tobacco was associated with more frequent and persistent tobacco smoking at 4½ years (Odds Ratio (OR): 1.98, 95% Confidence Interval (CI): 1.02, 3.83), independently of factors including baseline frequency of cannabis and tobacco use. Young adults who use cannabis should be advised not to co-administrate cannabis with tobacco, and comprise an important target group for tobacco smoking cessation interventions.

Changing Childbearing Norms During an Era of ART Expansion in Malawi, 2009 to 2015.

Community norms shape the childbearing goals and behaviors of persons living with HIV/AIDS (PLWHA) but little is known about how norms around HIV-positive childbearing have changed with expanded access to antiretroviral treatment (ART). We analyze data collected in 2009 and 2015 by the Tsogolo la Thanzi (TLT) project-a longitudinal, population-based study of young adults in southern Malawi. Respondents were asked about the acceptability of childbearing using vignettes that varied a hypothetical couple's HIV status and number of children. We assess mean differences in support for childbearing over time and by respondent gender and serostatus. The acceptability of childbearing for PLWHA increased dramatically over the 6-year period; however, support levels varied based on a couple's current number of children and whether they were seropositive concordant or discordant. Differences in attitudes by gender and HIV status diminished over time, pointing to a population-level convergence in norms about acceptable childbearing.

Serum GDNF levels and anxiety disorders in a population-based study of young adults

ObjectiveThe aim of this study was to verify the serum GDNF levels in individuals with anxiety disorder (AD) in a population-based study. MethodsThis was a cross-sectional study population-based, with people aged 18 to 35. AD's assessment was performed using the Mini International Neuropsychiatric Interview (M.I.N.I). Serum GDNF was measured by ELISA using a commercial kit. ResultsThe prevalence was 3.3% for post-traumatic stress disorder, 6.7% for panic disorders, 17% generalized anxiety disorder, 5.1% for obsessive- compulsive disorder and 7.5% for social phobia. Serum GDNF levels was higher in individuals with panic disorders (p = 0.013), generalized anxiety (p = 0.035), obsessive- compulsive disorder (p = 0.005) and social phobia (p = 0.004), when compared to individuals without ADs. Only post traumatic stress disorder is not associated with serum GDNF levels (p = 0.119). ConclusionIn this paper, we observed increased serum levels of GDNF in individuals with anxiety disorders, suggesting that this biomarker can be used as a putative marker for AD's. The knowledge of the physiological changes related to anxiety disorders can provide a better understanding of AD's pathogenesis, as well as, mechanisms involved in the progression of this condition.

Psychoactive substance abuse and dependence and its association with anxiety disorders: a population-based study of young adults in Brazil.

Objective:To evaluate the association between abuse of and dependence on different psychoactive substances and the presence of anxiety disorders in a sample of young adults from a city in southern Brazil.Methods:Between 2007 and 2009, we carried out a cross-sectional, population-based study of individuals aged 18-24 years who lived in Pelotas, a city in southern Brazil. We evaluated anxiety disorders using the Mini International Neuropsychiatric Interview 5.0 (MINI), and use of psychoactive substances with the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST 2.0/0MS). We used Fisher’s exact test for univariate analysis, and Poisson regression models with robust variance for multivariable analysis.Results:The sample consisted of 1,560 young adults. The overall prevalence of abuse/dependence was 26.9% for alcohol, 24.9% for tobacco, and 7.3% for illicit substances. Individuals with agoraphobia had a 32% higher prevalence of tobacco abuse/dependence (prevalence ratio [PR] = 1.32 [95%CI 1.01-1.74]). Individuals with posttraumatic stress disorder (PTSD) or generalized anxiety disorder (GAD) had a 2.41-fold (95%CI 1.22-4.77) and 1.76-fold (95%CI 1.00-3.11) higher prevalence of illicit substance abuse/dependence, respectively.Conclusion:In this population-based sample, we found associations between GAD, PTSD, and increased prevalence of illicit substance abuse/dependence. In addition, individuals with agoraphobia seem to have increased tobacco abuse/dependence.

Nutrition Facts Panels: Who Uses Them, What Do They Use, and How Does Use Relate to Dietary Intake?

BackgroundNutrition labels are a low-cost tool with the potential to encourage healthy eating habits. ObjectiveTo investigate correlates of frequent Nutrition Facts label use, describe the types of label information most often used, and measure how label use relates to dietary intake in young adults. DesignCross-sectional population-based study of young adults participating in Project Eating and Activity in Teens and Young Adults-IV. Participants/settingSurveys and food frequency questionnaires were completed during 2015-2016 by young adults (N=1,817; weighted sample=49% women) aged 25 to 36 years. Main outcome measuresNutrition Facts label use, frequency of using specific information on labels, and dietary intake. Statistical analyses performedRelative risks and adjusted means were used to examine how demographic, behavior, and weight-related factors were associated with Nutrition Facts panel use, and how label use related to dietary outcomes. Associations with P values <0.05 were considered statistically significant. ResultsApproximately one-third (31.4%) of participants used Nutrition Facts labels “frequently.” Use was significantly higher for women; for participants with high education and income; among those who prepared food regularly; among those who were physically active; among those with a weight status classified as overweight; and among those who were trying to lose, gain, or maintain weight. Label components used most often included sugars (74.1%), total calories (72.9%), serving size (67.9%), and the ingredient list (65.8%). Nutrition Facts label users consumed significantly more fruits, vegetables, and whole grains and fewer sugar-sweetened beverages, compared with nonusers. Nutrition Facts label users ate significantly more frequently at sit-down restaurants but less frequently at fast-food restaurants compared with nonusers. ConclusionsAlthough Nutrition Facts label use was associated with markers of better dietary quality in a population-based sample of young adults, only one-third of participants used labels frequently. Methods to improve label use should be studied, particularly through leveraging weight- or health-related goals (eg, interest in making healthier food choices), and meeting consumer preferences concerning label content.

Yoga and body image: Findings from a large population-based study of young adults

This study explored the potential for yoga to promote body satisfaction in a general population of young adults. The sample included 1664 participants (M age: 31.1, SD=1.6years) in Project EAT, a 15-year longitudinal study. Data from the third and fourth waves (EAT-III and EAT-IV), collected five years apart, were utilized. Practicing yoga (≥30min/week) was reported by 16.2% of young adults. After adjusting for EAT-III body satisfaction and body mass index, yoga practitioners had higher concurrent body satisfaction at EAT-IV than those not practicing yoga (difference: 1.5 units [95% CI: 0.1–2.8], p=.03). Among participants within the lowest quartile of prior (EAT-III) body satisfaction, there was preliminary evidence that body satisfaction at EAT-IV was higher among yoga practitioners than in other young adults. Findings suggest that yoga may be associated with improved body satisfaction, particularly among young adults with low prior body satisfaction.

Association between obesity and suicide in woman, but not in man: a population-based study of young adults

The relationship between obesity and suicide risk is still unclear with controversial research results. The aim of this study is to investigate the relationship between obesity and suicide risk for men and women in a population-based study of young adults. This is a cross-sectional population-based study that identified young adults between 18 and 35 years of age. Suicide risk was investigated through the structured clinical interview Mini. Weight and height were assessed, and participants were classified as normal-weight body mass index (BMI < 30) or obese (BMI > 30). The prevalence of obesity was of 19.9% of the total sample (n = 1953). Obesity was more prevalent among women and participants between 27 and 35 years of age. Suicide risk was present in 13.0% of the sample and more prevalent among women. In our study we found an association between obesity and suicide risk for women, but not for men. Obesity was associated with a higher prevalence of suicide risk in women. Given the strength of the relationship between BMI and suicide, identifying the mechanisms associated with obesity, especially for women, can lead to new insights into the prevention of suicide risk

Ventilatory function and cardiovascular disease risk factors: a cross-sectional study in young adults.

BackgroundThe association between impaired lung function and cardiovascular disease (CVD) risk factors has been shown in adults. However, there is little evidence of such an association in young adults, particularly from South America, where the burden of CVD and chronic obstructive pulmonary disease (COPD) is as high as that observed in more developed countries. We therefore investigated the relation between CVD risk factors including metabolic syndrome (MS), and lung function status in young adults from Chile.Methods970 subjects from a sample of 998 adults born between 1974 and 1978 in Limache, Chile, were studied. A Spanish translation of the European Community Respiratory Health Survey (ECRHS) questionnaire was used. Forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were measured. Weight, height, waist circumference (WC), blood pressure, Homeostatic model assessment (HOMA-IR), triglycerides, high density lipoprotein (HDL), glycaemia, and metabolic syndrome (MS) were also assessed.ResultsThe prevalence of MS was 11.8%. A lower FEV1 and lower FVC were associated with having MS (β-coefficient -0.13; 95% Confidence Interval [CI] -0.21 to -0.05, and β-coefficient -0.18; 95% CI -0.27 to -0.09, respectively). Both spirometric measures were also negatively associated with having an elevated HOMA-IR (β-coefficient for FEV1 -0.08; 95% CI -0.13 to -0.03, and β-coefficient for FVC -0.11; 95% CI -0.17 to -0.05). In males only, a lower FEV1 and FVC were associated with having elevated triglycerides (β-coefficient highest vs. lowest tertile -0.13, 95% CI -0.24 to -0.03, and β-coefficient -0.13, 95% CI -0.25 to -0.01, respectively). In women, a higher FEV1 and FVC were statistically significantly related to having higher levels of HDL. Ventilatory function was unrelated to hypertension or WC in this population.ConclusionIn this population-based study of young adults, a poorer ventilatory function was associated with many CVD risk factors. Endeavours to understand better causality issues of such associations are warranted.

Abstract MP82: Exergaming and Physical Activity Guidelines- A Population-Based Study of Young Adults

Background: Compared to traditional non-active video games, exergaming may contribute significantly to overall daily physical activity (PA), but the association in population-based samples has not been fully explored. Objectives: To assess whether total minutes of PA per week among exergamers differs from non-exergamers, and whether the likelihood of meeting PA guidelines differs between exergamers and non-exergamers. Methods: Data were available from the 2011-2012 wave of the Nicotine Dependence in Teens (NDIT) study (n=829). Multivariable models assessed the association between exergaming with moderate, vigorous, and moderate-to-vigorous PA (MVPA) minutes in the past week, and the association between exergaming and meeting PA guidelines after adjusting for age, household income, employment status, education, weight status, and screen time. Exergaming was defined as use ≥ 1-3 times per month in the past year, and PA guidelines were defined as ≥ 150 minutes of moderately intense PA, or ≥ 75 minutes of vigorously intense PA, or a combination. Minutes of PA were measured using the well-validated International Physical Activity Questionnaire. Sex differences in exergaming use and exergaming beliefs and attitudes were also assessed. Results: In this population-based sample of young adults (mean age 24 [SD: 0.7] years, 55% female [n=455]), 18% (n=148) of the participants were exergamers (54% female, n=80). Exergaming males and females reported an average of 88.4 and 65.7 exergaming minutes in the past week, respectively. Compared to male exergamers, female exergamers were more likely to believe that exergaming is a good way to integrate PA into their lives (p&lt;0.001), were more likely to prefer exergaming to indoor/outdoor sports (p=0.03), and were more likely to use fitness-training exergames at home (p=0.006). Perceived levels of exertion were also significantly different between male and female exergamers. The majority of male exergamers reported light (51%, n=23) or moderate (44%, n=20) exergaming exertion, whereas female exergamers reported moderate (53%, n=30), as well as light (28%, n=16) and intense (19%, n=11) exertion (p=0.02). After adjusting for covariates, male exergamers were not significantly different from male non-exergamers in total minutes of PA per week, but female exergamers reported 47 more minutes of moderate PA in the past week compared to female non-exergamers (p=0.03). There was no association between exergaming and meeting PA guidelines in either males or females. Conclusions: Exergaming contributes to moderate-intensity PA among females but not among males in this population based sample of young adults. Exergaming may therefore be an important source of PA for women, but the current landscape of exergames may be inadequate to substantially increase minutes of PA among males. Differences in attitudes toward exergaming should be further explored.

They still grieve—a nationwide follow‐up of young adults 2–9 years after losing a sibling to cancer

The aims of this study were to assess the prevalence of unresolved grief in bereaved young adult siblings and examine possible contributing factors. The study was a Swedish population-based study of young adults who had lost a brother or sister to cancer, 2-9 years earlier. Of 240 eligible siblings, 174 (73%) completed a study-specific questionnaire. This study focused on whether the respondents had worked through their grief over the sibling's death and to what extent. A majority (54%) of siblings stated that they had worked through their grief either 'not at all' or 'to some extent' at the time of investigation. In multiple regression analyses with unresolved grief as the dependent variable, 21% of the variance was explained by lack of social support and shorter time since loss. The majority of bereaved young adults had not worked through their grief over the sibling's death. A small group of siblings reported that they had not worked through their grief at all, which may be an indicator of prolonged grief. Lack of social support and more recent loss were associated with not having worked through the grief over the sibling's death.

Genetic Variations Of NPY And AGRP In Body Fatness Regulation

Evaluation of: van Rossum CT, Pijl H, Adan RA, Hoebee B, Seidell JC: Polymorphisms in the NPY and AGRP genes and body fatness in Dutch adults. Int. J. Obes. (Lond.). 30, 1522–1528 (2006). Neuropeptide Y (NPY) is one of the most potent orexigenic neuropeptides in the hypothalamus, a key brain area for energy-balance regulation. In addition, agouti-related protein (AGRP), an antagonist of the anorexigenic melanocortin system, is evidently involved in energy homeostasis. This longitudinal population-based study of young adults in The Netherlands puts further light on the potential involvement of the relatively rare NPY Leu7Pro and AGRP Ala67Thr polymorphisms in the variation of body fatness. Those with stable weight over 8 years, and those with weight gain, were analyzed separately. Male carriers of the NPY Pro7 allele had an increased body mass index and leptin level, which is consistent with previous reports. However, male carriers of the AGRP Thr67 allele had an increased body mass index, which is less co...

Respiratory Symptoms and Nocturnal Gastroesophageal Reflux: A Population-Based Study of Young Adults in Three European Countries

To estimate the possible association between reported symptoms of gastroesophageal reflux (GER) after bedtime, sleep-disordered breathing, respiratory symptoms, and asthma. Cross-sectional international population survey. Participants consisted of 2,661 subjects (age range, 20 to 48 years) from three countries (Iceland, Belgium, and Sweden), of whom 2,202 were randomly selected from the general population and 459 were added because of reported asthma. The investigation included a structured interview, spirometry, methacholine challenge, peak flow diary, skin-prick tests, and a questionnaire on sleep disturbances. In the random population sample, 101 subjects (4.6%) reported GER, which was defined as the occurrence of heartburn or belching after going to bed at least once per week. Subjects with nocturnal GER more often were overweight and had symptoms of sleep-disordered breathing than participants not reporting GER. Participants with GER were more likely to report wheezing (adjusted odds ratio [OR], 2.5), breathlessness at rest (adjusted OR, 2.8), and nocturnal breathlessness (adjusted OR, 2.9), and they had increased peak flow variability compared to the subjects without GER. Physician-diagnosed current asthma was reported by 9% of subjects with GER compared to 4% of those not reporting GER (p < 0.05). Subjects with the combination of asthma and GER had a higher prevalence of nocturnal cough, morning phlegm, sleep-related symptoms, and higher peak flow variability than subjects with asthma alone. The occurrence of GER after bedtime is strongly associated with both asthma and respiratory symptoms, as well as symptoms of obstructive sleep apnea syndrome. The partial narrowing or occlusion of the upper airway during sleep, followed by an increase in intrathoracic pressure, might predispose the patient to nocturnal GER and, consequently, to respiratory symptoms.

Quality of life in allergic rhinitis and asthma. A population-based study of young adults.

Quality of life has been found to be impaired both in patients with asthma and in patients with allergic rhinitis, but the relative burden of these diseases has not been investigated. We analyzed answers to the SF-36 questionnaire from 850 subjects recruited in two French centers participating in the European Community Respiratory Health Survey, a population-based study of young adults. Both asthma and allergic rhinitis were associated with an impairment in quality of life. However, 78% of asthmatics also had allergic rhinitis. Subjects with allergic rhinitis but not asthma (n = 240) were more likely than subjects with neither asthma nor rhinitis (n = 349) to report problems with social activities, difficulties with daily activities as a result of emotional problems, and poorer mental well-being. Patients with both asthma and allergic rhinitis (n = 76) experienced more physical limitations than patients with allergic rhinitis alone, but no difference was found between these two groups for concepts related to social/mental health. As asthma was not found to further impair the quality of life in subjects with allergic rhinitis for concepts related to mental disability and well-being, and as subjects with asthma often also suffer from allergic rhinitis, further studies on quality of life in asthma should ensure that the impairment in quality of life attributed to asthma could not result from concomitant allergic rhinitis.

Left ventricular diastolic function in young adults: The Coronary Artery Risk Development in Young Adults Study

Doppler transmitral flow velocities have been used to assess left ventricular diastolic function. Associations of transmitral velocities with specific physiologic variables and cardiovascular risk factors have not been reported previously in a large population-based study of young adults. We performed Doppler analysis of left ventricular inflow in 3492 black and white men and women (aged 23 to 35 years) in the year-5 examination of the Coronary Artery Risk Development in Young Adults (CARDIA) Study. First third filling fraction, peak flow velocity in early diastole (PFVE), peak flow velocity in late diastole (PFVA), and the PFVA/PFVE ratio were measured. Women had higher PFVE and PFVA than had men (PFVE: 0.81 +/- 0.13 m/sec versus 0.76 +/- 0.13 m/sec; PFVA: 0.47 +/- 0.11 m/sec versus 0.43 +/- 0.10 m/sec; both p < 0.001). Gender-specific multiple regression analyses showed that age, heart rate, systolic blood pressure, left ventricular percent fractional shortening, and body weight were independently and positively related to PFVA (all p < 0.001) in men and women. Age, heart rate, and forced expiratory lung capacity in 1 second were inversely related to PFVE and first third filling fraction (both p < 0.01). Left ventricular percent fractional shortening was positively related to PFVE and first third filling fraction (p < 0.001). Age, heart rate, and body weight were positively correlated with the PFVA/PFVE ratio (all p < 0.001). Height had weak negative associations with PFVA and PFVE in women only. These results suggest that, in young adults, Doppler measures of left ventricular diastolic filling are related to age, sex, body weight, blood pressure, heart rate, left ventricular systolic function, and lung function.