Young Adult Outcomes Research Articles

Real-Time Visual Biofeedback via Wearable Ultrasound Imaging Can Enhance the Muscle Contraction Training Outcome of Young Adults.

Huang, Z-H, Ma, CZ-H, Wang, L-K, Wang, X-Y, Fu, S-N, and Zheng, Y-P. Real-time visual biofeedback via wearable ultrasound imaging can enhance the muscle contraction training outcome of young adults. J Strength Cond Res 36(4): 941–947, 2022—Real-time ultrasound imaging (RUSI) can serve as visual biofeedback to train deep muscle contraction in clinical rehabilitative settings. However, its effectiveness in resistance training in sports/fitness fields remains unexplored. This article introduced a newly developed wearable RUSI system that provided visual biofeedback of muscle thickening and movement and reported its effectiveness in improving the training outcomes of muscle thickness change (%) during dynamic contraction. Twenty-five healthy young men participated and performed pec fly exercise both with and without RUSI biofeedback. Statistical analysis was conducted to examine the reliability of the measurements and the immediate effects of (a) RUSI biofeedback of muscle contraction and (b) training intensity (50 vs. 80% of 1-repetition maximum [1RM]) on the pectoralis major (PMaj) thickness change measured by ultrasound images. In addition to significantly high inter-contraction reliability (ICC3,1 > 0.97), we observed significantly increased PMaj thickness change for both training intensities upon receiving biofeedback in subjects, compared with without biofeedback (p < 0.001). We also observed significantly larger PMaj thickness change at 80% of 1RM compared with 50% of 1RM (p = 0.023). The provision of visual biofeedback using RUSI significantly enlarged the magnitude of PMaj thickness change during pec fly exercises, potentially indicating that RUSI biofeedback could improve the ability of targeted muscle contraction of PMaj in healthy young adults. To our knowledge, this study has pioneered in applying RUSI as a form of biofeedback during weight training and observed positive effectiveness. Future iterations of the technique will benefit more subject groups, such as athletes and patients with neuromuscular disorders.

The Long-Term Health and Human Capital Consequences of Adverse Childhood Experiences in the Birth to Thirty Cohort: Single, Cumulative, and Clustered Adversity.

Human capital—that is the cumulative abilities, education, social skills, and mental and physical health one possesses—is increasingly recognized as key to the reduction of inequality in societies. Adverse childhood experiences have been linked to a range of human capital indicators, with the majority of research in high-income, western settings. This study aims to examine the link between adverse childhood experiences and adult human capital in a South African birth cohort and to test whether associations differ by measurement of adversity. Secondary analysis of data from the Birth to Thirty study was undertaken. Exposure data on adversity was collected prospectively throughout childhood and retrospectively at age 22. Human capital outcomes were collected at age 28. Adversity was measured as single adverse experiences, cumulative adversity, and clustered adversity. All three measurements of adversity were linked to poor human capital outcomes, with risk for poor human capital increasing with the accumulation of adversity. Adversity was clustered by quantity (low versus high) and type (household dysfunction versus abuse). Adversity in childhood was linked to a broad range of negative outcomes in young adulthood regardless of how it was measured. Nevertheless, issues of measurement are important to understand the risk mechanisms that underlie the association between adversity and poor human capital.

Anti-neutrophil cytoplasmic antibody seropositivity in young adults aged up to 35 years: kidney histopathological findings and patient outcomes

ObjectiveTo investigate the clinical features, pathological renal findings, and outcomes in young adults with anti-neutrophil cytoplasmic antibody (ANCA) seropositivity.MethodsAdults aged ≤35 years, with ANCA seropositivity, who underwent renal biopsy and received treatment comprising a combination of corticosteroids and cyclophosphamide between January 2004 and May 2018, were retrospectively enrolled.ResultsThirteen patients with ANCA seropositivity were included, all of whom presented with kidney disease at diagnosis: 10 (76.9%) with ANCA-associated pauci-immune glomerulonephritis, one with ANCA-associated crescentic glomerulonephritis with immune complex deposition, one with immunoglobulin A nephropathy, and one with membranous nephropathy. The median serum creatinine level was 183.2 μmol/l (range, 55.0–1024.0 μmol/l). Respiratory symptoms (9/13 [69.2%]) and nonspecific gastrointestinal symptoms (5/13 [38.5%]) were the most common extrarenal manifestations. Remission was achieved in 10 (91%) of 11 ANCA-associated nephritis cases, and median interval from diagnosis to relapse was 30 months (range, 9–63 months). Cumulative relapse-free survival rates at 1 and 5 years were 100% and 88.9%, respectively. Overall, 1-year and 5-year renal survival rates were 80.8% and 58.9%, respectively.ConclusionRenal histopathology varied in young adults with ANCA seropositivity. Although relapse rates in this young adult population were generally low, long-term renal survival rates remain unsatisfactory.

Abstract TP180: Secular Trends For Demographics, Characteristics, Management, And Clinical Outcome Of Young Adults With Acute Ischemic Stroke.

Background: The incidence of stroke in young adults is increasing with the growing prevalence of stroke risk factors among young adults over the last decades. However, studies on secular trends in the young-age stroke population are scarce. Methods: We extracted data of acute ischemic stroke (AIS) patients aged 18-50 (n=7053; age, 43±6; male, 72%) from the multicenter stroke registry in South Korea. Demographics, risk factors, stroke characteristics, management, and clinical outcomes in young adults with AIS were summarized according to calendar year (2008-2019). Trends analysis was conducted using a linear regression model for continuous variables and the Mann-Kendall trend test for categorical variables. Results: There was no significant change between 2008 and 2019 in the proportions of young adults among female patients (7.1% to 7.0%, p=0.44). However, the proportions of young adults within male patients tended to decrease (12.4% to 10.7%; p=0.001) The prevalence, and awareness of risk factors were unchanged during the study period. Regarding stroke subtypes, there was a significant increase in other determined etiology (8% to 20%; p&lt;0.001) and a tendency to decrease in large artery atherosclerosis (26% in 2008; 34% in 2009 to 26% in 2019; p=0.28). The endovascular thrombectomy (EVT) rate increased (2% to 8%; p&lt;0.001), but the intravenous thrombolysis rate (8.8% to 10.6%) and door-to-needle time (38 to 36 min) did not change. Use of dual antiplatelet (DAPT; 29% to 55%; p=&lt;0.001) increased and direct oral anticoagulants (DOACs) in patients with atrial fibrillation tended to increase (11.7% in 2013 to 44.8% in 2019; p=0.07; DOAC began to be used in 2013 in Korea). However, the use of anticoagulants among young adult patients having atrial fibrillation tended to decrease (80% to 66%; p=0.054). Clinical outcomes, including a 3-month modified ranking scale 0-2 (84.6% to 85.2%), 1-year mortality (2.8% to 2.4%), and stroke recurrence rate (4.5 to 5.6%), did not improve during the study period. Conclusions: Among young adults with ischemic stroke, the EVT rate and use of DAPT or DOACs increased. Still, awareness of risk factors, door-to-needle time, and anticoagulation for atrial fibrillation required more attention to improve clinical outcomes.

Investigating Web-Based Nutrition Education Interventions for Promoting Sustainable and Healthy Diets in Young Adults: A Systematic Literature Review.

Background: Our current rapidly growing food systems are imposing a heavy burden on both environmental sustainability and human health. Sustainable and healthy diets aim to promote optimal health and have a minimal environmental impact. This study aimed to critically review and synthesise the evidence on the effectiveness of web-based nutrition education interventions aiming to promote sustainable and healthy diets among young adults. Methods: A systematic search of four databases (Medline, PsycINFO, Scopus, and Embase) was conducted in March 2021. Studies were included if they used an online platform to deliver the intervention to young adults and measured at least one aspect of sustainable and healthy diets, such as plant-based food intake, food waste, and local and seasonal produce. Of the 2991 studies, a total of 221 full-text articles were assessed for eligibility of which 22 were included in the final review. Results: A majority of the studies (82%) targeted fruit and vegetable consumption, and close to a quarter of studies (23%) targeted other aspects of a sustainable and healthy diet, such as red meat intake. Only one study included multiple aspects of a sustainable and healthy diet. Program delivery outcomes reported overall positive feedback and engagement. Conclusion: This review suggests that web-based interventions may be effective in promoting some sustainable diet-related outcomes in young adults. However, there is a need for developing and evaluating future programs to promote sustainable diets more comprehensively in order to help young adults make healthy and sustainable food choices.

Improved Survival of Young Adults with Cancer Following the Passage of the Affordable Care Act.

BackgroundCompared with their ensured counterparts, uninsured adolescents and young adults (AYAs) with cancer are more likely to present with advanced disease and have poor prognoses. The Patient Protection and Affordable Care Act (ACA), enacted in 2010, provided health care coverage to millions of uninsured young adults by allowing them to remain on their parents’ insurance until age 26 years (the Dependent Care Expansion, DCE). The impact of the expansion of insurance coverage on survival outcomes for young adults with cancer has not been assessed.ParticipantsUtilizing the Surveillance, Epidemiology, and End Results database, we identified all patients aged 12-16 (younger-AYAs), 19-23 (middle-AYAs), and 26-30 (older-AYAs) who were diagnosed with cancer between 2006-2008 (pre-ACA) and 2011-2013 (post-ACA).MethodsIn this population-based cohort study, we used an accelerated failure time model to assess changes in survival rates before and after the enactment of the ACA DCE.ResultsMiddle-AYAs ages 19-23 (thus eligible to remain on their parents’ insurance) experienced significantly increased 2-year survival after the enactment of the ACA DCE (survival time ratio 1.25, 95% confidence interval: 0.75-2.43, P = .029) and that did not occur in younger-AYAs (ages 12-16). Patients with sarcoma and acute myeloid leukemia accounted for the majority of improvement in survival. Middle-AYAs of hispanic ethnicity and those with low socioeconomic status experienced trends of improved survival after the ACA DCE was enacted.ConclusionSurvival outcomes improved for young adults with cancer following the expansion of health insurance coverage. Efforts are needed to expand coverage for the millions of young adults who do not have health insurance.

Multi-level outcomes for young adults with acquired brain injury through a remote intensive cognitive rehabilitation approach: a pilot intervention study

ABSTRACT Objective To investigate the effects of the Intensive Cognitive and Communication Rehabilitation (ICCR) program for young adults with acquired brain injury (ABI) using a quasi-experimental pilot intervention study design while transitioning to remote implementation. Method Twelve young adults with chronic ABI (treatment n = 7; control n = 5) participated in ICCR (i.e., lectures, seminars, individual cognitive rehabilitation (CR), technology training) for six hours/day, four days/week, for one or two 12-week semesters. Outcomes included classroom metrics, individual therapy performance, including Goal Attainment Scaling (GAS), standardized cognitive-linguistic assessments, and participation and health-related quality of life (QOL) measures. Results In the first semester (in-person and remote), treatment participants significantly improved in classroom exams; individual therapy (i.e., memory, writing, GAS); executive function and participation measures, but not QOL. In the second semester (remote), treatment participants significantly improved in classroom exams; essay writing; individual therapy (i.e., writing and GAS); and memory assessment, but not in participation or QOL. Treatment participants enrolled in consecutive semesters significantly improved in classroom exams, individual therapy (i.e., memory), participation and QOL, but not on standardized cognitive assessments. Controls demonstrated no significant group-level gains. Conclusion These preliminary results highlight the benefit of intensive, integrated, and contextualized CR for this population and show promise for its remote delivery.

Heart rate variability increases following automated acoustic slow wave sleep enhancement.

Acoustic stimulation has been shown to enhance slow wave sleep and in turn, cognition, and now cardiac outcomes in young adults. With the emergence of commercial acoustic devices in the home, we sought to examine the impact of an acoustic, slow wave enhancing device on heart rate variability in healthy, middle-aged males (n=24, 39.92±4.15years). Under highly controlled conditions, the participants were randomised to receive closed-loop brain state-dependent stimulation in the form of auditory tones (STIM), or no tones (SHAM), in a crossover design, separated by a 1 week washout period. STIM and SHAM were compared on measures of heart rate variability for the whole night and over the first three sleep cycles. We found an increase in slow wave activity following STIM compared with SHAM. There was a significant increase in high frequency power and standard deviation of the normalised RR-intervals (SDNN) during the STIM condition compared with SHAM (p&lt;0.05), due to changes observed specifically during N3. In conclusion, heart rate variability appears to improve following acoustic slow wave sleep enhancement.

Self-control in first grade predicts success in the transition to adulthood.

Childhood self-control has been linked with better health, criminal justice, and economic outcomes in adulthood in predominately white cohorts outside of the United States. We investigated whether self-control in first grade predicted success in the transition to adulthood in a longitudinal cohort of first graders who participated in a universal intervention trial to prevent poor achievement and reduce aggression in Baltimore schools. We also explored whether the intervention moderated the relationship between self-control and young adult outcomes. Teachers rated self-control using the Teacher Observation of Classroom Adaptation-Revised. Study outcomes were on-time high school graduation, college participation, teen pregnancy, substance use disorder, criminal justice system involvement, and incarceration (ages 19-26). Latent profile analysis was used to identify classes of childhood self-control. A high self-control class (n = 279, 48.1%), inattentive class (n = 201, 35.3%), and inattentive/hyperactive class (n = 90, 16.6%) were identified. Children with better self-control were more likely to graduate on time and attend college; no significant class differences were found for teen pregnancy, substance use disorder, criminal justice system involvement, or incarceration. A classroom-based intervention reduced criminal justice system involvement and substance use disorder among children with high self-control. Early interventions to promote child self-control may have long-term individual and social benefits.

Poorer Self-Reported Physical Health and Higher Anxiety Trait in Young Adults With Previous Coarctation Repair

Little is known about the impact of a coarctation repair on the functional outcomes of young adults. This study aimed to determine (1) the functional and mental health status in young adults with previous coarctation repair, and (2) the impact of late hypertension on their quality of life. A cross-sectional study using validated self-reported questionnaires (Short Form 36 version 2 [SF-36v2], Beck Depression Inventory [BDI], and State-Trait Anxiety Inventory [STAI]) was performed in 54 patients aged 15-47 years with previous paediatric coarctation repair. Questionnaire scores were compared to healthy age- and gender-matched controls. Patients' previously published 24-hour blood pressure monitoring results were included. Late hypertension was present in 64% (34/54) at a mean of 29±8 years after coarctation repair. SF-36v2 mean physical component summary score was significantly lower in coarctation patients compared with controls (53.1±6.8 vs 56.0±4.7, p=0.02), but there was no significant difference in mean mental component summary score (p=0.2). SF-36v2 mean role emotional score tended to be associated with 10 mmHg increases in mean 24-hour systolic blood pressure (regression coefficient 4.3 p=0.06). STAI mean trait anxiety score tended to be higher in coarctation patients compared with controls (36.6±9.0 vs 33.5±7.8, p=0.06). There was no significant difference in BDI scores between patients and controls. Young adults with previous coarctation repair report poorer physical health and tended towards higher anxiety trait compared to healthy controls. Strategies to improve self-reported physical health and anxiety should be explored. Long-term assessment of quality of life outcomes in coarctation patients is warranted.

Impact of locus of care on outcomes in adolescents and young adults with osteosarcoma and Ewing sarcoma treated at pediatric versus adult cancer centers: An IMPACT cohort study.

Location of cancer care (LOC; pediatric vs. adult center) impacts outcomes in adolescents and young adults (AYA) with some cancer types. Data on the impact of LOC on survival in AYA with osteosarcoma (OSS) and Ewing sarcoma (EWS) are limited OBJECTIVES: To compare differences in demographics, disease/treatment characteristics, and survival in a population-based cohort of AYA with OSS or EWS treated at pediatric versus adult centers METHODS: The Initiative to Maximize Progress in Adolescent Cancer Therapy (IMPACT) cohort captured demographic, disease, and treatment data for all AYA (15-21years old) diagnosed with OSS and EWS in Ontario, Canada between 1992 and 2012. Patients were linked to provincial administrative health care databases. Outcomes were compared between patients treated in pediatric versus adult centers. One hundred thirty-seven AYA were diagnosed with OSS (LOC: 47 pediatric, 90 adult) and 84 with EWS (38 pediatric, 46 adult). AYA treated at pediatric centers were more likely to be enrolled in a clinical trial (OSS 55% vs. 1%, p<.001; EWS 53% vs. 2%, p<.001) and received higher cumulative chemotherapy doses. Five-year event-free survival (EFS ± standard error) in OSS and EWS were 47% ± 4% and 43% ± 5%, respectively. In multivariable analysis, the impact of LOC (pediatric vs. adult center) on EFS in OSS (adjusted hazard ratio [HR] 1.15, 95% confidence interval [CI]: 0.58-2.27, p=.69) and EWS (adjusted HR 1.82, 95% CI: 0.97-3.43, p=.06) was not statistically significant. Despite disparities in trial participation and chemotherapy doses, outcomes did not differ by LOC suggesting that AYA with bone tumors can be treated at either pediatric or adult centers.

Extracorporeal Life Support for Status Asthmaticus: Early Outcomes in Teens and Young Adults.

Extracorporeal life support (ECLS) may be life saving for patients with status asthmaticus (SA), a difficult-to-treat, severe subset of asthma. Contemporary ECLS outcomes for SA in teens and young adults are not well described. The Extracorporeal Life Support Organization (ELSO) Registry was reviewed (2009-2019) for patients (15-35 years) with a primary diagnosis of SA. In-hospital mortality and complications were described. Multivariable logistic regression was used to identify independent risk factors for hospital mortality. Overall, 137 patients, (26 teens and 111 young adults; median age 25 years) were included. Extracorporeal life support utilization for SA sharply increased in 2010, coinciding with increased ECLS utilization overall. Median ECLS duration and length of stay were 97 hours and 11 days, respectively. In-hospital mortality and major complication rates were 10% and 11%, respectively. Nonsurvivors were more likely to have experienced ECLS complications, compared to survivors (86% vs. 42%, p = 0.003). Independent risk factors for in-hospital mortality included pre-ECLS arrest and any renal and/or neurologic complication. Prospective studies designed to evaluate complications and subsequent failure to rescue may help optimize quality improvement efforts.

Eculizumab precision-dosing algorithm for thrombotic microangiopathy in children and young adults undergoing HSCT

AbstractTransplant-associated thrombotic microangiopathy (TA-TMA) is a fatal posttransplant complication of hematopoietic stem cell transplantation. We recently reported that survival for TA-TMA has been improved by early intervention with eculizumab, a complement C5 inhibitor, guided by pharmacokinetic/pharmacodynamic (PK/PD) model-informed precision dosing. However, patients with gastrointestinal bleeding showed poor survival, even when treated with more frequent doses. Our objective was to develop separate models in bleeding and nonbleeding patients with TA-TMA and to propose precision dosing algorithms. Eculizumab PK/PD was analyzed in 19 bleeding and 38 nonbleeding patients (0.5-29.9 years of age). A complement activation biomarker (sC5b-9) and body weight were identified as significant determinants of eculizumab clearance regardless of bleeding. Eculizumab clearance after the first dose was higher in bleeding than in nonbleeding patients (83.8 vs 61.3 mL/h per 70 kg; P = .07). The high clearance was maintained over treatment doses in bleeding patients, whereas nonbleeding patients showed a time-dependent decrease in clearance. sC5b-9 levels were highest before the first dose and decreased over time, regardless of bleeding complications. A Monte Carlo Simulation analysis showed that the current dosing protocols recommended for atypical hemolytic uremic syndrome had <15% probability of attaining the target concentration of >100 μg/mL eculizumab in nonbleeding patients. We identified an intensified loading protocol to reach 80% target attainment. Our data clearly showed the need for individualized dosing for patients with significant bleeding and for ongoing dose adjustments to optimize outcomes. The developed models will be incorporated into a clinical decision guideline for precision dosing to improve outcomes in children and young adults with TA-TMA.

Outcomes of children and young adults with T-cell acute lymphoblastic leukemia/lymphoma who present in critical status.

Patients with T-cell acute lymphoblastic leukemia and lymphoma (T-ALL/LLy) commonly present with critical features such as hyperleukocytosis and mediastinal mass, which complicates completing a diagnostic and staging workup and prevents clinical trial enrollment. Consecutive patients with T-ALL/LLy from 1999 to 2019 at the Children's Hospital of Philadelphia were analyzed for pediatric intensive care unit (PICU) admission and various high-risk features as well as clinical trial enrollment and outcome. We identified 153 patients newly diagnosed with T-ALL/LLy, 53 (35%) required PICU-level care within 24hours and 73 (48%) within 7 days. Non-PICU patients had a significantly higher clinical trial enrollment rate (79.4%) versus PICU patients (56.1%, P=0.016). Patients who enrolled on a clinical trial had similar relapse risk to those who did not enroll (relapse rate 20%vs 29%, P=0.523). Nineteen patients were precluded from trial participation. Risk of relapse was increased for patients admitted to the PICU within 24hours (26%vs 13%, P=0.048). Forty-four patients with T-ALL presented with hyperleukocytosis, of which 30% relapsed versus 14% without (P=0.082). Patients who underwent apheresis for hyperleukocytosis were statistically more likely to relapse (47%vs 15%, P=0.007). Patients with elevated uric acid (20%vs 16%, P=0.278), mediastinal mass (20%vs 14%, P=0.501), or required emergent steroids (20%vs 16%, P=0.626) had a similar relapse risk. A single second relapse patient survived. Almost half of T-ALL/LLy patients required PICU-level care at diagnosis, making enrollment on clinical trials challenging, but trial enrollment predicted better outcome. Physicians should balance maintaining eligibility with safety to offer patients all options.

The role of protective psychological factors, self-care behaviors, and HbA1c in young adults with type 1 diabetes.

To investigate whether protective psychological factors in young adults with type 1 diabetes are associated with more optimal self-care behaviors and HbA1c, and to explore possible mediators between protective psychological factors and HbA1c. This cross-sectional study examined the associations between protective psychological factors (optimism, positive efficacy expectancies, and self-compassion), maladaptive psychological factors (depression, anxiety, and stress), self-care behaviors, and HbA1c in 113 young adults (17-25 years) with type 1 diabetes in Auckland, New Zealand. Pearson's correlations, multiple linear regressions, and multiple mediation analyses were used to examine associations and mediators. Higher positive efficacy expectancies (beliefs about coping with difficulties) were associated with more optimal HbA1c (β=-0.26, 95% CI: -1.99 to -0.45) and more optimal self-care behaviors (β=0.33, 95% CI: 0.28 to 0.92) in the adjusted models. Higher levels of self-compassion were associated with more optimal self-care behaviors (β=0.27, 95% CI: 0.09 to 0.43). Depression was associated with less optimal self-care behaviors (β=-0.35, 95% CI: -1.33 to -0.43) and stress was associated with less optimal HbA1c (β=0.26, 95% CI: 0.27 to 1.21). Mediation results suggested that self-care behaviors mediated the relationship between all three of the protective psychological factors and more optimal HbA1c, and that lower stress also mediated the relationship between higher self-compassion and more optimal HbA1c. This study adds to the emerging literature that protective psychological factors may play an adaptive role in improving health outcomes in young adults with type 1 diabetes. Interventions targeting protective psychological factors present a promising approach to optimizing wellbeing and self-care in youth with type 1 diabetes.

Asthma, atopy and lung function in young adults after hospitalisation for bronchiolitis in infancy: impact of virus and sex

BackgroundHospitalisation for bronchiolitis is a risk factor for asthma and impaired lung function during childhood, but outcomes in young adults are poorly described. Our primary aim was to study the...

Individual and parental factors on depressive disorder and its detrimental effects among adolescents and young adults: A study from Bihar state, India

IntroductionWorldwide depression is one of the most common chronic disorder as well as mental health problems in adolescent and young adult boys & girls. In Bihar, as per the report published by population council of India namely “Understanding the lives of adolescents and young adults (UDAYA) in Bihar, India”, pointed out that more than 90% boys & girls exposed their symptoms of mildly depressive disorders and nearly 15% boys and girls reported their symptom of moderate to severe depressive disorders. ObjectivesThis current study identified the risk factors of moderate to severe depressive disorders among adolescents and young adults from Bihar, a most underdeveloped state of India. This study also to identify is there any relationship between depressive disorders and educational outcome as well as suicidal outcome of adolescents and young adults in Bihar. Methodology adoptedDescriptive statistics, Logistic regression and Chi-square test were adopted to complete this study. ResultsThe likelihood of moderate to severe depressive disorder is higher among to those adolescents or young adults who were physically punished [AOR: 1.59; P < 0.05; 95% CI: 1.48–1.71] by their parent, had no permission to disclose their opinion to the other elder member of that family [AOR: 1.41; P < 0.05; 95% CI: 1.12–1.57] and to those whose parents neglect their child to hear personal things [AOR: 1.18; P < 0.05; 95% CI: 0.96–1.31] if they want to share, studied at private school and whose mother had no educational attainment or very less.

Tech-Aided Interventions for Vocational Skills in Adolescents and Young Adults with Autism Spectrum Disorder

Employment appears to be one of the greatest problems individuals with ASD have to deal with during their transition to adult life. In particular, unemployment or underemployment appears to be common among them, which suggests a gap in employment theory and practice focusing on the needs of this population. Tech-aided interventions appear to be promising since they can provide them opportunities to access competitive employment. The purpose of the current article is to examine the use of technology in interventions for adolescents and young adults with ASD in school, home, and community settings. In particular, it focused on the users of technology, the goals addressed, the type of technology employed, the contexts in which intervention practices were employed, and the outcomes for adolescents and young adults with ASD. In most of the studies, positive results were recorded and the importance of the work-related social skills was underlined. Technology appears to show potential for the enhancement of vocational skills of adolescents and young adults with ASD. Future research should focus on the improvement of work-related social skills and the skills needed for successful job seeking and an interview process. The maintenance and the generalization of the acquired skills should be examined too.

Local Policing and the Educational Outcomes of Undocumented College Students

A growing literature examines the impact of immigration and law enforcement on undocumented immigrants and their communities, but these studies are limited by the lack of reliable data on documentation status and their focus on federal immigration enforcement. Leveraging administrative student data from the City University of New York (CUNY) that reliably identify about 13,000 undocumented students among more than 350,000 first-year students, this article examines whether local policing practices that do not ostensibly target undocumented immigrants can affect the educational outcomes of undocumented young adults. Focusing on police stops around university campuses under the New York City Police Department's Stop, Question, and Frisk program, our findings show a substantial negative effect of police stops around campus on course credits for undocumented men but no impact on GPA or on the likelihood of receiving zero credits in the following term (stop-out). The negative effect is larger for Black and South Asian undocumented young men, groups that experience heightened surveillance by the local police. In contrast, campus police stops have little effect on documented students or undocumented women. The results illustrate how local policing practices, even in so-called sanctuary cities, can have chilling effects on undocumented groups with important implications for the links between the criminal justice system, immigration, and social inequality.

Clinical Characteristics of Multisystem Inflammatory Syndrome in Children and Young Adults With COVID-19: A Rapid Systematic Review

Background: The associated multisystem inflammatory syndrome in children (MIS-C) with coronavirus disease (COVID-19) is a novel syndrome that has phenotypic similarity to Kawasaki disease (KD). Objectives: This study systematically reviewed the demographic profile, clinical spectrum, treatment options, and outcomes of children and young adults under 21 years of age suffering from MIS-C. Methods: PubMed and Embase databases were searched from inception to July 3, 2020. A total of 39 studies involving 799 participants were included in the review. Critical appraisal of included studies was done using Joanna Briggs Institute Critical Appraisal Checklist for studies reporting prevalence data. A narrative synthesis was performed through descriptive summaries of demographic variables, clinical features, investigations, treatment details, and clinical outcomes. Results: The main complaints of the patients were fever (96.4%) followed by gastrointestinal symptoms. Serological evidence of preceding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was documented in 79.1% of the participants. Ventricular dysfunction (50.2%) was the most common echocardiographic finding. Intensive care was required for 77% of included participants, with 27.2% being mechanically ventilated. Also, 78.1% of the participants received intravenous immunoglobulins. The overall mortality rate was 1.5%. Conclusions: MIS-C associated with COVID-19 clinically resembles a hyperinflammatory state. More extensive studies will help in better defining this entity and delineating its phenotypic subtypes.