Revisión narrativa del modelo de desarrollo positivo para adultos emergentes chilenos / A narrative review of the positive development model for Chilean emerging adults / Revisão narrativa do modelo de desenvolvimento positivo para adultos emergentes chilenos

Introducción: El desarrollo positivo es un estadio de ajuste psicosocial que acentúa las potencialidades y los recursos entre jóvenes y sus contextos próximos. En Australia, se desarrolló el primer modelo de desarrollo positivo para adultos emergentes, el cual consta de cinco componentes (competencia social, satisfacción con la vida, confianza y tolerancia con los otros, confianza hacia autoridades e instituciones, acción y compromiso cívico), pero no ha sido investigado en Chile. Objetivo: Analizar la evidencia disponible en la literatura científica sobre los cinco componentes del modelo de desarrollo positivo en adultos emergentes universitarios de Chile. Materiales y métodos: Revisión narrativa de la literatura publicada entre 2013 y 2023, en bases de datos Web of Science, Scopus, SciELO, Redalyc y Dialnet. Resultados: Se obtuvieron 83 artículos, de los cuales 53 cumplieron los requisitos de inclusión; en su mayor parte fueron estudios cuantitativos (81,13%) y en español (75,47%). Se evidenció una disparidad en la cantidad de estudios por temática; se encuentra mayor investigación en satisfacción con la vida y acción y compromiso cívico. Conclusiones: Existen brechas en la literatura científica chilena en el estudio del desarrollo positivo; además de que se discuten particularidades idiosincrásicas y desafíos asociados a la etapa de adultez emergente.

Introduction: Positive development is a stage of psychosocial adjustment that accentuates the potentials and resources of young people and their close contexts. The first positive development model for emerging adulthood was developed in Australia, which includes five components: social; life satisfaction; trust and tolerance of others; trust in the authorities and institutions; and action and civic engagement. However, this model has not been investigated in Chile. Objective: To analyze the evidence available in the scientific literature on the five components of the positive development model in emerging adults universities. Materials and methods: A narrative review of the literature published between 2013 and 2023 in the Web of Science, Scopus, SciELO, Redalyc, and Dialnet databases was conducted. Results: 83 articles were selected, of which 53 met the inclusion criteria; most of them were qualitative studies (81.13%) and in Spanish (75.47%). There is an evident disparity in terms of the number of studies and topics, e.g., there is more research on life satisfaction and civic action and commitment. Conclusions: There are gaps in the Chilean scientific literature in the study of positive development. In addition, idiosyncratic particularities and challenges associated with the stages of emerging adulthood are discussed.

Introdução: O desenvolvimento positivo é uma fase de ajustamento psicossocial que acentua o potencial e os recursos dos jovens e dos seus contextos imediatos. Na Austrália, foi desenvolvido o primeiro modelo de desenvolvimento positivo para adultos emergentes, que consiste em cinco componentes (social, satisfação com a vida, confiança e tolerância com os outros, confiança nas autoridades e instituições, ação e envolvimento cívico), mas ainda não foi investigado no Chile. Objetivo: Analisar as evidências disponíveis na literatura científica sobre os cinco componentes do modelo de desenvolvimento positivo em adultos universitários emergentes no Chile. Materiais e métodos: Revisão narrativa da literatura publicada entre 2013 e 2023, nas bases de dados Web of Science, Scopus, SciELO, Redalyc e Dialnet. Resultados: foram obtidos 83 artigos, dos quais 53 atenderam aos requisitos de inclusão; A maioria deles eram estudos quantitativos (81,13%) e em espanhol (75,47%). Ficou evidente uma disparidade no número de estudos por tema; Há mais pesquisas sobre satisfação com a vida e ação e compromisso cívico. Conclusões: Existem lacunas na literatura científica chilena no estudo do desenvolvimento positivo; Além disso, são discutidas particularidades e desafios idiossincráticos associados à fase da idade adulta emergente.

Screen Use Time and Its Association With Mental Health Issues in Young Adults in India: Protocol for a Cross-Sectional Study.

BACKGROUND: Screen use time has increased in the past decade owing to the increased availability and accessibility of digital devices and the internet. Several studies have shown an association between increased screen use time and mental health issues such as anxiety and depression. However, studies in the young adult population-a demographic with high screen use-and in low- and middle-income country settings are limited. OBJECTIVE: This protocol describes a study that aims to measure self-reported screen use times and patterns in young adults (18-24 y) in India and assess if increased screen use time is associated with poorer mental well-being. METHODS: This protocol describes a cross-sectional study of a pan-India, web-based convenience sample of young adults (18-24 y) with access to digital devices with a screen and a minimum of secondary school education. Participants will be recruited through people in the professional networks of the investigators, which includes pediatricians. The survey will also be distributed via the social media pages of our organization (X [X Corp], Instagram [Meta], Facebook [Meta], etc). Sociodemographic details will be collected through a questionnaire designed by the authors; screen use time and patterns will be assessed using an adaptation of the Screen Time Questionnaire to include data on different apps and websites used on digital devices; and mental health parameters will be gauged using the Warwick-Edinburgh Mental Well-Being Scale, Generalized Anxiety Disorder Scale, Perceived Stress Scale, and Patient Health Questionnaire. For statistical analysis, we will consider the following variables: (1) the primary independent variable is screen use time; (2) other independent variables include age, gender, residence: rural or urban, educational qualifications, employment status, stress associated with familial financial status, average sleep time, number of people living in a house or rooms in that house, BMI, substance use, and past psychiatric history; and (3) dependent variables include mental well-being, depression, anxiety, and perceived stress. To quantify the association between screen use time and mental health, we will perform a Bayesian multivariate multiple regression analysis that models the possibility of multiple alternative hypotheses while accounting for relevant sociodemographic covariables. RESULTS: The survey instrument has been designed, and feedback has been obtained from the domain experts and members of our organization whose profile is similar to the potential study participants. The final data received after this study has been conducted will be analyzed and shared. As of January 2023, we have not yet initiated the data collection. CONCLUSIONS: Based on the findings of this study, we will be able to establish a correlation between device- and use-specific screen use time and various mental health parameters. This will provide a direction to develop screen use time and mental health guidelines among young adults. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/39707.

Racism and Health Among Aotearoa New Zealand Young People Aged 15-24 years: Analysis of Multiple National Surveys.

PURPOSE: This Aotearoa New Zealand-based study addresses a gap in literature focusing on individual experiences of racism among adolescents and young adults and its links to health. METHODS: This cross-sectional study uses data from multiple instances of the New Zealand Health Survey (2002/03, 2006/07, 2011/12, 2016/17) and General Social Survey (2008-2016) restricted to participants aged 15-24 years. Prevalence of reported experiences of racism are estimated. Meta-analytic techniques to pool data and multiple regression analyses are used to examine associations between experiences of racism and outcomes measures (mental and physical health, general health and well-being, life satisfaction, inability to access health care, and identity). The study used an ethical co-design process between university researchers and a rangatahi Maori (Maori young people) partnership group. RESULTS: Racism was higher among Maori, Pacific, and Asian young people compared to European young people. Racism was associated with all negative health and well-being measures examined for young people, including negative mental and physical health measures (12-Item Short Form Survey, Kessler Psychological Distress Scale), lower self-rated health, negative life satisfaction, higher unmet need for primary care, and identity measures (feelings of not belonging in New Zealand, less able to express their identity). DISCUSSION: The results of this study are concerning. Non-European young people disproportionately bear the burden of racism in Aotearoa New Zealand with a potentially substantial impact on their health and well-being. This is a breach of Indigenous (for Maori) and other international human rights and should be motivation to act to eliminate racism in all its forms.

Systematic review of treatment completion rates and correlates among young people accessing alcohol and other drug treatment.

BACKGROUND AND AIMS: Treatment completion is associated with improved alcohol and other drug (AOD) treatment outcomes. Unfortunately, treatment disengagement is common, particularly among young people. We reviewed and synthesised research on AOD treatment completion and/or early disengagement among young people. METHODS: We conducted a systematic review and meta-analysis of studies reporting on completion rates and/or early disengagement from psychosocial AOD treatment among adolescents and young adults. An overall estimated treatment completion rate was calculated using inverse-variance random effects meta-analysis, and random-effects meta-regression was used to identify between-study level moderators of completion rate. We completed a narrative review summarising literature on early treatment disengagement and within-study level correlates of treatment completion. Study quality was assessed using the EPHPP. RESULTS: Of the 6158 studies screened, we retained 410 for full text review and included 98 studies in the review. Treatment completion rates were reported in 88 studies, and early disengagement rates were reported in 13. The estimated overall treatment completion rate was 59 % (95 % CI=57-61 %), with experimental studies reporting higher rates of completion than observational studies. There was limited evidence for demographic or substance-related correlates of treatment completion. Contingency management was associated with increased completion rates, as was family-based intervention. CONCLUSIONS: Disengagement from AOD treatment among youth populations is common and contributes to poor treatment outcomes. Existing research has yielded little consensus on the factors associated with treatment completion. The use of contingency management strategies and involving family/social supports in treatment were identified as potential avenues for promoting ongoing treatment engagement.

Addressing Post-Pandemic Adolescent Health in Schools.

The coronavirus disease 2019 pandemic disrupted in-person learning for adolescents and young adults across the world. Inequities in learning outcomes were primarily caused by digital inequalities. Social needs of adolescent and young adult (AYA) emerged during the pandemic and school is a key part of supporting AYA social health. School-based health clinics can serve as a method to improve mental and physical health outcomes for AYA.

Telomere Length in Adolescent and Young Adult Survivors of Childhood Cancer.

We examined the leukocyte relative telomere length (RTL) in Korean adolescent and young adult (AYA) survivors of childhood cancer and evaluated the association of leukocyte RTL with multiple factors, including malignancy type, cancer treatment, age, and chronic health conditions (CHCs). Eighty-eight AYA survivors of childhood cancer with a median follow-up period of 73 months were recruited. RTL in pediatric cancer survivors was not significantly shorter than the predicted value for age-matched references. Neither age at diagnosis nor duration of therapy influenced the RTL. Among the 43 patients with hematologic malignancies, those who underwent allogeneic hematopoietic stem cell transplantation (HSCT) showed a significant shortening of the RTL compared with those who did not (p = 0.039). Among the 15 patients who underwent allogeneic HSCT, those who developed acute graft-versus-host disease (GVHD) of grade II or higher had significantly shorter RTL than those who did not (p = 0.012). Patients with grade II CHCs had significantly shorter RTL than those without CHCs or with grade I CHCs (p = 0.001). Survivors with ≥2 CHCs also exhibited shorter RTL (p = 0.027). Overall, pediatric cancer survivors had similar telomere lengths compared to age-matched references. HSCT recipients and patients with severe or multiple CHCs had shorter telomeres. GVHD augmented telomere attrition in HSCT recipients.

Impact of Korean Military Service on the Prevalence of Steatotic Liver Disease: A Longitudinal Study of Pre-enlistment and In-Service Health Check-Ups.

Background/Aims: Young Korean men are obligated to serve in the military for 18 to 21 months. We investigated the effects of military service on steatotic liver disease (SLD) and other metabolic parameters. Methods: Pre-enlistment health check-up performed from 2019 to 2022 and in-service health check-up performed from 2020 to 2022 were merged as paired data. SLD was defined as a hepatic steatosis index of 36 or higher. Hypertension (HTN) and hypertriglyceridemia were also included in the analysis. Results: A total of 503,136 paired cases were included in the analysis. Comparing pre-enlistment and in-service health check-ups, the prevalence of SLD (22.2% vs 17.6%, p<0.001), HTN (7.6% vs 4.3%, p<0.001), and hypertriglyceridemia (8.1% vs 2.9%, p<0.001) decreased during military service. In terms of body mass index, the proportion of underweight (8.2% vs 1.4%, p<0.001) and severely obese (6.1% vs 4.9%, p<0.001) individuals decreased over time. Regarding factors associated with SLD development and resolution, age was positively associated with SLD development (odds ratio, 1.146; p<0.001) and a health check-up interval of <450 days was a protective factor for SLD development (odds ratio, 0.746; p<0.001). Those serving in the marines were less likely to develop SLD, whereas those serving in the navy were more likely to develop SLD. Serving in the army or the navy was negatively associated with SLD resolution, whereas serving in the air force was positively associated with SLD resolution. Conclusions: The prevalence of SLD, HTN, and hypertriglyceridemia decreased substantially during Korean military service.

Factors associated with self-management behaviors among Chinese adults with ischemic stroke: A cross-sectional study.

Background: In China, adults with ischemic stroke are getting younger. Additionally, following a stroke, they often neglect self-management (SM), which significantly impacts the rehabilitation process and treatment outcomes. Objective: This study aimed to describe SM behavior and examine the relationship between stroke prevention knowledge, life stress, family relationships, and SM behavior among adults with ischemic stroke. Methods: A total of 125 participants were recruited between October 2022 and March 2023 based on defined inclusion criteria. Research instruments included a demographic questionnaire, the Stroke Self-management Behavior Scale for Young Adults, the Stroke Prevention Knowledge Questionnaire, the Perceived Stress Scale, and the Brief Family Relationship Scale. Data were analyzed using descriptive statistics and Pearson's product-moment correlation. Results: The mean score of SM behavior was 88.1 out of 130 (SD = 16.5). Stroke prevention knowledge and family relationships showed a moderate positive significant relationship with SM behavior (r = 0.39, r = 0.34, p <0.001, respectively). Life stress had a significant negative relationship with SM behavior (r = -0.33, p <0.001). Conclusion: The findings offer insights for nurses to develop nursing interventions to promote SM behavior among adults with stroke. Furthermore, they can assist hospitals in transitioning care to the community by emphasizing holistic nursing practices that educate about stroke prevention knowledge, encourage family support, and provide stress management strategies to enhance the SM abilities of adults with stroke.

Substance Use and College Completion Among Two-Year and Four-Year College Students From a Nationally Representative Longitudinal Study.

Young adults from disadvantaged populations access higher education through two-year colleges, but substance use research among young adults focuses on four-year colleges. Filling this research gap is important given recent policy changes that have increased marijuana availability for young adults. This study uses a subsample of college-enrolled participants from the National Longitudinal Study of Adolescent to Adult Health (Add Health) to evaluate whether substance use predicts educational attainment seven years later, comparing 888 students attending a two-year college with 1,398 matched students attending a four-year college. Matched students were identified using a propensity score method so that students were comparable on 15 measures, including precollege grades, precollege test scores, and precollege substance use. Compared with similar four-year college students, two-year college students were more likely to use methamphetamines, cocaine, or marijuana; more likely to report problematic substance use; and less likely to use alcohol. Two-year college students who used methamphetamines in the past year (incidence rate ratio (IRR) = 1.51, 95% CI (1.12, 2.04), p = 0.007) or past month (IRR = 1.69, 95% CI (1.09, 2.61), p = 0.02) or completed alcohol abuse treatment (IRR = 1.58, 95% CI (1.21, 2.07), p < 0.001) were less likely to complete college than two-year college students without those risk factors. Among the matched four-year college students, students who reported that drugs interfered with school or work in the past year (IRR = 1.84 (1.28, 2.64), p = 0.001), used cocaine in the past year (IRR = 1.47 (1.04, 2.08), p = 0.03), and used marijuana in the past year (IRR = 1.30 (1.07, 1.57), p = 0.007), past month (IRR = 1.31 (1.07, 1.61), p = 0.01), or ≥5 times in the past month (IRR = 1.44 (1.12, 1.85) p = 0.005) were less likely to complete college than the matched four-year college students without those risk factors. Substance use interventions should target both two-year and four-year college students. Two-year colleges that better accommodate students who complete substance use treatment may improve these students' completion. Students who use marijuana or cocaine or whose drug use impairs functioning may benefit from an incremental approach of completing a two-year degree prior to transferring to a four-year degree rather than enrolling directly in a four-year program.

Riboflavin transporter deficiency in young adults unmasked by dietary changes.

Riboflavin transporter deficiency (RTD) is a genetic disorder of reduced riboflavin (vitamin B2) uptake that causes progressive, multifocal neurological dysfunction. Most patients present in early childhood; if patients present later in life, symptoms usually develop more gradually. We report three previously healthy young adults, who developed rapidly progressive neurological symptoms after decreasing dietary intake of meat and dairy. After a diagnostic odyssey, the diagnosis of a riboflavin transporter deficiency was made. Treatment with high dose oral riboflavin (20-40 mg/kg/day) partially reversed symptoms. This case series highlights that reduced riboflavin intake as a result of dietary changes can unmask RTD at a later age. We emphasize the importance of early recognition of this progressive and potentially lethal disease and show that timely treatment with high dose riboflavin is highly effective.

Popularity of Zyn and other nicotine pouch brands among U.S. adolescents, young adults, and adults in 2021.

OBJECTIVE: This study identifies brands of nicotine pouches used in 2021, just before the surge in popularity of Zyn use. METHODS: We conducted a national, cross-sectional online survey of a general U.S. population (November to December 2021; N = 6131; age 13-40) via Qualtrics panels. Descriptive analyses and chi-squared tests (alpha = 0.05) were performed to assess ever and past-30-day use of nicotine pouch brands across adolescents (13-20), young adults (21-24), and adults (25-40), and to assess frequency of popular brands used among peers. RESULTS: The top brands ever used were Zyn (overall: 30.9%; adolescents: 31.9%; young adults: 33.2%; adults: 28.3%) and Lyft (overall: 28.8%; adolescents: 28.4%; young adults: 32.9%; adults: 26.3%), with no differences in ever-use by age group (p's > 0.095). The top brands used in the past-30-days were Zyn (overall: 26.4%; adolescents: 24.5%; young adults: 24.3%; adults: 30.0%) and Rush (overall: 24.2%; adolescents: 21.0%; young adults: 22.7%; adults: 28.6%). Adults (vs. adolescents, young adults) were more likely to report past-30-day use of Lyft (p = 0.004). Participants indicated Zyn (18.5%) and Lyft (18.2%) to be the most popular brands among peers. CONCLUSIONS: Even in 2021, Zyn was the most popular brand of nicotine pouches. Findings will help regulate and reduce impact of marketing of Zyn.

Class III Camouflage Orthodontic Treatment in Adult Patient with Anterior Crossbite and Abnormal Functional Shift: A Case Report.

Skeletal Class III malocclusion is a complex malformation with a prevalence of 81.6% in Airlangga University Dental Hospital, distributed in patients aged 15-45 years old. Camouflage treatment of skeletal Class III malocclusion improves prognosis with a mild-to-moderate shift. This study aimed to discuss orthodontic camouflage as an option for adult patients with Class III malocclusion, emphasizing its indications, implications, and expected results. This report presents the case of a 17-year-old male patient with poor facial aesthetics associated with protruded chin, abnormal functional shift, and temporomandibular joint pain. The facial profile was concave with lower anterior multiple diastemas, mandibular lip protrusion, mandibular displacement, and anterior crossbite. This case was treated by camouflage therapy using straight wire appliance system combined with elastic class III. After 24 months of treatment during the pandemic, the mandibular displacement and the crossbite were corrected, the teeth were arched, the anterior crossbite fixed, and the profile became convex. Camouflage orthodontic treatment can be an effective management option to achieve functional occlusion, stability, and a satisfactory aesthetic impression in adult patients with mild to moderate skeletal Class III deformities, anterior cross bite, and functional shift.

Young people's experiences of addiction to nicotine vaping products: A qualitative analysis from Aotearoa New Zealand.

INTRODUCTION: Young people who use nicotine-containing electronic cigarettes, or 'vapes', risk becoming addicted to these products. While several studies document dependency symptoms, few report in-depth qualitative analyses of addiction. METHODS: We explored experiences of self-reported vaping addiction using in-depth interviews with 22 young people aged 16-20 years who vaped and lived in Aotearoa New Zealand. Our semi-structured interview guide probed participants' early experiences and how they progressed from experimentation to addiction and explored how addiction affected their perceptions and daily routines. We used an inductive reflexive thematic analysis approach to interpret the data. RESULTS: Vaping's pervasiveness piqued participants' curiosity and encouraged trial. Most transitioned from experimentation to addiction within a couple of months; while a minority described a slower progression, nearly all felt irritable, angry or uncomfortable if they had to delay vaping. Intense cravings disrupted school and work routines and dictated how they spent their time. Many deeply regretted vaping and some suffered shame and embarrassment. These participants saw vaping as a threat to the well-being of younger youth, which they tried to shield from addiction. DISCUSSION AND CONCLUSIONS: We go beyond earlier studies by probing the burden vaping comes to represent, offering new insights into young people's everyday experiences of vaping addiction. In addition to informing health promotion campaigns, our findings could inform policy directions. Understanding the speed with which addiction can occur, its impact on daily life, and the considerable regret many felt could help inform a more strategic and sorely needed approach to reducing youth vaping.

The Experience of Adolescents and Young Adults in Their Cancer Journeys in Japan: I Try to Move Forward With Feeling That I Would Be Okay With "My Cancer".

Purpose: A cancer diagnosis can greatly affect adolescents and young adults (AYAs), especially those in their late teens and early twenties, who might have their special needs. This study aimed to understand the experiences of the AYAs who were diagnosed between 15 and 24 years of age in Japan, thinking about the care guide supporting them, from the time of their cancer diagnosis through the rest of their lives. Methods: Data were collected using semi-structured interviews, which were audio recorded and transcribed verbatim. Qualitative analysis of the transcripts was used to categorize these into themes for comprehensive interpretation. Results: Twenty AYAs participated; they were diagnosed between the ages 15 and 23 and were 19-29 years old at the time of the interview. In total, 14 core categories were identified, consisting of three themes (1) There is a feeling of distance between the cancer and me, (2) I face "my cancer" in my way, and (3) I feel that I would be okay with "my cancer." Conclusions: AYAs had their way of dealing with cancer while experiencing a distant feeling between themselves and the presence of the disease during their cancer journey. Although the process was not simple, they tried to live their lives in their own way, believing that they would be okay. Nurses must respect and understand that AYAs have a process of facing their own cancer with time and watch over AYAs' experiences to appropriately support them to successfully proceed further.

Harmonization of the Upfront Osteosarcoma Treatment Paradigm for Adolescents and Young Adults.

Limited guidance exists on streamlining cancer therapy for adolescent and young adult (AYA) patients 15-39 years of age, as much of the current data are extrapolated from pediatric or adult counterparts and can differ significantly between the two care models. Harmonization of standard treatment approaches has the potential to improve outcomes and establish a foundation for the development of future clinical trials. We present our experience harmonizing treatment and supportive care regimens for AYA patients with osteosarcoma receiving treatment with methotrexate, doxorubicin, and cisplatin (MAP) therapy on the pediatric and adult sarcoma services at the Memorial Sloan Kettering Cancer Center.

Disparities in the Occurrence of Long-Term Effects of Bone Marrow Suppression after Treatment in Adolescent Young Adult Breast Cancer Survivors.

BACKGROUND: Many adolescent and young adult (AYA) patients with breast cancer (BC) receive adjuvant therapy as initial treatment, with long-term bone marrow suppression as a potential complication, but no studies have evaluated the impact of race/ethnicity on the development of bone marrow suppression in AYA BC survivors. PATIENTS AND METHODS: Female patients ages 15-39 years diagnosed with BC (2006-2018) and surviving ≥ 2 years were identified from the California Cancer Registry and linked to statewide hospitalization data. We estimated the cumulative incidence of developing late effects of bone marrow suppression, such as leukopenia, anemia, thrombocytopenia, bleeding, and infection/sepsis, during hospital discharge diagnoses present ≥ 2 years after diagnosis. We examined the impact of sociodemographic and clinical factors on late effects using multivariate Cox proportional hazards regression. RESULTS: Of 11,293 patients, 42.8% were non-Hispanic (nH) White, 28.8% Hispanic, 19.5% nH Asian/Pacific Islander, and 7.5% nH Black. In multivariable analyses, nH Blacks had the highest risk (versus nH Whites) of anemia [hazard ratio (HR) 1.72, 95% confidence interval (CI) 1.47-2.02], leukopenia (HR 1.56, CI 1.14-2.13), thrombocytopenia (HR 1.46, CI 1.08-1.99), major infection/sepsis (HR 1.64, CI 1.4-1.92), and bleeding (HR 1.89, CI 1.39-2.58). Hispanics had a higher risk of developing anemia (HR 1.17, CI 1.04-1.32), bleeding (HR 1.4, CI 1.12-1.76), and major infections/sepsis (HR 1.36, CI 1.21-1.52). Asian/Pacific Islanders had only a higher risk of developing bleeding (HR 1.33, CI 1.03-1.72). Patients from a low neighborhood socioeconomic status had a 20% higher risk of infection/sepsis (HR 1.21, CI 1.1-1.34), but there were no associations for the other late effects. CONCLUSIONS: We identified that AYAs of nH Black, Hispanic, and Asian/Pacific Islander race/ethnicity are at an increased risk of several late effects after adjuvant therapy compared with nH White patients. From these data, providers can implement early/frequent screening of hematologic late effects in these high-risk survivors.

Liminal Space: A Retrospective Content Analysis of Ethics Consultation for Patients Aged 18-26.

PURPOSE: To characterize the primary ethical issue and contextual features of ethics consultation for patients aged 18-26 years based on setting (adult vs. pediatric). METHODS: A retrospective review of 965 ethics consultation notes to identify patients aged 18-26 years cared for in the pediatric or adult setting between January 1, 2016-December 31, 2020. We collected demographic information and used conceptual content analysis to identify the primary ethical issue and contextual features for each consult and analyzed these using descriptive statistics. RESULTS: We identified 46 consults (30 adult and 16 pediatric) for 40 unique patients (28 adult and 12 pediatric). The median age was 19 years in the pediatric setting and 24 in the adult setting. Fifty-three percent were female, 95% non-Hispanic, 68% White, and 76% were inpatient. The primary ethical issue in the adult setting was Refusal of Recommended Treatment (20%), while the dominant contextual issue was Communication Disputes/Conflicts Between the Staff and Patient (23%). The primary ethical issue for the pediatric setting was Goals of Care (31%) and the dominant contextual feature was concerns for Quality of Life (31%). DISCUSSION: The primary ethical issues and related contextual features this population experiences differ based on setting. Improved understanding of adolescent and young adult development, especially related to values formation, decision-making, and communication skills training may ameliorate some of these challenges. Referral patterns for this age group overall and particularly for patients on the ends of the spectrum and inpatients raise concerns for ethics consultation use. Further education about ethics services is recommended.

Time in childhood extracurricular activity and mental health of young adults with developmental disability.

BACKGROUND: People with developmental disability have higher rates of mental health problems such as anxiety, depression, psychological distress, or a limited sense of belonging to a community. Extracurricular activity can help children and adolescents build social connections beyond family, increasing social capital, which may promote mental health in the transition into adulthood. Little is known about such associations among people with developmental disability. OBJECTIVE: To examine associations of childhood extracurricular activity with mental health in young adulthood among people with and without developmental disability. METHODS: Data: Panel Study of Income Dynamics (PSID, 1968-2017), its Child Development Supplement (1997, 2002, 2007) and its Transition into Adulthood Supplement (2005-2019) (n = 2801). Time diaries measured time in activity. Outcomes were psychological distress (Kessler K6) and flourishing (Mental Health Continuum-Short Form). Adjusted linear regressions modeled associations. RESULTS: In nationally representative results, 9.6 % (95 % confidence interval, CI 7.8, 11.4) had a disability. Children without disability reported more average weekly time in group activity, 125.1 min (CI 113.2, 136.9) vs. 93.6 (CI 55.1, 132.0; not significant at conventional levels). In adjusted results, "some" group activity (0-180 weekly minutes) was associated with greater flourishing for those with developmental disability (0.89; CI 0.16, 1.61). CONCLUSIONS: Among people with developmental disability, group activity in childhood was associated with greater flourishing in young adulthood. More research is needed to understand the complex nature of activity participation for children with developmental disabilities.