Improving Access to Standardized Fertility Preservation Information for Older Adolescents and Young Adults with Cancer: Using a User-Centered Approach with Young Adult Patients, Survivors, and Partners to Refine Fertility Knowledge Transfer

2016 ◽  
Vol 33 (3) ◽  
pp. 528-535 ◽  
Author(s):  
Seline Tam ◽  
Natasha Puri ◽  
Derek Stephens ◽  
Laura Mitchell ◽  
Meredith Giuliani ◽  
...  
Keyword(s):  
Young Adults ◽  
Young Adult ◽  
Knowledge Transfer ◽  
Fertility Preservation ◽  
Adult Patients ◽  
Adolescents And Young Adults ◽  
Older Adolescents ◽  
User Centered

Adolescents and Young Adults With Hemophagocytic Lymphohistiocytosis Who Undergo Allogeneic Hematopoietic Cell Transplantation Are At Increased Risk Of Mortality Compared To Younger Patients

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 2087-2087 ◽  
Author(s):  
Shanmuganathan Chandrakasan ◽  
Rebecca Marsh ◽  
Michael Grimley ◽  
Jack Bleesing ◽  
Michael Jordan ◽  
...  
Keyword(s):  
Young Adults ◽  
Young Adult ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Hematopoietic Cell Transplantation ◽  
Adult Patients ◽  
Adolescents And Young Adults ◽  
Adolescent And Young Adult ◽  
Younger Patients ◽  
Risk Of Mortality ◽  
Increased Risk

Abstract Hemophagocytic lymphohistiocytosis (HLH) is a potentially life-threatening disorder of immune deregulation characterized by overwhelming immune activation and inflammation. Primary HLH was once thought to affect predominantly infants and young children. However, with increasing awareness, HLH is being diagnosed in adolescents and young adults. Currently, allogeneic hematopoietic cell transplantation (HCT) is the only curative therapy available for primary hemophagocytic lymphohistiocytosis (primary HLH). There is limited data on HCT outcome for adolescents and young adults with HLH. We reviewed the allogeneic HCT outcomes of 19 adolescents and young adults with HLH (12 males and 7 females) who underwent HCT from January 2000 to June 2013 at our center. The median age at transplantation was 18.2 years (range: 15.2 -27.2). The Majority (15/19) underwent reduced-intensity conditioning (RIC) regimen consisting of alemtuzumab, fludarabine, and melphalan. Thirteen patients received transplants from HLA- matched donors (10 MUD and 3 MSD). Bone marrow was the source of stem cells in 15 patients. The HCT outcome of this group was compared to outcome of children with HLH less than 15 years of age. Median follow up of adolescent and young adult patients following HCT is 280 days (range 9-1643 days). Mixed donor chimerism was noted in 20% (3/15) of patients who received RIC. Acute GVHD grade II-IV was noted in four patients. Overall survival for adolescent and young adult patients was 42.1% (8/19). In patients who received RIC, Kaplan Meier analysis revealed a long term estimated survival of 57%, compared to 75% for children less than 15 years of age (p=0.03). Cox proportional hazard modeling revealed a reduced risk of mortality in young patients undergoing RIC HCT compared to adolescent and young adult patients (HR 0.379 [0.154-0.933], p=0.035), controlling for donor match and source. Deaths in adolescent and young adult patients occurred from days +9 to +568 following HCT. The cause of death varied from fulminant bacterial sepsis (n=4), acute refractory GVHD (n=2), disseminated aspergillus and fungal sepsis (n=2), viral infection (n=2), and refractory chronic GVHD (n=1). In conclusion, adolescents and young adults with HLH who undergo allogeneic HCT are at increased risk of mortality compared to younger patients. Further studies are needed to identify risk factors and potential interventions to improve HCT outcome for adolescents and young adults with HLH. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Factors Associated with Non-Attendance at Dental Preventive Care in Slovak High School Students

2021 ◽  
Vol 18 (3) ◽  
pp. 1295
Author(s):  
Martin Samohyl ◽  
Jana Babjakova ◽  
Diana Vondrova ◽  
Jana Jurkovicova ◽  
Juraj Stofko ◽  
...  
Keyword(s):  
High School ◽  
Young Adults ◽  
High School Students ◽  
Preventive Care ◽  
Parental Influence ◽  
Adolescents And Young Adults ◽  
Control Group ◽  
School Students ◽  
Factors Associated ◽  
Older Adolescents

This study aimed to determine the factors associated with the avoidance of dental preventive care in high school students and their parents in the framework of The Youth and Parents Risk Factor Behavior Survey in Slovakia, the ongoing cross-sectional school-based survey of students and their parents or legal representatives. The data were collected using two separate standardized questionnaires: (i) the questionnaire for students (n = 515) and (ii) the questionnaire for parents (n = 681). The study group included 57 high school students (54.4% males) who did not visit the dentist for preventive care in the previous year. The control group included 458 students (35.8% males) who visited a dentist for preventive care at least once in the previous year. A significantly higher number of males (54.4%), older adolescents, and young adults (21.8%; 20.0%) were not visiting dental preventive care regularly. Incomplete family (56.1%), stressful situations at home (17.5%), and feeling unwell were the factors contributing to the avoidance of dental preventive care. More than 34.5% of adolescents and young adults were not visiting either dental preventive care or pediatric preventive care (adjusted odds ratio (AOR) = 5.14; 95% confidence interval (CI) = 2.40, 10.99). Children of divorced mothers and mothers with household income lower than EUR 900 had significantly higher dental care avoidance in bivariate analysis. A significantly higher percentage of fathers from the exposed group were not visiting dental preventive care regularly (47.8%, p < 0.05). The results of the study can be used as an educational intervention step focusing on the parental influence on adolescent and young adults’ behavior and as a challenge for the improvement of dental preventive care in older adolescents and young adults.

scholarly journals Evaluating Opioid Dispensing Rates among Pediatrics and Young Adults based on CURES Data Reporting in California from 2015-2019

2021 ◽  
Vol 67 (4) ◽  
pp. 23-32
Author(s):  
Michael Phan ◽  
Courtney Wong ◽  
Daniel Tomaszewski ◽  
Zeev Kain ◽  
Brooke Jenkins ◽  
...  
Keyword(s):  
Young Adults ◽  
Young Adult ◽  
Evaluation System ◽  
Age Groups ◽  
Secondary Analysis ◽  
Adult Patients ◽  
High Rate ◽  
Utilization Review ◽  
Opioid Use ◽  
Prescription Rates

Background Receipt of opioid prescriptions in pediatric and young adult patients may be a risk factor for future opioid misuse. Data from prescription drug monitoring programs provide insight on outpatient opioid use. In our study, we analyzed the opioid dispensing rates for pediatrics and young adults in California. Methods A secondary analysis was performed from 2015-2019 using Controlled Utilization Review and Evaluation System data. This database provides dispensing data of controlled substances in California. Patients younger than 25 years who were prescribed opiates were analyzed by county. We further divided them into two groups (children: ≤14 years; adolescents and young adult: 15-24 years). Descriptive statistics and heat maps were used to illustrate the trends in opioid usage among different age groups. Results The overall percentages for the number of opioids being dispensed to patients aged <25 years have decreased over the past four years. In 2015, 6 out of 58 counties in California were considered “high-rate” with >2.9% of opioids dispensed to patients younger than 25 years old; in 2019, this number reduced to zero. Patients 25 and older received a higher proportion of opioids compared to younger populations; in 2019, 35.91% of opioids were dispensed to patients 45-64, and 8.92% to patients younger than 25. Conclusion Pediatric opioid prescriptions have declined over the recent years. However, a high degree of variability of prescription rates between demographic counties was noted. More studies are warranted in order to understand this discrepancy in opioid prescribing among pediatric and young adult patients.

scholarly journals 204. Factors Impacting Fertility Preservation Decision-Making Among Transgender Adolescents And Young Adults

2019 ◽  
Vol 64 (2) ◽  
pp. S104
Author(s):  
Diane Chen ◽  
Moira A. Kyweluk ◽  
Afiya Sajwani ◽  
Elisa J. Gordon ◽  
Emilie K. Johnson ◽  
...  
Keyword(s):  
Decision Making ◽  
Young Adults ◽  
Fertility Preservation ◽  
Adolescents And Young Adults
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