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In 2015, 90% of US young adults with Internet access used social media. Digital and social media are highly prevalent modalities through which young adults explore identity formation, and by extension, learn and transmit norms about health and risk behaviors during this developmental life stage. The purpose of this study was to provide updated estimates of social media use from 2014 to 2016 and correlates of social media use and access to digital technology in data collected from a national sample of US young adults in 2016. Young adult participants aged 18-24 years in Wave 7 (October 2014, N=1259) and Wave 9 (February 2016, N=989) of the Truth Initiative Young Adult Cohort Study were asked about use frequency for 11 social media sites and access to digital devices, in addition to sociodemographic characteristics. Regular use was defined as using a given social media site at least weekly. Weighted analyses estimated the prevalence of use of each social media site, overlap between regular use of specific sites, and correlates of using a greater number of social media sites regularly. Bivariate analyses identified sociodemographic correlates of access to specific digital devices. In 2014, 89.42% (weighted n, 1126/1298) of young adults reported regular use of at least one social media site. This increased to 97.5% (weighted n, 965/989) of young adults in 2016. Among regular users of social media sites in 2016, the top five sites were Tumblr (85.5%), Vine (84.7%), Snapchat (81.7%), Instagram (80.7%), and LinkedIn (78.9%). Respondents reported regularly using an average of 7.6 social media sites, with 85% using 6 or more sites regularly. Overall, 87% of young adults reported access or use of a smartphone with Internet access, 74% a desktop or laptop computer with Internet access, 41% a tablet with Internet access, 29% a smart TV or video game console with Internet access, 11% a cell phone without Internet access, and 3% none of these. Access to all digital devices with Internet was lower in those reporting a lower subjective financial situation; there were also significant differences in access to specific digital devices with Internet by race, ethnicity, and education. The high mean number of social media sites used regularly and the substantial overlap in use of multiple social media sites reflect the rapidly changing social media environment. Mobile devices are a primary channel for social media, and our study highlights disparities in access to digital technologies with Internet access among US young adults by race/ethnicity, education, and subjective financial status. Findings from this study may guide the development and implementation of future health interventions for young adults delivered via the Internet or social media sites.

In contrast to previous perceptions that inflammatory bowel disease (IBD) patients are generally malnourished and underweight, there is mounting evidence to suggest that rates of obesity in IBD now mirror that of the general population. IBD is an immune-mediated condition that appears to develop in individuals who have not only a genetic predisposition to immune dysregulation but also likely exposure to various environmental factors which further potentiate this risk. With the surge in obesity alongside the rising incidence of IBD, particularly in developing nations, the role that obesity may play, not only in the pathogenesis but also in the natural history of disease has become a topic of growing interest. Currently available data exploring obesity's impact on the natural history of IBD are largely conflicting, potentially limited by the use of body mass index as a surrogate measure of obesity at varying time points throughout the disease course. While there are pharmacokinetic data to suggest possible detrimental effects that obesity may have on the response to medical therapy, results in this realm are also inconsistent. Moreover, not only is it unclear whether weight loss improves IBD outcomes, little is known about the safety and efficacy of available weight-loss strategies in this population. For these reasons, it becomes increasingly important to further understand the nature of any interaction between obesity and IBD.

Volleyball is an under-researched sport, particularly in relation to risk factors for head impacts and sports-related concussion (SRC). This study aimed to estimate the self-reported lifetime prevalence of SRC, post-injury help-seeking behaviour, and associations between SRC and age, sex at birth, playing experience, playing league, and playing position. A cross-sectional study was conducted using an online questionnaire to examine lifetime prevlaance and associations between SRC and personal and sport-related factors. The questionnaire collected demographic information, SRC history, and help-seeking behaviour. Descriptive statistics were used to estimate SRC prevalence and help-seeking behaviours among players with a history of SRC. A mixed-effect binary logistic model was conducted at a univariable and multivariable level to assess associations between SRC with playing experience, league, position, age, and gender. A total of 74 volleyball players, 44 females and 30 males, completed the questionnaire. The estimated self-reported lifetime prevalence of SRC was 35% (males 33%, females 36%). Medical support was limited both during and following a SRC. Only 39% of players reporting a SRC were diagnosed, with just 23-27% seeking medical help. Older and more experienced athletes had higher odds of reporting SRC. Those aged 28 years and above showed greater odds (OR=4.58-8.91) of reporting a SRC compared to those aged 16-21, and those with more than 13 years of experience showed greater odds (OR=4.04-9.51) than those with 1-3 years' experience. Professional players showed reduced odds (OR=0.05) compared to high school and university players in the multivariable model. SRC occur in volleyball with a lifetime prevalence of 35%, yet many incidents go undiagnosed and unmanaged. Older, more experienced players had greater odds of reporting a SRC, while professional-level athletes showed reduced odds when all factors are considered. Increased awareness and appropriate guidance are needed across all levels in volleyball.

With many teens having to transition from a mainly educational system of support to a set of health and social service systems (Shattuck et al. in Autism Res Treat https://doi.org/10.1155/2014/924182 , 2017), there is a critical need to advance research and support services in the area of autism and transition to aid autistic* individuals and their families. This study aims to learn more about the experiences of caregivers of autistic young adults, their experiences navigating the transition process post-graduation, and what realistic steps could be undertaken by high schools, vocational schools, colleges, Regional Centers, and places of employment to ease this transition. Ten semi-structured interviews were conducted with caregivers of autistic young adults over the age of 18 focused on their experiences helping their children navigate the transition to adulthood. Using an iterative and inductive coding approach, three overarching themes were uncovered with twelve subthemes. The three major themes recurring in caregiver interviews were their experiences with navigating service receipt, exploring the landscape of opportunities available for their children, and the parent experiences specific to their role in their child’s transition into adulthood. Findings from this study provide a chance for stakeholders to learn from the lived experiences of caregivers navigating the frustration and confusion pertaining to transition for their autistic adult child due to the highly prohibitive access to service receipt, experiencing significant financial burdens, finding a niche for their children that fits their needs, desires, and talents, and managing their well-being.

Approximately 3–4 boys for every girl meet the clinical criteria for autism in studies of community diagnostic patterns and studies of autism using samples of convenience. However, girls with autism have been hypothesized to be underdiagnosed, possibly because they may present with differing symptom profiles as compared to boys. This secondary data analysis used the National Database of Autism Research (NDAR) to examine how gender and symptom profiles are associated with one another in a gold standard assessment of autism symptoms, the Autism Diagnostic Observation Schedule II (ADOS-II; Lord, C., Luyster, R., Guthrie, W., & Pickles A. (2012a). Patterns of developmental trajectories in toddlers with autism spectrum disorder. Journal of Consulting and Clinical Psychology , 80 (3):477–489. https://doi.org/10.1037/a0027214 . Epub 2012 Apr 16. PMID: 22506796, PMCID: PMC3365612). ADOS-II scores from 6183 children ages 6–14 years from 78 different studies in the NDAR indicated that gender was a significant predictor of total algorithm, restrictive and repetitive behavioral, and social communicative difficulties composite severity scores. These findings suggest that gender differences in ADOS scores are common in many samples and may reflect on current diagnostic practices.

Patients and caregivers play a central role in health care safety in the hospital, ambulatory care setting, and community. Despite this, interventions to promote patient engagement in safety are still underexplored. We conducted an overview of review articles on patient engagement interventions in safety to examine the current state of the evidence. Of the 2,795 references we evaluated, 52 articles met our full-text inclusion criteria for synthesis in 2018. We identified robust evidence supporting patients' self-management of anticoagulation medications and mixed-quality evidence supporting patient engagement in medication and chronic disease self-management, adverse event reporting, and medical record accuracy. Promising modes of patient engagement in safety, such as anticoagulation management and patient portal access, are not widely implemented. We discuss major implementation priorities and propose directions for future research and policy to enhance patient partnership within safety efforts.

Recent research has suggested that autism may present differently in girls compared to boys, encouraging the exploration of a sex-differential diagnostic criteria. Gender differences in diagnostic assessments have been shown on the ADOS-II, such that, on average, females score significantly lower than males on all scales and are less likely to show atypicality on most items related to social communicative difficulties. Yet, gender differences in the latent structure of instruments like the ADOS-II have not been examined systematically. As such, this secondary data analysis examined 4,100 youth diagnosed with autism (M = 9.9, 813 female & 3287 male) examined item response trends by gender on the ADOS-II Module 3. Multi-Group Confirmatory Factor Analysis results show that the factor loadings of four ADOS-II items differ across the genders. One SCD item and one RRB item are strongly related to the latent factor in the female group, while two RRB items have larger factor loadings in the male group. The assumption of an identical latent factor structure for the ADOS-II Module 3 for males and females might not be justifiable. Possible diagnostic implications are discussed.

Xylans are the most abundant plant heteropolysaccharides and can account for over one-third of the content of cell walls in biomass. Xylans crystallize from dilute aqueous solution into crystal hydrates. Since lignin is closely associated with xylans in cell walls, we investigated the effect of residual lignin on crystal formation. We used β-(1 → 4) xylans from esparto grass, with and without 15% co-precipitated lignin. The xylan sample with lignin formed quasi-hexagonal platelets 605 nm in diameter, which were similar in morphology to those from the delignified xylan preparation. Crystallization, in this case, could serve as a mechanism for acquiring highly homogeneous and purified xylans. We then used Arabidopsis xylans that either contained or were deficient in glucuronic and 4-O-methylglucuronic acid sidechains—from wild-type and gux1/gux2 mutant plant lines, respectively—to test the effect of sidechains on xylan crystallization. We found that sidechains significantly impacted crystal dimensions, as xylans from wild-type Arabidopsis with sidechains formed smaller but highly crystalline nanoscale platelets with an average diameter of 412 nm. Xylans from the Arabidopsis mutant lacking sidechains formed spherulitic superstructures up to 5 microns in diameter. These spherulitic structures could be fragmented into crystallites measuring 46 nm by 27 nm. This study builds upon earlier xylan crystallization research, reporting, for the first time, on the preparation of a nanoparticle other than nanocellulose from a mutant plant line. Xylan hydrate crystals described herein expand the bioproduct repertoire for xylans and show that crystals with varying morphologies can be formed from a variety of xylan structures and purities.