Effect of Age and Sex on Stroke Mortality of Young and Middle-aged Adults in China,2002–2019,and Predictions to 2030

Objective This study aimed to examine the trends in stroke mortality among young and middle-aged adults in China.Methods Data were obtained from the China national vital registration system.Significant changes in mortality were assessed by Joinpoint regression.Age-period-cohort analysis was used to explain the reasons for the changes.Future mortality and counts were predicted by the Bayesian age-period-cohort model.Results Between 2002 and 2019,a total of 6,253,951 stroke mortality in young and middle-aged adults were recorded.The age-adjusted mortality rates(AAMRs)of women showed a downward trend.The annual percent changes(APC)were-3.5%(-5.2%,-1.7%)for urban women and-2.8%(-3.7%,-1.9%)for rural women.By contrast,the AAMRs per 100,000 for rural men aged 25–44 years continued to rise from 9.40 to 15.46.The AAMRS for urban men aged 25–44 years and urban and rural men aged 45–64years did not change significantly.Between 2020 and 2030,the projected stroke deaths are 1,423,584 in men and 401,712 in women.Conclusion Significant sex and age disparities in the trends of stroke mortality among young and middle-aged adults were identified in China.Targeted health policy measures are needed to address the burden of stroke in the young generation,especially for rural men,with a focus on the prevention and management of high risk factors.

Correlation between psychological traits and the use of smart medical services in young and middle-aged adults: An observational study

BACKGROUND Psychological problems affect economic development.However,there is a huge gap between mental health service resources and mental health service needs.Existing mental health service technology and platforms cannot meet all the diverse mental health needs of people.Smart medicine is a new medical system based online that can effectively improve the quality and efficiency of medical services and make mental health services accessible.AIM To explore the level of intelligent medical use among young and middle-aged people and its correlation with psychological factors.METHODS Convenience sampling was used to select 200 young and middle-aged patients with medical experience at the Third People's Hospital of Chengdu between January 2022 and January 2023 as the research subjects.The general condition Questionnaire,Eysenck Personality Questionnaire,Symptom Checklist-90,General Health Questionnaire,and Smart Medical Service Use Intention Questionnaire were used to collect data.Pearson’s correlation was used to analyze the correlation between the participants’willingness to use smart medical services and their personality characteristics,psychological symptoms,and mental health.RESULTS The results revealed that the mental health of young and middle-aged people was poor,and some had psycho-logical problems such as anxiety,depression,and physical discomfort.Familiarity,acceptance,and usage of smart healthcare in this population are at a medium level,and these levels correlate with psychological characteristics.Acceptance was positively correlated with E,and negatively correlated with P,anxiety,fear,anxiety/insomnia,and social dysfunction.The degree of use was negatively correlated with P,obsessive-compulsive symptoms,depression,anxiety,hostility,paranoia,and somatic symptoms.CONCLUSION The familiarity,acceptance,and usage of smart medical services among the middle-aged and young groups are related to various psychological characteristics.

Validity and Reliability of a Mental Health Recovery Checklist for Young Adults

The purpose of the present study is to evaluate the internal consistency and construct validity of a self-report checklist measuring clinical mental health recovery across six key domains:family and relationships,occupation and school,physical health,mental health,spirituality,and social support systems.The Mental Health Recovery Checklist(MHRC)was developed at The Dorm,an intensive outpatient mental health treatment program for young adults in New York,NY,and Washington DC that services individuals between the ages of 18 and 35 years old.The present study is cross-sectional,as data were pulled from clients’records who were discharged between January 2018 and May 2023.Pearson Correlations and Cronbach’s alpha were used to determine scale reliability.To establish validity,an Exploratory Factor Analysis(EFA)was conducted to assess a single-factor model using Principal Axis Factoring.Cronbach’s alpha was high(α=0.88),indicating good reliability.In the EFA,all items loaded strongly on a single factor.The unidimensional structure revealed in the EFA highlights the interconnected nature of various life domains as they pertain to mental health recovery in young adults.Future research is warranted to explore whether there are additional dimensions of mental health recovery that have not been assessed in the present scale.

Multimodal abnormalities of brain structures in adolescents and young adults with major depressive disorder:An activation likelihood estimation meta-analysis

BACKGROUND Major depressive disorder(MDD)in adolescents and young adults contributes significantly to global morbidity,with inconsistent findings on brain structural changes from structural magnetic resonance imaging studies.Activation likeli-hood estimation(ALE)offers a method to synthesize these diverse findings and identify consistent brain anomalies.METHODS We performed a comprehensive literature search in PubMed,Web of Science,Embase,and Chinese National Knowledge Infrastructure databases for neuroi-maging studies on MDD among adolescents and young adults published up to November 19,2023.Two independent researchers performed the study selection,quality assessment,and data extraction.The ALE technique was employed to synthesize findings on localized brain function anomalies in MDD patients,which was supplemented by sensitivity analyses.RESULTS Twenty-two studies comprising fourteen diffusion tensor imaging(DTI)studies and eight voxel-based morphome-try(VBM)studies,and involving 451 MDD patients and 465 healthy controls(HCs)for DTI and 664 MDD patients and 946 HCs for VBM,were included.DTI-based ALE demonstrated significant reductions in fractional anisotropy(FA)values in the right caudate head,right insula,and right lentiform nucleus putamen in adolescents and young adults with MDD compared to HCs,with no regions exhibiting increased FA values.VBM-based ALE did not demonstrate significant alterations in gray matter volume.Sensitivity analyses highlighted consistent findings in the right caudate head(11 of 14 analyses),right insula(10 of 14 analyses),and right lentiform nucleus putamen(11 of 14 analyses).CONCLUSION Structural alterations in the right caudate head,right insula,and right lentiform nucleus putamen in young MDD patients may contribute to its recurrent nature,offering insights for targeted therapies.

Determinants of Knowledge, Attitudes, and Practices among Young Adults Type 2 Diabetes Patients in Selected Tertiary Hospitals in Shandong Province, China

Objective: The purpose of this study is to understand the current situation of knowledge, attitude, and practice of self-management in young patients with type 2 diabetes mellitus (T2DM) and to explore the relationship between general conditions (personal, social, and environment, clinical factors) and their knowledge, attitude, and practices (KAP) of diabetes self-management, This aims to provide patients with high-quality nursing care management and services, as well as to provide relevant recommendations for effective self-management. Methods: This study is a descriptive correlational study that used the purposive sampling method to investigate 359 patients with T2DM aged 18-25 years in four designated tertiary hospitals in Shandong Province. Results: Knowledge of self-management was correlated with sex, age, education level, occupation and work situation, monthly household income, medical payment method, family and friend support, frequency of diabetes health education, and diabetes complications. The attitude subscale was correlated with sex, age, education level, work situation, and family and friend support. The practice subscale was associated with age, education level, work situation, family and friend support, frequency of diabetes health education, and HbA1c values. Conclusion: Young adults aged 18-25 with T2DM have positive attitudes towards diabetes self-management, but there are still deficiencies in knowledge acquisition and behavioral practice. The KAP of self-management of diabetes is influenced by personal factors such as sex, age, and education level, and socio-environmental factors such as family income and family or friends’ social support. Additionally, clinical factors such as complications and HbA1c values significantly impacted the patient’s disease self-management ability.

Influencing factors of fatigue in young and middle-aged patients with coronary heart disease:a cross-sectional study

Objective:To examine the present state of fatigue in young and middle-aged patients with coronary heart disease(CHD)and to identify the elements that may be affecting it.Methods:From December 2020 to June 2021,240 young and middle-aged patients with CHD who were being treated in the cardiology department of a tertiary care hospital in Suzhou were chosen using a convenience sampling method in order to gather data on the patients’sociodemographic status,fatigue,social support,and stress.Results:Of the 240 disseminated questionnaires,220 valid responses were returned,resulting in an effective recovery rate of 91.67%.The frequency of exhaustion was 51.8%,and the fatigue score was(5.27±2.77).The stress score was(11.15±3.36),while the overall social support score was(39.13±4.72).Binary logistic regression analysis indicated that age,exercise,staying up late,stress,social support,high-sensitivity troponin T,high-density lipoprotein,and ejection fraction were independent risk factors for fatigue in young and middle-aged patients with CHD(P<0.05).Conclusions:Fatigue is more prevalent in young and middle-aged patients with CHD.Clinical nurses can create a unique management plan for patients based on their lifestyle and behavioral patterns,stress levels,social support,and clinical signs to reduce fatigue.

The Relationship between Mental Health Literacy and Subjective Well-Being of Young and Middle-Aged Residents: Perceived the Mediating Role of Social Support and Its Urban-Rural Differences

This study investigates mental health literacy among young and middle-aged urban and rural residents and the differences in mental health literacy,perceived social support and subjective well-being.From January to February 2022,620 participants(320 rural and 300 urban residents)from three provinces of China were selected by con-venience sampling.A general data questionnaire,mental health literacy scale,perceived social support scale and subjective well-being scale were administered.The mental health literacy scores of urban residents were 3.34±0.57 and those of rural residents were 2.73±0.79.The results of multiple regression analysis showed that the mental health literacy scores of rural residents were more significant than those of urban residents in terms of sex and age,while urban residents’mental health literacy scores were more significant than those of rural resi-dents in terms of monthly income.Mental health literacy,perceived social support and subjective well-being of young and middle-aged urban and rural residents were all positively correlated(P<0.01).While the level of mental health literacy is better among urban residents than rural residents,perceived social support plays a partial mediating role between mental health literacy and subjective well-being of both urban and rural residents,and should be the focus of researchers seeking to improve the level of well-being of residents.

Effects of long COVID-19 among young adults in Turkey:A cross-sectional study

Objective:To investigate the cognitive state,psychological problems such as depression and anxiety,and pain in the musculoskeletal system among young adults with post-COVID-19(long COVID)syndrome.Methods:This descriptive study included 361 students studying at the Vocational School of Health Services of Bingöl University in Turkey.Data were collected using the Socio-Demographic Information form,the Beck’s Depression Inventory,the Cognitive Appraisal Scale,and the Visual Analogue Scale for pain.Results:Compared to those without COVID-19,the mean depression score,cognitive appraisal score,and mean Visual Analogue Scale score of the young adults with COVID-19 were significantly higher.There was no significant difference in pain assessment at rest between those with COVID-19 and those without COVID-19.Conclusions:Young adults with COVID-19 are more depressed,their cognitive functions are more easily negatively affected,and experience more pain during exercise.

Video-Based Interventions for Adolescents and Young Adults with Autism Spectrum Disorder:A Systematic

Many individuals with autism spectrum disorder(ASD)experience delays in the development of social and communications skills,which can limit their opportunities in higher education and employment resulting in an overall negative impact to their quality of life.This systematic review identifies 15 studies that explored the effectiveness of Video-Based Interventions(VBIs)for those with ASD during the critical years of adolescence and young adulthood.The 15 studies described herein found this to be an effective intervention for this population for the improvement of their vocational,daily living,and academic skills.In addition,VBIs allow for the maintenance and generalization of the different target behaviors that were examined.The majority of the studies located by this review also investigated the social validity of the intervention method with participants and caregivers and found these VBIs to have high social validity.Although a few studies that implemented VBIs to improve academic skills were located,the research on their use in this area was found to be lacking,indicating a gap in the research on VBIs.Increased usage of VBIs—including video modeling and video prompting—with the target population of those aged 15–28 with ASD is recommended with specific attention given to the use of VBIs to improve the academic and social skills of adolescents and young adults with ASD.

Maturity-onset diabetes of the young type 9 or latent autoimmune diabetes in adults:A case report and review of literature

BACKGROUND Maturity-onset diabetes of the young(MODY)is a monogenic genetic disease often clinically misdiagnosed as type 1 or type 2 diabetes.MODY type 9(MODY9)is a rare subtype caused by mutations in the PAX4 gene.Currently,there are limited reports on PAX4-MODY,and its clinical characteristics and treatments are still unclear.In this report,we described a Chinese patient with high autoimmune antibodies,hyperglycemia and a site mutation in the PAX4 gene.CASE SUMMARY A 42-year-old obese woman suffered diabetes ketoacidosis after consuming substantial amounts of beverages.She had never had diabetes before,and no one in her family had it.However,her autoantibody tested positive,and she managed her blood glucose within the normal range for 6 mo through lifestyle interventions.Later,her blood glucose gradually increased.Next-generation sequencing and Sanger sequencing were performed on her family.The results revealed that she and her mother had a heterozygous mutation in the PAX4 gene(c.314G>A,p.R105H),but her daughter did not.The patient is currently taking liraglutide(1.8 mg/d),and her blood glucose levels are under control.Previous cases were retrieved from PubMed to investigate the relationship between PAX4 gene mutations and diabetes.CONCLUSION We reported the first case of a PAX4 gene heterozygous mutation site(c.314G>A,p.R105H),which does not appear pathogenic to MODY9 but may facilitate the progression of latent autoimmune diabetes in adults.

Association of fatigue with short-term prognosis in young and middle-aged patients with coronary heart disease

Background:To investigate the effect of fatigue on the short-term prognosis of young and middle-aged patients with coronary heart disease(CHD).Methods:A cross-sectional,observational survey was distributed at a tertiary hospital in Suzhou,China.Patients were assessed for fatigue and their prognosis was assessed at 3 and 6 months after discharge.General Information Questionnaire,Fatigue Scale and Seattle Angina Questionnaire(SAQ)were used for the survey.The Cox proportional hazard model was used to analyze the impact of fatigue on the occurrence of major adverse cardiac events(MACEs)at 3 and 6 months after discharge.Multiple linear regression models were used to analyze the effect of fatigue on health-related quality of life(HRQoL)at 3 and 6 months after discharge.Results:199 patients were followed up with in the end.43 patients(21.6%)with MACE three months after discharge had a total SAQ score of(399.76±39.61).The overall SAQ score was(425.14±22.66)and 52 patients(26.1%)experienced MACE six months after discharge.Fatigue was identified as a risk factor for MACE 6 months after discharge by the Cox proportional hazard model(HR=2.939,95%CI:0.177~0.655,P=0.001)and as an independent risk factor for quality of life 3 and 6 months after discharge by multiple linear regression(P<0.001).Conclusions:In individuals who are young or middle-aged and have coronary heart disease,fatigue is a risk factor for the short-term prognosis.It is advised that clinical professionals prioritize patient fatigue assessment and improve management of fatigue symptoms.

Excessive 5-year weight gain predicts metabolic syndrome development in healthy middle-aged adults

AIM:To quantitatively examine the impacts of an easyto-measure parameter-weight gain-on metabolic syndrome development among middle-aged adults. METHODS:We conducted a five-year interval observational study.A total of 1384 middle-aged adults not meeting metabolic syndrome(MetS)criteria at the initial screening were included in our analysis.Baseline data such as MetS-components and lifestyle factors were collected in 2002.Body weight and MetS-components were measured in both 2002 and 2007.Participants were classified according to proximal quartiles of weight gain(WG)in percentages(%WG≤1%,1%< %WG≤5%,5%<%WG≤10%and%WG>10%, defined as:control,mild-WG,moderate-WG and severe-WG groups,respectively)at the end of the follow-up. Multivariate models were used to assess the association between MetS outcome and excessive WG in the total population,as well as in both genders. RESULTS:In total,175(12.6%)participants fulfilled MetS criteria within five years.In comparison to the control group,mild-WG adults had an insignificant risk for MetS development while adults having moderate-WG had a 3.0-fold increased risk for progression to MetS [95%confidence interval(CI),1.8-5.1],and this risk was increased 5.4-fold(95%CI,3.0-9.7)in subjects having severe-WG.For females having moderate-and severe-WG,the risk for developing MetS was 3.6(95% CI,1.03-12.4)and 5.5(95%CI,1.4-21.4),respectively. For males having moderate-and severe-WG,the odds ratio for MetS outcome was respectively 3.0(95%CI, 1.6-5.5)and 5.2(95%CI,2.6-10.2). CONCLUSION:For early-middle-aged healthy adults with a five-year weight gain over 5%,the severity of weight gain is related to the risk for developing metabolic syndrome.

Examining Social Media and Technology Attitudes in Older-Aged and Middle-Aged Adults: Relationship With Cognitive Flexibility and Sense of Inadequacy

The main purpose of this study is to reveal the relationship between the perceived cognitive flexibility and sense of inadequacy of older adults and middle adults with their attitudes towards social media use and technology.Of the participants,210(68.2%)were female and 98(31.8%)were male.The sample consisted of 49.4%of middle adults aged between 50-59 years,and a total of 308 adults,50.6%of whom were older adults aged 60 and over.“Personal Information Form”,“Sense of Inadequacy Scale”,“Cognitive Flexibility Scale”,and“Media and Technology Use and Attitudes Scale”were used to collect data in the research.According to the findings of the study,older-and middle-aged adults differed in their sense of inadequacy and cognitive flexibility capacity.A significant difference was found between social media use and technology attitudes of older and middle adults.The findings were discussed within the framework of the relevant literature.

Body mass index and its effects on liver fat content in overweight and obese young adults by proton magnetic resonance spectroscopy technique

AIM To assess the association between liver fat content(LFC) and weight status in young adults using proton magnetic resonance spectroscopy(1H MRS) technique.METHODSSeventy-eight healthy young adults, between 19-30 years of age participated in this study. This group was then separated into a control of 39 subjects and an overweight/obese group(OW/OB group) consisting of 39 subjects. Blood biochemical quantity and 1 H MRS was performed for LFC assessment.RESULTS LFC was found to be almost three times higher in OW/OB group when compared to the control group. A 48.7% incidence of non-alcoholic fatty liver disease in the OW/OB group was found. Blood biochemical measurements showed statistically higher low-density lipoproteins and triglyceride, lower highdensity lipoproteins, and increased glycosylated hemoglobin and fasting glucose in the OW/OB group. Body mass index was a significant independent predictor for LFC after adjusting for age and sex(multiple linear regression; β = 0.459, P <0.001).CONCLUSION Due to the prevalence of high LFC in the OW/OB group, it can be proposed that weight gain and obesity are sensitive indicators of high hepatic fat content.

Choroidal thickness measurements in young Saudi adult population: a cross-sectional study

AIM:To determine the choroidal thickness(CT)in young healthy Saudi adults using spectral-domain optical coherence tomography(SD-OCT)with an automated CT segmentation software.METHODS:Fifty-eight young adults(total of 116 eyes),39 males and 19 females participated in this study between the ages of 18 and 38y(mean 22.65±3.9y).All participants underwent ophthalmic screening examination,including the SD-OCT for measurements of CT in each quadrant egmented into five eccentric regions starting from the foveal region up to 4.5 mm towards the periphery.RESULTS:The choroid was thickest in the foveal region(central 1 mm,300±60μm)and began to progressively thinner beyond the parafovea(1.5–2.5 mm,284±67μm)towards the peripheral region(3.5–4.5 mm from the fovea,254±83μm).The superior choroid showed the thickest profile(309±57μm),while the nasal choroid exhibited the thinnest(229±76μm).The rate of the thinning with increasing eccentricity was more predominant in the nasal choroid,which thinned from the foveal region(294±58μm)to the peripheral region(158±55μm).The superior and inferior choroid did not show a statistically significant thinning with eccentricity(all P>0.05).There was no statistically significant difference in the CT between gender,age,and laterality of the eyes(all P>0.05).A significant association of myopia with thinner subfoveal choroid was observed(Pearson’s,r=0.37),and regression analysis showed that a 10.3μm choroidal thinning for each diopter increase of myopia.CONCLUSION:CT profile depends on eccentric and the quadrant.The CT profile across the measured area in the young Saudi adult population is comparable to other previous reports.Refractive error is critical for CT evaluation.

Digestive cancer incidence and mortality among young adults worldwide in 2020:A population-based study

BACKGROUND Digestive cancer has traditionally been thought of as a disease that mainly occurs in elderly individuals,and it has been ignored in young adults by both patients and physicians.AIM To describe the worldwide profile of digestive cancer incidence,mortality and corresponding trends among 20–39-year-olds,with major patterns highlighted by age,sex,development level,and geographical region.METHODS I performed a population-based study to quantify the burden of young adult digestive cancers worldwide.Global,regional,sex,and country-specific data estimates of the number of new cancer cases and cancer-associated deaths that occurred in 2020 were extracted from the GLOBOCAN Cancer Today database.To assess long-term trends in young adult digestive cancer,cancer incidence data and mortality data were obtained from the Cancer in Five Continents Plus database and the World Health Organization mortality database,respectively.The associations between the human development index(HDI)and digestive cancer burden in young adults were evaluated by linear regression analyses.RESULTS In 2020,there were an estimated 19292789 new cancer cases,resulting in 9958133 deaths worldwide,which equated to an age-standardized incidence rate(ASIR)of 5.16 and age-standardized mortality rate(ASMR)of 3.04,accounting for 12.24%of all new cancer cases and 25.26%of all cancer deaths occurring in young adults.The burden was disproportionally greater among males,with male:female ratios of 1.34 for incidence and 1.58 for mortality.The ASIRs were 2.1,1.4,and 1.0 per 100000 people per year,whereas the ASMRs were 0.83,1.1,and 0.62 per 100000 people per year for colorectal,liver,and gastric cancer,respectively.When assessed by geographical region and HDI levels,the cancer profile varied substantially,and a strong positive correlation between the mortality-to-incidence ratio of digestive cancer and HDI ranking was found(R^(2)=0.7388,P<0.001).CONCLUSION The most common digestive cancer types are colorectal,liver and gastric cancer.The global digestive cancer burden among young adults is greater among males and exhibits a positive association with socioeconomic status.The digestive cancer burden is heavy in young adults,reinforcing the need for primary and secondary prevention strategies.

Spontaneous Bilateral Pneumothorax in a Healthy Young Adult: A Comprehensive Case Report

Background: Spontaneous bilateral pneumothorax in healthy young adults is a rare and challenging condition that defies conventional diagnostic and etiological paradigms. This case report explores the presentation, diagnostic evaluation, management, and potential contributing factors in a 29-year-old male with no prior medical history who experienced bilateral spontaneous pneumothoraces. Aim: This case report aims to shed light on the complexities of managing spontaneous bilateral pneumothorax, particularly in the absence of common risk factors. It underscores the need for a thorough assessment and ongoing research to unravel the enigma surrounding this condition. Case Presentation: A healthy 29-year-old male presented with acute chest pain and shortness of breath, ultimately diagnosed with bilateral spontaneous pneumothoraces. Despite the absence of typical risk factors, advanced imaging techniques revealed valuable insights into the diagnosis and management of this unique presentation. Conclusion: Spontaneous bilateral pneumothorax in healthy individuals presents diagnostic challenges and raises questions about potential genetic predisposition, connective tissue disorders, and lifestyle-related triggers. While the acute phase was effectively managed, this case underscores the importance of interdisciplinary collaboration and ongoing research to comprehensively understand this condition.

Awareness and perceived barriers in practicing healthy living to prevent hypertension among young adults in Malaysia

Objective:To investigate the knowledge,attitude,and practice levels and perceived barriers towards healthy living to prevent hypertension among young adults in Malaysia.Methods:Adults aged 18-25 years reside in Malaysia were recruited via convenience sampling.Sociodemographic characteristics,medical knowledge on hypertension(K1),knowledge(K),attitude(A),practice(P)and perceived barriers in practising healthy living to prevent hypertension were assessed.Average scores were categorised into good(80%-100%),upper-moderate(70%-79%),lower-moderate(60%-69%)and poor(<60%).Multivariate analysis was performed to test the difference and relationship of variables.Pearson correlation test was used to test the association of two continuous variables.Results:A total of 1218 respondents participated in this survey.The mean score of K1 was 54.1%,while the knowledge,attitude,and practice towards healthy living were 82.7%,78.2%and 68.5%respectively.The prevalence of high salt intake,high fat intakes,low fibre intake,sedentary lifestyle and lack of annual health screening was 83.2%,81.4%,70.3%,and 73.2%,respectively.Abnormal BMI was associated with low P scores,while lower socio-economic status,unawareness of self-blood pressure reading and those without family history of hypertension were associated with lower scores in K1,K,A,and P.K1,K,A and P are significantly inter-related.The main perceived barriers included self-proclaimed good fit status,frequent consumption of out-of-home food,and addiction to high salt/fat food.Conclusions:The national strategies for health management should be prioritized in reducing salt and fat,promoting annual health screening,physical activities and fibre intake in this age group.

Different risk factors for advanced colorectal neoplasm in young adults

AIM: To compare the risk of developing advanced colorectal neoplasm(ACRN) according to age in Koreans.METHODS: A total of 70428 Koreans from an occupational cohort who underwent a colonoscopy between 2003 and 2012 at Kangbuk Samsung Hospital were retrospectively selected. We evaluated and compared odds ratios(OR) for ACRN between the young-adults(YA < 50 years) and in the older-adults(OA ≥ 50 years). ACRN was defined as an adenoma ≥ 10 mm in diameter, adenoma with any component of villous histology, high-grade dysplasia, or invasive cancer.RESULTS: In the YA group, age(OR = 1.08, 95%CI: 1.06-1.09), male sex(OR = 1.26, 95%CI: 1.02-1.55), current smoking(OR = 1.37, 95%CI: 1.15-1.63), family history of colorectal cancer(OR = 1.46, 95%CI: 1.01-2.10), diabetes mellitus related factors(OR = 1.27, 95%CI: 1.06-1.54), obesity(OR = 1.23, 95%CI: 1.03-1.47), CEA(OR = 1.04, 95%CI: 1.01-1.09) and low-density lipoprotein-cholesterol(OR = 1.01, 95%CI: 1.01-1.02) were related with an increased risk of ACRN. However, age(OR = 1.08, 95%CI: 1.06-1.09), male sex(OR = 2.12, 95%CI: 1.68-2.68), current smoking(OR = 1.38, 95%CI: 1.12-1.71), obesity(OR = 1.34, 95%CI: 1.09-1.65) and CEA(OR = 1.05, 95%CI: 1.01-1.09) also increased the risk of ACRN in the OA group.CONCLUSION: The risks of ACRN differed based on age group. Different colonoscopic screening strategies are appropriate for particular subjects with risk factors for ACRN, even in subjects younger than 50 years.

Risky Meetings Despite Knowledge of the Risk: A Qualitative Study of Young Adults Treated for Chlamydia Infection at a Sexual Transmitted Infection Clinic

The aim of the study was to describe the attitudes to risk behavior among patients diagnosed with a Chlamydia infection at a Sexual Transmitted Infection (STI) clinic. Qualitative interviews face-to-face were conducted with twenty patients, aged 18 - 30 years, with confirmed Chlamydia infections were included. An interview guide was used and the participants described the behavior that had led to the infection. The material was analyzed using qualitative content analysis. Eighteen informants were included and the theme was risk. Recurrent among the informants was risk behavior in sexual relations when using alcohol, while risk behavior in life in general was almost non-existent. Of the 18 informants, sixteen had previously been tested for STIs, and ten had had an STI before. Alcohol consumption emerged as a common denominator among the informants and as a contributor to risk. In contrast, almost none of the informants exposed themselves to any unnecessary risks in life in general.