O carcinoma epidermoide da região da cabeça e pescoço (CECP) é uma doença de alta prevalência, no Brasil e no mundo, e com grande impacto na qualidade de vida dos pacientes. Mais frequentemente, ocorre em pacientes ao redor da sexta década de vida, com longo histórico de tabagismo e etilismo. Nota-se, porém, um importante aumento na sua incidência em uma população mais jovem, em geral sem histórico de exposição duradoura aos fatores de risco clássicos, o que nos faz questionar se não se trata de uma doença de características distintas. Os objetivos deste estudo foram avaliar aspectos demográficos, clínicos e anatomopatológicos de pacientes com CECP em uma faixa etária inferior a 40 anos, comparando-os com pacientes de maior idade, especialmente em relação à sobrevida, exposição a fatores de risco, expressão de marcadores biológicos em amostras tumorais e não tumorais (margens livres de doença), bem como a presença do Papilomavirus Humano (HPV). Realizou-se estudo transversal de pacientes com carcinomas de cavidade oral (exceto lábio), orofaringe, laringe e hipofaringe, prospectivamente incluídos em um banco de tumores de CECP no período de 2002 a 2010 pelo grupo de pesquisa GENCAPO. Foram coletados dados demográficos, clínicos e patológicos para ambos os grupos de doentes, e realizou-se uma análise por pareamento em relação aos marcadores imunoistoquímicos p53, Ki-67, EGFR, VEGF e p16, em amostras tumorais e de mucosas normais. As análises de sobrevida global e livre de doença, bem como as comparações entre o tabagismo e o etilismo foram feitas com a população total da amostra. A incidência de tabagismo foi menor nos pacientes <40 anos (p=0,048), mas não a de etilismo (p=0,079), no entanto a carga tabágica foi menor entre os pacientes jovens (p<0,0001), bem como a carga etílica (p=0,012). As quantificações de imunoexpressão dos marcadores em amostras tumorais não foram diferentes entre os grupos para p53 (p=0,535), Ki-67 (p=0,669), EGFR (p=0,074), VEGF (p=0,423) e p16 (p=0,125). A análise de amostras não tumorais não mostrou diferença para os marcadores p53(p=0,570), EGFR (p=0,945) e VEGF (p=0,700). A expressão de Ki-67 foi menor em pacientes <40 anos (p=0,021). O HPV tipo 16 foi positivo em um caso de orofaringe em uma paciente (entre cinco) <40 anos, e em nenhum caso de cavidade oral e de laringe. O HPV tipo 18 foi negativo em todos os casos, de ambos os grupos. Na análise de sobrevida, foi observado que a sobrevida global de toda a coorte não mostrou diferença entre os grupos (p=0,754), mesmo se estratificarmos para cavidade oral (p=0,825), laringe (p=0,769) e orofaringe (p=0,891). A sobrevida livre de doença também não foi diferente entre os grupos (p=0,408), mesmo em se estratificando para cavidade oral (p=0,473), laringe (p=0,736) e orofaringe (p=0,510) em cinco anos. No entanto, a sobrevida livre de doença foi menor em pacientes <40 anos no primeiro ano (p=0,042). Na análise univariada, o estádio avançado e o etilismo foram associados a maior risco de morte para todos os sítios (p=0,010) e, na análise multivariada, além do estádio avançado (p=0,013), o etilismo foi fator de maior risco de morte para os casos de câncer de Laringe (p=0,024). Assim, concluímos que o CECP em pacientes com idade <40 anos não foi diferente, em relação às características anatomopatológicas testadas, e à imunomarcação para p53, Ki-67, EGFR, VEGF e p16 em relação aos CECPs em pacientes >=40 anos. O tabagismo e o etilismo foram menos intensos entre os pacientes <40 anos, e a positividade para o HPV foi muito baixa para todos os pacientes. A Sobrevida Global foi semelhante entre os grupos, embora o paciente <40 anos tenha apresentado maior índice de recidivas precoces / Head and Neck Squamous Cell Carcinoma (HNSCC) is a major health problem, in Brazil and around the World, due to its prevalence and impact in the quality of life of these patients. It usually occurs in the 6th and 7th, with an intensive exposure to the tobacco and alcohol. However, an increasing number of patients under 40 years is being affected by these tumors, which raises the hypothesis of different features of the disease in younger patients. The objectives of this study were to test if demographic, clinical and pathological aspects of patients with HNSCC vary according to the age, by comparing them with older patients in terms of survival, alcohol and tobacco exposure, HPV positivity through polymerase chain reaction (PCR), and biomarkers in tumor and non-tumoral samples of the aerodigestive tract. We conducted a cross-sectional study of patients with oral cavity (lips excluded), oropharynx, hypopharynx and larynx prospectively included in a multi-institutional HNSCC tumor bank - GENCAPO, from February 2002 to March 2010.Demographic, clinical and pathological data were analyzed. Using matched-pair analysis, we compared young and older patients in relation to immunohistochemical stainig of p53, Ki-67, EGFR, VEGF and p16 biomarkers in tumor and non-tumoral samples. Survival analyses, as well as exposition to tobacco and alcohol use, were performed taking into account the entire cohort. The incidence of tobacco use was lower in the young group (p=0,048), but not for alcohol use (p=0,079), and young patients had a lower lifelong cumulative exposure to tobacco (p<0,0001) and to alcohol (p=0,012). We found no differences in the stainig of tumoral samples for p53 (p=0,535), Ki-67 (p=0,669), EGFR (p=0,074), VEGF (p=0,423) and p16 (p=0,125). The analysis of the non tumoral samples was not different for p53 (p=0,570), EGFR (p=0,945) and VEGF (p=0,700). Expression of Ki-67 was lower in the young group (p=0,021). Analysis of p16 in non tumoral sites was not performed. HPV type-16 was positive in one case (in five) of oropharynx tumor, and in none of the cases of oral cavity and larynx. HPV type-18 was negative in all cases. In the Survival Analysis, the global survival among groups was not different for the entire cohort (p=0,754), and considering the cases of oral cavity (p=0,825), larynx (p=0,769) and oropharynx (p=0,891). The Free-disease Interval in five years was also not different for the entire cohort (p=0,408), and in cases of oral cavity (p=0,473), larynx (p=0,736) and oropharynx (p=0,510). Nevertheless, the Free-disease survival in one year was lower in the young group (p=0,042, in the entire cohort. In the univariated analysis, the late clinical stage was associated a risk for death in all of the sites (p=0,010). In the multivariated analysis, the late clinical stage was associated to higher risk for death (p=0,013) and, in the cases of tumors of larynx, the alcohol consume was associated to a higher risk for death (p=0,024). We conclude that the HNSCC in patients younger than 40 years was not different, in terms of histopathological aspects, immunoexpression for p53, Ki-67, EGFR, VEGF and p16, when compared with older patients. The tobacco and alcohol use was not so important among young patients, and the positivity for HPV was extremely low in both groups. The Overall Survive was similar among groups, although younger patients had a higher rate of early recurrence

Objectives Different studies have reported the association between perceived stress and unhealthy diet choices. We aimed to determine whether there is a relationship between perceived stress and fat intake among undergraduate medical students. Methods/Principal findings A cross-sectional study was performed including first-year medical students. The outcome of interest was the self-report of fat intake assessed using the Block Screening Questionnaire for Fat Intake (high vs. low intake), whereas the exposure was perceived stress (low/ normal vs. high levels). The prevalence of high fat intake was estimated and the association of interest was determined using prevalence ratios (PR) and 95% confidence intervals (95% CI). Models were created utilizing Poisson regression with robust standard errors. Data from 523 students were analyzed, 52.0% female, mean age 19.0 (SD 1.7) years. The prevalence of high fat intake was 42.4% (CI: 38.2%–46.7%). In multivariate model and compared with those with lowest levels of stress, those in the middle (PR = 1.59; 95%CI: 1.20–2.12) and highest (PR = 1.92; 95%CI: 1.46–2.53) categories of perceived stress had greater prevalence of fat intake. Gender was an effect modifier of this association (p = 0.008). Conclusions Greater levels of perceived stress were associated with higher fat intake, and this association was stronger among males. More than 40% of students reported having high fat consumption. Our results suggest the need to implement strategies that promote decreased fat intake.

Nous avons montré : a) qu’il existe un lien entre la consommation de cannabis et la présence de sténoses artérielles intracrâniennes multifocales chez le jeune adulte victime d’infarctus cérébral, b) que la prévalence des sténoses artérielles intracrâniennes atteint un tiers des cas dans une cohorte de 159 infarctus cérébraux du jeune adulte, c) que 13% des infarctus cérébraux dans cette série répondent aux critères angiographiques du syndrome de vasoconstriction cérébrale réversible déclenché majoritairement par la consommation de cannabis, d) que le tétrahydrocannabinol (THC, le principal produit actif du cannabis) inhibe in vitro la chaîne respiratoire mitochondriale de cerveau de rat, et induit une génération significative de peroxyde d’hydrogène. La génération de radicaux libres pourrait être un des mécanismes possibles de toxicité cérébrale du THC en jeu lors d’un infarctus cérébral. / We showed that: a) there was a link between cannabis use and intracranial arterial multifocal stenosis in a series of ischemic stroke in the young, b) the prevalence of intracranial arterial stenosis was up to 31% in a series of 159 ischemic strokes in the young, c) 13% of the patients in this series sustained the angiographic criteria of reversible cerebral vasoconstriction syndrome, and that the precipitating factor was the use of cannabis in 67% of cases, d) tetrahydrocannabinol (THC, the main active component in cannabis) inhibits the respiratory mitochondrial chain of the brain in rats and induces a significant production of hydrogen peroxide. These results suggest that one of the mechanisms of brain toxicity induced by cannabis in ischemic stroke patients, may be the high rate of generation of free radicals induced by THC

Abstract Recognition of individuals at highest risk for psychosis is challenging and no definitive biomarkers are yet available. Physical illnesses associated with a sedentary lifestyle are common in patients with severe mental illness. Both, bodyweight and risk for psychosis are associated with brain white matter (WM) abnormalities. There are several dysregulated pathways which are common in psychiatric illnesses and weight-related processes, but it is not known how weight and vulnerability for psychosis interact in the brain. The present study examines brain WM microstructure and its association to body mass index (BMI) in young adults with a familial risk for psychosis (FR). In addition, the level of physical activity and cardiorespiratory fitness in individuals vulnerable to psychosis was examined. Participants of the present study are members of the Northern Finland Birth Cohort 1986. Two separate clinical substudies were conducted. The first having been done when the participants were at age 15–16. At that time, physical activity was defined by postal questionnaire (n=6,987) and cardiorespiratory fitness was measured by a submaximal cycle ergometer test (n=4,803). Risk for psychosis was viewed from three perspectives, with possible overlap between groups: having familial risk for psychosis, existing prodromal symptoms at age 15–16, and development of hospital treated psychosis between the ages of 16 and 20 years. The latter substudy was conducted when the participants were aged between 20 and 25 years. Diffusion tensor imaging was performed on 108 participants. Our study showed that there was no difference in WM microstructure between FR and control groups suggesting that WM abnormalities are not a genetic feature for risk of psychosis in all populations. However, the association between BMI and WM microstructure differed significantly between the FR and control groups. We also demonstrated that the level of physical activity was lower before the onset of psychotic illness. Therefore, these results imply that it would be of great importance to consider weight and physical activity levels in subjects at risk for psychosis, in order to avoid the detrimental effects of a sedentary lifestyle on overall health. / Tiivistelmä Korkeimmassa psykoosiriskissä olevien tunnistaminen on haastavaa, eikä kunnollisia biomarkkereita ole käytettävissä. Vähäiseen liikunta-aktiivisuuteen liitetyt fyysiset sairaudet ovat yleisiä vakavaa mielenterveyshäiriötä sairastavilla. Sekä kehonpaino että psykoosialttius on yhdistetty aivojen valkean aineen rakenteen poikkeavuuksiin. Useat kehon säätelymekanismien poikkeavuudet liittyvät sekä psykiatrisiin sairauksiin että painoon liittyviin prosesseihin, mutta ei ole olemassa tutkimustietoa siitä, miten paino ja psykoosialttius vaikuttavat yhdessä aivojen rakenteeseen. Tässä osajulkaisuväitöskirjassa tutkitaan aivojen valkean aineen mikrorakennetta nuorilla aikuisilla, jotka ovat sukuriskissä sairastua psykoosiin, sekä painon vaikutusta valkean aineen rakenteeseen psykoosiriskissä. Lisäksi tutkitaan psykoosialttiiden nuorten liikunta-aktiivisuutta ja kuntoa. Tutkittavat kuuluvat Pohjois-Suomen vuoden 1986 syntymäkohorttiin. Kaksi osatutkimusta toteutettiin, joista aikaisempi kliininen tutkimus tutkittavien ollessa 15–16-vuotiaita. Tuolloin selvitettiin liikunta-aktiivisuus postikyselyn avulla (n=6,987) ja aerobinen kunto mittaamalla hapenottokyky polkupyöräergometrilla (n=4,803). Psykoosialttiutta tarkasteltiin kolmella tavalla, ja ryhmien välillä esiintyi osittaista päällekkäisyyttä: sukurasitus, 15–16 v. iässä raportoidut psykoosinkaltaiset oireet ja sairaalahoitoon johtanut psykoosi 16–20 v. iässä. Toinen kliininen osatutkimus toteutettiin tutkittavien ollessa 20–25-vuotiaita. Tutkimuksen yhteydessä tehtiin aivojen diffuusiotensorikuvaus 108 osallistuneelle. Aivojen valkean aineen mikrorakenteessa ei havaittu eroa sukuriskissä olevien ja kontrollien välillä viitaten siihen, että poikkeavuudet valkean aineen rakenteessa eivät olisi psykoosiriskin geneettinen piirre kaikissa populaatioissa. Havaitsimme kuitenkin, että assosiaatio painoindeksin ja valkean aineen rakenteen välillä oli erilainen sukuriski- ja kontrolliryhmissä. Tutkimus osoitti myös, että liikunta-aktiivisuus on alentunut jo ennen psykoosisairauden puhkeamista. Psykoosiriskissä olevien liikuntatottumuksiin ja painoon tulisi kiinnittää erityistä huomiota jo varhaisessa vaiheessa elimellisten sairauksien ehkäisemiseksi.

近幾年，青少年在國內圖書館逐漸受到重視，臺灣許多公共圖書館分別成立規劃出青少年空間，有的是圖書館新建立的，有的是重新整建後的。由於臺灣公共圖書館目前尚未有針對圖書館規劃的青少年空間設計指南，因此本研究將從美國青少年圖書館服務學會出版的〈國家青少年空間指南〉作為公共圖書館在規劃青少年空間的參考依據。希望能了解青少年使用專屬空間的需求與滿意度，規劃出我國青少年空間設計指南，除了提供公共圖書館未來在規劃青少年專屬空間時的參考依據，也能讓圖書館更加重視青少年族群之需求，規劃出更為完善的服務，提高青少年對公共圖書館青少年空間的滿意度，吸引更多潛在的青少年使用者利用圖書館。本研究之研究目的為：（1）探討青少年需求與圖書館青少年空間設計原則；（2）探討青少年對圖書館專屬空間之使用情形與滿意度；（3）探討青少年使用圖書館專屬空間的滿意度影響因素；（4）探討青少年空間改造後的成效。 本研究透過深度訪談及問卷調查探討青少年利用公共圖書館專屬空間之需求與情形，以及其對專屬空間之滿意度與影響因素，建構出四構面28項指標，作為公共圖書館未來在規劃與評估青少年專屬空間時的參考。本研究提出之研究結論如下：（1）最多青少年閱讀的課外讀物類型為小說、漫畫與期刊/雜誌；最多青少年喜愛的資訊主題為休閒娛樂、流行文化與旅遊；（2）青少年每月平均閱讀課外讀物的數量以1-2本最多；平均閱讀時間以1-2小時為主；最多人閱讀課外讀物原因為個人興趣、打發時間、休閒娛樂；（3）青少年使用圖書館的頻率以每週一次最多；使用圖書館青少年空間的頻率以每月至少一次最多；使用青少年空間的原因多為讀書自修或準備考試、閱讀與借閱書籍、環境舒適；（4）青少年最常使用的書籍主題以小說、漫畫、文學/散文為主；最常使用設施與服務為閱讀桌椅與沙發；（5）四館青少年認為青少年空間最重要的服務前五名為滿足我安靜閱讀學習、光線照明充足、安全的場所、乾淨舒適、書籍陳列方式讓我容易找到、書籍種類及數量滿足我的需求；（6）分析四館青少年最滿意的服務項目前五名，發現四館青少年皆滿意青少年為安全的場所、及時找到館員協助；四館青少年皆不滿意青少年空間提供的娛樂項目與飲食需求，以及進行藝術創作；（7）透過四象限圖分析，四館使用者皆迫切需要改善的項目為書籍陳列方式讓我容易找到；（8）28項指標中，尤其在青少年空間的規劃與設計，國中皆較高中（職）認為重要；國資圖使用者特別在青少年空間滿足我飲食需求較其他三館認為重要；（9）級別與館別是影響青少年空間使用滿意度的因素之一；（10）與2012年朱懿幰以及2013強美玟的研究比較，整體來看發現青少年仍希望青少年空間能滿足其在安靜閱讀學習與社交的需求。埔里鎮立圖書館青少年對於空調、閱讀桌椅、資訊查詢仍感到不滿意；（11）四館青少年對圖書館空間改造後感到滿意。 針對本研究的結論，提出以下幾點建議：（1）四間圖書館皆應加強青少年空間的書籍陳列方式；（2）國立臺灣圖書館應重新審視青少年空間提供的環境動線與空間設計；（3）新北市青少年圖書館應加強改善青少年空間的隔音設備，確保能滿足不同使用者的需求；（4）國立公共資訊圖書館應加強青少年空間網路的穩定性；（5）埔里鎮立圖書館應加強青少年空間的空調溫度。 / In recent years, young adults are getting increasingly attention in Taiwan’s libraries. Many public libraries in Taiwan have set up space for young adults, some of which are newly established, and some are re-established. Because there are not space design guidelines about library arrangement for young adults in the public libraries in Taiwan, this research will be based on “The National Teen Space Guidelines,” published by Young Adult Library Services Association in America to arrange young adult spacein public libraries in Taiwan. This study hopes to understand the needs and satisfaction of young adults using young adult space, and to contribute to space design guidelines for young adults in Taiwan's libraries. In addition, this study hopes to provide reference of future arrangement of young adults’ space to public libraries, and to let libraries turn more attention to the needs of young people, and design more comprehensive services to gain young people's satisfaction and to attract more potential young people to use library. The main purposes of the research are as follows: (1) to investigate young adults’ needs and establish principles behind young adult space in libraries; (2) to inquire into satisfaction and circumstances of young adult readers using young adult space in libraries; (3) to investigate the influencing factors behind young adults’ satisfaction with young adult space in libraries; (4) to investigate the effect of the reformation of young’s space. Through questionnaires and interviews, this study investigates young adults’ needs and usage of young adult space in public libraries, their satisfaction with young adult space, and influencing factors behind their satisfaction with young adult space to build four dimensions including 28 indicators for reference to future design of young adult space in public libraries. The statistical analyses of the retrieved questionnaires indicate the following conclusions: (1) the types of books young adults read most frequently are novels, comics and journals/magazines; their favorite topics are recreation, popular cultures and tourism; (2) teenagers usually read two books for extracurricular reading monthly; their average reading time is one or two hours; most of their purposes are personal interests, killing time, and entertainment. (3) the frequency of young adults' use of libraries is once a week; the frequency of young adults' use of young adult space is once a month; the reasons for young adults using young adult space are self-studying or preparing for examinations, reading and borrowing books, and its comfortable environment; (4) the categories of books young adults read most frequently mainly are fiction, comics, and literature/prose; the mostly-used facilities and services are reading tables and sofas; (5) the top five satisfaction items among the four public libraries are “It can satisfy my needs of reading/learning without any disturbance,” “It can provide sufficient light,” “It is a safe, clean and comfortable place,” “Its book arrangement lets me easily find books,” and “The categories and quantity of books can meet my needs.” (6) The analysis of the top five satisfactory services shows that teenagers of the four libraries unanimously agree with the items of “It is a safe place,” and “I can seek help from librarians in time;” on the other hand, they are unanimously unsatisfied with the recreation service, dining space as well as artistic creation; (7) through the four-quadrant map analysis, users of four libraries are in urgent need of the improvement in the item “Its book arrangement lets me easily find books.” (8) among the 28 indicators, junior high school students consider “plan and design of young adult space” more important than senior ones; users of young adult space in National Library of Public Information especially think “It meets my dining needs” more important than users of the other three libraries; (9) "different levels of school and different libraries" is one of the factors that influences the satisfaction of young adults; (10) compared with the study of Chu, Yi-Hsien (2012) and Chiwang, Mei-Wen (2013), teenagers generally hope that young adult space can meet their requirement for studying without any disturbance and socializing. Teenagers in Puli Library are still unsatisfied with air conditioning, reading tables and chairs, and searches for information; (11) teenagers in four libraries are all satisfied with the library space after rearrangement. According to the conclusions, the study suggests as the follows: (1) the four libraries should rearrange the displays of books in youth space; (2) National Taiwan Library should re-examine the environment and space design of its youth space; (3) New Taipei City Teenager Library should improve sound insulation of its youth space, to meet users needs; (4) National Library of Public Information should improve the stability of networks in its youth space; (5) Puli Library should reducethe temperature of its youth space.

Published research suggests that literature should transmit ethnic and societal values as well as reassure one's own confidence and self-respect. This study provides a model for examining Asian-American children's and adolescent literature critically from the perspective of identity issues. It examines fifteen award-winning Asian-American children's and adolescent titles written by writers of that culture and published in the United States from 1999 to 2007, with a focus on Chinese (Taiwanese) American, Korean American, and Japanese American books. As published studies indicate, self, social, and ethnic identities are significantly intertwined. Hence, a content analysis was conducted based on these three major groups of categories. The findings of the study demonstrate that even though the selected books cover all three aspects of the identity issues to a certain degree, a considerably greater number of depictions of ethnic identities are made over those of internal identities and social identities. Moreover, less than half of the main characters assume an active role in improving the difficult situation. Two major voids regarding the presentation of social identities are successful social integration and positive social interactions. Recommendations for teaching, writing, illustrating, publishing, and future research are suggested, including publishing more Asian-American books which present an optimistic outlook on life, active conflict-resolving behaviors, and a balance of gender among individuals with whom the main character interacts.

Introducción: El propósito de la investigación es identificar la relación entre el clima social familiar y la dependencia emocional en jóvenes universitarios con padres separados o divorciados en Lima Metropolitana. Método: Este estudio es empírico que utiliza la estrategia asociativa transversal, la muestra es de 190 participantes (Mujeres= 128 y Hombres=62), con edades que oscilaban entre 18 y 25 años (M=21.92). Se utilizó la Escala de Clima Social Familiar (FES) adaptada por Ruiz y Guerra (1993) y el Cuestionario de Dependencia emocional (CDE), adaptada por Ventura y Caycho en el 2016. Resultados: Se empleó el coeficiente Alpha de Cronbach y Omega, obteniendo valores mayores a .70, reflejando tener adecuadas puntuaciones de fiabilidad. Se obtuvieron correlaciones negativas y estadísticamente significativas en las dimensiones de Clima Social Familiar y la variable Dependencia Emocional con un tamaño del efecto (rrelaciones= -.41; rdesarrollo=-.44; restabilidad=-.34; p < .01) bajo y moderado. Conclusión: Se concluye que, a menores niveles de clima social familiar, están ligados a mayores niveles de dependencia emocional en jóvenes universitarios con padres separados o divorciados. / Background: The purpose of the research is to identify the relationship between family social climate and emotional dependence in university students with separated or divorced parents in Metropolitan Lima. Method: This study is empirical that uses the associative strategy, the sample is 190 participants (Women = 128 and Men = 62), with ages ranging between 18 and 25 years (M = 21.92). The Family Social Climate Scale (FES) adapted by Ruiz and Guerra (1993) and the Emotional Dependency Questionnaire (CDE), adapted by Ventura and Caycho in 2016, were used. Results: The Alpha coefficient of Cronbach and Omega was used, obtaining values ​​greater than .70, reflecting having adequate reliability scores. Negative and statistically significant correlations were obtained in the dimensions of Family Social Climate and the variable Emotional dependency with a low effect size (rrelations = -.41; rdevelopment = -. 44; restability = -. 34; p <.01) and moderate. Conclusion: It is concluded that lower levels of family social climate are linked to higher levels of emotional dependence in university students with separated or divorced parents. / Tesis

Perioder av aktivt identitetsutforskande är särskilt aktuellt för den unga vuxna individen. Flera delar av identiteten konsolideras under denna livsfas, där bl.a. frågan om att hitta en yrkesidentitet är central. För unga vuxna studerande, som avslutar en längre högskoleutbildning och står inför att gå ut i yrkeslivet, blir ett utforskande och prövande kring vem man varit som student samt kring framtida potentiella yrkesroller ofta aktuellt. Övergången i yrkeslivet kan också upplevas som ett ökat vuxenblivande. Syftet med denna studie är att undersöka hur ett urval sistaårsstuderande på högskolan upplever denna livsfas och sig själva utifrån fenomen som transition, identitetsprövande och vuxenblivande. Forskningsmetoden är kvalitativ och datainsamling gjordes genom semistrukturerade individuella intervjuer med sex studenter på olika ingenjörsprogram vid Kungliga tekniska högskolan. Insamlat datamaterial analyserades med Tematisk analys. Resultatet visar att studenterna upplever en påtaglig förändring i denna livsfas vilket för in dem i en period av såväl förhoppningar och tvivel kring framtiden. Livsfasen innebär också ett aktivt identitetsprövande kring potentiella framtida yrkesroller och rollen som vuxen. Dessa upplevelser presenteras i en deskriptiv del. Vid en djupare analys av upplevelserna framkommer att studenternas upplevelser är ambivalenta där sökandet kan beskrivas som dialektiska rörelser mellan motstridiga tankar och känslor. Detta beskrivs som tre ambivalenta teman; 1. Vilsenhet visavi tydlighet. 2.  Begränsad visavi fullkomnad yrkesidentitet samt 3. Ansvarsfullhet visavi kravlöshet. Resultaten diskuteras utifrån teorier om transition och vuxenblivande men tar främst fasta på såväl inre och yttre faktorer som är centrala i perioder av identitetsutforskande. Bland annat används Maricas identitetsstatusmodell som utgångspunkt där det konfliktfyllda i identitetsutveckling också lyfts fram. Studenternas ambivalens föreslås bland annat förstås utifrån fenomenet individuation med prövande mellan autonomi och närhet. Ett tema som ofta är centralt i identitetsutveckling, i synnerhet för unga vuxna. / Periods of more active identity exploration is assumed to be particularly in focus for the young adult individual. Several components of identity is consolidated during this phase of life, where finding a professional identity is central. For Young adult students completing a long higher education and facing the professional life, a process of exploration about potential future professional roles is likely to occur. The step into professional life can also be experienced as a further step into adulthood. The purpose of this study is to investigate how a selection of last year university students experiences this transition on the basis of phenomena like transition, identity exploration and adulthood. The research method is qualitative and data was collected through semi-structured individual interviews with six students in various engineering programs at The Royal Institute of Technology in Stockholm, Sweden. Data was analyzed through thematic analysis. The results show that students experience a significant change in this phase of life which makes them enter into a period of both hopes and doubts about the future. The life-phase also initiates a period of active identity exploration about potential future professional roles and the role as an adult. These experiences are presented in a descriptive part. A deeper analysis shows that students' experiences are ambivalent where their identity exploration can be described as dialectical movement between conflicting thoughts and emotions. These are referred to as three ambivalent themes: 1. Disorientation versus clarity. 2. Limited versus complete professional identity and 3. Responsibility versus permissiveness. The results are discussed based on theories of transition and emerging adulthood, but primarily cover both internal and external factors that are crucial in periods of identity exploration. The result is related to Marcia’s identity status model and also highlights the conflictual dynamics in identity development. Students' ambivalence is suggested to be understood as a phenomenon of individuation with a testing between autonomy and intimacy. A theme that is often central to identity development, especially for young adults.

Introduction : La transition des soins pédiatriques aux soins pour adultes peut être difficile. Si elle est réalisée de façon sous-optimale, cela peut entraîner de graves conséquences. Afin de mesurer la préparation à la transition de patients adolescents et jeunes adultes (AJA), le Transition Readiness Assessment Questionnaire (TRAQ) a été développé. Les objectifs de l’étude sont de 1) documenter les propriétés psychométriques de la version française du TRAQ (TRAQ-FR), 2) évaluer le degré d’accord sur le TRAQ-FR entre les AJA et leurs aidants naturels et 3) identifier les prédicteurs de la préparation à la transition. Méthodologie : Des AJA francophones (n=175) et leurs aidants naturels (n=168) ont été recrutés dans cinq cliniques d’un hôpital tertiaire canadien et ont complété le TRAQ-FR, le Pediatric Quality of Life Inventory Version 4.0 (PedsQLTM 4.0) et un questionnaire sociodémographique. La validité du TRAQ-FR a été déterminée en réalisant des analyses factorielles confirmatoires. Les accords et différences ont été mesurés en calculant des corrélations intra-classe et des tests-t pour échantillons appariés. Des prédicteurs de la préparation à la transition ont été identifiés par des régressions multivariées. Résultats : Le modèle à cinq facteurs du TRAQ est soutenu par les données et l’échelle globale du TRAQ-FR montre une bonne cohérence interne pour les scores des AJA et des aidants naturels (a=.85-.87). Le degré d’accord absolu sur l’échelle globale du TRAQ-FR est bon entre les informants (ICC=.80; d=.25), les AJA rapportant un score plus élevé que leurs aidants naturels. L’âge et le sexe des AJA sont des prédicteurs de la préparation à la transition. Conclusion : Le TRAQ-FR a de bonnes propriétés psychométriques lorsqu’il est complété par les AJA et leurs aidants naturels. Des études futures devraient explorer la validité prédictive et l’utilisation clinique du TRAQ-FR. / Background: Transitioning from pediatric to adult healthcare can be challenging and lead to severe consequences if done suboptimally. The Transition Readiness Assessment Questionnaire (TRAQ) was developed to assess adolescent and young adult (AYA) patients’ transition readiness. In this study, we aimed to 1) document the psychometric properties of the French-language version of the TRAQ (TRAQ-FR), 2) assess agreements and discrepancies between AYA patients’ and their primary caregivers’ TRAQ-FR scores, and 3) identify transition readiness contributors. Methods: French-speaking AYA patients (n=175) and primary caregivers (n=168) were recruited from five clinics in a tertiary Canadian hospital and asked to complete the TRAQ-FR, the Pediatric Quality of Life InventoryTM 4.0 (PedsQLTM 4.0), and a sociodemographic questionnaire. The validity of the TRAQ-FR was assessed using confirmatory factor analyses (CFA). Agreements and discrepancies were evaluated using intra-class correlation coefficients and paired-sample t-tests. Contributors of transition readiness were identified using regression analyses. Results: The five-factor model of the TRAQ was supported, with the TRAQ-FR global scale showing good internal consistency for both AYA patients’ and primary caregivers’ scores (a=.85- .87). AYA patients and primary caregivers showed good absolute agreement on the TRAQ-FR global scale with AYA patients scoring higher than primary caregivers (ICC=.80; d=.25). AYA patients’ age and sex were found to be contributors of transition readiness. Conclusions: The TRAQ-FR was found to have good psychometric properties when completed by both AYA patients and primary caregivers. Additional research is needed to explore the predictive validity and clinical use of the TRAQ-FR.

We sought to examine the concordance of two suicidal ideation items from the Patient Health Questionnaire-9 (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS), to evaluate the prevalence of suicidal ideation among pregnant women, and to assess the co-occurrence of suicidal ideation with antepartum depressive symptoms. A cross-sectional study was conducted among 1,517 pregnant women attending prenatal care clinics in Lima, Peru. Item 9 of the PHQ-9 assesses suicidal ideation over the last 14 days while item 10 of the EPDS assesses suicidal ideation in the past 7 days. The two suicidal ideation items have a high concordance rate (84.2 %) but a moderate agreement (the Cohen's kappa = 0.42). Based on the PHQ-9 and the EPDS, 15.8 and 8.8 % of participants screened positive for suicidal ideation, respectively. Assessed by the PHQ-9, 51 % of participants with suicidal ideation had probable depression. In prenatal care clinics, screening for suicidal ideation is needed for women with and without depressive symptoms. Future studies are needed to identify additional predictors of antepartum suicidality, determine the appropriate duration of reporting period for suicidal ideation screening, and assess the percentage of individuals with positive responses to the two suicidal ideation items at high risk of planning and attempting suicide. / This research was supported by an award from the National Institutes of Health (NIH), the Eunice Kennedy Shriver Institute of Child Health and Human Development (R01-HD-059835). The NIH had no further role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication. The authors wish to thank the dedicated staff members of Asociacion Civil Proyectos en Salud (PROESA), Peru and Instituto Especializado Materno Perinatal, Peru for their expert technical assistance with this research. The authors would like to thank Kathy Brenner for her help with revising this manuscript. / Revisión por pares