Amy Root, West Virginia University

As a professor of child development and family science, every year I witness college students heading home for the holidays after a few months of relative independence. Anecdotally, most students express excitement about returning home and say they’re looking forward to relaxing with family and friends.

However, it also can present a challenge for parents and their grown children. Parents may wonder: “What should I expect of my child when they return home after living away?” Adult children may be thinking: “I’m an adult, but I’m in my parents’ home. Do I need to ask permission to go out? Do I have a curfew?”

The adult child’s return home, even for a few days or weeks, may produce some stress for both generations. But, the parent-child relationship is always evolving, including negotiating – and renegotiating – power and control as children age.

In fact, families have been preparing for these new role changes for years. Think about when children enter middle school. They spend less time under their parents’ direct supervision. Parents must begin to find ways to stay connected with their children while encouraging independence. The challenge is the same with young adults, only their interests and the appropriate level of independence has changed.

Generally speaking, the parent-child relationship is relatively stable over time. And the good news is that most people navigate this transition successfully. Understanding a bit more about what developmental and family scientists know about this time of life might help ease the path forward.

Between adolescence and true adulthood

Many countries and societies consider you an adult once you turn 18. However, neuroscience research reveals that parts of the brain that are crucial for adult skills such as planning ahead, decision-making and controlling impulses do not finish developing until the mid- or late 20s. So, from a psychological perspective, the onset of adulthood is not universal and not determined by a specific age.

In 2000, psychologists introduced the concept of a period of development that spans ages 18 to 25: emerging adulthood. It’s a kind of in-between period, when people say they don’t feel fully adult.

It’s important to note that this developmental period is not something that everyone experiences. It’s most common in Western or industrialized countries, though there is research on the experiences of emerging adults in other cultures. This period of exploration and experimentation, however, is a luxury not available to all, with adolescents from lower socioeconomic backgrounds reaching milestones of adulthood such as financial independence or parenthood earlier than those from more affluent backgrounds.

But this life stage has become increasingly common in the 21st century, partly due to societal changes that give young adults more opportunities to explore identity and focus on themselves. For instance, the availability of birth control made sex without marriage more feasible for young adults. Many people take time before full-time work to pursue higher education. Today’s young adults can experiment with ideas and opportunities that weren’t available to them during adolescence.

You can probably imagine why emerging adult children and their parents might butt heads when under the same roof. The two generations’ differing opinions and ideals can set up conflict, especially when the child feels like an adult but the parent still sees them as a child. If parents can keep in mind that these young adult offspring are still navigating a distinct developmental phase, it may help them be supportive during this stage.

Relating adult to adult

When children leave the nest, the parent-child relationship goes through a period of adjustment. This is typical and, importantly, a necessary part of becoming an adult.

There’s likely to be a bit of trial and error for both the parent and the child as they figure out how to establish new ways of connecting and relating. But this isn’t the first time in a child’s life that a developmental transition has triggered the need for renegotiating the parent-child relationship. During adolescence, parents begin to provide their children with more freedom to make independent decisions; this requires parent and child to make adjustments in how they interact and relate to one another.

Psychology researchers point to several qualities of healthy parent-adult child relationships. Parents need to get comfortable with a low level of control over what their grown kids do. Parents can expect to know less about their adult child’s whereabouts when out for an evening and whom their adult child spends time with, something that parents monitor during adolescence. Maintaining a warm dynamic and encouraging independence are also key. Together, these attributes help parents promote success in their adult children, helping them grow into mentally healthy and well-adjusted members of society.

These tweaks in approach may initially be uncomfortable for parents. But with a little effort, they can successfully make this transition. It helps if they’ve maintained a good relationship with their kid all along. Psychologists typically define effective parenting during emerging adulthood as a relationship characterized by providing warm emotional support; supporting the child in making their own decisions; and refraining from using guilt to change a child’s beliefs.

Practical tips for evolving relationships

1. Be flexible and don’t compare. Every family is different, and each will navigate adult children returning home in unique ways. Likewise, there may be a need to adjust – and readjust – expectations and rules. Be comfortable with tweaking things to best suit your family.

2. Prepare by connecting. Discuss expectations from both generations before or shortly after the adult child returns home. Being proactive with communication will provide opportunities to connect and find common ground.

3. Establish boundaries and guardrails. Parents should communicate house rules for their adult children, and adult children should state their preferred boundaries. These guardrails should be developmentally appropriate and based on mutual respect.

4. Adjust expectations as needed. Parents should keep in mind that their child is in transition to adulthood. They should expect behavior that reflects having one foot in adolescence and the other in adulthood.

Warm, supportive parenting continues to be a good influence on development through the emerging adulthood years. Therefore, it is not surprising that emerging adults continue to seek guidance from their parents. Most parents and adult children find their new, more egalitarian relationship lets them connect in new, more mature ways.

Amy Root, Professor of Applied Human Sciences, West Virginia University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Heather Margonari, University of Pittsburgh; Jacques E. Chelly, University of Pittsburgh, and Shiv K. Goel, University of Pittsburgh

The opioid crisis remains a significant public health challenge in the United States. In 2022, over 2.5 million American adults had an opioid use disorder, and opioids accounted for nearly 76% of overdose deaths.

Some patients are fearful of using opioids after surgery due to concerns about dependence and potential side effects, even when appropriately prescribed by a doctor to manage pain. Surgery is often the first time patients receive an opioid prescription, and their widespread use raises concerns about patients becoming long-term users. Leftover pills from a patient’s prescriptions may also be misused.

Researchers like us are working to develop a personalized and comprehensive surgical experience that doesn’t use opioids. Our approach to opioid-free surgery addresses both physical and emotional well-being through effective anesthesia and complementary pain-management techniques.

What is opioid-free anesthesia?

Clinicians have used morphine and other opioids to manage pain for thousands of years. These drugs remain integral to anesthesia.

Most surgical procedures use a strategy called balanced anesthesia, which combines drugs that induce sleep and relax muscles with opioids to control pain. However, using opioids in anesthesia can lead to unwanted side effects, such as serious cardiac and respiratory problems, nausea and vomiting, and digestive issues.

Concerns over these adverse effects and the opioid crisis have fueled the development of opioid-free anesthesia. This approach uses non-opioid drugs to relieve pain before, during and after surgery while minimizing the risk of side effects and dependency. Studies have shown that opioid-free anesthesia can provide similar levels of pain relief to traditional methods using opioids.

Opioid-free anesthesia is currently based on a multimodal approach. This means treatments are designed to target various pain receptors beyond opioid receptors in the spinal cord. Multimodal analgesia uses a combination of at least two medications or anesthetic techniques, each relieving pain through distinct mechanisms. The aim is to effectively block or modulate pain signals from the brain, spinal cord and the nerves of the body.

For instance, nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen work by inhibiting COX enzymes that promote inflammation. Acetaminophen, or Tylenol, similarly inhibits COX enzymes. While both acetaminophen and NSAIDs primarily target pain at the surgical site, they can also exert effects at the spinal level after several days of use.

A class of drugs called gabapentinoids, which include gabapentin and pregabalin, target certain proteins to dampen nerve signal transmission. This decreases neuropathic pain by reducing nerve inflammation.

The anesthetic ketamine disrupts pain pathways that contribute to a condition called central sensitization. This disorder occurs when nerve cells in the spinal cord and brain amplify pain signals even when the original injury or source of pain has healed. As a result, normal sensations such as light touch or mild pressure may be perceived as painful, and painful stimuli may feel more intense than usual. By lessening pain sensitivity, ketamine can help reduce the risk of chronic pain.

Regional anesthesia involves injecting local anesthetics near nerves to block pain signals to the brain. This method allows patients to remain awake but pain-free in the numbed area, reducing the need for general anesthesia and its side effects. Common regional techniques include epidurals, spinal anesthesia and nerve blocks.

By activating different pain pathways simultaneously, multimodal approaches aim to enhance pain relief synergistically.

Psychology of pain perception

Psychological factors can significantly influence a patient’s perception of pain. Research indicates that mental health conditions such as anxiety, depression and sleep disturbances can increase pain levels by up to 50%. This suggests that addressing mood and sleep issues can be essential for pain management and improving overall patient well-being.

Psychological states can intensify the perception of pain by significantly influencing the neural pathways related to pain processing. For example, anxiety and stress activate the body’s fight or flight response, prompting the release of stress hormones that heighten nerve sensitivity. This can make pain feel more intense. Research has also found that higher anxiety levels before surgery are linked to increased anesthesia use during surgery and opioid consumption after surgery.

Complementary and alternative techniques that address psychological factors can reduce pain and opioid use by modulating pain transmission in the nervous system and activating neurochemical pathways that promote pain relief.

For example, aromatherapy uses essential oils to stimulate the olfactory system. This can help reduce pain perception and enhance overall well-being by evoking emotional responses and promoting relaxation.

Music therapy stimulates the auditory system, which can distract patients from pain, lower anxiety levels and foster emotional healing. This can ultimately lead to reduced pain perception.

Relaxation exercises, such as deep breathing and progressive muscle relaxation, activate the parasympathetic nervous system and help promote a state of rest. Engaging the parasympathetic system helps the body conserve energy, slow your heart rate, lower blood pressure and relieve muscle tension. This can lead to decreased pain sensitivity by promoting a state of calmness.

Acupuncture involves inserting thin needles into specific body points, stimulating the release of endorphins and other neurotransmitters. These molecules can interrupt pain signals and promote healing processes within the body.

Moving toward opioid-free surgery

Transitioning away from opioids in surgery requires a shift in both practice and mindset across the entire health care team. Beyond anesthesiologists, other providers, including surgeons, nurses and medical trainees, also use opioids in patient care. All providers would need to be open to using alternative pain management techniques throughout the surgical process.

In response to the increasing patient demand for opioid-free surgical care, our team at the University of Pittsburgh Medical Center launched the patient-initiated Opioid-Free Surgical Pain Management Program in May 2024. To address both the physical and emotional dimensions of pain while optimizing recovery and safety, we recruited surgeons, anesthesiologists, nurses, pharmacists and hospital administrators to participate in the initiative.

Over the course of six months, our team enrolled 109 patients, 79 of whom successfully underwent surgeries without opioids. Barriers to participating in the program included patient perception of severe pain, inadequately addressing stress and anxiety before the operation and limited education in the department about the program.

However, subsequent refinements to the program – such as giving patients muscle relaxants while they were recovering from anesthesia – improved participation and reduced opioid use. Importantly, none of the 19 patients who received opioids while recovering in the hospital post-op required further opioid prescriptions at discharge.

These results reflect the promise of our pathway to minimize reliance on opioids while ensuring effective pain management. Enhanced psychological support for patients and education for providers in surgery departments can broaden the effectiveness of a comprehensive approach to managing pain.

Heather Margonari, Lead Coordinator for the Opioid Free Pathway, University of Pittsburgh; Jacques E. Chelly, Professor of Anesthesiology, Perioperative Medicine and Orthopedic Surgery, University of Pittsburgh, and Shiv K. Goel, Clinical Associate Professor of Anesthesiology, University of Pittsburgh

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Julie Pollock, University of Richmond

When you bite into a juicy hamburger, slice into the perfect medium-rare steak or gobble down a plateful of chicken nuggets, your senses are most likely responding to the food’s smell, taste, texture and color. For a long time, these four attributes set meat apart from other food groups.

But in recent years, food companies have started to focus on the development of meat alternatives. Many people believe that transitioning away from meat-heavy diets can help with environmental sustainability as well as improve their own health.

The two main focuses of research have been on plant-based meat alternatives and lab-grown meat. Both have interesting challenges. Lab-grown meat requires growing animal cells and generating a meat product. Plant-based meat alternatives use plant materials to recreate animal-like structures and flavors.

Major food companies that have generated plant-based meat alternatives that consumers seem to enjoy include Impossible, Beyond Meat, Mosa Meat and Quorn.

From a scientific perspective, the development of plant-based meat alternatives is especially intriguing, because food manufacturers and researchers attempt to create products with similar textures, flavors, appearances and nutrient compositions to those juicy hamburgers or tender chicken fingers.

As a biochemist who teaches students about how food fuels our bodies, I focus my research on the composition and the production of these products and how they can mimic animal meat is intriguing to me.

Animal meats are composed primarily of protein, fat and water, with small amounts of carbohydrates, vitamins and minerals. The animal tissue consumed is typically muscle, which has a distinctive shape made from fibers of protein that are bundled together with connective tissue.

The size and shape of the protein fibers influence the texture of the meat. The amount and identity of natural lipids – fats and oils – found within a specific muscle tissue can influence the protein structure, and therefore the flavor, tenderness and juiciness, of the meat. Meat products also have a high water content.

Typically, plant-based meat alternatives are made using nonanimal proteins, as well as chemical compounds that enhance the flavor, fats, coloring agents and binding agents. These products also contain more than 50% water. To produce plant-based meat alternatives, the ingredients are combined to mimic animal muscle tissue, and then supplemented with additives such as flavor enhancers.

Developing a meatlike texture

Most meat replacements are derived from soy protein because it is relatively cheap and easily absorbs both water and fat, binding these substances so they don’t separate. Some companies will use other proteins, such as wheat gluten, legumes – lentils, chickpeas, peas, beans – and proteins from seed oils.

Since most animal meats include some amount of fat, which adds flavor and texture to the product, plant-based meat alternative manufacturers will often add fats such as canola oil, coconut oil or sunflower oil to make the product softer and tastier.

Proteins and fats don’t easily mix with water – that’s why the ingredients in salad dressings will sometimes separate into layers. When using these components, food manufacturers need to emulsify, or mix them, together. Emulsification is essential to making sure the proteins, fats and water form an integrated network with an appealing texture. Otherwise, the food product can end up greasy, spongy or just plain disgusting.

Many vegan meat alternatives also use gelling agents that bind water and fat. They help with emulsification because they contain starch, which interacts strongly with water and fat. This allows for more of a mixed network of the proteins, fats and water, making them meatier and more appealing to consumers.

Creating a product with a meatlike texture is not just a dump and stir process. Since animal meat is primarily muscle tissue, it has a unique spatial arrangement of the proteins, fats and water.

In order to mimic this structure, manufacturers use processes such as stretching, kneading, folding, layering, 3D printing and extrusion. Right now, the most popular processing method is extrusion.

Extrusion is a method by which the dry ingredients – plant proteins and fats – are fed into a machine along with a steady stream of water. The inner part of the machine rotates like a screw, combining the molecules, converting the structure of the plant material from spherical shapes to fibers.

Each plant protein behaves differently in the manufacturing process, so some plant-based meat alternatives might use different ingredients, depending on their structures.

Adding the savory flavor

Although the texture is essential, meat also has a distinctive savory and umami flavor.

A set of chemical reactions called Maillard browning helps develop the complex, rich flavor profiles of animal meats while they cook. So, additives such as yeast extracts, miso, mushrooms and spices can enhance the flavor of plant-based alternatives by allowing Maillard reactions to occur.

The aroma of cooked meats typically comes from chemical reactions between sugars and amino acids. Amino acids are the basic components of proteins. Lots of research has focused on attempting to replicate some of those reactions.

To promote these reactions, alternative meat developers will add browning agents, including specific amino acids such as cysteine, methionine and lysine, sugars and the vitamin thiamin. Adding natural smoke flavorings derived from hickory or mesquite can also give alternative meats a similar aroma.

Eating with the eyes

As the first-century Roman lover of food Apicius said, “We eat with our eyes first.”

That means that even if the texture is perfect and the flavors are on point, the consumer will still decide whether they want to buy and eat the vegan meat by the way it looks.

For this reason, food manufacturers will usually develop plant-based meat alternatives that look like classic meat dishes – hamburgers, meatballs, sausages or nuggets. They’ll also add natural coloring agents such as beetroot, annatto, caramel and vegetable juices that make plant-based alternatives look more like the color of traditional meat.

Plant proteins such as soy and wheat gluten do not brown like animal meat. So, some food manufacturers will increase the proportion of pea and lentil proteins they’re using, which makes the meat alternative look more brown while cooking.

With some research, it’s not too difficult to mimic the structure, texture, flavor and appearance of animal meats. But the question remains: Will people purchase and consume them?

It seems people do want plant-based meat. Countries all around the world have increased their demand for these products. In 2023, the global market was over US$7 billion, and it is predicted to grow by almost 20% by 2030.

Julie Pollock, Associate Professor of Chemistry, University of Richmond

This article is republished from The Conversation under a Creative Commons license. Read the original article.