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The aim of this mixed-studies systematic review was to synthesise existing research to identify if the five features of emerging adulthood (identity exploration; instability; self-focus; feeling in-between; possibilities) were evident in the self-management of long-term physical conditions by emerging adults (aged 18 – 29 years old). Five databases were systematically searched. Thirty papers met the eligibility criteria and were included. The synthesis identified that the five features of emerging adulthood are present in the self-management strategies and tasks of emerging adults living with long-term physical conditions. Due to numerous transitions, that characterise this unstable developmental period, emerging adults encounter specific self-management challenges. However, a greater understanding of the extent to which each of the five features are present and the challenges posed to the self-management of a long-term physical condition in emerging adults is required. This will inform targeted self-management supports and interventions in the future.

In the inaugural edition of Prosthetics and Orthotics Internationalin 1977, Dr Sidney Fishman identified the Psychological Sciences as one of six indispensable areas of skill and knowledge in professional prosthetic–orthotic practice. Since then, there have been substantial changes and developments in the complexity and capabilities of assistive technologies, greater emphasis on understanding the relationships between people and enabling technologies, growing recognition of the importance of the contexts and environments that support their use, and changes in both health care services and the professional development of prosthetists and orthotists. The aim of this narrative review is to reflect on the role of Prosthetics and Orthotics Internationalin shaping the evolving understanding of psychology in prosthetics and orthotics. There remains considerable potential and opportunity for the development and application of psychology in addressing the challenges of disability globally. However, a broad interpretation and application of the principles of rehabilitation psychology are needed if we are to meaningfully incorporate psychological science into the knowledge that informs prosthetic and orthotic practice.

Iron metabolism is critical for sustaining life and maintaining human health. Here, we find that iron homeostasis is linked to facultative heterochromatin assembly and regulation of gene expression during adaptive genome control. We show that the fission yeast Clr4/Suv39h histone methyltransferase is part of a rheostat-like mechanism in which transcriptional upregulation of mRNAs in response to environmental change provides feedback to prevent their uncontrolled expression through heterochromatin assembly. Interestingly, proper iron homeostasis is required, as iron depletion or downregulation of iron transporters causes defects in heterochromatin assembly and unrestrained upregulation of gene expression. Remarkably, an unbiased genetic screen revealed that restoration of iron homeostasis is sufficient to re-establish facultative heterochromatin and proper gene control genome-wide. These results establish a role for iron homeostasis in facultative heterochromatin assembly and reveal a dynamic mechanism for reprogramming the genome in response to environmental changes. Genome-wide analyses in fission yeast reveal that iron homeostasis influences facultative heterochromatin assembly to modulate gene expression in response to changes in growth temperature.

Nine human disorders result from the toxic accumulation and aggregation of proteins with expansions in their endogenous polyalanine (polyA) tracts. Given the prevalence of polyA tracts in eukaryotic proteomes, we wanted to understand the generality of polyA-expansion cytotoxicity by using yeast as a model organism. In our initial case, we expanded the polyA tract within the native yeast poly(Adenine)-binding protein Pab1 from 8A to 13A, 15A, 17A, and 20A. These expansions resulted in increasing formation of Pab1 inclusions, insolubility, and cytotoxicity that correlated with the length of the polyA expansion. Pab1 binds mRNA as part of its normal function, and disrupting RNA binding or altering cytoplasmic mRNA levels suppressed the cytotoxicity of 17A-expanded Pab1, indicating a requisite role for mRNA in Pab1 polyA-expansion toxicity. Surprisingly, neither manipulation suppressed the cytotoxicity of 20A-expanded Pab1. Thus longer expansions may have a different mechanism for toxicity. We think that this difference underscores the potential need to examine the cytotoxic mechanisms of both long and short expansions in models of expansion disorders.

Polyalanine expansions can result in aggregation and cause cytotoxicity. We have created the first yeast model of polyalanine-expansion aggregation and toxicity using the poly(Ade)-binding protein Pab1.

Although the serotonin transporter is a key target for antidepressants, its exact role in depression etiology remains unclear. While serotonin transporter knockout mice are a potential model to examine this problem, their depression profile is unclear in several ‘despair’ tests, and may be confounded by their hypoactivity phenotype (confirmed here by marble-burying and bedding tests). To assess depression in these mice, we evaluated wild-type, heterozygous, and serotonin transporter knockout C57BL6 male mice on a well-validated, anhedonia-based depression paradigm, the sucrose preference test. Overall, all three genotypes showed similar sucrose preference, indicating an unaltered hedonic state. These results demonstrate that depression-like behavior (unlike hypoactivity) is not a baseline phenotypic feature of serotonin transporter knockout mice, suggesting anew that these mice do not represent a genetic model of depression.

Objective The repair of the cleft lip nose and nasal deformity remains a challenging endeavor for reconstructive surgeons. Psychosocially, this complex, multifaceted deformity significantly stigmatizes the patient. Numerous techniques have been advocated by multiple authors for the treatment and reconstruction of these deformities, usually requiring serial staged reconstructions.Method Described is our technique for early primary repair of the cleft lip nasal deformity. The use of multiple suspension sutures to repair the nasal defect facilitates the repair of even very wide cleft lips.Conclusions These maneuvers provide an aesthetic and functional repair of the nasal defect in conjunction with the lip repair. Long-term results have minimized the need for surgical revision.

Objective: This is a review of modifications made to the classic technique for harvesting bone graft from the iliac crest. Prior techniques for harvesting iliac bone often resulted in significant postoperative pain, disability, and a cosmetically unacceptable scar and contour deformity.Design: A retrospective review of patients who underwent bone graft harvest over a 7-year period was done.Interventions: The modifications described use a skin incision medial to the anterior superior iliac crest. The medial aspect of the iliac crest is elevated along the midsagital axis of the crest. The medial cap is reflected outward, exposing cancellous bone.Results: A review of 51 patients demonstrated only two minor self-limiting complications.Conclusions: This procedure provides an abundant supply of both cortical and cancellous bone, an aesthetically acceptable scar, and decreased patient discomfort.

Reducing avoidable emergency department (ED) visits is an important health system goal. This is a retrospective cohort study of the impact of a primary care intervention including an in-hospital, free, adult clinic for poor uninsured patients on ED visit rates and emergency severity at a nonprofit hospital. We studied adult ED visits during August 16, 2009-August 15, 2011 (preintervention) and August 16, 2011-August 15, 2014 (postintervention). We compared pre- versus post-mean annual visit rates and discharge emergency severity index (ESI; triage and resource use–based, calculated Agency for Healthcare Research and Quality categories) among high-users (≥3 ED visits in 12 months) and occasional users. Annual adult ED visit volumes were 16 372 preintervention (47.5% by high-users), versus 18 496 postintervention. High-users’ mean annual visit rates were 5.43 (top quartile) and 0.94 (bottom quartile) preintervention, versus 3.21 and 1.11, respectively, for returning high-users, postintervention (all P< .001). Postintervention, the visit rates of new high-users were lower (lowest and top quartile rates, 0.6 and 3.23) than preintervention high-users’ rates in the preintervention period. Visit rates of the top quartile of occasional users also declined. Subgroup analysis of medically uninsured high-users showed similar results. Upon classifying preintervention high-users by emergency severity, postintervention mean ESI increased 24.5% among the lowest ESI quartile, and decreased 12.2% among the top quartile. Pre- and post-intervention sample demographics and comorbidities were similar. The observed reductions in overall ED visit rates, particularly low-severity visits; highest reductions observed among high-users and the top quartile of occasional users; and the pattern of changes in emergency severity support a positive impact of the primary care intervention.