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One in six older adults in the world is subjected to abuse (WHO 2022). In Israel, a national survey indicated an 18.4% prevalence of elder abuse. Older parents of an offspring with mental disorder are at increased risk of abuse. Exploring lawyers' experiences in elder abuse cases involving offspring with mental disorders. A qualitative study was conducted using in-depth interviews with 15 lawyers intervening via civil law in cases of elder abuse. Three themes were revealed: 'A seething kettle' – abusive offspring characteristics and family interactions; From a 'pure lawyer' to a 'therapeutic lawyer' – Transition from being a lawyer who examines intervention solely through a legal lens, to a lawyer who also considers the therapeutic aspects; How could things be different? Recommendations regarding training for lawyers; Expanding multidisciplinary teams including mental health professionals; Establishing therapeutic courts. Findings strengthened empirical evidence about the relationship between an abuser's characteristics and their interaction with his or her parents as risk factors for abuse. Therefore, effective intervention should aim to assist both older adult victims and their abusive offspring, integrating legal and therapeutic approaches; Repositioning of lawyers as 'therapeutic lawyers' and establishing therapeutic courts may facilitate the necessary change. [ABSTRACT FROM AUTHOR]

This paper expands the discussion on the effect of the subjective Holocaust influence level (SHIL) on the daily financial thinking and attitude of Holocaust survivors' offspring (HSO). For this purpose, we asked 253 Jewish-Israeli HSO about their financial satisfaction, materialism, income confidence, willingness to save money, generosity, and miserliness, and divided them into three groups based on their SHIL. We find that SHIL affects materialism, income confidence and generosity, but not financial satisfaction or motivation to save money. This paper increases our understanding of how the subjective perceptions of HSO impact the long-term influence of the Holocaust on their lives. [ABSTRACT FROM AUTHOR]

Intimate partner homicide is a major public health concern around the world and the most lethal outcome of domestic violence. Its impact on the surviving bereaved offspring is immense, yet there is a significant gap in the literature regarding the long-term effects of this type of loss. The current qualitative study is aimed at filling this gap. The study used the constructivist paradigm of bereavement as a theoretical background to reveal the meanings constructed by bereaved Israeli daughters whose biological mothers were killed in acts of intimate partner homicide by their biological fathers. Three main themes of meaning emerged from 12 in-depth semi-structured interviews: "destruction of one's home"; "blast injury"; and "in doubt". An examination of the three themes in the current study reveals a deep shatter in participants' world of meaning to its very basic foundations. In light of intense psychological and social forces, the participants constructed and reconstructed such narratives of meaning in a continuous process of meaning making throughout their lives, years, and decades post loss. Derived from the findings are implications for practice. Mental healthcare professionals must attend to this basic shatter with an extreme level of caution, as they help homicide survivors reconstruct a world of meaning shattered by loss. Moreover, the long-lasting effects emphasize an appropriate legal and political involvement; specifically, policy regulations and rights should provide psychosocial care programs that are suited to the needs of offspring co-victims of intimate partner homicide in particular. In light of the strong social influence on participants' loss experience, further efforts are required to raise social awareness about this burning social concern and to fight the stigmatization of co-victims of homicide in general and co-victims of intimate partner homicide in particular. [ABSTRACT FROM AUTHOR]

Background: Family history of Alzheimer's disease (AD) is associated with increased dementia-risk.Objective: The Israel Registry for Alzheimer's Prevention (IRAP) is a prospective longitudinal study of asymptomatic middle-aged offspring of AD patients (family history positive; FH+) and controls (whose parents have aged without dementia; FH-) aimed to unravel the contribution of midlife factors to future cognitive decline and dementia. Here we present the study design, methods, and baseline characteristics.Methods: Participants are members of the Maccabi Health Services, 40-65 years of age, with exquisitely detailed laboratory, medical diagnoses and medication data available in the Maccabi electronic medical records since 1998. Data collected through IRAP include genetic, sociodemographic, cognitive, brain imaging, lifestyle, and health-related characteristics at baseline and every three years thereafter.Results: Currently IRAP has 483 participants [mean age 54.95 (SD = 6.68) and 64.8% (n = 313) women], 379 (78.5%) FH+, and 104 (21.5%) FH-. Compared to FH-, FH+ participants were younger (p = 0.011), more often males (p = 0.003) and with a higher prevalence of the APOE E4 allele carriers (32.9% FH+, 22% FH-; p = 0.040). Adjusting for age, sex, and education, FH+ performed worse than FH-in global cognition (p = 0.027) and episodic memory (p = 0.022).Conclusion: Lower cognitive scores and higher rates of the APOE E4 allele carriers among the FH+ group suggest that FH ascertainment is good. The combination of long-term historical health-related data available through Maccabi with the multifactorial information collected through IRAP will potentially enable development of dementia-prevention strategies already in midlife, a critical period in terms of risk factor exposure and initiation of AD-neuropathology. [ABSTRACT FROM AUTHOR]

• The study supported the validity and reliability of the FCRSS fathers/mothers and young drivers in Spain. • Significant associations were found between parents' and young drivers' FCRSS scores and young drivers' self-reported driving styles. • Significant differences in FCRSS dimensions were found between mothers and fathers. • FCRSS serves as a useful assessment tool for gathering information on the strengths and weaknesses in families' safety practices. • FCRSS may be useful for developing tailored interventions. The Family Climate for Road Safety Scale (FCRSS; Taubman – Ben-Ari & Katz – Ben-Ami, 2013) is a comprehensive measure originally developed in Israel to assess parent-children relations in the specific context of driving. The scale consists of seven dimensions: Modelling, Feedback, Communication, Monitoring, Messages, Limits, and Non-commitment to Safety. While the original FCRSS examines the young drivers' perception across the seven domains, a version applicable to parents has also been developed by the same authors. The current study investigates the validity and reliability of the FCRSS-Spain for both parents and young drivers. A total of 377 parents (199 fathers and 178 mothers) and 243 of their children (143 daughters and 100 sons) responded to the FCRSS-Spain versions and provided sociodemographic data. In addition, the young drivers completed the Spanish version of the Multidimensional Driving Style Inventory (MDSI-Spain). Results from exploratory structural equation modelling (ESEM) indicate that six out of the seven FCRSS domains were replicable among Spanish drivers. The Messages dimension did not emerge as a consistent factor in the FCRSS for either parents or young drivers. All six factors demonstrated good internal consistency reliability (ordinal alpha coefficients exceeding 0.70), except for Non-commitment to safety. Significant differences were found between mothers and fathers in various FCRSS dimensions in the predicted direction, whereas no significant differences in FCRSS scores were found between young men and young women. As expected, associations were found between parents' scores in various FCRSS dimensions and the reckless, angry, dissociative, anxious, and careful driving styles reported by the young drivers, as well as between young drivers' FCRSS scores and their self-reported reckless, angry, dissociative, anxious, and careful driving styles. [ABSTRACT FROM AUTHOR]

Objective: As patients with psychotic illness have fewer offspring than controls, the persistence of psychotic illness is puzzling. We hypothesized that unaffected first-degree relatives of patients have more offspring than controls. Method: Probands were 4904, individuals with non-affective psychotic disorders identified from a hospitalization registry. Unaffected first degree relatives and matched controls were identified from the Israeli Population Registry. The number of offspring of unaffected parents, biological siblings and controls was ascertained. Results: Unaffected parents of psychotic patients had more offspring/person than controls; 4.5 ± 2.7 vs. 3.4 ± 2.2, P = 0.000. Unaffected parents from familial psychosis families (more than one affected family member) had 1.83 more offspring than controls; unaffected parents from non-familial psychosis families had 0.97 more offspring than controls (both P < 0.001). Conclusion: These findings might imply that genes which increase susceptibility for schizophrenia may be associated with increased number of offspring, perhaps supplying a partial explanation for the persistence of psychosis. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether maternal obesity poses a risk for long-term cardiovascular morbidity in the offspring.Study Design: Data were analyzed from a non-selective population of all infants born between the years 1991-2014 at the tertiary Soroka University Medical Center (SUMC), the sole hospital in the southern region of Israel. Offspring's cardiovascular morbidity from childbirth up to eighteen years old was compared among children whom their mothers were with and without obesity (maternal pre-pregnancy body mass index (BMI) ≥30 kg/m2). Kaplan-Meier survival curve was used to compare cumulative incidence of cardiovascular hospitalizations. Cox proportional hazards model was used to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for long-term cardiovascular hospitalizations.Results: A total of 242,342 deliveries met the inclusion criteria, 3290 (1.36%) had a BMI > 30 kg/m2. Total cardiovascular hospitalizations were comparable between the study groups (1.1% vs. 0.6%, OR = 1.79; 1.28-2.50). The Kaplan-Meier survival curve exhibited a difference in the cumulative incidence of total cardiovascular hospitalizations of the offspring (log-rank test, p < 0.001). In the Cox multi-variable analysis, a significant association was noted between obesity and cardiovascular morbidity even after adjustment for confounders such as maternal age, gestational age, hypertension and diabetes (adjusted HR = 1.59, 95% Cl 1.14-2.21).Conclusion: Maternal obesity is an independent risk factor for long-term cardiovascular morbidity in the offspring. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of our study was to evaluate the effect of IPI on long-term neurological morbidity of the offspring., Methods: In this retrospective cohort study, 144,397 singleton infants born to multiparous mothers, between the years 1991 and 2014 in a tertiary medical center, were evaluated for different perinatal outcomes and were followed until 18 years of age for long-term neurological morbidity according to three IPI groups: Short IPI (< 6 months), long IPI (> 60 months) and intermediate IPI (6-60 months). We used a Kaplan-Meier survival curve to compare cumulative incidence of long-term neurological morbidity, and a Cox regression analysis to control for confounders such as gestational age, birth weight and maternal age., Results: Offspring born to mothers with long IPI had higher rates of neurological morbidity (3.62% among offspring born after long IPI vs. 3.18% and 3.19% among offspring born after short and intermediate IPI, respectively, p = 0.041). The cumulative incidence of long-term neurological morbidity was significantly higher in the long IPI group (Kaplan-Meier log-rank test p < 0.001). Being born after a long IPI was found to be an independent risk factor for long-term neurological morbidity of the offspring (adjusted hazard ratio 1.2; 95% confidence interval 1.1-1.4; p < 0.001)., Conclusion: Long IPI is independently associated with an increased risk of long-term neurological morbidity of the offspring.

Drug allergy is associated with adverse short-term perinatal outcomes such as caesarian delivery and preterm delivery. The aim of the present study was to determine whether being born to a mother with known drug allergy increases the risk for long-term dermatological morbidity of the offspring. A population-based cohort study, comparing long-term dermatological morbidity of offspring to mothers with and without known drug allergy, was conducted. Dermatological morbidity was assessed up to the age of 18 years according to a predefined set of ICD-9 codes associated with hospitalization of the offspring. A Kaplan-Meier survival curve was used to compare cumulative incidence of long-term dermatological morbidity, and a Cox proportional hazards model was constructed to control of confounders. During the study period, 243,682 deliveries met the inclusion criteria, of them 4% (n = 9756) were of mothers with known drug allergy. Offspring born to mothers with known drug allergy had higher rates of long-term dermatological morbidity Likewise, the cumulative incidence of long-term dermatological morbidity was higher as compared with those without known drug allergy (Kaplan-Meier log-rank P = .021). Using a Cox proportional hazards model, controlling for confounders, being born to a mother with known drug allergy was found to be an independent risk factor for long-term dermatological morbidity of the offspring (adjusted HR 1.2, 95% CI 1.03-1.33, P = .016). Being born to a mother with known drug allergy is independently associated with higher risk for long-term dermatological morbidity of the offspring., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: Due to advances in medical care available for patients with congenital heart disease, these patients now have a longer life span. As a result, the number of pregnancies of mothers with congenital heart disease has increased. The purpose of the current study was to evaluate perinatal outcomes of women with congenital heart disease and to examine long-term cardiovascular morbidity of offspring to mothers with congenital heart disease., Materials and Methods: A population-based cohort analysis was performed including all singleton deliveries occurring between years 1991-2014 at Soroka University Medical Center. The primary exposure was defined as maternal congenital heart disease. Short-term perinatal outcomes as well as long-term cardiovascular related hospitalizations of the offspring up to the age of 18 years were compared between women with and without congenital heart disease. To compare perinatal outcomes between the two study groups, we conducted a Generalized Estimation Equation (GEE) model accounting for maternal age and multiple occurrence in the cohort, parity, fertility treatment, smoking and induction of labor. To compare cumulative long-term cardiovascular morbidity, we compared cardiovascular hospitalization incidence of offspring of mothers with and without congenital heart disease using Kaplan-Meier survival curve and Weibull regression analysis to control for maternal age, diabetes, smoking, hypertension, birth weight, and cesarean delivery., Results: During the study period 243,313 deliveries met the inclusion criteria, of which 369 were of mothers with congenital heart disease. Maternal congenital heart disease was found to be an independent risk factor for low birth weight (adjusted OR = 1.5 CI 95 % 1.06-2.32, p=0.022) and cesarean delivery (adjusted OR = 1.4 CI 95 % 1.09-1.86, p = 0.008). Mothers with congenital heart disease also had higher risk for placental abruption, but it was not statistically significant (adjusted OR = 2.3 CI 95 % 0.87-6.16, p = 0.09). Long-term cardiovascular morbidity was comparable between the groups (Log rank p = 0.251; adjusted HR = 1.6 CI 95 % 0.62-4.42, p = 0.313)., Conclusion: In conclusion, pregnancies of women with congenital heart disease are at an increased risk for adverse short-term perinatal outcomes, such as low birth weight and cesarean delivery. However, we did not find an increase in long-term cardiovascular morbidity among offspring of these women; still this association cannot be ruled out., Competing Interests: Declaration of Competing Interest The authors report no conflict of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Objective: Gestational diabetes mellitus (GDM) was previously found to be an independent risk factor for long-term cardiovascular morbidity of parturients and their offspring. The objective of this study was to investigate the association between family history of diabetes mellitus (DM) in non-diabetic mothers and long-term pediatric cardiovascular hospitalizations of their offspring., Study Design: In a hospital-based cohort study, the incidence of cardiovascular disorders was compared between offspring of non-diabetic mothers with and without a family history of DM. Cardiovascular hospitalizations were assessed up until 18years of age according to a predefined set of ICD-9 codes associated with hospitalization of offspring. Exclusion criteria included multiple gestations, mothers with pre-gestational or gestational diabetes, lack of prenatal care, and children with congenital malformations and chromosomal abnormalities. A Kaplan-Meier survival curve was used to compare cumulative hospitalizations incidence. A cox proportional hazards model was performed to control for confounders., Results: A total of 208,728 deliveries were included in the study. Of them, 17,040 (8.2%) offspring were born to non-diabetic mothers with a family history of DM. Significant differences in the rates of IVF, induction of labor, obesity, hypertensive disorders of pregnancy, smoking and birth weight were found between the two study groups. Total cardiovascular hospitalizations were comparable between the study groups (0.6% vs. 0.7%, p=0.416). The Kaplan-Meier survival curve exhibited no difference in the cumulative incidence of total cardiovascular hospitalizations of the offspring (log-rank test, p=0.271). A Cox regression model found that a family history of DM in non-diabetic mothers was not independently associated with long-term cardiovascular hospitalizations of the offspring after controlling for the following confounders: maternal age, birth weight, caesarian section and maternal hypertensive disorders (aHR=1.130, 95% CI 0.930-1.374, p=0.220)., Conclusion: A family history of DM in non-diabetic parturients, does not increase the risk for cardiovascular hospitalizations of their offspring., (Copyright © 2019 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.)

Objective: To investigate short-term adverse perinatal outcomes and long-term neuropsychiatric hospitalizations through 18 years of age in offspring conceived during copper intrauterine device (IUD) use., Study Design: We conducted a population-based cohort study comparing the pregnancy outcomes after 22 weeks of women who conceived with a copper IUD that was removed, women with a retained IUD and pregnancies without an IUD. Deliveries occurred between the years 1991 and 2014. We used a multivariable generalized estimating equation (GEE) logistic regression model analysis to control for confounders and for maternal clusters, a Kaplan-Meier survival curve to compare cumulative neuropsychiatric hospitalizations incidence and a Cox proportional-hazards model to evaluate long-term neuropsychiatric hospitalizations., Results: During the study period there were 221,805 deliveries, of which 203 (0.09%) and 149 (0.06%) occurred in patients with removed or retained copper IUD, respectively. Using GEE models, preterm delivery was independently associated with copper IUD use [odds ratio (OR) 2.1, 95% confidence interval (CI) 1.4-3.2 and OR 2.3, 95% CI 1.4-3.7 for removed and retained IUD, respectively]. We did not find an association between copper IUD presence or removal and the offspring's long-term neuropsychiatric hospitalizations (total long-term neuropsychiatric hospitalizations: 2.5%, 4.4% and 3.2% for removed, retained and no IUD, respectively, p=.71). Long-term neuropsychiatric hospitalization rate was comparable between the groups (Kaplan-Meier survival curve log rank p=.23)., Conclusion: Pregnancies in women who conceive with a removed or retained copper IUD are at an increased risk for short-term adverse perinatal outcomes, especially preterm delivery. For pregnancies that continued to at least 22 weeks, we found no benefit in IUD removal. However, the risk of long-term neuropsychiatric hospitalizations is not increased among offspring of these women., Implications: Our data are insufficient to make a recommendation as to whether removal or retention of a copper IUD during pregnancy is best, as after 22 weeks' gestation we have found no benefit in IUD removal. Careful surveillance and categorization of the pregnancy as "high risk" are warranted., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: Placental abruption is a major determinant of maternal and perinatal morbidity and mortality, often related to asphyxia and preterm birth. However, the impact of abruption on the long-term morbidity of the offspring is less investigated., Methods: We designed a hospital-based cohort study, in which the incidence of long-term neurology-related hospitalisations of offspring to women with and without placental abruption was assessed. All singleton deliveries between 1991 and 2014 were included in the study. Congenital anomalies, perinatal mortality, and multifetal pregnancies were excluded from the analyses. We compared cumulative morbidity incidence using Kaplan-Meier survival curves and estimated the risk for long-term neurological hospitalisations from Cox proportional hazards models after adjustment for putative including maternal age, parity, hypertensive disorders, pre-gestational and gestational diabetes, gender, ethnicity, and year of birth., Results: Over the 22-year period, 2 202 269 person-years of follow-up, there were 217 910 deliveries of which 0.5% (n = 1003) were complicated with placental abruption. The median (interquartile range) follow-up of children in the abruption and non-abruption groups was 10.3 (4.6, 15.9) and 12.0 (6.3, 16.5) years, respectively. The cumulative incidence of total neurological hospitalisations was comparable between abruption (3.32 per 1000 person-years) and non-abruption (3.16 per 1000 person-years). Abruption was associated with increased rates of cerebral palsy (hazard ratio [HR] 6.71, 95% CI 3.32, 13.58) and developmental disorders (HR 3.36, 95% CI 1.38, 8.13), but not for total neurology-related hospitalisations (HR 1.08, 95% CI 0.78, 1.49)., Conclusion: Placental abruption is associated with increased rate of cerebral palsy and developmental disorders in the offspring later in life. This study may define risk factors for childhood neuropsychiatric disorders, enabling early diagnosis and intervention in children with such disorders, and perhaps improving their prognosis., (© 2019 John Wiley & Sons Ltd.)

Otitis media (OM) carries a tremendous global health burden and potentially severe long-term consequences. The objective of this study was to determine the impact of birth at different gestational ages on the incidence of childhood OM.A population-based cohort analysis was conducted. All singleton deliveries occurring between 1991 and 2014 at a regional tertiary medical center were included. Gestational age on delivery was divided into six subgroups: early (&lt;34 weeks gestation; 0 out of 7) and late (34 weeks gestation; 0 out of 7 to 36 weeks gestation; 6 out of 7) preterm, and early (37 weeks gestation; 0 out of 7 to 38 weeks gestation; 6 out of 7), full (39 weeks gestation; 0 out of 7 to 40 weeks gestation; 6 out of 7), late (41 weeks gestation; 0 out of 7 to 41 weeks gestation; 6 out of 7) and post (⩾42 weeks 0 out of 7) term deliveries. Rates of OM-related hospitalizations up to 18 years of age were assessed. Weibull parametric hazards model was used to study the association between gestational age at birth and the risk for OM-related hospitalizations while controlling for potential confounders.During the study period, 238,622 deliveries met the inclusion criteria. OM-related hospitalizations of the offspring (n=4724) were significantly more common in the preterm (early 3.6%, late 2.4%) and early-term born children (2.2%) and decreased gradually across the full (1.9%), late (1.7%) and post (1.6%) term groups (χ2-test for trends P&lt;0.001). In the Weibull regression model, early preterm, as well as early-term deliveries exhibited an independent association with pediatric OM (adjusted hazard ratios: 1.67 and 1.09, respectively, P&lt;0.02).Deliveries occurring at preterm and early term are associated with higher rates of pediatric OM-related hospitalizations, which decrease gradually as gestational age advances.

Objective: We aimed to evaluate the association between advanced maternal age and the long-term health of the offspring., Methods: In this population-based cohort study, hospitalizations of offspring up to the age of 18 years were compared according to maternal age. The incidence of long-term hospitalizations of the offspring due to cardiovascular, endocrine, neurological, hematological, respiratory and gastro-intestinal morbidities was evaluated. Deliveries occurred between the years 1991 and 2014 in a tertiary medical center. Kaplan-Meier survival curves were used to compare cumulative morbidity incidence. Cox regression models were performed to control for confounders., Results: During the study period, 202,709 deliveries were included, of which 26,287 (12.9%) were in women aged 35-39 years, and 6,718 (3.3%) in women aged 40-50 years. Children born to older mothers did not have a significantly different cumulative incidence of long-term pediatric morbidities evaluated, as compared with the comparison group, using Kaplan-Meier survival analyses. In the Cox regression analyses, advanced maternal age did not exhibit an independent association with long-term morbidities of the offspring., Conclusion: Despite the association of advanced maternal age with adverse maternal and immediate neonatal outcomes, there does not seem to be an association with the long-term morbidity of the offspring., (© 2018 S. Karger AG, Basel.)