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Faith, as a way of how people understand God and the world and make or discover meaning in their life, is characterized by individual differences and changes over the lifetime. Our research investigates these changes over the life span in terms of hierarchically ordered types that are the elements in our developmental model, which is a critical advancement and modification of Fowler’s theory of faith development. This study is the first to investigate whether there is development in faith over the adult life span and to identify predictors of developmental change. Our mixed-method design used three-wave longitudinal data (mean lag time 10.47 years from Wave 1 to Wave 3). A sample of N = 75 participants were interviewed with the faith development interview three times and each time answered comprehensive questionnaires. Results evidenced faith development over the life span: a majority in our data moved to a higher type, while change to a lower type did occur. Openness to experience and the religious schema truth of text and teachings were potential antecedents for faith development. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Dickkopf1 (DKK1) was originally identified as a secreted protein that antagonizes Wnt signaling. Although DKK1 is essential for the developmental process, its functions in postnatal and adult life are unclear. However, evidence is accumulating that DKK1 is involved in tumorigenesis in a manner unrelated to Wnt signaling. In addition, recent studies have revealed that DKK1 may control immune reactions, although the relationship of this to Wnt signaling is unknown. Other DKK family members, DKK2-4, are likely to have their own functions. Here, we review the possible novel functions of DKKs. We summarize the characteristics of receptors of DKKs and the signaling mechanisms through DKKs and their receptors, provide evidence showing that DKKs are involved in tumor aggressiveness independently of Wnt signaling, and emphasize promising cancer therapies targeting DKKs and receptors. Lastly, we discuss various physiological and pathological processes controlled by DKKs.

Background: Environmental pollution with toxic heavy metals can be lead to the possible contamination of rice. Rice is a staple food widely consumed in the urban and rural parts of Liberia daily. Rice is cultivated in approximately 113 countries and a fundamental source for energy and protein. Objective: The study assesses selected heavy metals (As, Pb, Cd, Se, and Cr) concentration in selected imported rice and traditionally grown rice and bulgur wheat in Liberia. Methods: Six grade of imported rice, Bulgar wheat, and traditionally grown rice were purchased from the Duport Road and Red-Light markets in Greater Monrovia and analyze using X-ray Fluorescence Spectrometer. All data were analyzed using XLSTAT, and data was used to calculate the risk factor of each rice sample. Results: The mean concentration of heavy metal found in the rice as follow: As, 1.31ppm; Cd, 9.42ppm; Cr. 12.3ppm; Se, 5.73ppm; and Pb, 1.75ppm. The estimated daily intakes (EDIs) were calculated in combination with the rice consumption data. The mean intakes of As, Cd, Cr, Se, and Pb through rice were estimated to be 1.32, 9.42. 12.4. 5.74, and 1.75 mg/kg BW/day. Chromium has the average estimated daily intake. The combined hazard index for the heavy metals in each sample and the total cancer risk for each sample contributed most significantly to a cancer risk of rice consumption during adult life expectancy.Conclusion: The selected heavy metal concentration from the rice sample was above the FAO/WHO reference Standard but was within the range of the contaminant level except for chromium, which is above the accepted range. However, the hazard index and the total cancer risk indicate a potential non-carcinogenic and carcinogenic risk. Â

Congenital anomalies of the infrarenal inferior vena cava (IVC) are well described in adult life, however, little information exists on their associations in fetal life. Here, we describe a case of a monochorionic diamniotic (MCDA) twin pregnancy complicated by selective fetal growth restriction (sFGR) with an incidental finding of a double IVC in one child. In fetal life, variants of the infrarenal IVC are strongly associated with heart defects, which might suggest haemodynamic alterations or genetic causes, even more so in our case with MCDA twins complicated by sFGR.

Syftet med denna uppsats är att kartlägga vuxna ungdomars upplevelser av skolämnet idrott och hälsa på gymnasial nivå. På vilket sätt har ämnet skapat en bra grund för framtiden och vad uppskattar man ha lärt sig för väsentlig kunskap för framtida aktiviteter för att bibehålla en hälsosam livsstil i vuxen ålder? Metoden som använts för denna studie är kvantitativa enkäter som är riktade mot unga vuxna som gått ur gymnasiet efter 2011. Studien visar att majoriteten av lektionerna i idrott och hälsa utgörs av bollsporter och lekaktiviteter även på gymnasial nivå. Medan andra aspekter i ämnet som orientering och fridlufsliv får betydligt mindre plats trots att detta är delar av ämnet som enligt resultatet i denna studie anses önskvärda i vuxenlivet. Hälsa och träning får relativt stor plats i lektionsplaneringen men eleverna anser att dom inte får tillräckligt med kunskap i ämnet. De viktiga aspekterna som tas i beaktning till resultatet är ämnesinnehåll, idrottsvanor och aktivitetsnivåer under och efter gymnasiet, men även unga vuxnas upplevelser och användning av kunskapen från idrott och hälsa. Detta är viktiga faktorer som kan ha påverkat lärandet i ämnet och behovet för framtiden. Resultatet av studien visar att generellt anser respondenterna att man inte får med sig relevant kunskap från lektionerna och man önskar att det lades större fokus på träningslära, kost och hälsa. Ett visst könsmönster går att särskilja då tjejer rör mindre på sig under gymnasietiden men efter gymnasiet är aktivitetsnivåerna likställda och att det vanligaste sättet att aktivera sig är löpning och gymträning i vuxen ålder. Något man kan ha i åtanke är om detta beror på faktorer som brist av planeringstid och resurser. Eller är det ett sätt att göra det enkelt för sig? The purpose of this essay is to map the experiences of young adults in the school subject of sports and health at high school level. In what way has the subject created a good foundation for the future and what do you appreciate having learned as essential knowledge for future activities to maintain a healthy lifestyle in adulthood? The method used for this study is quantitative surveys aimed at young adults who graduated from high school after 2011. The study shows that most lessons in physical education and health consist of ball sports and play activities even at high school level. While other aspects of the subject such as orienteering and outdoor life receive considerably less space, even though these are parts of the subject which, according to the results of this study, are considered desirable in adult life. Health and exercise have a relatively large place in the lesson planning, but the students believe that they do not get enough knowledge on the subject. The important aspects that are considered for the result are subject content, sports habits, and activity levels during and after high school, but also young adults' experiences and use of the knowledge from sports and health. These are important factors that may have affected learning in the subject and the need for the future. The results of the study show that, in general, the respondents believe that they do not get relevant knowledge from the lessons, and they wish that there was a greater focus on training, nutrition and health. A certain gender pattern can be distinguished as girls move less during high school, but after high school the activity levels are equal and that the most common way to get active is running and gym training in adulthood. Something to keep in mind is whether this is due to factors such as lack of planning time and resources. Or is it a way to make it easy for yourself?

Background: Associations between body mass index (BMI) and psychological distress (PD) have been reported; however, few longitudinal studies have accounted for likely life-course differences in BMI and PD stability, consistency, and their interplay across time. Methods: Via random intercepts cross-lagged panel models, we assessed the predictive effects (from BMI to PD or vice-versa) across the last two centuries in the Coronary Artery Risk Development in Young Adults [CARDIA, beginning in 1985-6] study using the Center for Epidemiological Studies-Depression Scale [CES-D], and in the National Child Development Study [NCDS, beginning in 1958] and British Cohort Study [BCS, beginning in 1970] using the Malaise Inventory [MI]), assessed at least 4 times in adult life. Findings: In CARDIA (n = 4724), NCDS58 (n = 7149) and BCS70 (n = 5967), autoregressive effects were stronger for BMI than for PD, meaning that carry-over effects from one occasion to the next were larger for BMI than for PD. Small interindividual correlations between traits of higher BMI and higher PD were identified among females (rfemale

Listening-related fatigue is a potentially serious negative consequence of an aging auditory and cognitive system. However, the impact of age on listening-related fatigue and the factors underpinning any such effect remain unexplored. Using data from a large sample of adults ( N = 281), we conducted a conditional process analysis to examine potential mediators and moderators of age-related changes in listening-related fatigue. Mediation analyses revealed opposing effects of age on listening-related fatigue: Older adults with greater perceived hearing impairment tended to report increased listening-related fatigue. However, aging was otherwise associated with decreased listening-related fatigue via reductions in both mood disturbance and sensory-processing sensitivity. Results suggested that the effect of auditory attention ability on listening-related fatigue was moderated by sensory-processing sensitivity; for individuals with high sensory-processing sensitivity, better auditory attention ability was associated with increased fatigue. These findings shed light on the perceptual, cognitive, and psychological factors underlying age-related changes in listening-related fatigue.

Intrauterine life is one of the most important periods of life. As the development of the fetus continues, the mechanisms that affect adult health also begin to mature. With the hypothesis denoted “fetal programming,” it is thought that the presence of endocrinological disorders, toxins, infectious agents, the nutritional status of a mother, and nutrients related to placental functionality all have an effect on future life. Therefore, the fetus must adapt to the environment for survival. These adaptations may be involved the redistribution of metabolic, hormonal, or cardiac outputs in an effort to protect the brain, which is one of the important organs, as well as the slowing of growth to meet nutritional requirements. Unlike lifestyle changes or treatments received in adult life, the early developmental period tends to have a lasting effect on the structure and functionality of the body. In this review, fetal programming and the effects of fetal programming are discussed.

Background and aims: High remnant cholesterol is associated with cardiovascular disease (CVD), but whether CVD risk attributable to remnant cholesterol vary between young and later adults remains unknown. The study aimed to assess age differences in the association between remnant cholesterol and CVD. Methods: This prospective study included 95 663 participants without CVD and lipid-lowering treatment at baseline, including 16 254 young adults (age 18–39 years) and 79 409 later adults (age ≥40 years). Individuals were grouped by clinically meaningful remnant cholesterol concentrations of

Aims Occupational therapy services include measurement and promotion of time organization as important for adolescents' daily life management and well-being into adulthood. This study examined the internal consistency reliability of the Time Organization and Participation Scale (TOPS) among adolescents and their parents, associations between time organization and age, gender differences in time organization, and agreement levels between adolescents' and parents' perceptions of time-organization abilities. Methods Seventy-five adolescents with typical development and their parents completed the TOPS self-report and parent versions. Results Both TOPS versions showed high internal consistency (.80-.94). No significant correlations were found between age and time-organization patterns. Girls self-reported significantly more emotional response following disorganization in time. Parents' total scores explained 52.1% of the variance in their children's total scores. Conclusions Adolescence, a critical transitional period of preparing for independent adult life, involves a continual interaction between person, occupation, and environment while using skills to organize in time. The TOPS's self- and parent-reports are reliable and can raise awareness of time-organization deficiencies in daily activities and emotional consequences. The use of the TOPS to assess adolescents' time-organization abilities can inform intervention design to help adolescents develop an awareness of their time use and foster their daily performance.

Forkhead box (FOX) proteins are an evolutionarily conserved family of transcription factors that play numerous regulatory roles in eukaryotes during developmental and adult life. Dysfunction of FOX proteins has been implicated in a variety of human diseases, including cancer, neurodevelopment disorders and genetic diseases. The FOX family members share a highly conserved DNA-binding domain (DBD), which is essential for DNA recognition, binding and function. Since the first FOX structure was resolved in 1993, >30 FOX structures have been reported to date. It is clear now that the structure and DNA recognition mechanisms vary among FOX members; however, a systematic review on this aspect is lacking. In this manuscript, we present an overview of the mechanisms by which FOX transcription factors bind DNA, including protein structures, DNA binding properties and disease-causing mutations. This review should enable a better understanding of FOX family transcription factors for basic researchers and clinicians.

Generational overlap affects the care time demands on parents and grandparents worldwide. Here, we present the first global estimates of the experience of simultaneously having frail older parents and young children (“sandwichness”) or young grandchildren (“grandsandwichness”) for the 1970-2040 cohorts using demographic methods and microsimulations. We find that sandwichness is more prevalent in the Global South – e.g. people born in 1970 in Sub-Saharan Africa are twice as likely to be sandwiched as Europeans – but is expected to decline globally by one-third between 1970 and 2040. The Global North might have reached a peak in the simultaneous care time demands from multiple generations but the duration of the grandsandwich state will increase by up to one year in Africa and Asia. This increasing generational overlap implies more care time demands over the entire adult life course but also opens up the opportunity for the full potential of grandparenthood to materialize.

BACKGROUND: Centers for Independent Living (CILs) can help out-of-school youth with disabilities. CIL services may be particularly important for minority youth with disabilities that face additional transition barriers. OBJECTIVE: This literature review documents existing practices that might aid CILs as they seek to help youth, including minority youth, with disabilities transition to adult life. METHODS: First, we conducted a literature search to identify practices that might help CILs assist youth with disabilities transition to independent living (IL) in early adult life. Then we examined various literature syntheses of postsecondary transition interventions with evidence of promise or efficacy for any IL-related outcome—regardless of whether the intervention targeted youth with disabilities. RESULTS: We discovered a variety of practices CILs might learn from or consider adopting to help youth with disabilities transition to adult life. However, the practices rarely focused on minority youth and usually had limited or no evidence about whether they improved IL outcomes. CONCLUSIONS: The limitations of the evidence we found suggest the need to develop and test interventions that help transition age youth with disabilities—especially minority youth with disabilities—achieve their IL goals.

This is a story of a young bride, typical of many Italian women of her generation, who struggled with the proposition of having to leave all she knew and loved behind to join her husband and a new life in ‘America’. Threading this common story of emigration, journeying, and settling, however, are the memories of a devoted grandson who, charmed by grandma’s fascinating narratives of “home”, embarks in his adult life on his own journey, back to the fount of his origins. Nonna Artemisia had left Italy on the promise to her father that she would endeavour to return someday to be with him again. The author, captivated by his grandmother’s lifelong feeling of separation, symbolically returns her spirit to its original familial home.

Nerves and blood vessels (BVs) establish extensive arborized networks to innervate tissues and deliver oxygen/metabolic support. Developmental cues direct the formation of these intricate and often overlapping patterns, which reflect close interactions within the peripheral neurovascular system. Besides the mutual dependence to survive and function, nerves and BVs share several receptors and ligands, as well as principles of differentiation, growth and pathfinding. Neurovascular (NV) interactions are maintained in adult life and are essential for certain regenerative mechanisms, such as wound healing. In pathological situations (e.g., type 2 diabetes mellitus), the NV system can be severely perturbed and become dysfunctional. Unwanted neural growth and vascularization are also associated with the progression of some pathologies, such as cancer and endometriosis. In this review, we describe the fundamental NV interactions in development, highlighting the similarities between both networks and wiring mechanisms. We also describe the NV contribution to regenerative processes and potential pathological dysfunctions. Finally, we provide an overview of current in vitro models used to replicate and investigate the NV ecosystem, addressing present limitations and future perspectives.

This article reports on the development of a new transition service in Norfolk; ‘Preparing for Adult Life’ (PfAL), led by Adult Services (ASSD). It identifies the strategies that were used to devel...

German-born Charles Mohr (1824–1901) spent most of his adult life working as a pharmacist in Mobile, Alabama. In addition, he contributed multiple scientific and popular articles on the botany of the Southeastern United States. Suffering from many physical ailments, he sought treatment in thermal baths and cool climates, including Asheville, North Carolina. There he was able to work with botanists at the newly established Biltmore Herbarium. In early 1900, he and his family moved to Asheville, where he completed reading the proof of his magnum opus, Plant Life of Alabama. He died in Asheville 17 July 1901—two weeks before his book was published—and is buried there.

A new species of the genus Wyeomyia, Wyeomyia (Decamyia) anthica sp. n., is described based on morphological and molecular analyses and is illustrated in larval, pupal and adult life stages. Among the four valid species of the subgenus Decamyia, the new species is closest to Wy. ulocoma (Theobald, 1903), from which it can be distinguished by morphological characters of the male genitalia, larval and pupal stages, and mitochondrial cytochrome c oxidase 1 gene sequence. Wyeomyia ulocoma is recorded from Brazil for the first time.

This study aimed to assess the effects of aging on mind wandering (MW) using a sustained attention to response task (SART) with a low cognitive demand. All task-unrelated thoughts (TUTs) and the subcategory of stimulus-independent thoughts (SITUTs) were examined across the adult life span. The relationship between MW, cognitive variables (attention, inhibition, working memory), and non-cognitive variables (mindfulness, psychological well-being, and anxiety) was investigated. The sample included 210 healthy participants from 20 to 89 years old. The overall results showed few or no age-related changes in both TUTs and SITUTs. Path analyses revealed that the effect of age on both TUTs and SITUTs was only indirect and mediated by attentional resources, as well as by some aspects of psychological well-being (i.e., emotional competence), which had a direct effect, however. These findings raise doubts about any age-related differences between young and older adults’ MW. Changes in MW across the adult life span are thus discussed along with the method and tasks used to assess it and different variables affecting it.

Introdução: O acompanhamento dos escolares quanto a instalação do excesso de peso é de fundamental importância, visto os problemas que podem decorrer desse excesso na vida adulta. Objetivo: O presente estudo analisou o índice de massa corporal de estudantes de uma escola privada do interior do Pará, no período de 3 anos. Métodos: Participaram do estudo 269 alunos de 6ª a 8ª série, matriculados de 2011 a 2013. Os estudantes foram divididos em três grupos para serem avaliados: o G1 (alunos avaliados da 6ª à 8ª série); o G2 (alunos avaliados da 7ª à 9ª série); e o G3 (alunos avaliados da 8ª série ao 1º ano). Os escolares foram avaliados quanto à massa corporal, estatura e índice de massa corporal (IMC). Os dados foram analisados quanto à normalidade e adotou-se a correlação de Pearson para os dados paramétricos e de Spearman para os dados não paramétricos. O nível de significância adotado foi de p

The acronym for the CCN family was recently revised to represent “cellular communication network”. These six, small, cysteine-enriched and evolutionarily conserved proteins are secreted matricellular proteins, that convey and modulate intercellular communication by interacting with structural proteins, signalling factors and cell surface receptors. Their role in the development and physiology of musculoskeletal system, constituted by connective tissues where cells are interspersed in the cellular matrix, has been broadly studied. Previous research has highlighted a crucial balance of CCN proteins in mesenchymal stem cell commitment and a pivotal role for CCN1, CCN2 and their alter ego CCN3 in chondrogenesis and osteogenesis; CCN4 plays a minor role and the role of CCN5 and CCN6 is still unclear. CCN proteins also participate in osteoclastogenesis and myogenesis. In adult life, CCN proteins serve as mechanosensory proteins in the musculoskeletal system providing a steady response to environmental stimuli and participating in fracture healing. Substantial evidence also supports the involvement of CCN proteins in inflammatory pathologies, such as osteoarthritis and rheumatoid arthritis, as well as in cancers affecting the musculoskeletal system and bone metastasis. These matricellular proteins indeed show involvement in inflammation and cancer, thus representing intriguing therapeutic targets. This review discusses the current understanding of CCN proteins in the musculoskeletal system as well as the controversies and challenges associated with their multiple and complex roles, and it aims to link the dispersed knowledge in an effort to stimulate and guide readers to an area that the writers consider to have significant impact and relevant potentialities.

The key to having a good quality of life for an adult with hemophilia rests largely on how he or she was managed as children. With effective prophylaxis, young men can begin their adult life with excellent joint function and few, if any, other sequelae from their disease. Unfortunately, this outcome is not always (nor often) attained because of the limitations of the mainstay of treatment, which is factor replacement therapy. In resource-rich countries with an adequate supply of factor concentrates, the treatment burden and formation of inhibitors limit the potential for an ideal outcome, whereas in much of the world, factor concentrates are too expensive to even be an option. The novel agent, emicizumab, which has become available in numerous countries around the world, is reshaping how one approaches the treatment of children with hemophilia A. This Forum Article, based on a State-of-the-Art lecture given at the 2020 International Society on Thrombosis and Haemostasis Virtual Meeting, presents an approach including clinically applicable algorithms for treating children with hemophilia A in the new era with emicizumab.

The article defines a crisis in relations to faith and describes its consequences. The article also shows: reasons why people decide to leave the Church, reasons for changing denomination, as well as the paths to conversion.

Knowledge about gender convergence in housework time is confined to changes studied across repeated cross-sections of data. This study adds a dynamic view that links broader social shifts in men’s and women’s housework time to individual life-course profiles. Using panel data from the German Socio-Economic Panel Study (1985–2015), our analysis is the first to trace changes in housework time across the entire adult life course (ages 20–90) and across a large range of cohorts (1920–1990). The results revealed two types of gender convergence in housework time. First, the gender gap converged across the life course, narrowing by more than 50 percent from age 35 until age 70. Life-course profiles of housework time were strongly gendered, as women's housework time peaked in younger adulthood and declined thereafter, whereas men’s housework time remained stably low for decades and increased only in older age. Second, the gender gap converged across cohorts, narrowing by 40 percent from cohorts 1940 until 1960. Cohort profiles of housework time showed strong declines in women and moderate increases in men. Both cohort trends were linear and extended to the most recently born, supporting the notion of continued convergence in housework time.

Este texto propõe-se a analisar a reforma do ensino médio no Brasil sob uma perspectiva específica: seu potencial de ir além da tradicional tarefa de capacitar o estudante para ingressar na universidade ou na carreira, passando a oferecer ao jovem uma formação mais ampla e equilibrada, de modo a prepará-lo para a entrada na vida adulta. Ao refletir acerca de suas propostas, conteúdos e viabilidade, este estudo examina a existência de potencialidades para a inserção de valores básicos e outros aspectos edificantes na vida do estudante. Constata-se que, de fato, isso acontece, e é a Base Nacional Comum Curricular (BNCC) que traz essa possibilidade para o bojo da reforma. As apreciações feitas a respeito dessa política brasileira referenciam-se em pesquisas bibliográficas sobre modelos e tendências recentes no debate sobre ensino médio e em experiências internacionais. Ao fim do trabalho, são feitas algumas considerações e sugestões para ajudar a implantação exitosa de suas propostas.

The article is devoted to the issues of feelings and emotions and contained in the rich scientific heritage of Stefan Szuman, described in the context of his pedagogical and psychological achievements. It presents the scholar’s biography, and then characterizes his scientific achievements in the field of psychology and pedagogy. Due to Szuman’s particular interest in children’s artistic creation, his views in this field were discussed, with particular emphasis on the importance of feelings and emotions that accompany children and young people in creating and receiving works of art. Then, the characteristics of teachers’ personal traits according to Szuman were also made. In his opinion, teachers’ professional work should focus on good aesthetic education of students in schools. The views of the Polish psychologist on the role of art in adult life were also presented. The article indicates those elements of Szuman’s views in which he spoke about the participation of feelings in the process of creating and receiving works of art.

Successful social engagement is one of many important outcomes for deaf youth as they transition from high school to adult life. This study examined the effect of self-advocacy and social/life skill trainings in secondary school settings on social engagement after high school using propensity score modeling and data from the large-scale and nationally representative National Longitudinal Transition Study-2. Analyses focused on three types of post-high school social engagement: frequency of seeing friends, involvement in group activities, and participation in community service. A fourth outcome variable was created to indicate whether the individual was at least minimally engaged. Results found that deaf youth who received self-advocacy training in secondary school were significantly more likely to be at least minimally engaged than those who had not. These findings suggest that self-advocacy training in high school can help protect deaf youth against social isolation in young adulthood.

We investigate the association between women’s educational levels and housework participation across cultural contexts and through different stages in the life-course. In testing the suggestion from previous research that women with higher levels of education spend less time on housework than do women with less education, we found that this argument holds true for single women in Japan, Taiwan, and the United States. Our results also indicate that for all American women and for single and married Taiwanese women without children, their numbers of years of education correlate inversely with their daily hours of domestic labour; however, this correlation does not exist for married Taiwanese women with children. Similarly, the educational levels of married Japanese women—with or without children—have no bearing on their housework participation.

The present study investigated the effects of childhood physical neglect (CPN), childhood physical abuse (CPA), and the moderator role of perceived resilience on adult life satisfaction (LS). The N...

Background Hearing loss is associated with a greater risk of death in older adults. This relationship has been attributed to an increased risk of injury, particularly due to falling, in individuals with hearing loss. However, the link between hearing loss and mortality across the life span is less clear. Methods We used structural equation modeling and mediation analysis to investigate the relationship between hearing loss, falling, injury, and mortality across the adult life span in public-use data from the National Health Interview Survey and the National Death Index. We examined (a) the association between self-reported hearing problems and later mortality, (b) the associations between self-reported hearing problems and the risk of injury and degree and type of injury, (c) the mediating role of falling and injury in the association between self-reported hearing problems and mortality, and (d) whether these relationships differ in young (18–39), middle-aged (40–59), and older (60+) age groups. Results In all 3 age ranges, those reporting hearing problems were more likely to fall, were more likely to sustain an injury, and were more likely to sustain a serious injury, than those not reporting hearing problems. While there was no significant association between hearing loss and mortality in the youngest category, there was for middle-aged and older participants, and for both, the fall-related injury was a significant mediator in this relationship. Conclusions Fall-related injury mediates the relationship between hearing loss and mortality for middle-aged as well as older adults, suggesting a need for further research into mechanisms and remediation.

Purpose Women with anorectal malformation (ARM) are expected to have a normal life span, therefore, gynecological and psycho-sexual issues are also important. Aim of the study was to assess these aspects in adult females with history of ARM. Methods Thirty-seven women from two ARM referral centers, aged ≥ 16, were identified. Gynecologic visit, cervicovaginal swab, pelvic ultrasound, FSH, LH, prolactin, progesterone, 17–β–estradiol, DHEAS, testosterone, TSH during follicular and luteal phases, and administration of FSFI questionnaire to screen the female sexual functioning were performed. Data were compared with six controls. Results Nineteen patients, mean age 21.7 (16–45), participated to the study. Associated anomalies, mostly affecting limbs, vertebrae and genitalia, were present in 57.8% of cases. Mullerian anomalies were retrieved in 36.8%. Hormones’ levels were normal. Concerning sexual functioning, four women (21%) reported dyspareunia or impossible penetration, four did not answer the FSFI questionnaire due to lack of confidence about their sexuality, and three scored lower than the cut-off value for female sexual function. Conclusion This study confirms the importance of a multidisciplinary long-term follow-up for ARM patients, including a careful study of the reproductive tract to detect and treat those conditions that could affect the fertility. Moreover, an appropriate psychological support should be provided.

The relationship between qualitative data analysis software (QDAS) and the development of new methods remains underexplored. While scholars argue that software tactics are used only to implement analytic strategies, some strategies are made possible only with new software developments. Aligned with the Five-Level QDA method, we aim to address the gap in the literature by thoroughly presenting the methodological aspects of an existing narrative inquiry. To be systematic in our explanation of QDAS integration, we begin by offering background information about the original project, followed by an analytical plan, which was informed by our researcher’s subjectivity and generativity theory. We then introduce our translational process that merges our subjective narrative strategy with objective ATLAS.ti tactics into a comprehensive framework for analysis. The findings, presented as a conceptual mapping of the data, informed deeper metaphorical exploration of generativity which is discussed as a life-long process of intergenerational connectedness.

Introduction Worldwide, there is a global progressive rise of chronic kidney disease. In parallel, children born after intra-uterine growth retardation are surviving to adult-life and beyond. This study describes the association of birthweight with and estimated glomerular filtration rate (eGFR). Methods Australian Diabetes, Obesity and Lifestyle (AusDiab) study participants were asked to complete a birthweight questionnaire. The associations between birthweight and eGFR were determined. Results A total of 4502 reported information related to their birthweight, with the other responders did not provide a value. The birthweight of the participants ranged from 0.4 to 7.0 kg with a mean-(SD) of 3.37 (0.7) kg. The mean (95%CI) birthweight was lower for females, 3.28 (0.6) kg, when compared to males, 3.5 (0.7) kg. Eight percent had a birthweight less than 2.5 kg. The eGFR was strongly and positively associated with birthweight, with people in the lowest sex-specific birthweight-quintiles having the lowest mean eGFR. This relationship persisted with adjustment for confounding factors. The OR(CI) for eGFR

Purpose: Pathological phimosis in childhood typically results in circumcision. Long-term follow-up data for men circumcised in childhood are lacking. This study sought long-term data regarding satisfaction with circumcision and voiding symptoms from men who had childhood circumcision between 1989 and 2010. Methods: Following ethical approval, a postal survey was sent to males > 17 years who underwent circumcision at an age < 16 years for pathological phimosis. Results: The survey was sent to 177 men, 23 completed surveys were returned [19 histology proven Lichen Sclerosus [LS, BXO], 4 chronic balanitis]. Mean age at circumcision was 9.7 years [range 3-15], at survey 23.5 years [18-37]. Seven [all > 9 years] remembered the decision for circumcision. Four warranted urologist review as adults, three required surgery for voiding symptoms and one still performs structure therapy; all had LS. When asked which treatment option[s] they would have considered; ten of them chose circumcision, nine of them chose preputioplasty, eight of them chose topical creams [two of them chose all three options, one man chose both foreskin preserving options]. Eight agreed with the statement ''Having a circumcision in childhood or adolescence had an impact on my adult life''; this was positive in two men but negative in five men-they wouldn't have chosen circumcision. Conclusions: The response rate to the survey was low, making it difficult to draw firm conclusions. However, even in this limited sample, not all men would choose childhood circumcision for pathological phimosis, data supporting the need for larger studies of alternative treatment options. In addition, some men circumcised for childhood LS had significant voiding difficulties in adulthood.

A Bochdalek hernia is the most common congenital diaphragmatic hernia (CDH). It can rarely evade prenatal detection and persist into adulthood with minimal symptoms. Large CDH repair has often required an open approach in the past. In this article, we present a case of a patient with large CDH who was asymptomatic until later in her adult life who subsequently developed symptoms and sought a surgical evaluation. A minimally invasive transabdominal approach was used to effectively reduce and repair this rare giant hernia. The patient has remained free of recurrence and has had resolution of her symptoms after 18 months of follow-up. This case illustrates that even the largest of these can be handled in a minimally invasive fashion and achieve durable results.