Life Expectations Research Articles

Regional inequalities in years of life lost within the European Economic Area: Using the Gini coefficient and slope index of inequality to assess spatial disparities

Abstract Background Health inequalities have been linked to reduced life expectations. This study aimed to investigate regional variations in all-cause years of life lost (YLLs) in European Economic Area (EEA) countries prior to the COVID-19 pandemic. Methods Demographic data were extracted from Eurostat for 1390 small regions 32 EEA countries. Age-standardised sex specific YLL rates per 100,000 population in 2019 were estimated for EEA regions (Eurostat NUTS level 3) using methodologies derived from the Global Burden of Disease study. Relative spatial disparities were evaluated using the Gini coefficient (GC) and absolute spatial disparities assessed using the slope index of inequality (SII). Results Between EEA countries, relative geographical inequality in age-standardized YLL rates was higher than within them, slightly more so for males (GC = 16.96% [95% CI = 16.26-17.65]) than females (14.22% [13.62-14.82]). Among females, the UK (11.21% [95% CI 10.11-12.30]), Greece, and Croatia had the highest relative spatial inequality, while Ireland (3.37% [2.26-4.48]), Slovakia, and the Netherlands had the lowest. For males, Belgium (10.76% [9.34-12.17]), the UK, and Croatia exhibited the highest relative spatial inequality, while Ireland (1.99% [1.18-2.81]), Lithuania, and Slovakia had the lowest. Germany had the largest absolute geographical inequality in YLLs among females (SII=16.86% [16.28 to 17.44]), followed by Estonia and the UK. Among males, Estonia had the largest absolute spatial inequality (36.60% [-10.88 to 84.07]), followed by Latvia and Hungary. Ireland had the lowest absolute spatial inequality for both females and males. Conclusions Relative and absolute disparities in premature mortality rates are evident across regions of the EEA, both within countries and across the entire region. These findings offer insights for national and local stakeholders, aiding them in customising public health interventions to target spatial health disparities.

‘It provided me with a sense of safety that I hadn’t felt in weeks.’ A qualitative case study of service users’ experiences with sensory rooms in psychiatric inpatient units

Introduction Sensory rooms are environments designed to provide sensory input to help service users regulate arousal and manage distress. Sensory rooms are widely implemented in psychiatric inpatient units, but limited knowledge exists on how the sensory rooms are perceived by those who use them. This study investigated service users’ experiences with sensory rooms during admission. Methods A qualitative case study using semi-structured interviews conducted with 20 participants, admitted in acute, intensive, and open inpatient psychiatric units in Copenhagen, Denmark. Participants used the sensory rooms under guidance from occupational therapists or physiotherapists and were subsequently interviewed about their experiences. Interviews were transcribed and subjected to thematic analysis. Results Participants reported that being in the sensory rooms helped them to reconnect to their body and to experience peace of mind. Over time, participants used the sensory approaches to develop self-management strategies and enable participation in activities. Conclusion This study concludes that most of the participants had a positive experience in the sensory room under guidance from one of the unit’s physio or occupational therapists. Participants experienced increased physical and mental calmness in the sensory room and an increased sense of safety which made a difference during their admission and, for several of them, also in terms of their expectations for everyday life following their discharge.

Automated workforce, financial precarities and family consumption: The importance of demand-side policies under the background of automation applications

The continuous innovation of automation technology is expanding its application in the workplace, with wide-ranging implications for the economy and society. However, it is not yet clear how workplace automation changes people’s consumption behavior. This paper conducts an empirical analysis in this regard based on the Chinese General Social Survey. The main results are shown as follows: (1) One standard deviation increase in automation contributes to an average reduction of 7.073 % in family consumption. This finding is validated by conducting several robustness and endogeneity checks using various measures of automation and consumption, instrumental variable approach, placebo analysis, etc. (2) The mechanism is that automation decreases family income and work-related social capital, resulting in a decline in families’ socioeconomic status and increased financial precarities. In addition, financial uncertainties brought about by automation decrease people’s subjective well-being, expectations for future life and risk appetite, thus prompting them to lower consumption as a precautionary measure to prepare for potential risks caused by the technological change. (3) Automation has greater negative effects on hedonic and developmental consumption, which are about three times the impact on non-hedonic and basic living expenses respectively, thus leading to a downgrade in families’ consumption structure. In addition, its effect is more pronounced for families with lower economic status, having no houses and living in urban areas. This study also highlights the importance of demand-side policies in the application of automation technology by finding that better labor protection is needed to mitigate automation’s adverse consequences for family consumption. In the context of automation’s increasingly profound impact on the society, this research has important policy implications.

Predictors of preparedness for well-dying among middle-aged and older adults.

This study investigated psychosocial factors related to preparedness for well-dying among middle-aged and older adults and verified a model that can predict it along with psychosocial factors and demographic profiles to provide useful information for intervention. The participants were 340 middle-aged and older Korean adults aged 40-79 years. The predictive models were verified using stepwise regression and decision tree analyses. The results revealed that personality, meaning of life, hardiness, intrinsic religiosity, death anxiety, family support, subjective well-being, and expectations for future life were significantly correlated with preparedness for well-dying among middle-aged and older adults. A stepwise regression analysis revealed that meaning of life accounted for the greatest variance in preparedness for well-dying. A decision tree model predicting preparedness for well-dying included search for meaning, the presence of a spouse, family support, having a job, tenacity, conscientiousness, and positive emotions. These findings suggest that search for meaning and tenacity in middle-aged and older adults as well as the presence of a spouse or occupation and family support may play important roles in preparing for well-dying.

Exploring the experience of multiple sclerosis patients in Turkey: Insights from a national survey

Objective: To evaluate sociodemographic profile, clinical characteristics, disability and treatment status of multiple sclerosis (MS) patients in Turkey with respect to patient perspectives and expectations. Methods: A total of 2,176 MS patients participated in this cross-sectional questionnaire survey including items on sociodemographic, disease and treatment characteristics, daily life and perspectives and expectations. Results: Mean (SD) patient age was 36.4(9.4) years and 76.3% of patients were females. The numbness/weakness in the extremities (57.3%) was the most common presenting symptom. Overall, 56.8% reported treatment switch (due to attacks in 47.3%), while 22.2% reported physical disability and 39.7% reported work-related problems. Males had higher rate of MS-related physical disability (33.0% vs. 19.0%, p<0.001) than females. Use of an assistive device was a more common in patients with longer disease duration (≥15 years; 39.0%) and in those under IV treatment (64.0%). Nearly half of patients reported significant concerns related to uncertainty of the future and impaired quality of life as well as lack of hope for future improvement. The majority of patients reported that they would prefer less frequent SC injection dosing and 43.3% reported preference for monthly high- efficacy SC injection. Conclusion: This nationwide questionnaire-based study in Turkish MS patients revealed the altered disability status with respect to sociodemographic profile, and altered treatment expectations specific to the route of administration, in addition to significant concerns regarding the uncertainty of the future, impaired quality of life and lack of hope for future improvement in nearly half of patients.

An Empirical Study on the Psychological Impact of 'Internet Celebrity Culture' on Adolescents in Small Towns through Xiaohongshu

With the widespread popularity of social media, the culture of internet celebrities has significantly impacted adolescents. This study explores the psychological effects of "luxurious" lifestyle content shared by influencers on Xiaohongshu (Red) on adolescents in small towns in China. Employing both quantitative and qualitative research methods, we investigated how the portrayal of influencer content on Xiaohongshu shapes the values and life expectations of minors. The findings reveal significant differences in values, life satisfaction, and mental health among adolescents who frequently engage with such content. These insights offer a new perspective on the impact of social media content on youth psychological development and provide recommendations for parents, educators, and policymakers on guiding adolescent use of social media more effectively.

Digital Representations of Illness: Key Issues in Cancer Patient Narratives

Language has proven to possess tremendous power: words not only reflect our perception of the world, but they also have an impact on other people’s ideas (Foucault, 2002; Fairclough, 2003; Koller, 2017). This is especially significant in the case of health communication, which, in the last few years, has raised a particular interest as a result of the number of health-related discourses that have emerged on the Internet (Harvey, 2013; Brookes and Hunt, 2021). Exchanging information has become so easy and quick now that more and more people are starting to share their stories of illness, raising awareness and seeking for emotional support, which has highlighted the therapeutic role of storytelling (Conti, 2019). Given that cancer is the leading cause of death in the world (WHO, 2022), and considering the growing trend towards storytelling and the extraordinary power of language, the aim of this paper is to analyse how cancer patients use language in their narratives when describing their illness experiences. To conduct our analysis, we compiled a corpus of cancer narratives written in English and used corpus linguistic tools (McEnery and Hardie, 2012) such as Sketch Engine (Kilgarriff et al., 2014) to explore how cancer, illness, health, life and death are represented. Preliminary findings show that, although the word ‘cancer’ seems to be commonly used by English-speaking cancer patients, they do not often talk about death, especially about their own, suggesting that death may still be a taboo in our society. In addition, as reflected in their narratives, patients seem to change their life expectations, values and priorities after living with cancer. Furthermore, our findings suggest that patients may understand certain issues such as ‘being healthy’ differently from the general population.

Doctoral Degree Changes the Individual Life Expectations: Case Study of PhD Holders from Northeast Normal University

Doctoral Degree Changes the Individual Life Expectations: Case Study of PhD Holders from Northeast Normal University

Integrating network pharmacology and computational biology to propose Yiqi Sanjie formula's mechanisms in treating NSCLC: molecular docking, ADMET, and molecular dynamics simulation.

Non-small cell lung cancer (NSCLC) remains a leading cause of cancer-related deaths globally. Current treatments often do not fully meet efficacy and quality of life expectations. Traditional Chinese medicine (TCM), particularly the Yiqi Sanjie formula, shows promise but lacks clear mechanistic understanding. This study addresses this gap by investigating the therapeutic effects and underlying mechanisms of Yiqi Sanjie formula in NSCLC. We utilized network pharmacology to identify potential NSCLC drug targets of the Yiqi Sanjie formula via the Traditional Chinese Medicine Systems Pharmacology (TCMSP) database. Compounds with favorable oral bioavailability and drug-likeness scores were selected. Molecular docking was conducted using AutoDock Vina with structural data from the Protein Data Bank and PubChem. Molecular dynamics (MD) simulations were performed with Desmond Molecular Dynamics System, analyzing interactions up to 500 nanoseconds using the OPLS4 force field. ADMET predictions were executed using SwissADME and ADMETlab 2.0, assessing pharmacokinetic properties. Using network pharmacology tools, we performed Search Tool for the Retrieval of Interaction Genes/Proteins (STRING) analysis for protein-protein interaction, Kyoto Encyclopedia of Genes and Genomes (KEGG) for pathway enrichment, and gene ontology (GO) for functional enrichment, identifying crucial signaling pathways and biological processes influenced by the hit compounds bifendate, xambioona, and hederagenin. STRING analysis indicated substantial connectivity among the targets, suggesting significant interactions within the cell cycle regulation and growth factor signaling pathways as outlined in our KEGG results. The GO analysis highlighted their involvement in critical biological processes such as cell cycle control, apoptosis, and drug response. Molecular docking simulations quantified the binding efficiencies of the identified compounds with their targets-CCND1, CDK4, and EGFR-selected based on high docking scores that suggest strong potential interactions crucial for NSCLC inhibition. Subsequent MD simulations validated the stability of these complexes, supporting their potential as therapeutic interventions. Additionally, the novel identification of ADH1B as a target underscores its prospective significance in NSCLC therapy, further expanded by our comprehensive bioinformatics approach. Our research demonstrates the potential of integrating network pharmacology and computational biology to elucidate the mechanisms of the Yiqi Sanjie formula in NSCLC treatment. The identified compounds could lead to novel targeted therapies, especially for patients with overexpressed targets. The discovery of ADH1B as a therapeutic target adds a new dimension to NSCLC treatment strategies. Further studies, both in vitro and in vivo, are needed to confirm these computational findings and advance these compounds towards clinical trials.

IBD Is Like a Tree: Reflections From Older Adults With Inflammatory Bowel Disease.

Despite the growing proportion of older adults with inflammatory bowel disease (IBD), their lived experience is not well understood. IBD literature is generally focused on younger adults, and few studies are qualitative. Older adults may report well-being differently than younger adults, so it is important that we learn about their goals and priorities with a chronic disease. The study sought to understand the lived experience of older adults with IBD and explore their perceptions and priorities. We conducted in-depth interviews with patients ≥60 years of age with IBD to evaluate the impact and perception of IBD in the context their overall health and life. We used a hybrid inductive-deductive thematic analysis of our transcripts to identify underlying patterns. We achieved thematic saturation after 22 interviews. We produced 4 major themes: (1) having IBD at an older age, (2) financial ramifications of IBD at an older age, (3) expectations for a meaningful life, and (4) unmet needs. Prominent subthemes included (1) ageism, loss of autonomy, and barriers to healthcare; (2) retirement and insurance issues; (3) redefining quality of life and gratitude; and (4) social isolation and navigating daily life with IBD. Having IBD later in life presents unique challenges. Physicians treating older patients should consider age-sensitive communication, susceptibility to social isolation, and practices for healthy aging in the context of IBD. Patient priorities for further investigation include more representation in the media and educational material tailored for older adults with IBD.

Exoscopic versus Microscopic Surgery in 5-ALA-Guided Resection of High-Grade Gliomas.

Background: Glioma surgery has been remarkably enhanced in the past 2 decades, with improved safety and limited but improved life expectations. The fluorescence-guided resection of high-grade gliomas (HGGs) plays a central role in this sense, allowing a greater extent of resection (EOR). The introduction of exoscopic-guided surgery may be considered in implementing fluorescence techniques over traditional microscopes. We present the application and the advantages of exoscopic-guided surgery compared to microscopic surgery in tumor resection guided by 5-ALA fluorescence in patients with HGGs. Methods: Ten consecutive patients underwent surgery for HGG resection. The surgery was performed via an exoscopic-guided procedure (Olympus ORBEYE) and after the oral administration of Gliolan 5 h before the procedure. During surgery, the procedure shifted to using a microscopic (Kinevo 900, Zeiss) view. The intensity of the fluorescence under the two different procedures was subjectively measured in different picture samples during the surgery on a 1 to 5 (from minimum to maximum) scale. The brightness of the surgical field and the detailing of the anatomy were also analyzed comparatively. Results: Among the ten patients, the histopathological diagnosis was an high-grade glioma in all cases. In nine cases, it was possible to achieve gross total resection. There was no perioperative mortality. The median fluorescence intensity, on a scale of 1-5, was 4.5 in the exoscope group and 3.5 in the microscope group (p < 0.01). Conclusions: The exoscopic-guided surgery adds advantages to traditional fluorescence-guided surgery with 5-aminolevulinic acid. Beyond the important advantage of low cost and the possibility to perform collaborative surgeries, it adds a plain and continuous visualization of the tumor and offers advantages in the surgical field of fluorescence-guided glioma surgery compared to the microscopic-guided one.

Research on Digital Empowerment of Public Sports Service System Construction

Building a higher-level public service system for national fitness is an important cornerstone for accelerating the construction of a sports powerhouse, and it is an inherent requirement that meets the people's expectations for a high-quality life. Digital empowerment will become an effective engine and sustained driving force for achieving high-quality supply of public services for national fitness. Through research, an analysis was conducted on the current situation and challenges of a higher-level public service system for national fitness. The study suggests that a wider range of participants are required by a higher-level public service system for national fitness, which requires a renewed understanding of human needs. A stronger element support requires overall system governance, and a more balanced resource layout requires full utilization of data platforms. This study proposes suggestions: to strengthen the construction of digital infrastructure for public sports services; Accelerate the construction of digital talent teams for public sports services; Establish a mechanism for sharing information and data on public sports services, and strengthen the construction of digital technology governance mechanisms for public sports services. Research aimed at promoting the construction of a digital empowerment public sports service system.

Development and validation of the DBS-PS (Deep Brain Stimulation-Perception Scale): Assessing parkinsonian patients' expectations to prevent post-operative disappointment?

BackgroundRecent literature suggests that taking into consideration and evaluating preoperative expectations of Parkinson's disease (PD) patients candidates to deep brain stimulation (DBS), can contribute to treatment effectiveness. However, few validated instruments investigating preoperative expectations are available. We present the development and validation of the DBS-PS (Deep Brain Stimulation – Perception Scale). MethodsThe DBS-PS is an 11 questions self-administered scale, with answers rated on a 10-point Likert scale (1 completely false, 10 completely true). Items were generated on the basis of patient's interviews analyzed by an expert group and reached consensus. The scale is divided into three domains: expectations for PD, expectations for social-life and leisure, expectations for intimate life. Exploratory factor analysis (EFA) completed by item response theory (IRT) analysis was conducted to validate the theoretical structure of the DBS-PS. Results64 PD patients aged 59.18 (SD = 5.74) years with PD diagnosed since 9.36 (SD = 4.09) years completed the DBS-PS preoperatively. EFA confirmed a 3 factors scale structure (eigenvalue >1) explaining 69% of variance (factor 1: 43%; factor 2: 17%; factor 3: 9%). Reliability (Cronbach's α: 0.714 for factor 1, 0.781 for factor 2, 0.889 for factor 3) and discriminant validity (Pearson coefficient r < 0.50) were satisfactory. IRT showed good model fit, preserved unidimensionality, but some local dependences were observed. ConclusionThe DBS-PS shows satisfactory psychometric properties. It is easy to administer in routine practice with preoperative PD patients. It constitutes an interesting basis for cognitive restructuring before neurosurgery, by highlighting dysfunctional cognitions and measuring the benefits of cognitive restructuring therapy.

The current status of apathy in patients with dementia and its factors: A systematic review

ObjectiveTo systematically evaluate the current status of apathy in dementia patients and its associated factors. MethodsWe searched Chinese and English databases to collect studies on the associated factors of apathy in patients with dementia from inception to March 14, 2023. Two researchers independently screened the literature, evaluated the quality, and extracted the data ResultsA total of 20 studies were included, and the incidence of apathy in patients with dementia ranged from 21 % to 90 %. According to the model of apathy proposed by Massimo in 2018, the associated factors were divided into individual factors for dementia patients, caregiver factors, and environmental factors. The individual factors of apathy in patients with dementia mainly include demographic characteristics, the severity of cognitive impairment, a combination of other behavioral and psychological symptoms of dementia, acute medical problems or adverse drug reactions, unmet needs, and malnutrition. Caregiver factors mainly include emotional expressions of hostility or criticism towards dementia patients and caregivers’ expectations for a better life in the future. Environmental factors mainly include too high or too low stimulation and a lack of daytime activities ConclusionsExisting studies have shown that the incidence of apathy in dementia patients is high and is affected by multi-dimensional factors. There are more studies on individual factors in dementia patients and fewer studies on caregivers and environmental factors. In the future, a large number of high-quality studies are needed to demonstrate the mechanism of apathy in dementia patients and to find more related factors.

Analisis Perbedaan Tingkat Authentic Happiness Ditinjau Dari Jenis Kelamin Pada Dewasa Madya Di Kelurahan Kalianyar

This background is based on the emergence of a phenomenon in middle adulthood, where individuals adjust themselves independently to life and social expectations. Usually, men and women experience their happiest years in middle adulthood, a period which is also known as a period of crisis (generativity) and generally this phase is the period when men and women reach the peak of their happiness. Finding out whether men and women experience different levels of happiness in middle adulthood is the main aim of this research. With a sample size of 2,300 people, this research used comparative quantitative methodology. Because the study topic or data source is very broad, cluster sampling is used, namely the sample determination method. Therefore, certain population areas are used as the basis for sampling. The sample taken was 100 respondents, namely, 50 middle-aged men and 50 middle-aged women who were the samples for this study. Therefore, the level of happiness in middle adulthood does not differ significantly between men and women.

Student and staff expectations of university life - a pilot study.

Student expectations of university lack clarity, yet unmet expectations may negatively impact upon satisfaction, attainment and progression. This questionnaire-based pilot study explored student and staff expectations, in a large English widening participation university. In all, 65 students and 27 staff participated. Most notable was the similarity of student responses regardless of demographic characteristics. However, students already in paid work were significantly more likely to agree that they liked the university and found it easy to make friends. Students who might consider taking on paid work expressed significantly more concern that they may struggle with their academic work whilst those not in paid work had significantly more concerns about exams and self-directed learning. In terms of transferable academic skills, Black students were significantly less likely than white students to expect to make detailed class notes for themselves, albeit within this small sample size, while those first-in-family identified more academic skills needs than other student groups. Significantly more staff than students considered classroom attendance necessary. This pilot study suggests future research directions, including the impact of paid work and ethnicity on specific academic skills and underlines the importance of student support.

Glorified Image, Gloomy Life: Diversified Perceptions and The Transformation in nature of Migration in Bangladeshi Villages

Migration refers to the movement of people from their origin to another place for diversified reasons. The glorified image and good life expectations are a matter of discussion whenever it comes to migration but the gloomy sides, transforming perceptions in this migration issue, are still in the shade in Bangladeshi Villages. This article examined the nature of migration and prevailing multiple perceptions and the transformation in these perceptions over decades in Shakhail, Uladab, And Mirkutiya villages located in Tangail District, Dhaka, Bangladesh. This article addresses migration and growth, how the young perceive "bidesh" and how family economic progress affects migration patterns. It is also concerned with the process of materiality determining status. Psychological breakdown, seclusion, and separation are also discussed in this article with relevant case studies. I have Identified various perceptions, which are the collective perceptions of different people from these village communities. In addition, I have tried to predict the future of these villages with the help of Lee's push-pull theory with relevant narrative analysis.

Expectations of children and adolescents suffering from cancer

IntroductionInvestigation expectations for children and adolescents with cancer is an important issue for their psycho-emotional development as well as their quality of life.ObjectivesTo investigate the expectations of children suffering from cancer.Methods102 questionnaires were collected from pediatric patients suffering from neoplasia disease (62 boys and 40 girls) with a median age of 13 years, covering the multidimensional expectation questionnaire (MEQ) suitable for children with cancer in a 4-point Likert scale. The MEQ was then evaluated using the SPSS.21 statistical package, which resulted in 13 questions. The questionnaire of expectations highlighted three factors that referred to the “family life expectations”, “daily life / daily routine and career prospects”, and “expectations of networking friendship”, respectively. The statistical results were obtained by multi-line regression analysis, with the Stata 12.1 statistical package, while ethical issues were complied with and licensed.ResultsMEQ reliability (Cronbach’s alpha) for the entire scale was 0.82 and for agents ranged from 0.65-0.84. Overall, pediatric cancer patients delivered a fairly high average score of 3,33 ± 0,42 questions in the expectation’s questionnaire, while the mean scores were 3,29 ± 0,63, 3,51 ± 0, 45 and 3.19 ± 0.54, respectively. From the results of the analysis of multiple regression, it appeared that, as the age increases, the patients with neoplastic disease have overall 76 lower expectations (p = 0.014), while the satisfaction of the doctors-nursing staff in the total expectations is positive (p = 0.018). In the family life expectancy factor, the age of children appears to play a negative role in increasing age (p = 0.019), while positive body image and satisfaction with doctors-nursing staff (p = 0.040, p = 0.006) respectively. It appeared that children aged&gt; 13 years have worse outcomes in expectations of the daily routine and career prospects with (p = 0.037).ConclusionsThe MEQ has proven to be a valid and reliable tool that can provide pediatric staff and researchers with information about the expectations of children and adolescents with cancer that require long-term health care.Disclosure of InterestNone Declared

Life course studies – conceptual and methodological approaches and solution

Studies of the life course address the fundamental issue of social sciences – understanding the social change, its directions, reasons and perspectives, the interaction of micro- and macro levels of social reality. Studies of life course developed independently in different social sciences and scientific traditions cover a broad range of topics, issues and methodological approaches. These variety of studies were grouped into few major research frameworks: psychological within the studies of personality development; longitudinal sociological focused on life course of different cohorts and comparative studies of generations, social groups, countries and regions; domain-based – studies of trajectories in different life domains; demographic studying the timing of life events; studies of stability and transformation of values and biographical research. The multiple methodological approaches to study the life course are suggested to group in two main categories – concurrent and retrospective which differ by the time distance between the occurrence of an event and the reporting about the event. Concurrent approach is characterized by relatively high reliability of the measurement, but low flexibility in selecting research indicators, long time for the organization of data collection and large financial investments. Retrospective approach provides high flexibility in organization and design of the survey, allows free selection of indicators to test research hypotheses, but the reliability of the data is hampered by the memory errors and context effect. None of these approaches alone can satisfy the needs and requirements of studying the life course and collecting dynamic multi-level data. The possible solution is to design and test the multimodal approach combining the advantages of different research methods and mitigating their drawbacks. The new long-term longitudinal project “Life course, values and expectations of the generation of 1990s” (G90) included the test of an autobiographical method of data collection for random samples of the general population in quantitative design. The testing revealed high sensitivity of the method to the format (handwritten, printed or oral), high differentiation between respondents in completeness of information and the selection of events included in the autobiography. Supplementing autobiographies by in-depth interviews increased the data standardization, completeness and comparability. The drawbacks of this method found during the survey are high demand for resources for data analysis, individual approach to each autobiography, low respondents’ cooperation in highly demanding tasks, and ethical issues. The future of the life course studies can be found in the convergence of different research frameworks, multidisciplinary research projects, and the application of mixed-model integrated methodology.

Challenges of Cutaneous Care in Hyperthyroidism: A Case Report

Cutaneous manifestations of thyroid disease are one of the first notable signs of thyroid hormone dysregulation. Skin changes in hyperthyroidism vary from individual to individual. In dark skinned Africans it may be challenging to detect these dermatoses and care for the patients with these dermatoses if they arise. Making the actual cutaneous diagnosis in hyperthyroidism may be impaired by co-morbidities, drug-drug interactions, hypersensitive reactions, unusual presentation of common diseases, immunosuppression that may result to opportunistic infections and similar presentations of dermatoses. There may be dermatoses that may co-exist with other dermatoses within the same site. The peculiarity of our case report is that we present three females with hyperthyroidism that cut across different age groups with different cutaneous lesions. This case report aims to present the challenges of making accurate skin diagnosis and challenges that arise in actually caring for them. Counselling the patient on the appropriate care and prognosis of these skin lesions would help in improvement of quality of life and unwanted expectations