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Purpose: The purpose of this study was to assess the association between Adult Day Health Center (ADHC) participation and health-related quality of life. Design and Methods: Case-controlled prospective study utilizing the Medical Outcomes Survey Form 36 (SF-36) to compare newly enrolled participants from 16 ADHC programs with comparable community-dwelling older adults who did not attend an ADHC. Assessments were conducted at study enrollment, 6 and 12 months. Results: ADHC participants (n = 57) and comparison group subjects (n = 67) were similar at baseline in age, ethnic diversity, medical conditions, depression, cognition, immigration history, education, income, and marital status. Significantly more comparison group subjects lived alone (p = 0.002). One year after enrollment, the SF-36 domains role physical and role emotional improved significantly. Adjusted role physical scores for ADHC participants improved (23 vs. 36) but declined for the comparison group (38 vs. 26, time by group interaction p = 0.01), and role emotional scores improved for ADHC participants (62 vs.70) but declined for the comparison group (65 vs. 48, time by group interaction p = 0.02). Secondary analyses revealed that changes in daily physical functioning, depressed affect, or cognitive functioning did not explain the improvements found in role physical and role emotional scores for ADHC participants. No significant differences in trends for the 2 groups occurred for the SF-36 domains physical functioning, social functioning, and mental health. Implications: ADHC participation may enhance older adults' quality of life. Quality of life may be a key measure to inform care planning, program improvement, and policy development of ADHC.

This article explains the importance of alphabet books in early reading development. Alphabet books encourage literacy development in the following ways: (1) unlock the symbols of language; (2) connect knowledge to other sources; (3) provide book usage knowledge to young children; (4) complement children's enjoyment of books; and (5) aid early readers in becoming independent readers and writers. The article presents several suggestions for supporting alphabet book use with children. Table 1 lists 53 alphabet books for preschoolers. Table 2 lists 21 alphabet books for emergent and beginning readers.

Aim: Population connectivity of benthic marine organisms depends strongly on planktonic larval dispersal and is controlled by geographic distance and oceanographic structure. We examine isolation by distance versus resistance to barriers (ocean current boundaries) against a background of post‐glacial habitat expansion in a small benthic fish of the Adriatic Sea. Location: Adriatic Sea, Eastern Mediterranean. Taxon: Tripterygion tripteronotum. Methods: We performed population genetic analyses using mitochondrial control region sequences of 550 individuals from 25 locations sampled along the Eastern Adriatic coast. Investigations of population structure included differentiation tests, cluster analyses and distance‐based redundancy analysis. We then ran Lagrangian simulations of passive larval drift to examine correlations among population structure, geographic distance and the Adriatic gyre system. To test for signatures of a post‐glacial range expansion, we modelled the demographic history of the populations and examined the geographic distribution of genetic diversity. Results: Genetic population structure corresponded to the Adriatic gyres without additional effect of geographic distance. Inference of northward‐biased gene flow between the northern and the Istrian gyre was consistent with simulated trajectories of passive drift, whereas the phylogeographic break coinciding with the boundary between the Central and the Northern Adriatic gyre was stronger than predicted by drift simulations. Genetic connectivity of populations within gyres was high. Genetic signatures of population expansion were consistent with a rapid post‐glacial recolonization of the northern Adriatic. Main conclusions: The combination of dense sampling and passive drift simulation allowed us to distinguish among effects of geographic distance, oceanographic features and palaeoenvironmental changes on current population structure. Comparisons between realized and potential connectivity illustrate the value of integrating different data sources to understand population structure and inform conservation planning. [ABSTRACT FROM AUTHOR]

Young children were grouped according to socioeconomic status determined by their parents' educational level (college, high school, or less). Subjects were assigned tasks on sets of pictures which could be organized on the basis of taxonomic or complementary relations. There were no significant differences in level of recall or clustering. (Author/DWH)

Objective: We sought to understand the experiences of patients with lung cancer and to see if attitudes varied by demographic factors.Methods: We administered a 63-question survey by phone or online among 174 patients with lung cancer. Factor analysis was used to identify two groups of questions with a conceptual relationship and high Cronbach's alphas, stigma and satisfaction with care. We used a multivariable analysis to identify predictors of self-blame and the factors of stigma and satisfaction with care.Results: Patients were satisfied with the quality of their care and treatment choices but did not feel that there is enough public support for or research in lung cancer. Predictors of lower satisfaction with care were never being a smoker, lack of college education, not living in a rural location, refusing to report income, and not knowing/not being sure of stage. Self-blame was modest; in multivariable analysis, predictors of self-blame were believing that smoking was a cause of their lung cancer, younger age, male sex, living in a suburban location, and not knowing/not being sure of the stage of the cancer. Reported stigma was low and the only predictor for stigma was being married. Despite low scores on their personal experience of stigma, patients reported a high degree of stigmatization of lung cancer in general. Smoking was a significant predictor of personal stigma.Conclusion: Despite satisfaction with their treatment and care, lung cancer patients feel that society stigmatizes them as a general population. Patients who smoke are more likely to report that they have personally experienced stigma. [ABSTRACT FROM PUBLISHER]

Shimmering is a collective defence behaviour in Giant honeybees (Apis dorsata) whereby individual bees flip their abdomen upwards, producing Mexican wave-like patterns on the nest surface. Bucket bridging has been used to explain the spread of information in a chain of members including three testable concepts: first, linearity assumes that individual "agent bees" that participate in the wave will be affected preferentially from the side of wave origin. The directed-trigger hypothesis addresses the coincidence of the individual property of trigger direction with the collective property of wave direction. Second, continuity describes the transfer of information without being stopped, delayed or re-routed. The active-neighbours hypothesis assumes coincidence between the direction of the majority of shimmering-active neighbours and the trigger direction of the agents. Third, the graduality hypothesis refers to the interaction between an agent and her active neighbours, assuming a proportional relationship in the strength of abdomen flipping of the agent and her previously active neighbours. Shimmering waves provoked by dummy wasps were recorded with high-resolution video cameras. Individual bees were identified by 3D-image analysis, and their strength of abdominal flipping was assessed by pixel-based luminance changes in sequential frames. For each agent, the directedness of wave propagation was based on wave direction, trigger direction, and the direction of the majority of shimmering-active neighbours. The data supported the bucket bridging hypothesis, but only for a small proportion of agents: linearity was confirmed for 2.5%, continuity for 11.3% and graduality for 0.4% of surface bees (but in 2.6% of those agents with high wave-strength levels). The complimentary part of 90% of surface bees did not conform to bucket bridging. This fuzziness is discussed in terms of self-organisation and evolutionary adaptedness in Giant honeybee colonies to respond to rapidly changing threats such as predatory wasps scanning in front of the nest. [ABSTRACT FROM AUTHOR]

The pharmaceutical diclofenac (DCF) is released in considerably high amounts to the aquatic environment. Photo-transformation of DCF was reported as the main degradation pathway in surface waters and was found to produce metabolites with enhanced toxicity to the green algae Scenedesmus vacuolatus. We identified and subsequently confirmed 2-[2-(chlorophenyl)amino]benzaldehyde (CPAB) as a transformation product with enhanced toxicity using effect-directed analysis. The EC50 of CPAB (4.8 mg/L) was a factor of 10 lower than that for DCF (48.1 mg/L), due to the higher hydrophobicity of CPAB (log K ow = 3.62) compared with DCF (log D ow = 2.04) at pH 7.0. [Copyright &y& Elsevier]

Peroxisome proliferator-activated receptor (PPAR)-γ modulates substrate metabolism and inflammatory responses. In experimental rats subjected to myocardial ischemia-reperfusion (IR), thiazolidinedione PPAR-γ activators reduce infarct size and preserve left ventricular function. Troglitazone is the only PPAR-γ activator that has been shown to be protective in I/R in large animals. However, because troglitazone contains both α-tocopherol and thiazolidinedione moieties, whether PPAR-γ activation per se is protective in myocardial I/R in large animals remains uncertain. To address this question, 56 pigs were treated orally for 8 wk with troglitazone (75 mg·kg-1·day-1), rosiglitazone (3 mg·kg-1·day-1), or α-tocopherol (73 mg·kg-1·day-1, equimolar to troglitazone dose) or received no treatment. Pigs were then anesthetized and subjected to 90 min of low-flow regional myocardial ischemia and 90 min of reperfusion. Myocardial expression of PPAR-γ, determined by ribonuclease protection assay, increased with troglitazone and rosiglitazone compared with no treatment. Rosiglitazone had no significant effect on myocardial contractile function (Frank­Starling relations), substrate uptake, or expression of proinflammatory cytokines during I/R compared with untreated pigs. In contrast, preservation of myocardial contractile function and lactate uptake were greater and cytokine expression was attenuated in pigs treated with troglitazone or α-tocopherol compared with untreated pigs. Multivariate analysis indicated that presence of an α-tocopherol, but not a thiazolidinedione, moiety in the test compound was significantly related to greater contractile function and lactate uptake and lower cytokine expression during I/R. We conclude that PPAR-γ activation is not protective in a porcine model of myocardial I/R. Protective effects of troglitazone are attributable to its α-tocopherol moiety. These findings, in conjunction with prior rat studies, suggest interspecies differences in the response to PPAR-γ activation in the heart. [ABSTRACT FROM AUTHOR]

Children's drawings from two Peruvian samples were scored by the Goodenough-Harris Drawing Test. A modified IQ estimate was devised to eliminate the influence of clothing style on intelligence quotients, Variations in clothing style, however, did not account entirely for observed group differences. Differential exposure to formal academic education seemed to provide a more appropriate explanation for the differences in mean performances. [ABSTRACT FROM AUTHOR]

In some styles of Javanese wayang kulit, grimingan flows forth from the hands of the gender player for nearly four of the eight or so hours that comprise an all-night performance. Although their performances are regularly punctuated by other musical events, sometimes a gender player will be asked to perform grimingan for 30-40 minutes without pause. How does a musician generate such an extended solo performance? It turns out that the answer depends on whom you ask. Some performers say that you can play anything as long as it is in the correct mode or pathet. Other gender players tell you that they just keep repeating ‘the melody.’ Through interviews and recording sessions, it gradually became clear to me that each performer did possess a collection of melodies designated for use in the creation of grimingan segments. Working outward from transcriptions of different performers’ grimingan melodies in what they described as their most compact form, and by transcribing more than 50 hours of performance, I have documented the process by which performers expand their versions of compact melodies to fill the necessary minutes of accompaniment. While their approaches to the process are necessarily idiosyncratic, a few rules can be derived to describe the process in each mode. Transcription and analysis have revealed the process by which the performers created their music. Understanding the process revealed the flexible but identifiable nature of the form of grimingan.

Porteus Maze tests from the Grace Arthur Point Scale of Performance Test kit were administered to two groups of Campa Indians from a tropical forest village on the Tambo River, eastern Peru. The first group, whose performance was described previously, was tested in 1977. These Ss were four Campa men and two women in their thirties and forties: all Ss but one were nonliterate. The second group, tested in 1978, comprised five 13- to 16-year-old males who had attended the village mission school for four to six years. Educated teenage Ss were sons of Ss from the first group. Because Campa children in this region are under considerable pressure to attend school, uneducated Ss matched for age could not be found for comparisons with educated children. The single (male) literate S from the first group was dropped in order to make nonliterate/literate comparisons. The Porteus Mazes provide a nonverbal assessment of ability to formulate and execute a plan. They comprise 14 mazes of successively increasing complexity, each requiring Ss to mark the shortest continuous path from beginning to end without crossing lines or entering "dead-ends." The mazes are believed to be relatively free from the influences or cultural background or educational experience. If this is so, Campa performances should compare favorably with those of North Americans and, additionally, nonliterate adults and their children should perform similarly. [ABSTRACT FROM AUTHOR]

An assessment of intellectual ability free from the influence of educational or cultural background would be of considerable value to researchers who wish to make direct, cross-cultural comparisons of intellectual functioning. In an attempt to examine the appropriateness of two potential measures, a pilot study was conducted to compare performances on the Culture Fair Intelligence Test (CFIT) and the Goodenough-Harris Draw-A-Person test. [ABSTRACT FROM AUTHOR]

This paper describes performances of five adult Campa Indians on Porteus maze tests. The Campas are a tribal people who typically live in small two- or three-family hamlets scattered through the tropical forests of Eastern Peru from about latitude 9° to 12° South of the Equator and longitude 73° to 75° West. They subsist by cultivation, fishing, and hunting. [ABSTRACT FROM AUTHOR]

Purpose: To assess the impact of the COVID-19 pandemic and associated mitigation measures on persons with sensory impairments (SI), including visual impairments (VI) and hearing impairments (HI)., Design: Cross-sectional survey., Methods: Adults with VI (best-corrected visual acuity <20/60 in the better-seeing eye), HI (International Classification of Diseases, Tenth Revision, codes), and age- and sex-matched controls (n = 375) were recruited from the University of Michigan. The 34-item Coronavirus Disability Survey was administered. Both χ 2 tests and logistic regression were used to compare survey responses between groups., Results: All groups reported high levels of disruption of daily life, with 80% reporting "a fair amount" or "a lot" of disruption (VI: 76%, HI: 83%, CT: 82%, P = .33). Participants with VI had greater difficulty with day-to-day activities and were more likely to cite the following reasons: caregiver was worried about COVID-19 (odds ratio [OR] VI  = 7.2, 95% CI = 3.5-14.4, P < .001) and decreased availability of public transportation (OR VI  = 5.0, 95% CI = 1.5-15.6, P = .006). Participants with VI, but not HI, showed a trend toward increased difficulty accessing medical care (OR VI  = 2.0, 95% CI = 0.99-4.0, P = .052) and began relying more on others for day-to-day assistance (OR VI  = 3.1, 95% CI = 1.6-5.7, P < .001). Overall, 30% reported difficulty obtaining trusted information about the pandemic. Those with VI reported more difficulty seeing or hearing trusted information (OR VI  = 6.1, 95% CI = 1.6-22.1, P = .006). Employed participants with HI were more likely to report a reduction in wages (OR HI  = 2.5, 95% CI = 1.2-5.3, P = .02)., Conclusions: Individuals with VI have experienced increased disruption and challenges in daily activities related to the pandemic. People with SI may benefit from targeted policy approaches to the current pandemic and future stressors. Minimal differences in some survey measures may be due to the large impact of the pandemic on the population as a whole. The SARS-CoV-2 (COVID-19) pandemic and public health mitigation measures have had an exceedingly large impact around the globe. As of the time of writing, more than 114 million global cases (28 million US) had been diagnosed, and there had been more than 2.5 million fatalities attributed to COVID-19 (517,000 US). 1 , 2 ., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Intrauterine growth restriction (IUGR) is a condition whereby a fetus is unable to achieve its genetically determined potential size. IUGR is a global health challenge due to high mortality and morbidity amongst affected neonates. It is a multifactorial condition caused by maternal, fetal, placental, and genetic confounders. Babies born of diabetic pregnancies are usually large for gestational age but under certain conditions whereby prolonged uncontrolled hyperglycemia leads to placental dysfunction, the outcome of the pregnancy is an intrauterine growth restricted fetus with clinical features of malnutrition. Placental dysfunction leads to undernutrition and hypoxia, which triggers gene modification in the developing fetus due to fetal adaptation to adverse utero environmental conditions. Thus, in utero gene modification results in future cardiovascular programming in postnatal and adult life. Ongoing research aims to broaden our understanding of the molecular mechanisms and pathological pathways involved in fetal programming due to IUGR. There is a need for the development of effective preventive and therapeutic strategies for the management of growth-restricted infants. Information on the mechanisms involved with in utero epigenetic modification leading to development of cardiovascular disease in adult life will increase our understanding and allow the identification of susceptible individuals as well as the design of targeted prevention strategies. This article aims to systematically review the latest molecular mechanisms involved in the pathogenesis of IUGR in cardiovascular programming. Animal models of IUGR that used nutrient restriction and hypoxia to mimic the clinical conditions in humans of reduced flow of nutrients and oxygen to the fetus will be discussed in terms of cardiac remodeling and epigenetic programming of cardiovascular disease. Experimental evidence of long-term fetal programming due to IUGR will also be included.

The free-market rhetoric dominating health-policy discussions today frames health-care goods and services as commodities that consumers will or will not buy at a given price. Health-care systems are being redesigned and hospitals restructured with a view to increased efficiency and productivity. Drawing on the experiences of clinical nurses in the United States, this paper shows how the application of economism to nursing may severely disrupt the ecology of good practice, leading to difficulties in meeting minimal standards of nursing care and severely constraining the acts of compassion called for by the human experiences of illness, loss, and death. Concerns about moral responsibility and conflicts between institutional and nursing goals are described. Increasing mistrust of health-care systems on the part of practitioners, patients, and families suggests that it is time to attend closely to the moral ecology of caring practices.