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Introduction Smoking and smoke exposure among pregnant women remain persistent public health issues. Recent estimates suggest that approximately one out of four nonsmokers have measurable levels of cotinine, a marker indicating regular exposure to secondhand smoke. Epidemiological research has attempted to pinpoint individual-level and neighborhood-level factors for smoking during pregnancy. However, most of these studies have relied upon self-reported measures of smoking. Aims and Methods To more accurately assess smoke exposure resulting from both smoking and secondhand exposure in mothers during pregnancy, we used Bayesian regression models to estimate the association of cotinine levels with tobacco retail outlet (TRO) exposure and a neighborhood deprivation index (NDI) in six counties in North Carolina centered on Durham County. Results Results showed a significant positive association between TRO exposure (β = 0.008, 95% credible interval (CI) = [0.003, 0.013]) and log cotinine after adjusting for individual covariates (eg, age, race/ethnicity, education, marital status). TRO exposure was not significant after including the NDI, which was significantly associated with log cotinine (β = 0.143, 95% CI = [0.030, 0.267]). However, in a low cotinine stratum (indicating secondhand smoke exposure), TRO exposure was significantly associated with log cotinine (β = 0.005, 95% CI = [0.001, 0.009]), while in a high cotinine stratum (indicating active smoking), the NDI was significantly associated with log cotinine (β = 0.176, 95% CI = [0.005, 0.372]). Conclusions In summary, our findings add to the evidence that contextual factors are important for active smoking during pregnancy. Implications In this study, we found several significant associations that suggest a more nuanced understanding of the potential influence of environmental- and individual-level factors for levels of prenatal smoke exposure. Results suggested a significant positive association between TRO exposure and cotinine levels, after adjusting for the individual factors such as race, education, and marital status. Individually, NDI was similarly positively associated with cotinine levels as well. However, when combining TRO exposure alongside NDI in the same model, TROs were no longer significantly associated with overall cotinine levels.

Currently, the majority of dementia care is provided at home by informal caregivers. Most informal caregivers share a routine with their loved ones and change their activity patterns to adapt to a new routine of persons with dementia (PWDs). Given the dementia caregiving context, caregivers’ mobility behaviors and PWDs’ mobility may be positively associated. This study aimed to characterize patterns of GPS-derived community mobility in dementia dyads and examine relationships between PWDs’ and caregivers’ mobility patterns. Six dyads wore a GPS data logger inside and outside the home for 8-11 days. Twelve participants generated valid GPS track files (N=110). Four temporal and spatial mobility metrics were derived from GPS data (total distance, time use, median speed, and convex hull area). Then we calculated Pearson correlation coefficients between PWDs and their caregivers over all tracks. All dyads made active out-of-home trips, indicated by mean daily distance (range: 6,198 - 115,592m for PWDs; 5,125 - 108,857m for caregivers). Median speed of movement ranged from 0.09 to 1.29 km/hour for PWDs, and from 0.21 to 0.97 km/hour for caregivers. The mean size of convex hull over the monitoring period indicates a limited space usage level in both PWDs and caregivers, meaning restricted community mobility despite relatively large distance trips. The correlation coefficient was positive and significant for each metric (r = 0.70-0.97, p < .001). These results suggest substantial agreement in the mobility metrics between PWD and their caregivers, indicating a high level of dyadic effects of a partner’s experience of community mobility.

In this short response to Peter Clarke's thorough and interesting tracing of the developments in Richard McCormick's approach to moral questions, I take a perspective external to the concerns of Clarke's paper. I propose to look at the developments in McCormick's approach not so much from the perspective of contemporary Catholic moral theology but from that of the impact on the practices and beliefs of the Catholic community. From that perspective, the really important events in McCormick's theological development are his rejection of the received teaching on contraception and his closely connected embracing of a moral theory that implies that there are no moral absolutes, namely, proportionalism.

This is a response to James Dubois’ “Is anesthesia intrinsically wrong?” I do not address many of the claims in this article but only DuBois’ use of the moral evaluation of the medical use of anesthesia as a counter example to two lines of reasoning developed to defend the traditional Catholic prohibition of contraception. Elizabeth Anscombe's dialectical defense of this teaching does not imply that such a defense must logically apply to the use of anesthesia. John Finnis’ defense of this teaching on the basis of a natural law argument does not imply that consciousness is a basic human good.

This paper explores the implications of Roman Catholic teachings on social justice and rights to health care. It argues that contemporary societies, such as those in North America and Western Europe, have an obligation to provide health care to their citizens as a matter of right. Moral considerations provide a basis for evaluating concerns about the role of equality when determining health care entitlements and giving some precision to the widespread belief that the right to health care requires equal entitlement to health care benefits.