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Purpose: Though the frequency of gesture use by infants has been related to the development of different language abilities in the initial stages of language acquisition, less is known about whether this frequency (or "gesture rate") continues to correlate with language measures in later stages of language acquisition, or whether the relation to language skills also depends on the accuracy with which such gestures are produced (or reproduced). This study sets out to explore whether preschoolers' narrative abilities are related to these two variables, namely, gesture rate and gesture accuracy. Method: A total of 31 typically developing 3- to 4-year-old children participated in a multimodal imitation task, a context-based gesture elicitation task, and a narrative retelling task. Results: Results showed that there was a significant positive correlation between the children's narrative scores and their gesture accuracy scores, whereas higher rates of gesture use did not correlate with higher levels of narrative skill. Further multimodal regression analysis confirmed that gesture accuracy was a positive predictor of narrative performance, and moreover, showed that gesture rate was a negative predictor. Conclusions: The fact that both gesture accuracy and gesture rate are strongly and differently linked to oral language abilities supports the claim that language and gesture are highly complex systems, and that complementary measures of gesture performance can help us assess with greater granularity the relationship between gesture and language development. These findings highlight the need to use gesture during clinical assessments as an informative indicator of language development and suggest that future research should further investigate the value of multimodal programs in the treatment of language and communication disorders. [ABSTRACT FROM AUTHOR]

Objective. To estimate mortality from diabetes mellitus (DM) for the period 2001-2011 in the Republic of Panama, by province/indigenous territory, and determine its relationship with biological and socioeconomic risk factors. Methods. Cases for the years 2001-2011 with DM listed as the principal cause of death were selected from Panama's National Mortality Registry. Crude and adjusted mortality rates were generated by sex, age, and geographic area. Linear regression analyses were performed to determine the relationship between DM mortality and biological and socioeconomic risk factors. A composite health index (CHI) calculated from biological and socioeconomic risk factors was estimated for each province/indigenous territory in Panama. Results. DM mortality rates did not increase for men or women during 2001-2011. Of the biological risk factors, being overweight had the strongest association with DM mortality. Of the socioeconomic risk factors, earning less than US$ 100 per month had the strongest association with DM mortality. The highest socioeconomic CHI scores were found in a province that is predominantly rural and in areas with indigenous populations. The highest biological CHI scores were found in urban-rural provinces and those with the highest percentage of elderly people. Conclusions. Regional disparities in the association between DM mortality and DM risk factors reaffirm the heterogeneous composition of the Panamanian population and the uneven distribution of biological and social determinant risk factors in the country and point to the need to vary management strategies by geographic area for this important cause of disability and death in Panama. [ABSTRACT FROM AUTHOR]