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We present a laboratory study of photoelectric charging of dust particles and their lofting on a conducting surface in the presence of external electric fields. Insulating particles with diameter <45 μm are dispersed on a conducting surface exposed to ultraviolet (UV) light. In addition to the UV exposure, a positive or negative external electric field is applied. Independent of the orientation of the external electric field, the dust particles are found to be positively charged but with different mechanisms. It is shown that the orientation of the external electric field controls the dynamics of photoelectrons emitted from the dust particles and the conducting substrate surface. Distinctly different lofting results are shown between these two electric field cases. The results provide insight for understanding dust charging and release and helping develop mitigation solutions in particle accelerators, semiconductor manufacturing, fusion reactors, and space exploration to planetary bodies. [ABSTRACT FROM AUTHOR]

Background: Respiratory syncytial virus (RSV) is a substantial cause of infant morbidity and mortality due to seasonal peaks of bronchiolitis across the United States. Clinical and viral surveillance plays a pivotal role in helping hospital systems prepare for expected surges in RSV bronchiolitis. Existing surveillance efforts have shown a geographic pattern of RSV positivity across the United States, with cases typically starting in the southeast and spreading north and west. Public health measures implemented due to the COVID‐19 pandemic disrupted viral transmission across the nation and altered the expected seasonality of RSV. The impact of these changes on the geographic progression of infant RSV bronchiolitis across the United States has not been described. Methods: Here, we used clinical and viral surveillance data from four health care systems located in different regions of the United States to describe the geographic progression of infant RSV bronchiolitis across the country from 2015 to 2023. Results: Prior to widespread circulation of SARS‐CoV‐2, infant RSV bronchiolitis followed an established geographic pattern associated with seasonal epidemics originating in Florida and spreading north (North Carolina and New York) and later westward (Nevada). Although public health and social measures implemented during the COVID‐19 pandemic disrupted the seasonality of RSV disease, infant RSV bronchiolitis epidemics progressed across the nation in a pattern identical to the prepandemic era. Conclusions: Our findings highlight the importance of ongoing clinical and viral surveillance to optimally track the onset of RSV epidemics and allow health care systems to prepare for expected RSV bronchiolitis surges. [ABSTRACT FROM AUTHOR]

The current study examined teacher competence and contextual factors associated with teacher‐reported stress in low‐income urban elementary schools. Using a sample of 106K‐5th grade teachers from 14 low‐income urban elementary schools, associations between observed use of instructional and behavior management practices, teacher‐reported stress, perceived instrumental and emotional supports, class‐wide student academic performance, and behavioral functioning were examined. Teacher‐reported stress was significantly related to perceived emotional support, instrumental support, class‐wide student academic performance, and class‐wide student behavioral functioning. Instrumental and emotional supports, observed instructional and behavioral management practices, and class‐wide student academic and behavioral functioning jointly predicted teacher stress. Results from a dominance analysis identified class‐wide behavioral functioning, and emotional and instrumental support as the strongest predictors of teacher stress. Study limitations and implications for research and practice are discussed. Practitioner points: Sources of work‐related stress rated most highly by teachers included student performance on standardized tests, teaching, student learning, student engagement, and behavior problems.The strongest predictors of teacher stress were student behavioral functioning, teacher perceived emotional and instrumental support.No relationship was found between teacher stress and instructional/behavioral classroom practices. Impact Statement: Class‐wide student behavioral functioning, teacher‐reported emotional and instrumental supports are found to predict teacher stress in low‐income elementary schools. [ABSTRACT FROM AUTHOR]

With decades of electronic health records linked to genetic data, large biobanks provide unprecedented opportunities for systematically understanding the genetics of the natural history of complex diseases. Genome-wide survival association analysis can identify genetic variants associated with ages of onset, disease progression and lifespan. We propose an efficient and accurate frailty model approach for genome-wide survival association analysis of censored time-to-event (TTE) phenotypes by accounting for both population structure and relatedness. Our method utilizes state-of-the-art optimization strategies to reduce the computational cost. The saddlepoint approximation is used to allow for analysis of heavily censored phenotypes (>90%) and low frequency variants (down to minor allele count 20). We demonstrate the performance of our method through extensive simulation studies and analysis of five TTE phenotypes, including lifespan, with heavy censoring rates (90.9% to 99.8%) on ~400,000 UK Biobank participants with white British ancestry and ~180,000 individuals in FinnGen. We further analyzed 871 TTE phenotypes in the UK Biobank and presented the genome-wide scale phenome-wide association results with the PheWeb browser. The proliferation of large biobanks necessitates statistical methods designed for genetic analysis on biobank data. Here, the authors have developed a frailty model-based method for GWAS analysis of time-to-event phenotypes in large biobanks that accounts for relatedness in samples and censoring of phenotypes. [ABSTRACT FROM AUTHOR]

Background: Molecular testing (MT) refines risk stratification for thyroid nodules that are indeterminate for cancer by fine needle aspiration (FNA) cytology. Criteria for selecting nodules for MT vary and remain largely untested, raising questions about the best strategy for maximizing the usefulness of MT while minimizing the harms of overtesting. We used a unique data set to examine the effects of repeat FNA cytology-based criteria for MT on management decisions and nodule outcomes. Methods: This was a study of adults (age 25–90 years; 281 women and 72 men) with cytologically indeterminate (Bethesda III/IV) thyroid nodules who underwent repeat FNA biopsy and Afirma Gene Expression Classifier (GEC) testing (N = 363 nodules from 353 patients) between June 2013 and October 2017 at a single institution, with follow-up data collected until December 2019. Subgroup analysis was performed based on classification of repeat FNA cytology. Outcomes of GEC testing, clinical/sonographic surveillance of unresected nodules, and histopathologic diagnoses of thyroidectomies were compared between three testing approaches: (i) Reflex (MT sent on the basis of the initial Bethesda III/IV FNA), (ii) SemiRestrictive (MT sent if repeat FNA is Bethesda I–IV), and (iii) Restrictive (MT sent only if repeat FNA is Bethesda III/IV) testing approaches. Results: Restricting MT to nodules that remain Bethesda III/IV on repeat FNA would have missed 4 low-risk cancers and 3 noninvasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTP) (collectively 2% of the test population) but would have avoided diagnostic surgery for 42 benign nodules (12% of the test population). The Restrictive testing strategy was more specific (delta 0.126 confidence interval [CI 0.093 to 0.159] and 0.129 [CI 0.097 to 0.161], respectively) but less sensitive (delta −0.339 [CI −0.424 to −0.253] and −0.340 [CI −0.425 to −0.255], respectively) than the Reflex and SemiRestrictive approaches for detecting NIFTP or cancer. Conclusions: Repeat FNA cytology can guide the selection of cytologically indeterminate thyroid nodules that warrant MT. The Restrictive model of performing Afirma GEC only on nodules with two separate biopsies showing Bethesda III/IV cytology would reduce the rate of diagnostic surgery for histologically benign nodules while missing only rare low-risk tumors. Given the low but nontrivial risks of thyroidectomy, the higher specificity of the Restrictive testing approach disproportionately outweighs the potential harms. [ABSTRACT FROM AUTHOR]

The article presents a case study related to adolescent boy of high academic achievement without formal psychiatric history has presented to the emergency department.

To examine the rate of self-reported vision impairment, eye disease, and eye care utilization among residents of subsidized senior housing (SSH) communities. In this cross-sectional, observational study, residents of 14 SSH communities in Jefferson County, AL, USA self-reported their vision status and eye care utilization as part of vision screening events held in their community. Two hundred and thirty-seven residents self-reported their vision status, presence of eye disease, and eye care utilization. A third of participants (33.3%) reported difficulty with distance vision while 38% reported difficulty with near vision. Rates of eye disease among this sample were as follows: 40.3% reported having cataracts, 13.6% reported having glaucoma, 4.2% reported having age-related macular degeneration, and 5.5% reported having diabetic retinopathy. The majority of participants (52.8%) had not been to see an eye care provider within the last year. Persons with vision impairment were less likely to report having seen an eye care provider within the last year than those without impairment (p =.03). This study illuminates the low utilization of eye care among socioeconomically disadvantaged older adults residing in SSH, especially among those with vision impairment and eye disease. Vision-related health care is important in maintaining both physical and mental health in older adults. [ABSTRACT FROM AUTHOR]

Polygenic risk scores (PRS) for breast cancer have potential to improve risk prediction, but there is limited information on their utility in various clinical situations. Here we show that among 122,978 women in the FinnGen study with 8401 breast cancer cases, the PRS modifies the breast cancer risk of two high-impact frameshift risk variants. Similarly, we show that after the breast cancer diagnosis, individuals with elevated PRS have an elevated risk of developing contralateral breast cancer, and that the PRS can considerably improve risk assessment among their female first-degree relatives. In more detail, women with the c.1592delT variant in PALB2 (242-fold enrichment in Finland, 336 carriers) and an average PRS (10–90th percentile) have a lifetime risk of breast cancer at 55% (95% CI 49–61%), which increases to 84% (71–97%) with a high PRS (> 90th percentile), and decreases to 49% (30–68%) with a low PRS (< 10th percentile). Similarly, for c.1100delC in CHEK2 (3.7–fold enrichment; 1648 carriers), the respective lifetime risks are 29% (27–32%), 59% (52–66%), and 9% (5–14%). The PRS also refines the risk assessment of women with first-degree relatives diagnosed with breast cancer, particularly among women with positive family history of early-onset breast cancer. Here we demonstrate the opportunities for a comprehensive way of assessing genetic risk in the general population, in breast cancer patients, and in unaffected family members. Identifying women at high risk of breast cancer has important implications for screening. Here, the authors demonstrate that polygenic risk scores improve breast cancer risk prediction in the population, in women with mutations in high-risk genes and in women with close relatives with the disease. [ABSTRACT FROM AUTHOR]

Background: Most people with diabetes are not attaining desirable levels of HbA1c (glycated haemoglobin), or of blood pressure and cholesterol, leaving them at risk of developing complications.Aim: To identify ways of improving diabetes control by gaining insight into patients' attitudes/beliefs.Design and Setting: Questionnaires were offered to patients attending for a diabetes review in the 24 GP practices of North East Hampshire and Farnham Clinical Commissioning Group.Method: Infrequent attenders were contacted by post. Volunteers then participated in focus groups.Results: Self-reported medication adherence was good with 83% (98/118) of responders recording ≥9 on a 10-point scale. Patients generally accepted they 'needed' and 'could take' medication. A substantial minority reported 'not liking' taking tablets. Focus groups confirmed this and revealed a reluctance to change lifestyle, with medication reported as a way to evade it. A total of 68 out of 112 responders (60.7%) knew their HbA1c value. However, focus groups identified little understanding of HbA1c, with responders perceiving it as medical jargon. Phrases such as 'stuck-on-sugar' or 'sugarload' were suggested as being semantically easier to understand. The questionnaire revealed trust in clinicians. This was confirmed in focus groups but confounded by frequent reports of healthcare providers giving inadequate/incorrect advice.Conclusion: Investment in lifestyle change is needed. Participants were reluctant to change and saw medication as a way of avoiding it. HbA1c needs to be better explained. Intuitive phrases such as 'stuck-on-sugar' or 'sugarload' could be adopted into common parlance. Inadequate/incorrect advice seems to be hampering diabetes management and there appears to be a need for more diabetes-trained clinicians. [ABSTRACT FROM AUTHOR]

An integrative literature review was performed to identify the challenges in current cognitive screening. The aim of the review was to serve as an evaluative resource to guide clinicians in the selection of the best available cognitive screening measures for early assessment of mild cognitive impairment (MCI) in people with chronic diseases. The review classified the available cognitive screening measures according to purpose, time to administer, and cognitive domains assessed as: 1) simple/ brief cognitive screening measures, 2) disease specific screening measures, 3) domain specific screening measures, 4) self-administered screening measures, and 5) technology-based screening measures. There is no single optimal cognitive measure for all patient populations and settings. Although disease specific cognitive screening measures are optimal, there is a lack of validated screening measures for many chronic diseases. Technology-based screening measure is a promising avenue for increasing the accessibility of cognitive screening. Future work should focus on translating available screening measures to mobile technology format to enhance the utility in busy primary care settings. Early cognitive screening in persons with chronic disease should enhance appropriate referrals for detailed neurocognitive examination and cognitive interventions to preserve and or minimize cognitive decline. [ABSTRACT FROM AUTHOR]

Purpose of the Study: To examine the rate of vision impairment and the relationship between vision impairment, cognitive impairment, and chronic comorbid conditions in residents of federally subsidized senior housing facilities. Design: Cross-sectional, observational study. Methods: Vision screening events were held at 14 subsidized senior housing facilities in Jefferson County, Alabama for residents aged 60 years and older. Visual function (distance vision, near vision, and contrast sensitivity) measured with habitual correction if worn, cognitive status, and chronic comorbid conditions (hypertension, heart problems, circulation problems, and diabetes) were assessed. Results: A total of 238 residents participated in the vision screenings. Most residents (75%) were African American. Vision impairment was common, with 40% of participants failing the distance acuity screening and 58% failing the near acuity screening; failure was defined as vision worse than 20/40 in either eye. Additionally, 65% failed the contrast sensitivity screening. A total of 30.6% of seniors had cognitive impairment. Regarding comorbid chronic conditions, 31% had circulation problems, 39% had diabetes, 41% had heart problems, and 76% had hypertension (59% had 2 or more of these). Visual acuity differed significantly between cognitive status groups and with the presence of heart and circulation problems. Implications: This study is among the first to provide information about vision impairment in this socioeconomically disadvantaged group of older adults. Vision impairment was common. Cognitive impairment and comorbid chronic conditions accounted for a small to moderate percentage of the variance in distance vision, near vision, and contrast sensitivity. Future studies should focus on strategies to facilitate access to eye care in this vulnerable population. [ABSTRACT FROM AUTHOR]

The article focuses on a study that evaluates the diagnostic accuracy of clinical measures used to diagnose Achilles tendon injuries. Topics of the study include use of biomedical databases MEDLINE and EMBASE to gather data, performing quality assessment using the Quality Assessment of Diagnostic Accuracy Studies-2 tool and the study showing that clinical measures for Achilles tendon injury have greater diagnostic than screening capability.

Purpose To examine whether older adults with vision impairment differentially benefit from cognitive speed of processing training ( SPT) relative to healthy older adults. Methods Secondary data analyses were conducted from a randomised trial on the effects of SPT among older adults. The effects of vision impairment as indicated by (1) near visual acuity, (2) contrast sensitivity, (3) self-reported cataracts and (4) self-reported other eye conditions (e.g., glaucoma, macular degeneration, diabetic retinopathy, optic neuritis, and retinopathy) among participants randomised to either SPT or a social- and computer-contact control group was assessed. The primary outcome was Useful Field of View Test ( UFOV) performance. Results Mixed repeated-measures ancovas demonstrated that those randomized to SPT experienced greater baseline to post-test improvements in UFOV performance relative to controls ( p's < 0.001), regardless of impairments in near visual acuity, contrast sensitivity or presence of cataracts. Those with other eye conditions significantly benefitted from training ( p = 0.044), but to a lesser degree than those without such conditions. Covariates included age and baseline measures of balance and depressive symptoms, which were significantly correlated with baseline UFOV performance. Conclusions Among a community-based sample of older adults with and without visual impairment and eye disease, the SPT intervention was effective in enhancing participants' UFOV performance. The analyses presented here indicate the potential for SPT to enhance UFOV performance among a community-based sample of older adults with visual impairment and potentially for some with self-reported eye disease; further research to explore this area is warranted, particularly to determine the effects of eye diseases on SPT benefits. [ABSTRACT FROM AUTHOR]

Purpose: To examine the association between age-related eye disease (ARED), visual impairment, and health-related quality of life (HRQOL). Methods: We used data from the 2006 and 2008 Behavioral Risk Factor Surveillance System to examine self-reported visual impairment and two HRQOL domains-physical impairment (including poor general health, physical unhealthy days, activity-limitation days, and disability) and mental distress (including mental unhealthy days, life dissatisfaction, major depression, lifetime depression, and anxiety) for people aged 65 years or older, by ARED status. Results: People with any ARED were more likely than those without to report visual impairment as well as physical impairment and mental distress. The prevalence of visual impairment ( P trend <0.001) and physical impairment ( P trend <0.001) increased with increasing number of eye diseases after controlling for all covariates. There was no significant linear trend, however, in mental distress among people with one or more eye diseases. Conclusion: ARED was found to be associated with visual impairment and poorer HRQOL. Increasing numbers of AREDs were associated with increased levels of visual impairment and physical impairment, but were not associated with levels of mental distress. [ABSTRACT FROM AUTHOR]

This study aims to contribute to the body of knowledge about post-adoption functioning of international adoptees by examining patterns of anxiety among young children adopted from China by Australian families. The study had two objectives: to examine anxiety in children adopted from China comparing this sample to available normative data and to examine the associations among child anxiety and child (e.g., age at adoption) and parent (e.g., age, education level) factors. Parents of 59 children adopted from China completed online a number of measures of child anxiety, temperament, and parent psychological well-being. Results indicated a high prevalence of anxiety symptoms among the adopted children when compared with available data from normative samples, particularly related to separation contexts. A number of factors, including inhibited temperament and younger age of parents, were associated with child anxiety. Clinical and research implications are discussed. [ABSTRACT FROM PUBLISHER]

Purpose: We compared the rates of specialized care for residents with Alzheimer's disease or dementia in special care units (SCUs) and other nursing home (NH) units and examined the associations of SCU residence with process of care and resident outcomes. Design and Methods: Data came from the 2004 National Nursing Home Survey. The indicators of process of care included physical restraints, continence management, feeding tubes, and influenza and pneumococcal vaccinations. Resident outcomes included pressure ulcers, hospitalization, emergency room visits, weight loss, and falls. Analyses were conducted by using Stata SE version 10. Results: Multivariate logistic regression analyses show that SCU residents were more likely to have received specialized dementia care and specialized behavioral problem management. They were less likely to have bed rails (adjusted odds ratio [AOR] = 0.39, AOR = 0.35, ps < .01), use catheters (AOR = 0.33, AOR = 0.33, ps < .01), and yet more likely to have toilet plans/bladder training for incontinence control (AOR = 1.90, AOR = 1.62, ps < .01) than those in regular units and those in NHs without an SCU. Moreover, SCU residents were less likely to have pressure ulcers, hospitalization than those in regular units, and less likely to have experienced weight loss than those in NHs without an SCU. However, they were more likely to have falls (AOR = 1.32, AOR = 1.36, ps < .05) than those in regular units and those in NHs without an SCU. Implications: Our study shows that SCU residents had, in general, better process of care than those in regular units and in NHs without an SCU. Further studies are needed to assess specific outcome changes among SCU residents and to evaluate the cost-effectiveness of having such units. [ABSTRACT FROM PUBLISHER]

Objectives: To present the bother subscales of the Nursing Home Vision-Targeted Health-Related Quality of Life Questionnaire (NHVQoL) and to examine their relationship to the original NHVQoL subscales and objective measures of visual function. Method: 395 nursing home residents completed the bother subscales. Associations between bother subscales and original subscales and objectively measured vision were evaluated. Results: Mean bother scores ranged from 1.97 to 2.30, reflecting an average rating of "a little" bother. For 20 NHVQoL items, more than 50% of participants reported "a lot" of bother. All NHVQoL original subscale scores were moderately correlated with bother subscales (p < .0001). Bother subscales and visual acuity were not highly correlated. Discussion: Nursing home residents are bothered by reductions in vision-targeted health-related quality of life. The NHVQoL bother subscales may probe the personal burden of visual problems in this population that is not captured by the original subscales or objectively measuring visual function. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To examine the relationships between changes from baseline to post-Resources for Enhancing Alzheimer's Caregiver Health (REACH) intervention in caregiver (CG) self-reported health, burden, and bother. DESIGN: Randomized, multisite clinical trial. SETTING: CG and care recipient (CR) homes in five U.S. cities. PARTICIPANTS: Four hundred ninety-five dementia CG and CR dyads (169 Hispanic, 160 white, and 166 African American) receiving intervention and their controls. INTERVENTION: CGs were assigned to the REACH intervention or a no-treatment control group. Intervention subjects received individual risk profiles and the REACH intervention through nine in-home and three telephone sessions over 6 months. Control subjects received two brief “check-in” telephone calls during this 6-month period. MEASUREMENTS: The primary outcome was change in CG health status from baseline to after the intervention. Secondary outcomes were CG burden and bother after the intervention. RESULTS: After the intervention, CGs reported better self-rated health, sleep quality, physical health, and emotional health, which was related to less burden and bother with their caregiving role than for CGs not receiving the intervention. Changes in depression appeared to mediate these relationships. Several racial and ethnic group differences existed in physical and emotional health, as well as in total frustration with caregiving, emotional burden, and CG-rated bother with CR's activities of daily living and instrumental activities of daily living at baseline and at follow-up, although differences between baseline and posttest did not vary according to race. CONCLUSION: A structured, multicomponent skills training intervention that targeted CG self-care behaviors as one of five target areas, improved self-reported health status, and decreased burden and bother in racially and ethnically diverse CGs of people with dementia. [ABSTRACT FROM AUTHOR]

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Fog is thought to influence ecological function in coastal forests worldwide, yet few data are available that illuminate the mechanisms underlying this influence. In a California redwood forest we measured water and nitrogen (N) fluxes from horizontally moving fog and vertically delivered rain as well as redwood tree function. The spatial heterogeneity of water and N fluxes, water availability, tree water use, and canopy N processing varied greatly across seasons. Water and N fluxes to soil (annual average of 98% and 89%, respectively) across the whole forest occurred primarily in the rain season and was relatively even across the whole forest. In contrast, below-canopy flux of fog water and N declined exponentially from the windward edge to the forest interior. Following large fog events, soil moisture was greater at the windward edge than anywhere else in the forest. Physiological activity in redwoods reflected these differences in inputs across seasons: tree physiological responses did not vary spatially in the rain season, but in the fog season, water use was greater, yet water stress was less, in trees at the windward edge of the forest versus the interior. In both seasons, vertical passage through the forest changed the amount of water and form and concentration of N, revealing the role of the tree canopy in processing atmospheric inputs. Although total fog water inputs were comparatively small, they may have important ecosystem functions, including relief of canopy water stress and, where there is fog drip, functional coupling of above- and belowground processes. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To evaluate the association between the Minimum Data Set's (MDS) Vision Patterns section and near and distance visual acuity and contrast sensitivity in nursing home residents. DESIGN: Cross-sectional study. SETTING: Seventeen nursing homes in the Birmingham, Alabama, area. PARTICIPANTS: Three hundred seventy-one nursing home residents aged 55 and older with Mini-Mental State Examination scores of 13 or greater. MEASUREMENTS: The MDS 2.0 assessment for vision from the date closest to acuity and contrast sensitivity assessment were obtained from the resident's medical record. Acuity and contrast sensitivity were measured using the ETDRS chart and Pelli-Robson chart, respectively. RESULTS: The MDS rating of visual status was associated with distance and near visual acuity and contrast sensitivity. The MDS performed poorly in distinguishing residents with mild visual impairment from those with moderate visual impairment. For residents who were rated on the MDS as having adequate vision, 45.9% had distance acuity worse than 20/40 in the better eye, 72.8% had near acuity worse than 20/40 in the better eye, and 85.8% had contrast sensitivity less than 1.50. CONCLUSION: The MDS 2.0 assessment for vision in nursing home residents is positively associated with visual acuity and contrast sensitivity but does not adequately distinguish between individuals with mild and moderate visual impairment and classifies many as having adequate vision who have visual impairment. The validity of the MDS 2.0 as a mechanism for triggering comprehensive eye care for nursing home residents is questionable. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To evaluate the effect of vision-enhancing interventions (cataract surgery or refractive error correction) on physical function and cognitive status in nursing home residents. DESIGN: Longitudinal cohort study. SETTING: Seventeen nursing homes in Birmingham, Alabama. PARTICIPANTS: A total of 187 English-speaking adults aged 55 and older. INTERVENTION: Participants took part in one of two vision-enhancing interventions: cataract surgery or refractive error correction. Each group was compared against a control group (persons eligible for but who declined cataract surgery or who received delayed correction of refractive error). MEASUREMENTS: Physical function (ability to perform activities of daily living and mobility) was assessed using a series of self-report and certified nursing assistant ratings at baseline and at 2 months for the refractive error correction group and at 4 months for the cataract surgery group. The Mini Mental State Examination was also administered. RESULTS: No significant differences existed within or between groups from baseline to follow-up on any of the measures of physical function. Mental status scores significantly declined from baseline to follow-up for the immediate ( P=.05) and delayed ( P<.02) refractive error correction groups and for the cataract surgery control group ( P=.05). CONCLUSION: Vision-enhancing interventions did not lead to short-term improvements in physical functioning or cognitive status in this sample of elderly nursing home residents. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To investigate the relationship between self-report and behavioral indicators of pain in cognitively impaired and intact older adults. DESIGN: Quasi-experimental, correlational study of older adults. SETTING: Data were collected from residents of nursing homes, assisted living, and retirement apartments in north-central Florida. PARTICIPANTS: One hundred twenty-six adults, mean age 83; 64 cognitively intact, 62 cognitively impaired. MEASUREMENTS: Pain interviews (pain presence, intensity, locations, duration), pain behavior measure, Mini-Mental State Examination, analgesic medications, and demographic characteristics. Participants completed an activity-based protocol to induce pain. RESULTS: Eighty-six percent self-reported regular pain. Controlling for analgesics, cognitively impaired participants reported less pain than cognitively intact participants after movement but not at rest. Behavioral pain indicators did not differ between cognitively intact and impaired participants. Total number of pain behaviors was significantly related to self-reported pain intensity (β=0.40, P=.000) in cognitively intact elderly people. CONCLUSION: Cognitively impaired elderly people self-report less pain than cognitively intact elderly people, independent of analgesics, but only when assessed after movement. Behavioral pain indicators do not differ between the groups. The relationship between self-report and pain behaviors supports the validity of behavioral assessments in this population. These findings support the use of multidimensional pain assessment in persons with dementia. [ABSTRACT FROM AUTHOR]

Common variants at only two loci, FTO and MC4R, have been reproducibly associated with body mass index (BMI) in humans. To identify additional loci, we conducted meta-analysis of 15 genome-wide association studies for BMI (n > 32,000) and followed up top signals in 14 additional cohorts (n > 59,000). We strongly confirm FTO and MC4R and identify six additional loci (P < 5 × 10−8): TMEM18, KCTD15, GNPDA2, SH2B1, MTCH2 and NEGR1 (where a 45-kb deletion polymorphism is a candidate causal variant). Several of the likely causal genes are highly expressed or known to act in the central nervous system (CNS), emphasizing, as in rare monogenic forms of obesity, the role of the CNS in predisposition to obesity. [ABSTRACT FROM AUTHOR]