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Social distancing policies have been implemented around the world to reduce the spread of coronavirus disease 2019 (COVID-19). These measures have included temporary restrictions on mass gatherings and the closure of public facilities, limiting the pursuit of leisure activities such as travel while allowing more time for at-home pursuits, including creative activities such as gardening and painting. Previous research has demonstrated the benefits of physical activity for psychological well-being during COVID-19, but less attention has been given to the potential benefits of creative pursuits, such as arts and music. The present study investigated changes in the pursuit of creative, non-creative, and physical leisure activities and the relationship between engaging in leisure, the motivations for and barriers to pursuing these activities, and psychological well-being during COVID-19. A total of 3,827 participants from 74 countries completed an online leisure activities questionnaire and the World Health Organization Five Well-Being Index. Logistic regression indicated that gender, age, social distancing adherence, and employment status significantly predicted leisure engagement during COVID-19. Compared to sports and outdoor pursuits, participation in creative activities was generally more likely to increase during this period, while participation in non-creative activities was less likely to increase. Multiple linear regression indicated that maintaining or increasing time on leisure activities significantly predicted well-being during COVID-19, with increased time spent on home crafts and artisanship, fine arts, musical and performing arts engagement, sports and outdoor pursuits, niche and IT interests, and language activities each predicting higher well-being outcomes. Motivations such as seeking creative expression and mental stimulation, keeping fit, and maintaining social connections also predicted higher well-being. These findings suggest that participation in both physical and creative leisure activities may offer protective benefits for well-being during COVID-19, and that strategies to promote engagement in creative activities should also be considered in future guidance for mental health during periods of lockdown or isolation., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Morse, Fine and Friedlander.)

A new protocol for eliciting insight ("Aha!"/Eureka) moments is proposed, involving the solving of British-style cryptic crosswords. The mechanics of cryptic crossword clues are briefly explained, and the process is set into the insight literature, with parallels being drawn between several different types of cryptic crossword clues and other insight-triggering problems such as magic, jokes, anagrams, rebus, and remote association puzzles (RAT), as well as "classic" thematic or spatial challenges. We have evidence from a previous survey of cryptic crossword solvers that the "Aha!" moment is the most important driver of continued participation in this hobby, suggesting that the positive emotional "payback" has an energizing effect on a participant's motivation to continue solving. Given the success with which a good quality cryptic crossword elicits "Aha!" moments, cryptics should prove highly valuable in exploring insight under lab conditions. We argue that the crossword paradigm overcomes many of the issues which beset other insight problems: for example, solution rates of cryptic crossword clues are high; new material can easily be commissioned, leading to a limitless pool of test items; and each puzzle contains clues resembling a wide variety of insight problem types, permitting a comparison of heterogeneous solving mechanisms within the same medium. Uniquely among insight problems, considerations of expertise also come into play, allowing us to explore how crossword solving experts handle the deliberate misdirection of the cryptic clue more effectively than non-expert, but equally experienced, peers. Many have debated whether there is such a thing as an "insight problem" per se : typically, problems can be solved with or without insight, depending on the context. We argue that the same is true for cryptic crosswords, and that the key to the successful triggering of insight may lie in both the difficulty of the challenge and the degree to which misdirection has been used. Future research is outlined which explores the specific mechanisms of clue difficulty. This opens the way to an exploration of potential links between solving constraints and the experiencing of the "Aha!" moment, which may shed light on the cognitive processes involved in insight solution.

Study Design: Qualitative, semi-structured interviews., Objectives: Neuropathic pain (NP) can be psychologically and physically debilitating, and is present in approximately half of the spinal cord injured (SCI) population. However, under half of those with NP are adherent to pain medication. Understanding the impact of NP during rehabilitation is required to reduce long-term impact and to promote adherence to medication and psychoeducation recommendations., Setting: United Kingdom., Methods: Five males and three females with SCI and chronic NP, resident in rehabilitation wards at a specialist SCI center in the United Kingdom, took part. Semi-structured interviews were conducted with participants less than 15 months post-SCI (mean = 8.4 months). Verbatim transcripts were subject to interpretative phenomenological analysis (IPA)., Results: Three super-ordinate themes were identified, mediating pain and adherence: (1) the dichotomy of safety perceptions; (2) adherence despite adversity; and (3) fighting the future. Analyses suggest that experience of the rehabilitation setting and responsiveness of care shapes early distress. Attitudes to medication and psychosocial adjustment are relevant to developing expectations about pain management., Conclusions: Enhancing self-efficacy, feelings of safety in hospital, and encouraging the adoption of adaptive coping strategies may enhance psychosocial and pain-related outcomes, and improve adherence to medication. Encouraging adaptive responses to, and interpretation of, pain, through the use of interventions such as coping effectiveness training, targeted cognitive behavioral pain management, and acceptance-based interventions such as mindfulness, is recommended in order to reduce long-term reliance on medication., Competing Interests: Compliance with ethical standardsThe authors declare that they have no competing interests.

The installation of roofing materials with increased solar reflectance (i.e., "cool roofs") can mitigate the urban heat island effect and reduce energy use. In addition, meteorological changes, along with the possibility of enhanced UV reflection from these surfaces, can have complex impacts on ozone and PM 2.5 concentrations. We aim to evaluate the air-quality impacts of widespread cool-roof installations prescribed by California's Title 24 building energy efficiency standards within the heavily populated and polluted South Coast Air Basin (SoCAB). Development of a comprehensive rooftop area database and evaluation of spectral reflectance measurements of roofing materials allows us to project potential future changes in solar and UV reflectance for simulations using the Weather Research Forecast and Community Multiscale Air Quality (CMAQ) models. 2012 meteorological simulations indicate a decrease in daily maximum temperatures, daily maximum boundary layer heights, and ventilation coefficients throughout the SoCAB upon widespread installation of cool roofs. CMAQ simulations show significant increases in PM 2.5 concentrations and policy-relevant design values. Changes in 8-h ozone concentrations depend on the potential change in UV reflectance, ranging from a decrease in population-weighted concentrations when UV reflectance remains unchanged to an increase when changes in UV reflectance are at an upper bound. However, 8-h policy-relevant ozone design values increase in all cases. Although the other benefits of cool roofs could outweigh small air-quality penalties, UV reflectance standards for cool roofing materials could mitigate these negative consequences. Results of this study motivate the careful consideration of future rooftop and pavement solar reflectance modification policies., Competing Interests: The authors declare no conflict of interest.

Objectives: Metaphorical expressions of persistent pain play an influential role in the modulation of pain. This may be particularly distressing for those with physical disabilities such as spinal cord injury (SCI). Neuropathic pain (NP) after SCI is often described using metaphorical expressions such as burning and electricity. This study explored the use of metaphors by those with NP after SCI., Design: A qualitative, semi-structured interview design was employed., Methods: Data were analysed using content analysis (CA) and interpretative phenomenological analysis to explore prevalence of metaphor use and its meaning. Sixteen individuals aged between 23 and 82 years, with chronic NP (persisting for 3 months or longer), arising from SCI were interviewed in their homes or on hospital wards (M = 10, F = 6). Interviews lasted between 40 and 120 min., Results: The results capture a range of metaphorical expressions embedded in participants' accounts. Three themes emerged: (1) pain as a personal attack, (2) the desire to be understood, and (3) conveying distress without adequate terminology. CA revealed that younger age, female gender, and outpatient status were associated with increased metaphor use., Conclusions: This study highlights the power of metaphor in eliciting understanding of NP after SCI from others, whilst demonstrating the challenge of communicating NP. Cognitive treatment that incorporates image-based techniques with acceptance and mindfulness-based therapies may encourage adaptive responses to, and interpretation of, pain. This may subsequently reduce pain-related distress and catastrophizing. Statement of contribution What is already known on this subject? Neuropathic pain is often described with metaphorical language such as burning and crushing. For those with physical limitations, metaphor use may induce or exacerbate psychological distress. However, for those with spinal cord injuries, metaphor use has received little attention. What does this study add? Metaphor use is common in those with spinal cord injury, with differences across gender and age. Core metaphors used conceptualized pain as an attacker or likened pain to heat and burning. Such language may have benefits in terms of improved understanding and increased empathy, but may be reflective of catastrophic thinking., (© 2016 The British Psychological Society.)

We examined the prospective impact of injury severity, functional impairment, and pain on participation in the community and subsequently on life satisfaction and self-rated health of 260 burn survivors 5 years post-discharge. Predictor variables include injury severity and total body surface area burned (assessed during acute care), functional independence (assessed at 12 months post-discharge), pain (assessed at the 24th month), and participation (assessed at the 48th month). Participation predicted life satisfaction and self-rated health. Functional independence and injury severity had significant indirect influences on adjustment via their influence on participation. Pain predicted both outcome variables. Clinical and research implications are discussed., (© The Author(s) 2015.)

Reducing distracters detrimental to commercial truck driving is a critical component of improving the safety performance of commercial drivers, and makes the highways safer for all drivers. This study used a driving simulator to examine effects of cell phone, texting, and email distractions as well as self-reported driver optimism bias on the driving performance of commercial truck drivers. Results revealed that more visually demanding tasks were related to poorer driving performance. However, the cell phone task resulted in less off-the-road eye glances. Drivers reporting being "very skilled" displayed poorer driving performance than those reporting being "skilled." Onboard communication devices provide a practical, yet visually and manually demanding, solution for connecting drivers and dispatchers. Trucking company policies should minimize interaction between dispatchers and drivers when the truck is in motion. Training facilities should integrate driving simulators into the instruction of commercial drivers, targeting over-confident drivers., (© 2016 The Author(s).)

This paper presents a relatively unexplored area of expertise research which focuses on the solving of British-style cryptic crossword puzzles. Unlike its American "straight-definition" counterparts, which are primarily semantically-cued retrieval tasks, the British cryptic crossword is an exercise in code-cracking detection work. Solvers learn to ignore the superficial "surface reading" of the clue, which is phrased to be deliberately misleading, and look instead for a grammatical set of coded instructions which, if executed precisely, will lead to the correct (and only) answer. Sample clues are set out to illustrate the task requirements and demands. Hypothesized aptitudes for the field might include high fluid intelligence, skill at quasi-algebraic puzzles, pattern matching, visuospatial manipulation, divergent thinking and breaking frame abilities. These skills are additional to the crystallized knowledge and word-retrieval demands which are also a feature of American crossword puzzles. The authors present results from an exploratory survey intended to identify the characteristics of the cryptic crossword solving population, and outline the impact of these results on the direction of their subsequent research. Survey results were strongly supportive of a number of hypothesized skill-sets and guided the selection of appropriate test content and research paradigms which formed the basis of an extensive research program to be reported elsewhere. The paper concludes by arguing the case for a more grounded approach to expertise studies, termed the Grounded Expertise Components Approach. In this, the design and scope of the empirical program flows from a detailed and objectively-based characterization of the research population at the very onset of the program.

Objective: This study is among the first to examine the effect of talking on a cell phone or text messaging while driving in teens with and without attention deficit/hyperactivity disorder (ADHD)., Method: Teens (average age 17years) with a diagnosis of ADHD (N=16) were matched with typically developing controls (N=18). All participants operated a driving simulator while (1) conversing on a cell phone, (2) text messaging, and (3) with no distraction during a baseline condition. Six indicators of driving performance were recorded: (a) time to complete the drive; (b) lane deviations; (c) variability in lane position (i.e., root mean square [RMS]); (d) reaction time; (e) motor vehicle collisions; and, (f) speed fluctuation., Results: Significantly greater variation in lane position occurred in the texting task compared to no task and the cell phone task. While texting, in particular, teens with ADHD took significantly less time to complete the scenario. No significant main effects of group were found., Conclusions: Generally, those with ADHD did not differ in regard to driving performance, when compared to controls, with the exception of one outcome: time to complete scenario. These findings suggest that distracted driving impairs driving performance of teen drivers, regardless of ADHD status. Texting while driving had the greatest negative impact on driving performance, particularly with regard to variability in lane position (i.e., RMS). This study sheds light on key issues regarding injury prevention, with the intent of providing pediatric care providers with the knowledge to inform teen drivers of risks associated with distracted driving which will ultimately result in reduced rates of motor vehicle crashes and concomitant injuries., (Published by Elsevier Inc.)

Purpose: This article presents an in-depth, idiographic study examining the lived experience of chronic pain following spinal cord injury (SCI). Neuropathic pain (NP) occurs in a large majority of the SCI population and is particularly intractable to treatment. It can be both psychologically and physically debilitating. This study examines how the experience of NP is mediated by its meaning to the sufferer., Methods: Semi-structured interviews were conducted with eight people with SCI and chronic NP, attending outpatient clinics at a specialist SCI Centre in the UK. Verbatim transcripts were subjected to interpretative phenomenological analysis to further understand the experience., Results: Analysis suggested that NP has powerful consequences upon the sufferer's physical, psychological and social well-being, in line with a biopsychosocial understanding of pain. Three super-ordinate themes were identified: a perceived gap between treatments received and participants' views of what they wanted and needed; a fight for life control and acceptance; and feeling understood by others with SCI, but isolated from the non-understanding able-bodied., Conclusions: The results are discussed in terms of the possible application of acceptance-based therapy to NP and the potential for the alleviation of the debilitating consequences of NP., Implications for Rehabilitation: Chronic NP after SCI is often described as worse than the injury itself, often impacting upon the sufferers physical and psychological health. The experiences of persons with SCI-specific NP highlight the impact of pain on their physical, psychological and social health. This indicates that healthcare professionals should incorporate a biopsychosocial approach for managing pain post-SCI. Routine clinical follow-up of SCI patients with chronic NP, as well as comprehensive pain management treatment programmes, could address the three themes evidenced in the current study, by moving routine intervention with NP away from pain relief, towards pain management. Continued education for patients, friends, family members and healthcare professionals may be beneficial in promoting understanding and awareness of NP and its consequences following SCI.

Objectives: This study tested an a priori contextual model of the mediating effects of participation on the predictive relationships of functional impairment, family satisfaction, and pain to quality of life (QoL) following traumatic spinal cord injury (SCI)., Design: A longitudinal design was used to study 144 persons following discharge for traumatic SCI. Predictor variables included functional impairment and family satisfaction (at 12 months post-discharge) and the presence of pain (at 24 months), and mediating variables were two indicators of participation (assessed 48 months post-discharge). Life satisfaction and self-rated health status at 60 months post-discharge were the outcome variables., Methods: A path model tested hypothesized prospective effects of functional impairment, family satisfaction and pain on participation and the subsequent effects of participation on the QoL variables., Results: Greater functional impairment and pain were predictive of less participation, and participation significantly predicted both indicators of QoL. The two participation variables mediated the relationship of functional impairment and pain to life satisfaction over time. Family satisfaction had an indirect effect on QoL through its association with social integration., Conclusions: Participation appears to mediate the prospective influence of functional impairment, family satisfaction, and pain on QoL in the years following SCI. These findings provide insight into factors that can predict QoL post-SCI and support the use of contextual models to understand the temporal influence of disability and psychological variables on participation and subsequent QoL., Statement of Contribution: What is already known on this subject? Life satisfaction and self-rated health status are important aspects of quality of life following traumatic spinal cord injury. Functional impairment has been inconsistently predictive of these variables over time. Prospective research to date has not examined the mediating effects of participation in predicting quality of life. What does this study add? The results indicate that greater functional impairment and pain are prospectively predictive of lower participation. Greater participation, in turn, is prospectively predictive of greater quality of life. Participation appears to mediate the prospective influence of functional impairment, family satisfaction, and pain to quality of life., (© 2013 The British Psychological Society.)

Singing is universal, and understanding sung words is thought to be important for many listeners' enjoyment of vocal and choral music. However, this is not a trivial task, and sung text intelligibility is probably affected by many factors. A survey of musicians was undertaken to identify the factors believed to have most impact on intelligibility, and to assess the importance of understanding sung words in familiar and unfamiliar languages. A total of 143 professional and amateur musicians, including singers, singing teachers, and regular listeners to vocal music, provided 394 statements yielding 851 references to one or more of 43 discrete factors in four categories: performer-related, listener-related, environment-related and words/music-related. The factors mentioned most frequently in each of the four categories were, respectively: diction; hearing ability; acoustic; and genre. In more than a third of references, the extent to which sung text is intelligible was attributed to the performer. Over 60% of respondents rated the ability to understand words in familiar languages as "very important," but only 17% when the text was in an unfamiliar language. Professional musicians (47% of the sample) rated the importance of understanding in both familiar and unfamiliar languages significantly higher than amateurs but listed fewer factors overall and fewer listener-related factors. The more important the respondents rated understanding, the more performer-related and environment-related factors they tended to list. There were no significant differences between the responses of those who teach singing and those who do not. Enhancing sung text intelligibility is thus perceived to be within the singer's control, at least to some extent, but there are also many factors outside their control. Empirical research is needed to explore some of these factors in greater depth, and has the potential to inform pedagogy for singers, composers, and choral directors.

Objective: Adolescents with disruptive behavior disorder, including ADHD, are more likely to engage in risky driving practices and, consequently, are more likely to be involved in a motor vehicle crash (MVC) than their non-ADHD peers. It is unclear whether symptoms of inattention, hyperactivity/impulsivity, or oppositional defiant disorder (ODD) increase risk of poor driving outcomes., Method: A total of 41 participants (16-19 years old) reported their ADHD and ODD symptoms and risky driving practices (errors and violations). History of citations and MVCs were acquired from state records. Relative predictive utility of symptom dimensions was assessed using multiple regressions., Results: Inattention solely predicted driving variables of interest: Greater levels of inattention were predictive of more citations, MVCs, and self-reported errors and violations., Conclusion: Findings suggest that symptoms of inattention play a primary role in driving-related problems among adolescents. Implications for future research and practice are discussed., (© 2012 SAGE Publications.)

Objectives: We studied the predictive impact of family satisfaction, marital status, and functional impairment on the trajectories of life satisfaction over the first 5 years following medical treatment for traumatic spinal cord injury, burns, or interarticular fractures (total N = 662). It was anticipated that fewer functional impairments, being married, and greater family satisfaction would predict higher life satisfaction trajectories., Method: The Functional Independence Measure, the Family Satisfaction Scale, and the Life Satisfaction Index were administered 12, 24, 48, and 60 months postdischarge., Results: Trajectory modeling revealed that greater functional impairment significantly predicted lower life satisfaction, regardless of injury type. However, this association diminished when marital status and family satisfaction were entered into the models. Greater family satisfaction and being married predicted greater life satisfaction across time. Moreover, there was no evidence for increases in life satisfaction trajectories over time: Trajectories were stable across time for all injury groups., Conclusions: Results suggest that being married and greater family satisfaction promote life satisfaction among those who traumatically acquire disability, and these beneficial effects may be more salient than the degree of functional impairment imposed by the condition., ((c) 2014 APA, all rights reserved.)

Studies have documented a link between distracted driving and diminished safety; however, an association between distracted driving and traffic congestion has not been investigated in depth. The present study examined the behavior of teens and young adults operating a driving simulator while engaged in various distractions (i.e., cell phone, texting, and undistracted) and driving conditions (i.e., free flow, stable flow, and oversaturation). Seventy five participants 16-25 years of age (split into 2 groups: novice drivers and young adults) drove a STISIM simulator three times, each time with one of three randomly presented distractions. Each drive was designed to represent daytime scenery on a 4 lane divided roadway and included three equal roadway portions representing Levels of Service (LOS) A, C, and E as defined in the 2000 Highway Capacity Manual. Participants also completed questionnaires documenting demographics and driving history. Both safety and traffic flow related driving outcomes were considered. A Repeated Measures Multivariate Analysis of Variance was employed to analyze continuous outcome variables and a Generalized Estimate Equation (GEE) Poisson model was used to analyze count variables. Results revealed that, in general more lane deviations and crashes occurred during texting. Distraction (in most cases, text messaging) had a significantly negative impact on traffic flow, such that participants exhibited greater fluctuation in speed, changed lanes significantly fewer times, and took longer to complete the scenario. In turn, more simulated vehicles passed the participant drivers while they were texting or talking on a cell phone than while undistracted. The results indicate that distracted driving, particularly texting, may lead to reduced safety and traffic flow, thus having a negative impact on traffic operations. No significant differences were detected between age groups, suggesting that all drivers, regardless of age, may drive in a manner that impacts safety and traffic flow negatively when distracted., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Primary Objective: To examine the predictive associations of family satisfaction, functional impairment, pain, and depression on health-related quality-of-life (HRQoL) among persons with traumatic brain injury (TBI) through structural equation modelling (SEM)., Research Design: Participants were part of a larger longitudinal study of adjustment following TBI. Direct and indirect effects of predictor variables on HRQoL were analyzed through SEM., Methods and Procedures: The sample included 131 participants with TBI (89 men, 42 women) who had been discharged from an acute care hospital. The Sickness Impact Profile was administered to measure HRQoL at or beyond 24 months post-discharge. Predictor variable measures included the Functional Independence Measure, Family Satisfaction Scale and single items assessing the presence of pain and depression., Main Outcomes and Results: SEM revealed direct effects of functional impairment (p < 0.001), family satisfaction (p < 0.01), depression (p < 0.05) and pain (p < 0.01) on HRQoL. Indirect effects from functional impairment (p < 0.05) and pain (p < 0.05) to HRQoL through depression were also present., Conclusions: The presence of pain and depression, greater functional impairment and lower family satisfaction were predictively associated with lower HRQoL. Depression further mediated the effects of pain and functional impairment on HRQoL. The present study advances understanding of the ways in which pain, depression and functional impairment predict HRQoL.

Identifying reliable predictors of positive adjustment following traumatic brain injury (TBI) remains an important area of inquiry. Unfortunately, much of available research examines direct relationships between predictor variables and outcomes without attending to the contextual relationships that can exist between predictor variables. Relying on theoretical models of well-being, we examined a theoretical model of adjustment in which the capacity to engage in intentional activities would be prospectively associated with greater participation, which in turn would predict subsequent life satisfaction and perceived health assessed at a later time. Structural equation modeling of data collected from 312 individuals (226 men, 86 women) with TBI revealed that two elements of participation--mobility and occupational activities--mediated the prospective influence of functional independence and injury severity to optimal adjustment 60 months following medical discharge for TBI. The model accounted for 21% of the variance in life satisfaction and 23% of the variance in self-rated health. Results indicate that the effects of functional independence and injury severity to optimal adjustment over time may be best understood in the context of participation in meaningful, productive activities. Implications for theoretical models of well-being and for clinical interventions that promote adjustment after TBI are discussed.

Objective: To examine whether an individualized problem-solving intervention provided to family caregivers of persons with severe disabilities provides benefits to both caregivers and their care recipients., Design: Family caregivers were randomly assigned to an education-only control group or a problem-solving training (PST) intervention group. Participants received monthly contacts for 1 year., Participants: Family caregivers (129 women, 18 men) and their care recipients (81 women, 66 men) consented to participate., Main Outcome Measures: Caregivers completed the Social Problem-Solving Inventory-Revised, the Center for Epidemiological Studies-Depression scale, the Satisfaction with Life scale, and a measure of health complaints at baseline and in 3 additional assessments throughout the year. Care recipient depression was assessed with a short form of the Hamilton Depression Scale., Results: Latent growth modeling was used to analyze data from the dyads. Caregivers who received PST reported a significant decrease in depression over time, and they also displayed gains in constructive problem-solving abilities and decreases in dysfunctional problem-solving abilities. Care recipients displayed significant decreases in depression over time, and these decreases were significantly associated with decreases in caregiver depression in response to training., Conclusions: PST significantly improved the problem-solving skills of community-residing caregivers and also lessened their depressive symptoms. Care recipients in the PST group also had reductions in depression over time, and it appears that decreases in caregiver depression may account for this effect., (PsycINFO Database Record (c) 2012 APA, all rights reserved.)

Objective: Unintentional injury is the leading cause of pediatric mortality. One leading cause of unintentional injury is pedestrian injury. Children with developmental disabilities, particularly those with attention-deficit/hyperactivity disorder-combined type (ADHD-C) seem to have increased pedestrian injury risk. This study examined (1) the differences in pedestrian behavior between children with ADHD-C and normally developing comparison children and (2) the mediating factors that might link ADHD-C with pedestrian injury risk., Patients and Methods: A total of 78 children aged 7 to 10 years (39 children with ADHD-C diagnoses and 39 age- and gender-matched typically developing children) participated. The main outcome measure was pedestrian behavior, as measured in a semi-immersive, interactive, virtual pedestrian environment. Key pedestrian variables related to different aspects of the crossing process were identified: (1) before the cross (ie, evaluating aspects of the crossing environment); (2) making the cross (ie, deciding to cross and initiating movement); and (3) safety of the cross (ie, safety within the pedestrian environment after the decision to cross was made)., Results: Children with ADHD-C chose riskier pedestrian environments to cross within (F(1,72) = 4.83; P < .05). No significant differences emerged in other aspects of the crossing process. Executive function played a mediating role in the relationship between ADHD-C and the safety of the cross., Conclusions: Children with ADHD-C seem to display appropriate curbside pedestrian behavior but fail to process perceived information adequately to permit crossing safely.

The impact of primary fine particulate matter (PM2.5) from ship emissions within the Southern California Air Basin is quantified by comparing in-stack vanadium (V) and nickel (Ni) measurements from in-use ocean-going vessels (OGVs) with ambient measurements made at 10 monitoring stations throughout Southern California. V and Ni are demonstrated as robust markers for the combustion of heavy fuel oil in OGVs, and ambient measurements of fine particulate V and Ni within Southern California are shown to decrease inversely with increased distance from the ports of Los Angeles and Long Beach (ports). High levels of V and Ni were observed from in-stack emission measurements conducted on the propulsion engines of two different in-use OGVs. The in-stack V and Ni emission rates (g/h) normalized by the V and Ni contents in the fuel tested correlates with the stack total PM emission rates (g/h). The normalized emission rates are used to estimate the primary PM2.5 contributions from OGVs at 10 monitoring locations within Southern California. Primary PM2.5 contributions from OGVs were found to range from 8.8% of the total PM2.5 at the monitoring location closest to the port (West Long Beach) to 1.4% of the total PM2.5 at the monitoring location 80 km inland (Rubidoux). The calculated OGV contributions to ambient PM2.5 measurements at the 10 monitoring sites agree well with estimates developed using an emission inventory based regional model. Results of this analysis will be useful in determining the impacts of primary particulate emissions from OGVs upon worldwide communities downwind of port operations.

Secondary aerosols comprise a major fraction of fine particulate matter (PM2.5) in all parts of the country, during all seasons, and times of day. The most abundant secondary species include sulfate, nitrate, ammonium, and secondary organic aerosols (SOAs). The relative abundance of each species varies in space and time as a function of meteorology, source emissions strength and type, thermodynamics, and atmospheric processing. Transport of secondary aerosols from upwind locations can contribute significantly at downwind receptor sites, especially regionally in the eastern United States, and across a given urbanized area, such as in Los Angeles. Processes governing the formation of the inorganic secondary species (sulfate, nitrate, and ammonium) are fairly well understood, although the occurrence of nucleation bursts initiated with the formation of ultrafine sulfuric acid particles observed regionally on clean days in the eastern United States was unexpected. Because of the complex nature of organic material in air, much is still to be learned about the sources, formation, and even spatial and temporal distributions of SOAs. For example, a considerable fraction of ambient organic PM is oxidized organic species, many of which still need to be identified, quantified, and their sources and formation mechanisms determined. Furthermore, significant uncertainty (approaching 50% or more) is associated with estimating the SOA fraction of organic material in air with current methods. This review summarizes the findings of the Supersites Program and related studies addressing secondary particulate matter (PM), including spatial and temporal variations of secondary PM and its precursor species, data and methods for determining the primary and secondary fractions of PM mass, and findings on the anthropogenic and natural fractions of secondary PM.

Simultaneous measurements of gas- and aerosol-phase hydrogen peroxide (H2O2) have been made at two sites in Los Angeles, one near the Pacific coast at the University of California at Los Angeles (UCLA), and the other in downtown Los Angeles with close proximity to a heavily traveled freeway (freeway site). At both the freeway and UCLA sites, gas-phase H2O2 levels were similar, averaging 1.17 +/- 1.0 and 1.05 +/- 0.6 ppb, respectively. The particle-associated H2O2 in both fine (PM2.5) and coarse (>PM2.5) modes was higher at the freeway site, as compared to UCLA, by a factor of 2. However, when aerosol-phase H2O2 is normalized to particle mass loadings, the fine-mode H2O2 levels are very similar at the two sites: 0.42 +/- 0.3 and 0.58 +/- 0.3 ng H2O2/microg particle mass at the freeway and UCLA sites, respectively. The normalized coarse-mode H2O2 levels were significantly higher at the freeway site than at UCLA, 1.05 +/- 0.3 and 0.51 +/- 0.3 ng/microg, respectively. Estimating aerosol liquid water content on the basis of relative humidity and aerosol mass, a calculated equivalent H2O2 in aerosol liquid water averages 70 mM, more than 2 orders of magnitude higher than concentrations predicted by gas-particle partitioning (Henry's law), which averages 0.1 mM. This indicates that the sampled particles are capable of generating H2O2 in aqueous solution. These corresponding aqueous-phase H2O2 concentrations in aerosol liquid water exceed levels that have been observed to produce cellular damage to lung epithelial cells in laboratory experiments by at least 3 orders of magnitude. Although most measurements of H2O2 in particles were made using an extraction solution adjusted to pH 3.5, a set of measurements indicates that H2O2 from fine-mode particles extracted in the physiologically relevant pH range 5-7.5 also generate H2O2 with only slightly lowered efficiency; coarse-mode H2O2 production dropped by 75% at the upper end of this range. Finally, a small set of measurements was performed to investigate the degree to which the recently developed Versatile Aerosol Concentrator Enrichment System (VACES) affects H2O2 levels in concentrated ambient aerosols. The VACES appeared to a have minimal impact on particulate H2O2.

Individual organic compounds found in particulate emissions from vehicles have proven useful in source apportionment of ambient particulate matter. Species of interest include the hopanes, originating in lube oil, and selected PAHs generated via combustion. Most efforts to date have focused on emissions and apportionment PM10 or PM2.5 However, examining how these compounds are segregated by particle size in both emissions and ambient samples will help efforts to apportion size-resolved PM, especially ultrafine particles which have been shown to be more potent toxicologically. To this end, high volume size-resolved (coarse, accumulation, and ultrafine) PM samples were collected inside the Caldecott tunnel in Orinda, California to determine the relative emission factors for these compounds in different size ranges. Sampling occurred in two bores, one off-limits to heavy-duty diesel vehicles, which allows determination of the different emissions profiles for diesel and gasoline vehicles. Although tunnel measurements do not measure emissions over a full engine duty cycle, they do provide an average emissions profile over thousands of vehicles that can be considered characteristic of "freeway" emissions. Results include size-fractionated emission rates for hopanes, PAHs, elemental carbon, and other potential organic markers apportioned to diesel and gasoline vehicles. The results are compared to previously conducted PM2.5 emissions testing using dynamometer facilities and othertunnel environments.

The ability to quantify the chemical and physical forms of transition metals in atmospheric particulate matter (PM) is essential in determining potential human health and ecological effects. A method for the speciation of iron in atmospheric PM has been adapted which involves extraction in a well-defined solution followed by oxidation state specific detection. The method was applied to a suite of environmental aerosols. Ambient atmospheric aerosols in an urban area of St. Louis (the St. Louis-Midwest Supersite) were collected on Teflon substrates and were leached in one of four different solutions: (1) >18.0 Momega water; (2) 140 microM NaCl solution; (3) pH = 7.4 NaHCO3 solution; and (4) pH = 4.3 acetate buffering system. Fe(ll) was determined directly using the Ferrozine method as adapted to liquid waveguide spectrophotometry using a 1 m path-length cell. Fe(lll) was determined similarly after reduction to Fe(ll). It was found that, at low ionic strength, pH exerted a major influence on Fe(ll) solubility with the greatest Fe(ll) concentration consistently found in the pH = 4.3 acetate buffer. Soluble Fe(lll) (as defined by a 0.2 microm filter) varied little with extractant, which implies that most of the Fe(lll) detected was colloidal. To characterize well-defined materials for future reference, NIST standard reference materials were also analyzed for soluble Fe(ll) and Fe(lll). For all SRMs tested, a maximum of 2.4% of the total iron (Urban Dust 1649a) was soluble in pH = 4.3 acetate buffer. For calibration curves covering the ranges of 0.5-20 microg/L Fe(ll), excellent linearity was observed in all leaching solutions with R2 values of > 0.999. Co-located filters were used to test the effect of storage time on iron oxidation state in the ambient particles as a function of time. On two samples, an average Fe(ll) decay rate of 0.89 and 0.57 ng Fe(ll) g(-1) PM day(-1) was determined from the slope of the regression, however this decrease was determined not to be significant over 3 months (95% confidence). As an application of this method to mobile source emissions, size-resolved PM10 samples were collected at the inlet and outlet of the Caldecott Motor Vehicle Tunnel in northern California. These samples indicate that the coarse fraction (PM10-PM2.5) contains almost 50% of the total soluble Fe(ll) in the aerosol.

The carbonaceous component of atmospheric particulate matter (PM) is considered very important with respect to the observed adverse health effects of PM. Particulate organic and elemental carbon have traditionally been measured off-line after daily, time-integrated particle collection on filters. However, the subdaily or hourly variability of elemental carbon (EC) and organic carbon (OC) can help to assess the variability of sources, ambient levels, and human exposure. In this study, the performance of the Sunset Laboratory Inc. semicontinuous EC/OC monitorwas assessed in a Los Angeles location representing typical urban pollution. An intermonitor comparison showed high precision (R2 of 0.98 and 0.97 for thermal OC and EC, respectively). By changing the inlet configurations of one of the monitors (adding a denuder, a Teflon filter, or both), the influences of positive and negative sampling artifacts were investigated. The positive artifact was found to be relatively large (7.59 microg/m3 on average), more than 50% of measured OC, but it was practically eliminated with a denuder. The negative artifact was much smaller (less than 20% of the positive artifact) and may be neglected in most cases. A comparison of different temperature profiles, including a fast 4-min analysis using optical EC correction, showed good agreement among methods. Finally, a novel configuration using a size selective inlet impactor removing particles greater than 250 nm in diameter allowed for semicontinuous size-fractionated EC/OC measurements. Evolution of OC at different temperatures of the thermal analysis showed higher volatility OC in larger particles.

Particulate matter emissions were measured in two bores of the Caldecott Tunnel in Northern California during August and September 2004. One bore (Bore 1) is open to both heavy- and light-duty vehicles while heavy-duty vehicles are prohibited from entering the second bore (Bore 2). Particulate matter number and mass size distributions, chemical composition, and gaseous copollutants were recorded for four consecutive days near the entrance and exit of each bore. Size-resolved emission factors were determined for particle number, particle mass, elemental carbon, organic carbon (OC), sulfate, nitrate, and selected elements. The size distributions in both the bores showed a single large mode at roughly 15-20 nm in mobility diameter, with occasional smaller modes around 100 nm. The PM10 mass emission factor for heavy-duty vehicles was 14.5 times higher than that of light-duty vehicles. The particles derived from diesel are more abundant in elemental carbon, 70.9% of PM10 emissions, as compared to the light-duty vehicles. Conversely, a greater percentage of OC was found in light-duty emissions than heavy-duty emissions. In comparison to previous studies at the Caldecott Tunnel, less particle mass but more particle numbers are emitted by vehicles than was the case 7 years ago.

A personalized, miniaturized air sampling system was evaluated to estimate the daily exposure of pediatric asthmatics to nitrogen dioxide (NO2). The lightweight device (170 g) uses a sampling pump connected to a solid sorbent tube containing triethanolamine (TEA)-impregnated molecular sieve. The pump is powered by a 9 V battery and samples air over a 24 h period at a collection rate of 0.100 L/min. After exposure, the solid sorbent is removed from the tubes for spectrophotometric analysis (Griess Assay). The lower detection limit of the overall method for NO2 is 11 microg/m3. The linearity, precision and accuracy of the sampler was evaluated. Different NO2 concentrations generated in the laboratory (range: 50 to 340 microg/m3) were simultaneously measured by the TEA tube samplers and colocated continuous chemiluminescent NO(x) analyzers (reference method). The coefficient of determination for the laboratory test derived from ordinary linear regression (OLR) was r2 = 0.99 (y(OLR) = 0.94 x -4.58) and the precision 3.6%. Further, ambient NO2 concentrations in the field (range: 10-120 microg/m3) were verified with continuous chemiluminescent monitors next to the active samplers. Re-weighted least squares analysis (RLS) based on the least median squares procedure (LMS) resulted in a correlation of r2 = 0.68 for a field comparison in Riverside, CA (y(RLS) = 1.01 x -0.94) and r2 = 0.92 in Los Angeles, CA (y(RLS) = 1.31 x -7.12). The precision of the TEA tube devices was 7.4% (at 20-60 microg/m3 NO2) under outdoor conditions. Data show that the performance of this small active sampling system was satisfactory for measuring environmental concentrations of NO2 under laboratory and field conditions. It is useful for personal monitoring of NO2 in environmental epidemiology studies where daily measurements are desired.

Ambient ultrafine particles have gained attention with recent evidence showing them to be more toxic than larger ambient particles. Few studies have investigated the distribution of chemical constituents within the ultrafine range. The current study explores the size-fractionated ultrafine (10-180 nm) chemical composition at urban source sites (USC and Long Beach) and inland receptor sites (Riverside and Upland) in the Los Angeles basin over three different seasons. Size-fractionated ultrafine particles were collected by a NanoMOUDI over a period of 2 weeks at each site. Measurements of ultrafine mass concentrations varied from 0.86 to 3.5 microg/m3 with the highest concentrations observed in the fall. The chemical composition of ultrafine particles ranged from 32 to 69% for organic carbon (OC), 1-34% for elemental carbon (EC), 0-24% for sulfate, and 0-4% for nitrate. A distinct OC mode was observed between 18 and 56 nm in the summer, possibly indicating photochemical secondary organic aerosol formation. The EC levels are higher in winter at the source sites due to lower inversion heights and are higher in summer at the receptor sites due to increased long-range transport from upwind source areas. Nitrate and sulfate were measurable only in the larger particle size ranges of ultrafine PM. Collocated continuous measurements of particle size distributions and gaseous pollutants helped to differentiate ultrafine particle sources at each site.

Primary Objective: To investigate the internal consistency, long-term stability and validity of the Life Satisfaction Index-A (LSI-A) in a sample of survivors of traumatic brain injury (TBI)., Research Design: Cohort study., Methods and Procedures: LSI-A was administered to survivors of TBI at 12, 24, 48 and 60 months post-injury during telephone interviews. Participants rated their quality of life, independence and participation in activities as well as health status at 24 months. Internal consistency was evaluated with Coefficient alpha. Pearson's r was used to investigate score stability. Test validity was explored with Pearson's r and Analysis of Covariance with age and sex as covariates., Experimental Interventions: None., Main Outcomes and Results: Coefficient alphas ranged from 0.85-0.92. Test-re-test coefficients ranged from 0.42-0.77. The LSI-A was positively correlated with self-reported quality of life, independence, activity level and health status., Conclusions: The LSI-A is a reliable and valid measure of the construct of life satisfaction among survivors of TBI.

Primary Objective: Determine (1) the sensitivity of world-wide-web searches for deaths among persons with traumatic brain injuries and (2) factors associated with the likelihood of identifying deceased persons with traumatic brain injuries., Research Design: Stratified case series., Methods and Procedures: Sequential submission of 371 deceased persons with traumatic brain injuries to a world-wide-web site to determine inclusion in the Social Security Death Index (SSDI)., Main Outcomes and Results: Almost 87% of deceased persons ages 50+ were found, 69.8% of persons ages 30-49 and 34.6% of persons younger than age 30. Other factors influencing the likelihood of finding deceased persons in the SSDI were male gender, white race, being married, knowing the Social Security number and survival of 1+ years post-injury., Conclusions: The SSDI provides useful information for mortality studies among persons with traumatic brain injuries, but does a poor job of identifying deaths among younger persons. Sole reliance on the SSDI may result in under-ascertainment of mortality.

A periodic review of the National Ambient Air Quality Standards for Particulate Matter by the U.S. Environmental Protection Agency (EPA) will assess the standards with respect to levels, particle size, and averaging times. Some members of the scientific community in the United States and Europe have suggested the use of PM1 instead of PM2.5 as the fine particle measurement standard. This proposed standard is intended to reduce the influence of coarse particle sources on PM2.5, because some evidence suggests that PM1-2.5 is dominated by coarse particulate matter (PM) sources. In this study, coarse (PM2.5-10), intermodal (PM1-2.5), and fine (PM2.5) mass concentrations at four different sites are measured with continuous and time-integrated sampling devices. The main objective is to compare variations in these three size ranges while considering the effects of location, sources, weather, wind speed, and wind direction. Results show strong correlations between PM1 and intermodal PM in receptor sites. The contribution of PM1-2.5 to PM2.5 is highest in the summer months, most likely due to enhanced long-range transport. Coarse PM is poorly correlated with intermodal PM. Continuous data suggest that PM1 is growing into PM1-2.5 via complex processes involving stagnation of the aerosol during high relative humidity conditions, followed by advection during daytime hours.

Continuous measurements of particle number (PN), particle mass (PM10), and gaseous pollutants [carbon monoxide (CO), nitric oxide (NO), oxides of nitrogen (NOx), and ozone (O3)] were performed at five urban sites in the Los Angeles Basin to support the University of Southern California Children's Health Study in 2002. The degree of correlation between hourly PN and concentrations of CO, NO, and nitrogen dioxide (NO2) at each site over the entire year was generally low to moderate (r values in the range of 0.1-0.5), with a few notable exceptions. In general, associations between PN and O3 were either negative or insignificant. Similar analyses of seasonal data resulted in levels of correlation with large variation, ranging from 0.0 to 0.94 depending on site and season. Summertime data showed a generally higher correlation between the 24-hr average PN concentrations and CO, NO, and NO2 than corresponding hourly concentrations. Hourly correlations between PN and both CO and NO were strengthened during morning rush-hour periods, indicating a common vehicular source. Comparing hourly particle number concentrations between sites also showed low to moderate spatial correlations, with most correlation coefficients below 0.4. Given the low to moderate associations found in this study, gaseous co-pollutants should not be used as surrogates to assess human exposure to airborne particle number concentrations.

For this study, we investigated the reliability and validity of the FSS (Family Satisfaction Scale) in survivors of traumatic brain injury (TBI). The FSS was administered during the 12- and 60-month follow-up interviews. Data analyses included Cronbach's Alpha to determine internal consistency and analysis of variance to determine the relationship of FSS total score to Life Satisfaction Index-A (LSI-A) total scores, marital status, living arrangement, and number of family contacts outside the home. Cronbach's Alphas were 0.94 (12 months, N = 541) and 0.95 (60 months, N = 340). FSS total score and marital status were significantly related at both 12 months (F(3, 534) = 6.04, p < 0.001) and 60 months postdischarge (F(3, 335) = 4.52, p < 0.005). FSS total scores are correlated with the number of family contacts (r(342) = 0.12, p < 0.03) and with LSI-A total scores (r(337) = 0.43, p < 0.001). The FSS has excellent internal consistency with survivors of TBI. We also demonstrated the evidence of convergent validity.

Individual organic compounds can be used as tracers for primary sources of ambient particulate matter (PM) in chemical mass balance receptor models. Previous work has examined PM2.5 only and usually over long sampling periods encompassing entire days or longer. In this study, a high-flow-rate, low-pressure-drop ultrafine particle separator was deployed to collect sufficient mass for organic speciation of ultrafine and accumulation mode aerosol on a diurnal basis. Particles between 0.18 and 2.5 microm in diameter were collected on a quartz-fiber impaction substrate, and ultrafine particles below 0.18 microm were collected downstream on a high-volume filter. Four daily time period samples (morning, midday, evening, and overnight) were sampled over five weekdays to form a weekly average composite for each diurnal period. Sampling was conducted at two sites over two seasons; summer (August) and winter (January) samples were collected at both an urban site near downtown Los Angeles (University of Southern California) and a downwind, inland site in Riverside, CA. Hopanes, used as organic markers for vehicular emissions, were found to exist primarily in the ultrafine mode. Levoglucosan, an indicator of wood combustion, was quantified in both size ranges, but more was present in the accumulation mode particles. An indicator of photochemical secondary organic aerosol formation, 1,2-benzenedicarboxylic acid, was found primarily in the accumulation mode and varied with site, season, and time of day as one would expect for a photochemical product. The atmospheric variations of particulate cholesterol and other organic acids were also considered. By examining the diurnal variation, size-fractionation, and intercorrelations of individual organic compounds, the sources and atmospheric fate of these tracers can be better understood and their utility as molecular markers can be assessed.

Primary Objective: To assess the relationship between depression and life satisfaction among survivors of traumatic brain injury (TBI) over a 3-year period after injury. It was hypothesized that survivors of TBI with depression would have decreased life satisfaction., Research Design: Two groups (depression vs no depression) longitudinal design., Methods and Procedures: Interviewed survivors of TBI (n = 324) by telephone at 24, 48 and 60 months after hospitalization. At the 24-month interview, 90 (27.8%) respondents reported a post-injury diagnosis of depression and 234 (72.2%) reported no diagnosis. Respondents then completed the Life Satisfaction Index I-A, which was repeated at the 48- and 60-month interviews., Main Outcomes and Results: The depression group had significantly lower life satisfaction than the no depression group at 24-, 48- and 60-month interviews., Conclusions: Depression and diminished life satisfaction among survivors of TBI are persistent problems that require the close attention of medical and rehabilitation professionals.

Background: Stevens-Johnson syndrome (SJS) is an extreme, systemic allergic reaction with potentially morbid ocular complications. The main ocular complications include severe dry eyes, corneal scarring, symblepharon, and keratopathy., Case Report: Stevens-Johnson syndrome developed in a 69-year old man as a result of a hypersensitivity reaction to the drug allopurinol three years before his referral to our clinic. He had been treated, but was left with corneal scarring, hyperemia, and sore, chronic dry eyes, which necessitated continuous lubrication. The patient was fit with RGP sealed scleral contact lenses of high oxygen permeability, which produced a remarkable improvement of his signs and symptoms and allowed him to completely cease the use of artificial tears., Conclusion: Stevens-Johnson syndrome is a serious systemic condition in which the foremost ocular complication is severe dry eyes. This report shows that it can be managed successfully with RGP sealed scleral lenses of high permeability.

The fireplace combustion of wood is a significant and largely unregulated source of fine particle pollution in the United States. Source apportionment techniques that use particulate organic compounds as tracers have been successful in determining the contribution of wood smoke to ambient fine particle levels in specific areas in California. To apply these techniques to the rest of the United States, the differences in emissions profiles between different wood smoke sources and fuel types should be resolved. To this end, a series of fireplace source tests was conducted on six fuel wood species found in the Southern United States to determine fine particulate emission factors for total mass, ionic and elemental species, elemental and organic carbon, and over 250 individual organic compounds. The wood species tested, chosen for their high abundance and availability in the Southern U.S. region, were yellow poplar, white ash, sweetgum, mockernut hickory, loblolly pine, and slash pine. The differences in the emissions of compounds such as substituted phenols and resin acids help to distinguish between the smoke from hardwood and softwood combustion. Levoglucosan, a cellulose pyrolysis product which may serve as a tracer for wood smoke in general, was quantified in the emissions from all the wood species burned. The furofuran lignan, yangambin, which was emitted in significant quantities from yellow poplar combustion and not detected in any of the other North American wood smokes, is a potential species-specific molecular tracer which may be useful in qualitatively identifying particulate emissions from a specific geographical area where yellow poplar is being burned.

Wood smoke is a significant source of air pollution in many parts of the United States, and epidemiological data suggest a causal relationship between elevated wood smoke levels and health effects. The present study was designed to provide information on the potential respiratory health responses to subchronic wood smoke exposures in a Native American community in New Mexico. Therefore, this study used the same type of wood under similar burning conditions and wood smoke particle concentrations to mimic the conditions observed in this community. Brown Norway rats were exposed 3 h/day, 5 days/week for 4 or 12 weeks to air as control, or to 1 or 10 mg/m3 concentrations of wood smoke particles from pinus edulis. The wood smoke consisted of fine particles (< 1 microm) that formed larger chains and aggregates having a size distribution of 63-74% in the < 1-microm fraction and 26-37% in the > 1-microm fraction. The particle-bound material was primarily composed of carbon, and the majority of identified organic compounds consisted of sugar and lignin derivatives. Pulmonary function, specifically carbon monoxide-diffusing capacity and pulmonary resistance, was somewhat affected in the high-exposure group. Mild chronic inflammation and squamous metaplasia were observed in the larynx of the exposed groups. The severity of alveolar macrophage hyperplasia and pigmentation increased with smoke concentration and length of exposure, and the alveolar septae were slightly thickened. The content of mucous cells lining the airways changed from Periodic Acid Schiff- to Alcian Blue-positive material in the low-exposure group after 90 days. Together, these observations suggest that exposure to wood smoke caused minor but significant changes in Brown Norway rats. Further studies are needed to establish whether exposure to wood smoke exacerbates asthmalike symptoms that resemble those described for children living in homes using wood stoves for heating and cooking.