People with dementia playing casual games on a tablet

Objective: Preserving clients’ quality of life (QoL) has become increasingly important in dementia care. Engagement in pleasant and meaningful activities may influence this QoL. We studied people with dementia’s experiences and views of independent tablet games in a practice-based study, conducted at two day-care centres and five small-scale living facilities for people with dementia in the city of Rotterdam. Method: The participants were 54 clients (24 men, 30 women; mean age 83 years) who participated in a total of 177 game-playing sessions. Ten existing iPad games and three new game prototypes were evaluated. Written informed consent was obtained from the clients or the clients’ representatives prior to the study. Data collection included epidemiological and game playing characteristics. Observers took note of the specific game(s) offered, the clients’ mood and engagement, and the duration of game playing. Immediately after each participant finished playing,a short 4-question interview was conducted to discover their opinion on the game. The participants’ answers were recorded verbatim. Qualitative content analysis was used to explore their experiences and views of the games. Results: This study revealed positive experiences related to people’s need for achievement, self-esteem, sense of connection and belonging, identity, having something to do, and admiration for the game. Negative experiences included failure (low self-esteem), annoyance and a sense of insecurity. Conclusions: This study shows there is potential for people with dementia to play casual games on a tablet as a pleasant and meaningful activity. It is important, however that there is a match between the game, the touchscreen skills of the person with dementia, and their ambitions or interests. It is challenging to find the right game for the right person. An interactive tool to support the choice of the game that is most suitable and a database of dementia-friendly tablet games may support the use of these games by people with dementia, in health care organisations as well as at home

The secular trends in male:female ratio at birth in postwar industrialized countries.

Finnish investigators [Vartiainen et al. Environmental Chemicals and Changes in Sex Ratio: Analysis Over 250 Years in Finland. Environ Health Perspect 107:813-815 (1999)] presented the sex ratio of all newborn babies from 1751 to 1997 in order to evaluate whether Finnish long-term data are compatible with the hypothesis that the decrease in the ratio of male to female births after World War I and World War II in industrial countries is caused by environmental factors. They found an increase in the proportion of males from 1751 to 1920, which was interrupted by peaks in male births during World War I and World War II and followed by a decrease thereafter, similar to the trends in many other countries. The turning point of male proportion, however, preceded the period of industrialization and introduction of pesticides and hormonal drugs. Thus, a causal association between these environmental exposures and this decrease is unlikely. In addition, none of the various family parameters (e.g., paternal age, maternal age, age difference in parents, birth order) could explain the historical time trends. Vartiainen et al. concluded that at present it is unknown how these historical trends could be mediated. The postwar secular decline of the male:female ratio at birth is not an isolated phenomenon and parallels the decline of perinatal morbidity and mortality, congenital anomalies, and various constitutional diseases. This parallelism indicates a common etiology and may be caused by reduction of conceptopathology, as a correlate to increasing socioeconomic development. An inverted dose response or the dose-response fallacy due to vanishing male conceptuses explains the low sex ratios before World War I and World War II in newborns from black parents and from the lowest socioeconomic classes

Do physical work factors and musculoskeletal complaints contribute to the intention to leave or actual dropout in student nurses?:A prospective cohort study

Background: Little is known, whether physical workload and musculoskeletal complaints (MSCs) have an impact on the intended or actual dropout of nursing students in the later years of their degree program. Purpose: Studying the determinants of intention to leave and actual dropout from nursing education. We hypothesized that physical workload and MSCs are positively associated with these outcomes. Methods: A prospective cohort study among 711 third-year students at a Dutch Bachelor of Nursing degree program. Multivariable backward binary logistic regression was used to examine the association between physical work factors and MSCs, and intention to leave or actual dropout. Results: Intention to leave was 39.9% and actual dropout 3.4%. Of the nursing students, 79% had regular MSCs. The multivariable model for intention to leave showed a significant association with male sex, working at a screen, physical activity, decision latitude, co-worker support, distress and need for recovery. The multivariable model for dropout showed a significant association with living situation (not living with parents), male sex, sick leave during academic year and decision latitude. Conclusions: Our research shows that the prevalence of MSCs among nursing students is surprisingly high, but is not associated with intention to leave nor with actual dropout

Pregnancy reduces concurrent pup care behaviour in meerkats, generating differences between dominant and subordinate females

DATA AVAILABILITY : Data available from the Dryad Digital Repository:https://doi.org/10.5061/dryad.gxd2547rf (Rotics et al., 2023).SUPPORTING INFORMATION: TABLES S1a- b. Pregnancy status effects on individual relative contribution to pup provisioning - results of a GLMM and post-hoc comparisons. TABLES S2a- b. Pregnancy status effects on individual relative contribution to guarding - results of a GLMM and post-hoc comparisons. TABLES S3a- b. Pregnancy status effects on babysitting- results of a GLMM and post-hoc comparisons. TABLE S4. Pregnancy status effects on the proportion of food items that females donated to pups (generosity)- results of a GLMM. Table S5. Changes throughout pregnancy days in relative individual contribution to provision modelled using GAMM. TABLE S6. Changes throughout pregnancy days in body weight (g) modelled using GAMM. TABLE S7. The effect of being pregnant while lactating (yes/no) on lactation duration - results of an LMM. TABLE S8. Rank (dominant/subordinate) differences in the probability of being pregnant (yes/no) during the pup-provisioning period - results of a GLMM. TABLE S9. Subordinates contraception experiment: comparisons of cooperative behaviours between subordinate females treated with contraceptive jab versus control subordinate females (saline jab). TABLE S10. Pregnant females feeding experiment: comparisons of cooperative behaviours between late pregnant dominant females that were provided with food supplement versus control unfed dominant females. TABLE S11. Pregnancy status effects on individual absolute contributions to provisioning and guarding - results of two separate GLMMs. This table summarizes the results of repeating the analyses conducted on relative contributions to provisioning and guarding (Tables S1 and S2) with analyses on absolute contributions. FIGURE S1. Pregnancy effects on absolute contributions to cooperative behaviours. This figure is equivalent to Figure 1a,b in the manuscript but presents absolute contributions rather than relative ones.   FIGURE S2. Effects of pregnancy-related, experimental manipulations on individual absolute contributions to provisioning. This figure is equivalent to Figure 3 in the manuscript but presents absolute contributions rather than relative ones.    FIGURE S3. Differences between dominants (DOM) and subordinates (SUB) in cooperative behaviours (provisioning, guarding and babysitting) without accounting for pregnancy status.1. In some mammals, and particularly in cooperative breeding ones, successive bouts of reproduction can overlap so that a female is often pregnant while still nurturing dependent young from her previous litter. Such an overlap requires fe-males to divide their energetic budget between two reproductive activities, and pregnancy costs would consequently be expected to reduce investment in con-current offspring care. However, explicit evidence for such reductions is scarce, and the potential effects they may have on work division in cooperative breeders have not been explored. 2.Using 25 years of data on reproduction and cooperative behaviour in wild Kalahari meerkats, supplemented with field experiments, we investigated whether pregnancy's reduces contributions to cooperative pup care behaviours, including babysitting, provisioning and raised guarding. We also explored whether pregnancy, which is more frequent in dominants than subordinates, could account for the reduced contributions of dominants to the cooperative pup care behaviours. 3. We found that pregnancy, particularly at late stages of gestation, reduces con-tributions to cooperative pup care; that these reductions are eliminated when the food available to pregnant females is experimentally supplemented; and that pregnancy effects accounted for differences between dominants and subordi-nates in two of the three cooperative behaviours examined (pup provisioning and raised guarding but not babysitting). 4. By linking pregnancy costs with reductions in concurrent pup care, our findings illuminate a trade-off between investment in successive, overlapping bouts of reproduction. They also suggest that some of the differences in cooperative behaviour between dominant and subordinate females in cooperative breeding mammals can be a direct consequence of differences in their breeding frequency.European Research Council; Human Frontier Science Program; University of Zurich; MAVA Foundation; Swiss National Science Foundation; Northern Cape Department of Environment and Nature Conservation.http://www.wileyonlinelibrary.com/journal/janeMammal Research InstituteZoology and Entomolog

Volumetric evaluation of CT images of adrenal glands in primary aldosteronism

Objectives: To investigate whether adrenal volumetry provides better agreement with adrenal vein sampling (AVS) than conventional CT for subtyping PA. Furthermore, we evaluated whether the size of this contralateral adrenal was a prognostic factor for clinical outcome after unilateral adrenalectomy.Methods: We retrospectively analyzed volumes of both adrenal glands of the 180 CT-scans (88/180 with unilateral and 92/180 with bilateral disease) of the patients with PA included in the SPARTACUS trial of which 85 also had undergone an AVS. In addition, we examined CT-scans of 20 healthy individuals to compare adrenal volumes with published normal values.Results: Adrenal volume was higher for the left than the right adrenal (mean and SD: 6.49 ± 2.77 ml versus 5.25 ± 1.87 ml for the right adrenal; p &lt; 0.001). Concordance between volumetry and AVS in subtyping was 58.8%, versus 51.8% between conventional CT results and AVS (p = NS). The volumes of the contralateral adrenals in the patients with unilateral disease (right 4.78 ± 1.37 ml; left 6.00 ± 2.73 ml) were higher than those of healthy controls reported in the literature (right 3.62 ± 1.23 ml p &lt; 0.001; left 4.84 ± 1.67 ml p = 0.02). In a multivariable analysis the contralateral volume was not associated with biochemical or clinical success, nor with the defined daily doses of antihypertensive agents at 1 year follow-up.Conclusions: Volumetry of the adrenal glands is not superior to current assessment of adrenal size by CT for subtyping patients with PA. Furthermore, in patients with unilateral disease the size of the contralateral adrenal is enlarged but its size is not associated with outcome.</p

Rates of spectacle wear in early childhood in the Netherlands

BACKGROUND: Refractive errors are relatively common all around the world. In particular, early onset myopia is associated with a significant burden in later life. Little is known about refractive errors in preschool children. The aim of this study was to assess the prevalence of spectacle wear, visual acuity and refractive errors in young Dutch children. METHODS: We analyzed data of three prospective population-based studies: 99,660 3- to 5-year-olds undergoing vision screening at preventive child healthcare organizations, 6934 6-year-olds from the Generation R study, and 2974 7-year-olds from the RAMSES study. Visual acuity was measured with Landolt-C or LEA charts, spectacle wear was assessed, and refractive errors at age 6 and 7 were measured with cycloplegic refraction. RESULTS: The prevalence of spectacle wear ranged from 1.5 to 11.8% between 3 to 7 years with no significant gender differences. Among children with spectacle wear at 6 years (N = 583) and 7 years (N = 350) 29.8 and 34.6% had myopia respectively, of which 21.1 and 21.6% combined with astigmatism; 19.6 and 6.8% had hyperopia, 37.2 and 11.1% hyperopia and astigmatism, and 12.5 and 32.7% astigmatism only. CONCLUSIONS: Spectacle wear in European children starts early in preschool and increases to a relatively frequent visual aid at school age. Advocating early detection and monitoring of refraction errors is warranted in order to prevent visual morbidities later in life