A 3-day 'stroke camp' addressed chronic disease self-management elements and perceived stress of survivors of stroke and their caregivers reduced: Survey results from the 14 US camps.

BACKGROUND: Stroke is a leading cause of disability for persons with stroke (PWS). Difficulty coping with long-term stress for PWS and their caregivers (CG) contributes to their poor health. Variations of chronic-disease self-management programs (CDSMPs) have reduced long-term stress in PWS and CGs. CDSMPs include training for decision-making, problem-solving, resource utilization, peer support, developing a patient-provider relationship, and environmental support. OBJECTIVE: This study examined whether a user-designed stroke camp addressed CDSMP domains, used consistent activities, and decreased stress in PWS and CG. METHODS: This open cohort survey study followed STROBE guidelines and assessed stress at four timepoints: 1 week before camp, immediately before camp, immediately after camp, and 1 month after camp. Mixed-model analysis examined changes in stress from the two baseline time points to the two post-camp time points. The research team reviewed documents and survey responses to assess activities described in camp documents and CDSMP domains across camps. POPULATION: PWS and CG who attended a camp in 2019. The PWS sample (n = 40) included50% males, aged 1-41-years post stroke, 60% with ischemic, one-third with aphasia, and 37.5% with moderate-severe impairment. CG sample (n = 24) was 60.8% female, aged 65.5 years, and had 7.4 years CG experience. RESULTS: Stress decreased significantly in PWS (Cohen's d = -0.61) and CGs (Cohen's d = -0.87) from pre- to post-camp. Activities addressing all but one CDSMP domains were evident across camps. CONCLUSIONS: Stroke camp is a novel model that addresses CDSMP domains, which may reduce stress in PWS and CG. Larger, controlled studies are warranted.

The Legal Implications of Detecting Alzheimer's Disease Earlier.

Early detection of Alzheimer's disease (AD) raises a number of challenging legal questions. In this essay, we explore some of those questions, such as: Is a neurological indicator of increased risk for AD a legally relevant brain state before there are any outward behavioral manifestations? How should courts address evidentiary challenges to the admissibility of AD-related neuroimaging? How should the government regulate the marketing of neuroimaging diagnostic tools? How should insurance coverage for the use of these new tools be optimized? We suggest that many voices and multidisciplinary perspectives are needed to answer these questions and ensure that legal responses are swift, efficient, and equitable.

The effects of parental CO2 environment on seed quality and subsequent seedling performance in Bromusrubens.

Seeds were collected and compared from parent plants of Bromusrubens L. (Poaceae), an exotic Mojave Desert annual grass, grown in ambient (360 µmol mol-1) and elevated (700 µmol mol-1) CO2 to determine if parental CO2 growth conditions affected seed quality. Performance of seeds developed on the above plants was evaluated to determine the influence of parental CO2 growth conditions on germination, growth rate, and leaf production. Seeds of B. rubens developed on parents grown in elevated CO2 had a larger pericarp surface area, higher C:N ratio, and less total mass than ambient-developed seeds. Parental CO2 environment did not have an effect on germination percentage or mean germination time, as determined by radicle emergence. Seedlings from elevated-CO2-developed seeds had a reduced relative growth rate and achieved smaller final mass over the same growth period. Elevated-CO2-developed seeds had smaller seed reserves than ambient seeds, as determined by growing seedlings in sterile media and monitoring senescence. It appears that increased seed C:N ratios associated with plants grown under elevated CO2 may have a major effect on seed quality (morphology, nutrition) and seedling performance (e.g., growth rate and leaf production). Since the invasive success of B. rubens is primarily due to its ability to rapidly germinate, increase leaf area and maintain a relatively high growth rate compared to native annuals and perennial grasses, reductions in seed quality and seedling performance in elevated CO2 may have significant impacts on future community composition in the Mojave Desert.

Radiation frost susceptibility and the association between sky exposure and leaf size.

Plants growing in exposed and sheltered habitats have characteristic leaf structure and physiology that are traditionally associated with the total amount of incident sunlight. However, greater sky exposure also increases the susceptibility of leaves to radiation frost. Plants with large horizontal broadleaves are particularly susceptible to both overheating during the day and freezing at night. Moreover, the combined effects of high daytime sun-exposure and nighttime frost susceptibility could be particularly stressful to plant tissues. The purpose of this study was to evaluate the influence of elevation and microsite exposure (i.e. net loss of longwave radiation) on frost susceptibility, as well as the corresponding intraspecific variation in leaf size in the subalpine daisy (Erigeron peregrinus). Measured decreases in upper hemisphere infrared radiation (sky IR) of 0.014 W m-2 m-1 occurred with increasing elevation, beyond decreases predicted due to changes in air temperature and water content, resulting in an average decrease of 0.029 W m-2 m-1. Previous equations of sky IR based on air temperature and humidity were improved by adding this elevational term (r 2 improved from 0.52 to 0.71). In contrast, a mean decrease of 6.5 W m-2 m-1 occurred with increasing sky exposure across a subalpine meadow. Leaf size in Taraxacum officinale decreased linearly with increasing elevation and a corresponding decline in sky IR. No difference in daily solar irradiance was measured across the same elevational gradient. Also, E. peregrinus had smaller leaves at high elevation microsites with greater sky exposure and decreased sky IR, while there was a much weaker association between leaf size and the amount of total daily solar irradiance. Differences in plant leaf structure and physiology traditionally associated with daytime sun-exposure may also be influenced by nighttime sky exposure and the susceptibility to radiation frosts.