Fifty-eight adults with Down syndrome (ages 31 to 56 years at time of first testing, mean age, 43.5) were assessed longitudinally over 10 years for the purpose of modeling aging-related change in cognitive function and adaptive behavior. Cognitive function was assessed seven times using the Woodcock-Johnson Tests of Cognitive Ability-Revised Early Development Battery. Adaptive behavior was evaluated five times using the Inventory for Client and Agency Planning. Multi-level (hierarchical linear) modeling procedures were used to model change with age. Findings provided further evidence of changes in performance with age and included selected effects for participants who completed the 10 years of study and those who were lost to follow-up as well as for age cohorts.

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Medication Alliance can be successfully implemented in an inpatient setting, enhancing knowledge, attitudes and at least some skill domains of staff in dealing with non-adherent patients. The equivalence of results between the expert and novice trained training groups suggests that Medication Alliance may be more broadly disseminated using a cost-effective train-the-trainer model.

The purpose of this study was to examine the nature of leisure in a sample of older adults with intellectual disability. Twenty-nine older adults participated in indepth interviews. An interview guide was utilized which included topics relating to leisure participation and social interaction in a variety of environments. Data were analysed according to the constant comparative method. The most pronounced theme that emerged from the data was lack of self-determination in leisure. Participants had few opportunities to freely choose leisure in any aspect of their lives. In many cases, opportunities for self-determined leisure were further constricted by age-related changes in the participants' lives.

Pregnant smokers attending a local health department WIC clinic were randomly assigned to one of two self-help smoking cessation programs or usual care. The multiple component program resulted in larger quit rates than usual care during the last month of pregnancy (11 percent vs 3 percent) and postpartum (7 percent vs 0 percent). Achieving quit rates in WIC similar to those in studies conducted at prenatal care settings, suggests that smoking cessation programs for low-income pregnant WIC clients are feasible. (Am J Public Health 1990; 80:76-78.) IntroductionEstimates suggest that 32 percent of all women of child-bearing age smoke with only 21 percent quitting during