Summary A group of 70 low birth weight infants and 49 matched controls were studied at 3;5 years of age for speech and language development and hearing acuity as part of an ongoing developmental study of low birth weight infants. Results showed that the low birth weight infants were found to be significantly delayed in language expression and comprehension when compared with their controls. There was not a significant difference between the two groups in speech articulation or hearing. Certain social and environmental factors were found to be strong predictors of speech and language development in both groups.

The consequences of smoking for women are of particular concern in light of recent observations that more adolescent females than males are taking up smoking. To date, few studies have explored gender differences in depth, but we do know that males and females smoke for different reasons and that current smoking prevention programs may be differentially effective depending on gender. Recent evidence suggests that the school environment may have an important influence on smoking. The purpose of this study, therefore, was to explore gender differences in the relationships between cigarette smoking and adolescents' experiences of school climate and their relationships with the school and significant adults in their lives. A secondary data analysis was done using a data set derived from a student survey conducted in 20 secondary schools in British Columbia (BC), Canada, which included 8,179 students in grades 8 to 12. Analyses were primarily descriptive. The results demonstrated that adolescent girls who smoke are more likely than either males or nonsmoking females to experience powerlessness in their school environment and to feel considerably less attachment to the school. Female smokers are more likely than males or female nonsmokers to be engaged in oppositional, distanced, and unsatisfactory relationships with important adults in their lives, particularly those who are in positions of relative power and authority. These findings are discussed in relation to critical and feminist perspectives that suggest smoking is part of a larger discourse of resistance within schools. The implications for health practitioners are discussed.

Climate change is an existential threat to the vast global permafrost domain. The diverse human cultures, ecological communities, and biogeochemical cycles of this tenth of the planet depend on the persistence of frozen conditions. The complexity, immensity, and remoteness of permafrost ecosystems make it difficult to grasp how quickly things are changing and what can be done about it. Here, we summarize terrestrial and marine changes in the permafrost domain with an eye toward global policy. While many questions remain, we know that continued fossil fuel burning is incompatible with the continued existence of the permafrost domain as we know it. If we fail to protect permafrost ecosystems, the consequences for human rights, biosphere integrity, and global climate will be severe. The policy implications are clear: the faster we reduce human emissions and draw down atmospheric CO2, the more of the permafrost domain we can save. Emissions reduction targets must be strengthened and accompanied by support for local peoples to protect intact ecological communities and natural carbon sinks within the permafrost domain. Some proposed geoengineering interventions such as solar shading, surface albedo modification, and vegetation manipulations are unproven and may exacerbate environmental injustice without providing lasting protection. Conversely, astounding advances in renewable energy have reopened viable pathways to halve human greenhouse gas emissions by 2030 and effectively stop them well before 2050. We call on leaders, corporations, researchers, and citizens everywhere to acknowledge the global importance of the permafrost domain and work towards climate restoration and empowerment of Indigenous and immigrant communities in these regions.

The circumstances surrounding the deaths of 23 patients on a behavior stabilization unit during a 1-year period were examined. The death rate was more than double that of previous years, and raised concern for the staff. The majority of deaths (n = 17) occurred within 2 months of admission to the unit, and 16 of the patients who died had a diagnosis of vascular or mixed dementia. The presenting behaviors for these patients may be similar to those of pre-death restlessness, a condition that may affect individuals in their last hours or days of life. No literature can be found linking pre-death restlessness with end-stage vascular dementia. The memory of how a person dies can linger for family and loved ones (Enck, 1992). Distress caused by behaviors with end-stage dementia may be alleviated if the symptoms of pre-death restlessness are recognized. It may be a relief for family and staff to know the patient is indeed dying, rather than exhibiting new and seemingly uncontrollable behaviors. In that situation, appropriate palliative care could be initiated for the patient's and family's comfort. Accurate nursing assessment, evaluation, communication, and documentation of both the behaviors and interventions is vital in supporting both patients and families.