Usefulness of fixed-dose drug combinations]

Diurnal rhythm of serum melatonin concentrations was estimated in 12 men with low back pain syndrome before and after exposure to a very low-frequency magnetic field (2.9 mT, 40 Hz, square wave, bipolar). Patients were exposed to the magnetic field for 3 weeks (20 min per day, 5 days per week) either in the morning (at 10:00 hr) or in the late afternoon (at 18:00 hr). Significant depression in nocturnal melatonin rise was observed regardless of the time of exposure. This phenomenon was characteristic for all the subjects, although the percent of inhibition of melatonin secretion varied among the studied individuals.     

Effects of sleep inertia after daytime naps vary with executive load and time of day.

The effects of executive load on working memory performance during sleep inertia after morning or afternoon naps were assessed using a mixed design with nap/wake as a between-subjects factor and morning/afternoon condition as a within-subject factor. Thirty-two healthy adults (mean 22.5 ± 3.0 years) attended two laboratory sessions after a night of restricted sleep (6 hrs), and at first visit, were randomly assigned to the Nap or Wake group. Working memory (n-back) and subjective workload were assessed approximately 5 and 25 minutes after 90-minute morning and afternoon nap opportunities and at the corresponding times in the Wake condition. Actigraphically assessed nocturnal sleep duration, subjective sleepiness, and psychomotor vigilance performance before daytime assessments did not vary across conditions. Afternoon naps showed shorter EEG assessed sleep latencies, longer sleep duration, and more Slow Wave Sleep than morning naps. Working memory performance deteriorated, and subjective mental workload increased at higher executive loadings. After afternoon naps, participants performed less well on more executive-function intensive working memory tasks (i.e., 3-back), but waking and napping participants performed equally well on simpler tasks. After some 30 minutes of cognitive activity, there were no longer performance differences between the waking and napping groups. Subjective Task Difficulty and Mental Effort requirements were less affected by sleep inertia and dissociated from objective measures when participants had napped in the afternoon. We conclude that executive functions take longer to return to asymptotic performance after sleep than does performance of simpler tasks which are less reliant on executive functions. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

碳酸盐溶液中富水充填材料的腐蚀及劣化机理

为了研究碳酸根离子对富水充填材料的影响,通过强度检测、扫描电镜观察、X射线衍射分析和红外光谱测试,分析富水充填材料在碳酸钠溶液中浸泡后的宏观及微观结构变化,并对其腐蚀及劣化机理进行探讨.富水充填材料在质量分数为10%的碳酸钠溶液中浸泡后,抗压强度随浸泡时间延长大幅度降低,浸泡90 d后抗压强度比标养28 d抗压强度降低72.5%,浸泡28 d后出现泥化现象.X射线衍射图谱显示,富水充填材料在质量分数为10%的碳酸钠溶液中浸泡后有碳硫硅钙石生成,且随浸泡时间延长碳硫硅钙石的生成量增大.红外光谱结果未发现[AlO₆]存在,证实在碳酸钠溶液中富水充填材料硬化体中钙矾石急剧减少,转变为烂泥状的碳硫硅钙石;碳硫硅钙石作为无胶结力物质,会对富水充填材料硬化体造成严重破坏,表明碳酸盐溶液对富水充填材料具有腐蚀作用.      

The effect of light regimen, floor space, and energy and protein levels during the growing period on body weight and early egg size

Experiments were conducted to determine the possibility of reducing the daily requirement of laying hens for Ca, available P (AP), and protein by providing the hens with adequate levels of these nutrients only during those hours of the day that the physiological need for these nutrients for formation of various components of the eggs are increasing. The results of the Ca experiment indicated that the daily Ca requirement cannot be reduced by providing the hens with adequate levels of Ca during the afternoon (1500 to 2100 h) and inadequate Ca level during the morning (0500 to 1500 h). Providing the hens with most of the daily Ca need during the afternoon did not have a beneficial effect on shell quality as compared to the control group that received a diet with 3.5% Ca during the morning and the afternoon. On the other hand, inadequate Ca intake during the afternoon adversely affected shell quality as compared to the control group (P < 0.05). The AP experiment indicated that egg production performance and shell quality can be maintained satisfactorily as long as the daily intake of AP is adequate, regardless of whether most of the AP is consumed during the morning or the afternoon. Egg production and shell quality of hens fed a diet with 0.4% AP during the morning and 0.1% AP during the afternoon or 0.1% AP during the morning and 0.4% AP during the afternoon were not different than the control group that received a diet with 0.25% AP during the morning and the afternoon. The results of two protein experiments failed to indicate that egg production performance of laying hens can be maintained satisfactorily by providing them with an adequate level of protein (16%) only during the morning and inadequate level of protein (10%) during the afternoon or, conversely, compared to the control group that received a diet with 16% protein both during the morning and afternoon (P < 0.05). The supply of adequate protein with sufficient amino acids, during the morning and the afternoon, was required for satisfactory maintaining egg production performance. Under the conditions selected for the conduct of this study, the results of the current experiments, combined with those of a previous report, failed to support the hypothesis that satisfactory performance may be maintained by providing the hens with adequate levels of protein, AP, and Ca only during those hours of the day when the physiological need for these nutrients for formation of various components of the egg are increasing.     

In vitro transfer rate of 14C from acetate-1-14C into ovarian steroids in the rat ovary during the estrous cycle and effects of LH and FSH

Fluctuations of ovarian biosynthetic activity and effects of exogenous LH and FSH on it during the estrous cycle were investigated by measuring in vitro transfer rates of 14C from 14C-1-acetate into progesterone (P), 20 alpha-hydroxy-pregn-4-en-3-one (20 alpha-OH-P) and estrogen (estradiol and estrone, E) in the ovarian homogenates from rats autopsied at 2 hour intervals. The transfer rate of 14C from 14C-1-acetate into P was lowest in the afternoon of estrus and increased from the morning of diestrus 1, making its peaks during the afternoon of diestrus 2 and in the midnight of proestrus. The transfer of 14C into 20 alpha-OH-P was high on the days of diestrus 2 and proestrus with its peak in the afternoon of the latter day. The maximum transfer of 14C into E in the afternoon of proestrus and a high rate in the morning of estrus with relatively low one in the midnight were observed. Exogenously injected LH (150 mug) or FSH (150 mug) was either stimulatory or inhiibitory to the transfer rates of 14C from 14C-1-acetate into ovarian steroids. During day time of diestrus 2 and midnight between proestrus and estrus, the transfer of 14C into P and 20 alpha-OH-P increased by LH, and during day time of proestrus and from the afternoon of estrus to the morning of diestrus 1 decreased. The transfer of 14C into E increased by LH from the afternoon of diestrus 2 to the morning of proestrus, and decreased during the afternoon of proestrus and from the afternoon of estrus to the morning of diestrus 2. Administration of FSH was also stimulatory or inhibitory. The 14C transfer into P and 20 alpha-OH-P increased by FSH from the afternoon of estrus to the morning of proestrus, but in the afternoon of proestrus they decreased. Transfer of 14C into E increased by FSH significantly on the days of diestrus 2 and proestrus, and slightly on the day of estrus, while it decreased in the afternoon of diestrus 1.     

Factors affecting non-attendance in an ophthalmic outpatient department

The object of the study was to establish the non-attendance rates in an ophthalmic outpatient department and any non-attendance patterns that may be useful in managing future outpatient resources. A detailed retrospective survey of monthly non-attendance rates was carried out in the outpatient department of a dedicated eye hospital over a 1 year period looking at differences in non-attendance between morning and afternoon clinics and new and review patients. A total of 43,004 scheduled outpatient appointments predominantly from the suburban population of the Merseyside region were made at St Paul's Eye Hospital from the 1 February 1990 to 31 January 1991. Five thousand four hundred and twenty-four appointments were missed giving an overall non-attendance rate of 12.6%. Non-attendance rates for morning and afternoon appointments were 12.0% and 13.0%, respectively: and for new and review patients, 11.9% and 12.8%, respectively. Logistic regression analysis showed that patients with afternoon appointments were on average 1.10 times more likely to non-attend than morning patients (P = 0.002), and that review patients were 1.09 times more likely to non-attend than new patients (P = 0.04). In order to maximize outpatient department efficiency, a reduction in non-attendance is essential. Establishing patterns for non-attendance provides us with a framework around which we can plan measures to compensate for outpatient non-attendance.     

Estrus detection using radiotelemetry or visual observation and tail painting for dairy cows on pasture

The efficiency and accuracy of estrus detection using HeatWatch (DDx Inc., Denver, CO) or visual observation were compared in an autumn-calving Friesian herd (n = 48 per group) and a spring-calving Jersey herd (n = 50 per group) grazing on pasture. Cows in the group monitored by the HeatWatch system were fitted with a pressure-sensitive transmitter that signaled mounting activities associated with estrus. Visual observation was carried out for about 20 min before the morning and afternoon milkings and was aided by a strip of paint applied over the tailhead. Ovarian cyclicity was monitored with progesterone concentrations in milk samples collected twice a week. The efficiency and accuracy of estrus detection were, respectively, 98.4 and 97.6% for visual observation and 91.7 and 100% for HeatWatch detection. Autumn-calving herds differed from spring-calving herds in duration of estrus (9.7 vs. 7.3 h), number of mounts (13.6 vs. 8.5), total duration of mounts (36.8 vs. 19.9 s), and mean duration of a mount (2.6 vs. 2.3 s). There was no significant variation in the distribution of the time of onset of estrus or mounting activities at different hours of the day. Conception rate was similar for AI after estrus detection with HeatWatch (65.8%) or after visual observation (65.0%). The highest conception rate was obtained when AI was carried out between 12 and 18 h after the first mount. Both the HeatWatch system and visual observation plus tail painting can be used for estrus detection of dairy cows on pasture.     

Influence of mating frequency on sow reproductive performance

Gilts and sows were bred one, two, or three times during a single estrous period in a commercial herd for evaluating the effect of mating frequency on reproductive performance. Estrus detection started at approximately 0630 daily by applying back pressure to females with the presence of a mature boar. Natural mating was used. Gilts detected in estrus were mated in the morning of d 1 (AM), the morning of d 1 and 2 (AM-AM), and the morning and afternoon of d 1 and morning of d 2 (AM-PM-AM) for mating frequencies 1, 2, and 3, respectively. Sows were bred in the AM, AM-AM, AM-PM-AM (1), and morning of d 1 and morning and afternoon of d 2 [AM-AM-PM (2)] for mating frequency 1, 2, 3 (1), and 3 (2), respectively. Breeding events in the morning and afternoon started at approximately 0730 and 1530. Females were randomly assigned to a mating frequency. Boars were randomly assigned to each breeding event. In total, 256 gilts and 766 sows were involved in the study. Gilts with a single mating (76.5%, P = .06) and triple matings (80.4%, P < .05) had higher farrowing rates than those with double matings (65.3%). No differences (P > .1) in the farrowing rates of sows were observed between mating frequencies 1, 2, 3 (1), and 3 (2). Double-mated gilts had more (P < .03) total born (9.7 vs 8.6) and pigs born alive (9.3 vs 8.2) than did single-mated gilts. There were no differences (P > .3) in total born and pigs born alive in sows between mating frequencies. We concluded that triple-mating gilts and sows did not improve farrowing rate and litter size compared with single and double matings. There were no differences in farrowing rate and litter size between double- and single-mated sows. Gilts with double matings had a larger litter size than those with a single mating.     

GUTI: a measure of urgent task involvement among adults with attention-deficit hyperactivity disorder

12 volunteers performed exhaustive exercise tests in the morning and afternoon. Paired-means t tests indicated that anaerobic capacity, as reflected by maximal accumulated oxygen deficit, was 26% higher (p < .01) in the afternoon than in the morning. VO2max appeared higher and VO2 kinetics seemed faster in the afternoon, but differences did not attain statistical significance. Thus, the time of day affects anaerobic capacity and may influence other responses to exercise.     

Age, time of testing, and proactive interference.

A four-list version of a release from proactive interference paradigm was used to assess the degree to which older (aged 58-78 yrs) and younger adults (aged 18-32 yrs) tested at optimal and nonoptimal times of day are vulnerable to interference effects in memory, effects that may increase at nonoptimal times. Morning type older adults and Evening type younger adults were tested either early in the morning or late in the afternoon. Standard buildup and release effects were shown for all age groups except for older adults tested in the afternoon; they failed to show release. Recall and intrusion data suggested that older adults are more vulnerable to proactive interference than younger adults and that for older adults at least, interference effects are heightened at nonoptimal times of day. The data are discussed in terms of an inhibitory model of control over the contents of working memory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Loading changes in time-based parameters of glottal flow waveforms in different ergonomic conditions

The effects of prolonged (5 x 45 min) reading in different environmental and ergonomic conditions on time-based glottal waveform parameters of normal female and male subjects (n = 80) were studied. The exposure groups (n = 5 females and males per cell) consisted of eight combinations of the following factors: (1) normal (< 65 dB) or high (> 65 dB) speech output level; (2) sitting or standing posture; (3) low (25 +/- 5%) or high (65 +/- 5%) relative humidity of ambient air. Two rest (morning and noon) and three loading (two in the morning and one in the afternoon) samples were recorded and analyzed. The glottal waveforms were obtained by inverse filtering of the acoustical signal using an automatic method. The following time based parameters were analyzed from the estimate glottal flow waveform: (1) length of fundamental period; (2) open quotient; (3) speed quotient, and (4) closing quotient. The analysis was based on inverse filtering of the first stressed syllable of 'paappa' word repeated 3 x 5 times with normal, maximally soft and maximally loud phonation. Humidity was a significant factor in several instances. The interactions between gender and the loading factors were striking.     

Quantitative and topographical study of retinal ganglion cells in the chameleon (Chameleo chameleon)

The existence of a circadian rhythm of atrial natriuretic peptide (ANP) in humans is controversial. We studied the plasma ANP response to isotonic blood volume expansion in the morning and in the afternoon and its relationship with adrenocorticotropic hormone (ACTH)-cortisol diurnal variation in seven normal subjects. Basal plasma ANP level was similar in the morning (19.6 +/- 2.4 pg/ml) and in the afternoon (21.8 +/- 4.8 pg/ml). The ANP peak obtained with saline infusion (0.9% NaCl, 12 ml/kg) in the morning (49.4 +/- 8 pg/ml) did not differ from that obtained in the afternoon (60.3 +/- 10.1 pg/ml). There was no correlation between the individual mean cortisol and ACTH levels and the ANP peak obtained with saline infusion. These data indicate no diurnal variation in plasma ANP secretion induced by blood volume expansion and no relationship between plasma ANP peak and ACTH-cortisol diurnal variation.     

Behavioral, situational, and temporal effects of treatment of ADHD with methylphenidate

OBJECTIVE: To determine the behavioral, situational, and temporal effects of 4 months of methylphenidate (MPH) treatment for attention-deficit hyperactivity disorder (ADHD). METHOD: Ninety-one children with ADHD were randomly assigned to receive either MPH (titrated to a target dose of 0.7 mg/kg twice a day) or a placebo. Treatment effects were investigated with measures sensitive to various behaviors (core and associated symptoms), situations (home and school), time periods (morning and afternoon, after reaching the target dose, and after 4 months of treatment), and side effects. RESULTS: MPH treatment improved symptoms of ADHD and oppositional behavior at school, both in the morning and afternoon, but not at home. Side effects (increase in physiological and effective symptoms, lack of weight gain) were significantly more frequent with MPH than with placebo treatment. Benefit was evident after titration, but the onset of some side effects was delayed. Side effects were reported by parents but not by teachers. CONCLUSIONS: Positive effects of MPH on behavior are evident in the classroom, but with MPH given twice daily, parents do not report that MPH improves behavior at home. Greater impact on home behavior may require three times daily MPH and combined treatments.     

Time-of-day effects on response of natural killer cells to acute stress in men and women.

Diurnal influences on natural killer (NK) cell changes to acute stress were assessed in 21 men and 21 women assigned to either an acute stress (mental arithmetic) or control task condition. Sessions began at either 8 a.m. or 2 p.m. Number of NK (CD3–CD56+) cells and NK activity were measured at baseline, during the 5-min task, and 60 and 90 min after the task. Both morning and afternoon stress participants had elevated NK cell numbers during the task. After the task, number of NK cells decreased in morning stress participants but remained significantly above baseline levels 60 and 90 min posttask. NK cell numbers in afternoon stress participants decreased to below baseline levels 60 and 90 min after the task. Changes in NK activity were driven primarily by diurnal influences. NK activity increased in all morning participants and stayed increased 60 and 90 min posttask. NK activity of all afternoon participants also increased during the task but dropped below baseline 60 and 90 min later. Greater increases in NK levels and activity during the task were associated with greater heart rate changes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The lateral calcaneal artery

OBJECTIVE: To determine whether application of topical aqueous lidocaine to a laceration attenuates the pain from the subsequent lidocaine injection in children. DESIGN: Prospective, double-blind study. SETTING: A large, urban, tertiary care children's hospital emergency department. PATIENTS: A convenience sample of 100 children, five to 16 years of age, presenting with simple lacerations over a six-month period. INTERVENTIONS: An unlabelled 3-ml solution of either 1% lidocaine or placebo (saline) was used to soak a Telfa pad (Kendall, Mansfield, MA) and then placed onto the laceration for 10 minutes. The wound was then injected with 1% lidocaine, irrigated, and sutured per standard emergency department protocol. Independent pain response was elicited from the patient and parent four times: before any intervention, after the soak, after the injection, and at the end of the procedure. Blood pressure and heart rates were recorded at the same intervals. RESULTS: Four patients were excluded. Of the 96 remaining patients, 46 received the placebo and 50 received lidocaine. Age, sex, race, and laceration length and location were similar between groups. Physiologic parameters did not differ between groups. For all four pain ratings, the independent variables of age, sex, race, and laceration length or location did not differ between groups. Topical lidocaine was ineffective in relieving pain from the injection. When groups were combined, a significant negative correlation was noted for age versus injection pain (P = .035), with older children reporting less pain from injection than younger children. CONCLUSION: For children, soaking a simple laceration with 1% lidocaine does not decrease pain from the subsequent lidocaine injection.     

A randomized, double-blind trial comparing combinations of nevirapine, didanosine, and zidovudine for HIV-infected patients: the INCAS Trial. Italy, The Netherlands, Canada and Australia Study

CONTEXT: Current guidelines recommend that individuals infected with the human immunodeficiency virus type 1 (HIV-1) be treated using combinations of antiretroviral agents to achieve sustained suppression of viral replication as measured by the plasma HIV-1 RNA assay, in the hopes of achieving prolonged remission of the disease. However, until recently, many drug combinations have not led to sustained suppression of HIV-1 RNA. OBJECTIVE: To compare the virologic effects of various combinations of nevirapine, didanosine, and zidovudine. DESIGN: Double-blind, controlled, randomized trial. SETTING: University-affiliated ambulatory research clinics in Italy, the Netherlands, Canada and Australia (INCAS). PATIENTS: Antiretroviral therapy-naive adults free of the acquired immunodeficiency syndrome with CD4 cell counts between 0.20 and 0.60x10(9)/L (200-600/microL). INTERVENTION: Patients received zidovudine plus nevirapine (plus didanosine placebo), zidovudine plus didanosine (plus nevirapine placebo), or zidovudine plus didanosine plus nevirapine. MAIN OUTCOME MEASURE: Plasma HIV-1 RNA. RESULTS: Of the 153 enrolled patients, 151 were evaluable. At week 8, plasma HIV-1 RNA levels had decreased by log 2.18, 1.55, and 0.90 in the triple drug therapy, zidovudine plus didanosine, and zidovudine plus nevirapine groups, respectively (P<.05). The proportions of patients with plasma HIV-1 RNA levels below 20 copies per milliliter at week 52 were 51%, 12%, and 0% in the triple drug therapy, zidovudine plus didanosine, and zidovudine plus nevirapine groups, respectively (P<.001). Viral amplification was attempted in 59 patients at 6 months. Viral isolation was unsuccessful in 19 (79%) of 24, 10 (53%) of 19, and 5 (31%) of 16 patients in the triple drug therapy, zidovudine plus didanosine, and zidovudine plus nevirapine groups, respectively. Among patients from whom virus could be amplified, resistance to nevirapine was found in all 11 patients receiving zidovudine plus nevirapine and in all 5 patients receiving triple drug therapy. Rates of disease progression or death were 23% (11/47), 25% (13/53), and 12% (6/51) for the zidovudine plus nevirapine, zidovudine plus didanosine, and triple drug therapy groups, respectively (P=.08). CONCLUSIONS: Triple drug therapy with zidovudine, didanosine, and nevirapine led to a substantially greater and sustained decrease in plasma viral load than the 2-drug regimens studied. Our results also suggest that suppression of viral replication, as demonstrated by a decrease in the plasma HIV-1 RNA load below the level of quantitation of the most sensitive test available, may at least forestall the development of resistance.     

Influence of vitamin B6 intake on the content of the vitamin in human milk

The influence of the level of vitamin B6 intake on the content of the vitamin in milk was studied in 19 healthy subjects whose stages of lactation ranged from 3 weeks to 30 months. Total vitamin B6 intakes, including extra-dietary sources of the vitamin, ranged from 1.3 to 12.5 mg per day with six subjects consuming less than the recommended allowance of 2.5 mg per day (RDA, 1974). Subjects consuming less than 2.5 mg of vitamin B6 per day had significantly less vitamin B6/liter milk (129 mug) than groups consuming 2.5 to 5.0 or greater than 5.0 mg per day (239 and 314 mug, respectively). Among subjects consuming greater than 2.5 mg of vitamin per day the stage of lactation did not influence the levels of protein or vitamin B6 in milk. Vitamin B6 intakes two to five times the recommended allowance did not significantly elevate the level of the vitamin in milk compared to values for subjects whose intakes approximated the allowance. The vitamin B6/protein ratio in milk of subjects consuming less than 2.5 mg vitamin B6 per day was 13 mug/g and was significantly lower than that observed for the other two groups (23 and 28 mug/g). Daily and weekly variations of the vitamin B6 and protein content in milk of individuals were small. However, marked diurnal variations in the vitamin B6 content were found in milk of individuals taking daily supplements of the vitamin with peak levels occurring in the afternoon 3 to 5 hr after supplements were taken in the morning.     

Circadian rhythms have no effect on cycling performance

The aim of this research was to determine if circadian rhythms have an effect on time trial cycling performance of 15 min duration. Seven males (Mean+/-SD): age, 22.3+/-4.9 yr; height 179.0+/-7.9 cm, body mass 74.5+/-15.5 kg; VO2max 68.0+/-5.7 ml x kg(-1) x min(-1) who were all competitive cyclists or triathletes with previous experience in laboratory testing procedures volunteered to participate in this study. Each of the seven subjects underwent a series of four tests; one VO2 max test, and three 15 min maximal performance tests, at varying times during a 24 hr period. Testing times were at 08.00-10.00; 14.00-16.00 and 20.00-22.00 hours. Heart rate was recorded during the last 10-15 seconds of each minute and blood lactate levels were taken at 5 and 10 min during exercise and again immediately post-exercise. O2 consumption was measured continuously using open circuit spirometry. RPE was measured using the Borg scale at 5 and 10 min during, and again immediately following the completion of testing. Resting oral temperature was the only variable to show a significant time of day effect (p<0.05). Oral temperature during the afternoon was higher than both morning and evening results by 0.76 degrees C and 0.09 degrees C respectively. Total work (kJ) and average power output (W) were recorded at their highest during the morning session and reached a trough during the afternoon session, but these differences were not significant (p = 0.9997 and 0.9972 respectively). The results obtained in this study indicate that while certain biological rhythms are present, they appear to have no effect on this type of cycling performance. Although athletic performance may be enhanced by training programs that are compatible with an individuals body clock, the ability to perform and train at various times has an adaptive response which appears to over-ride these naturally inherent rhythms.     

Marital satisfaction, recovery from work, and diurnal cortisol among men and women.

Design: Multilevel modeling was used to model relationships between salivary cortisol, daily diary ratings of work experiences, and Marital Adjustment Test scores (Locke & Wallace, 1959), in a sample of 60 adults who sampled saliva 4 times per day over 3 days. Results: Among women but not men, marital satisfaction was significantly associated with a stronger basal cortisol cycle, with higher morning values and a steeper decline across the day. For women but not men, marital satisfaction moderated the within-subjects association between afternoon and evening cortisol level, such that marital quality appeared to bolster women's physiological recovery from work. For both men and women, evening cortisol was lower than usual on higher-workload days, and marital satisfaction augmented this association among women. Men showed higher evening cortisol after more distressing social experiences at work, an association that was strongest among men with higher marital satisfaction. Conclusion: This work has implications for the study of physiological recovery from work, and also suggests a pathway by which marital satisfaction influences allostatic load and physical health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)