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COVID-19 pandemic-related changes in wellness behavior among older Americans
BMC Public Health volume 21, Article number: 755 (2021)
COVID-19 has taken its toll on citizens in all 50 states of the United States. The United States (U.S.) leads the world with 30,291,863 confirmed reported cases and 549,664 deaths as of March 29, 2021 compared to globally confirmed cases at 127,442,926 and 2,787,915 deaths as of March 29, 2021. The U.S. federal government primarily left the response to the virus to individual states, and each implemented varying measures designed to protect health of citizens and the state’s economic well-being. Unintended consequences of the virus and measures to stop its spread may include decreased physical activity and exercise, shifting access and consumption of food, and lower quality-of-life. Therefore, our primary goal was to quantify the impact of COVID-19 on health and well-being by measuring changes in physical activity, mental health-quality of life, food security and nutrition in adults ages 40 and older. We believed shifts in health behaviors would be more prevalent in minorities, less educated, lower socio-economic status, older adults, and those with underlying health conditions, so a secondary goal was to determine the impact of COVID-19 on these sub-populations.
We conducted an online survey with 9969 adults 40 years and older between 9 August and 15 September 2020 in urban areas across the four U.S. census regions. The survey included questions about demographic variables, pre-existing health conditions, physical activity, access to food, quality-of-life, and nutritional food status and asked participants to respond with information from pre-pandemic and pandemic conditions. We used paired-sample t-tests to detect changes in variables after the start of the pandemic and Cohen’s d to determine effect sizes.
Our main findings showed a decrease in physical activity since the onset of COVID-19 for minorities and non-minorities. Food security also slightly increased for minorities during the pandemic, but we found no other changes in food security, quality-of-life indicators, or nutritional status of those who responded to this survey.
It is concerning that physical activity declined. Such activity helps maintain physical and mental health, and it is also an important time to socialize for many older adults. In many ways, our data indicate that the older adult population in U.S. cities may be more resilient than expected during the pandemic. However, the pandemic could have negative impacts that we did not detect, either due to the survey instrument or the timing of our survey, so the health and well-being of older adults should continue to be monitored in order to mitigate potential negative impacts.
Even though COVID-19 continues to be a global health emergency and the United States (U.S.) leads the world with 30,291,863 confirmed reported cases and 594,664 deaths as of March 29, 2021 compared to globally confirmed cases at 127,442,926 and 2,787,915 deaths as of March 29, 2021 . The lack of a coordinated public health response from the federal government at the start of the pandemic in the U. S. was crippling and led to the virus spreading unabated . Some states enacted measures that included stay-at-home policies, closing of businesses, face coverings, and social distancing, whereas other states did not [3, 4]. Unintended consequences of the virus and measures to stop its spread may include decreased physical activity and exercise, shifting consumption patterns and access to food, and feelings of anxiety [5,6,7].
As COVID-19 continues unrelentingly, barriers to physical activity and exercise may be higher for some groups of people than others. For example, closure of gyms, bowling alleys, and supervised exercise classes, combined with a lack of home gym equipment, prevented a continuation of physical activity in older adults . We defined well-being from a public health perspective as meeting physical and mental health approaches to disease prevention . In addition to lost direct benefits from exercise, a reduction in the ability for older adults to socialize leads to an increased likelihood that they may suffer the loss of independence, which in turn may lead to cognitive impairment . Those who can maintain higher levels of physical activities during the pandemic may display lower levels of depression and anxiety, which are key indicators of quality-of-life .
Whereas the ability to maintain an active lifestyle decreased during COVID-19, sedentary behaviors such as sitting, sleeping, and engaging in more television or computer watching increased .
Mobility of citizens was restricted to essential workers and essential services in some local jurisdictions and states where stay-at-home policies were enacted to keep citizens safe.
[3, 4]. In New Zealand, which also restricted movement of citizens, a cross-sectional survey of 238 adults 18 years and older, between March–May 2020 found that 85% of the participants maintained regular physical activity prior to the lockdown, but only 49% were able to maintain regular exercise routine after the lockdown [13, 14]. Another study reported a decline in step count worldwide associated with confinement periods between January and March 2020 due to COVID-19 . This research did not report the intensity of physical activity, but the authors believe that there is a negative linear relationship between decreases in step count and decreases in physical activity. In a health context, this decline in routine physical activity and exercise is concerning because these activities confer health benefits that mitigate risks associated with chronic diseases .
Quality-of-life (physical and mental health)
We used the Center for Disease Control’s definition of quality-of-life for individuals, which includes physical and mental perceptions (e.g., energy level, mood), health risks and conditions of functional status, social support, and socioeconomic status . Recent research explored the relationships between resilience, hope preventive behaviors, subjective well-being, and psychological health among adults and found that high levels hope had a positive effect on resilience which translated to better mental well-being ; while another study reported anxiety measures of 600 participants using the Self-Rating Anxiety Scale where they compared anxiety risks they found that 93.67% had no anxiety symptoms, 6.33% felt anxiety, 82.83% had no symptoms of depression and 17.17% were depressed, women suggesting most participants were psychologically stable .
Individuals with high physical activity levels during the pandemic experienced lower levels of depression and anxiety and higher levels of quality-of-life . Research examining effects of COVID-19 on mental health of older adults with a pre-existing major depressive disorder found that although older adults may experience physical distancing, they were not necessarily socially isolated: social isolation was mitigated for many by virtual connections with friends and family . Even though physical activity was not included as a variable in the study, their findings suggest that physical activity could be introduced virtually as a source of social connection. Interestingly, another study looked at the physical activity levels of patients with cardiac disease in New York City and Minneapolis/Saint Paul and found a marked decline in physical activity due to pandemic restrictions that did not return to pre-pandemic levels even when restrictions began to ease . Finally, social isolation induced by quarantine restrictions may cause mental health disturbances such as acute stress, depression, irritability, poor sleep habits, fear, and anxiety. Mental health stressors and poor sleep affect the immune system by decreasing the human body’s ability to fight infection [21, 22].
Food security and nutrition
Beyond access to physical activity and key social interactions that influence quality-of-life, COVID-19 restrictions may influence availability, access, and selection of nutritional food due, in part, to widespread closure of affordable food outlets . Food security and nutritional intake has been used interchangeably to convey the necessary components of a food secure household; however, these terms are independent. Food security is defined as all people having access at all times to enough food for an active, healthy life . The United States Department of Agriculture (USDA) defines ranges of food security as: 1) high food security – no food-access problems or limitations and 2) marginal food security one or two indicators of food access limitation . The ranges for food insecurity are 1) low food security – indicators of food access limitations but no reduction in food intake and 2) very low food security – “disrupted eating patterns and reduced food intake” . Nutritional intake refers to the quality of an individual’s diet to prevent malnutrition and improve body function. Nutritional intake should focus on maximizing consumption of fruits, vegetables, and healthy proteins to mitigate negative effects of noncommunicable diseases and complications such as high blood pressure, high cholesterol, obesity, and diabetes [25, 26].
Research supports physical activity and exercise as a non-pharmaceutical response to maintain good respiratory, cardiovascular, musculoskeletal, and mental well-being . The CDC has suggested that the use of the term well-being is a valid population outcome measure . Food security, nutritional food intake, and high quality-of-life increase resilience in older adults. Therefore, our primary goal was to quantify the impact of COVID-19 on physical and mental well-being by measuring changes in physical activity, physical and mental health (quality-of-life), food security, and nutrition in adults ages 40 and older. We predicted decreases in physical activity, food security, nutrition, and well-being associated with COVID-19. We believed these shifts in health behaviors would be more prevalent in minorities, less educated, with lower socio-economic status, older adults, and those with underlying health conditions, so a secondary goal was to determine the impact of COVID-19 on these sub-populations.
Participants and sampling
Our research is a cross-sectional study designed to determine the impact of COVID-19 on physical activity, food security, mental health (quality-of-life), and diet among vulnerable populations who live in urban cities and were more likely to experience severe symptoms or likely to die from complications associated with COVID-19. We sampled 9969 participants ages 40 years or older between 9 August through 15 September 2020. Relying on the prospective participant panel of individuals willing to complete online surveys, Qualtrics  managed the recruitment process using specifications provided by the authors with the goal of obtaining a sample from urban cities across the four census regions of the United States. Qualtrics sought to obtain a sample that was balanced by sex (male, female) and a combination of race (White, Asian, Black) and ethnicity (Hispanic, Non-Hispanic). Urban cities, as defined by the U.S. Census Bureau, have a population of more than 50,000 . In addition to using the categories of race and ethnicity, a Minority Status construct was defined as “yes” if race was anything other than White (non-Hispanic), with minority status otherwise “no”.
In addition to demographic questions, the survey included questions about pre-existing health conditions and a set of four constructs assessed under two conditions: “before” (thus, a retrospective condition) and “since” the start of COVID-19 in the U.S. Specifically, participants completed four subscales measuring these constructs in the “before” condition, and then participants completed the same set of four subscales in the “since” condition. These constructs included physical activity, food security, quality-of-life (physical and mental), and nutrition.
Pre-existing health conditions
Participants selected options from a list of 19, including arthritis, back issues, fibromyalgia, hearing impairment, high cholesterol, hip issues, knee issues, macular degeneration, multiple sclerosis, osteoporosis, Parkinson’s disease, shoulder issues, stroke, visual impairments/eye health issues, lung disease (e.g., asthma, COPD, chronic bronchitis), cancer, kidney disease, heart attack, high blood pressure, and other (free response). We derived an overall index of health problems by adding the number of conditions, which yielded a maximum score of 20 (including the diabetes response). In addition, we developed an index of conditions (possible range 0–6) that have been linked to increased COVID-19 severity, which included lung disease, cancer, kidney disease, heart attack, high blood pressure, and diabetes .
We assessed physical activity with a two-item scale adapted from the National Health Interview Survey  (see Table 1 for questions and scores assigned to responses), which has been a validated instrument since 1950 .Scores may range from 0 to 6, with higher scores indicating higher levels of physical activity. Physical activity was assessed by calculating separate scores for pre- and pandemic conditions and compared using a paired-sample t-test . The two items making up this subscale had Pearson-r correlations of 0.49 and 0.52 for pre-pandemic and pandemic conditions, respectively (both significant at p < 0.05, n = 9669). The variable “physical activity change,” is the result of subtracting the pre-pandemic score from the pandemic score.
We assessed food security through a four-item subset of the short form of the Household Food Security Scale [33, 34] (see Table 2 for questions and scores assigned to responses). The initial total score calculated for each participant was subtracted from eight so that a higher number indicated higher levels of food security. Scores may range from 0 to 8. Food security was assessed by calculating separate scores for pre- and pandemic conditions and compared with a paired sample t-test . The internal consistency of the Food Security Scale was 0.88 and 0.92 for the pre-pandemic and pandemic conditions, respectively, indicating good reliability for the measure. The variable “food security change,” is the result of subtracting the pre-pandemic score from the pandemic score.
Quality-of-life (physical and mental health)
We measured quality-of-life using three questions from the Centers for Disease Control’s Health-Related Quality-of-Life—4 questions (Table 3) . Technical documentation from the Health-Related Quality-of-Life —4 provides extensive explanation of the measure’s psychometric characteristics [35, 36]. We determined quality-of-life by averaging the number of days in the previous month for physical health not good, mental health not good, and days in which poor physical and mental health prevented the respondent from doing their usual activities. Thus, our measure provides an indicator of reduced quality-of-life, with a possible range of 0 to 31. For the set of three questions making up the quality-of-life measure, internal consistency reliability was 0.88 and 0.81 for the pre-pandemic and pandemic conditions, respectively, indicating good reliability for the measure. Quality-of-life was measured in pre- and pandemic conditions and averages were compared using a paired sample t-test . The variable “quality-of-life change” is the result of subtracting the pre-pandemic score from the pandemic score.
We measured nutrition with the Dietary Screening Tool (DST) . The 24-item short-form of the Dietary Screening Tool was developed and validated for use with middle-aged and older adults [38, 39]. The questions vary in number of response options and score points per option, resulting in a total possible range between 0 and 100 points. Healthier options within each question receive a higher score, so a higher total score indicates a more nutritious diet. Nutrition was measured in pre- and pandemic conditions and averages were compared using a paired sample t-test . Internal consistency reliability for the DST was 0.61 and 0.62 (both n = 9969) for the pre-pandemic and pandemic conditions, respectively. The variable “nutrition change” is the result of subtracting the pre-pandemic score from the pandemic score.
Descriptive statistics were used to describe the sample (demographic variables and pre-existing health conditions). Planned comparisons using paired sample t-tests were used to test a priori hypotheses related to (1) changes in health-related variables in pre-pandemic and pandemic conditions (four tests), and (2) identical planned comparisons considered separately based on minority sample (yes or no) (eight tests). Correlations between a set of variables were examined in an exploratory fashion. Tests for statistical significance were based on α = 0.05, and appropriate effect sizes were also evaluated using Cohen’s standard levels of effect size .
We collected demographic data from participants across the four United States census regions: Northeast (n = 2966, 30% of total sample), Midwest (n = 2352, 24%), South (n = 2664, 27%), and West (n = 1987, 20%). The sample population was 57% female (n = 5733) and 43% male (n = 4236) and racially diverse (White n = 7330, 74% of total sample; Black n = 1381, 14%; Asian n = 694, 7%; Hispanic n = 536, 5%; Other Non-Hispanic n = 31, < 1%). Minority status was defined as “yes” if race was anything other than White (Non-Hispanic), so 26% of the sample was minority status.
Participants ages ranged from 40 to 100 years (m = 62.1, SD = 11.2): middle-aged (40 to 59, n = 3503, 35% of total sample), older (60 to 74, n = 5364, 54%), and oldest (75 to 100, n = 1102, 11%). Education level varied among the sample: less than high school (n = 124, 1% of total sample); high school/general equivalency degree (GED) (n = 1501, 15%); some college (n = 1848, 19%); associate or technical school degree (n = 1341, 14%), bachelor’s degree (n = 2845, 29%), graduate degree (n = 2295, 23%), prefer not to answer (n = 15, < 1%). Household income data were collected using a measure with eight levels: less than $10,000 (n = 363, 4% of total sample), $10,000 to $14,999 (n = 363, 4%), $15,000 to $24,999 (n = 811, 8%), $25,000 to $34,999 (n = 944, 10%), $35,000 to $49,999 (n = 1285, 13%), $50,000 to $74,999 (n = 1883, 19%), $75,000 to $99,999 (n = 1376, 14%), $100,000 and higher (n = 2537, 25%), and prefer not to answer (n = 407, 4%).
Pre-existing health conditions
The health conditions reported by participants ranged from 0 to 14 (M = 2.23, SD = 1.94) from the full set of 20 possible health conditions. From the smaller set of six possible health conditions associated with more severe COVID-19 disease, the health conditions reported by participants ranged from 0 to 5 (m = 0.64, SD = 0.73).
Changes in health-related variables pre- and pandemic
Table 4 reports a set of planned comparisons (using t-tests) between pre-pandemic and pandemic health and well-being variables, all of which were significant at the α = .05 level (Table 4). Because significance could have been due to the large sample size, so we calculated effect sizes using Cohen’s d . Cohen’s d for physical activity reached the small effect size, which means that physical activity was higher in pre-pandemic conditions than in pandemic conditions. Effect size did not reach the small level among other comparisons (d ≤ 0.20), so changes observed in food security, nutrition, and quality-of-life are negligible.
Additional planned comparison tests were repeated separately for participants with minority status or White (non-Hispanic) (see Table 5). Consistent with the results for the whole sample, minority and non-minority groups showed a decrease in level of physical activity during the pandemic compared to pre-pandemic. Additionally, the minority group increased food security. All other changes in health and well-being from pre-pandemic to pandemic conditions for the minority and non-minority group were negligible (Table 5).
Exploration of correlations between variables
Table 6 reports the Pearson-r correlations between variables, including minority status (minority), level of education (education), income level (income), age level (age), and presence of at least one of 20 possible pre-existing health conditions (health). The variable also included physical activity, food security, nutrition, and quality-of-life as assessed using their associated “change” variables from pre-pandemic to pandemic conditions. Cases were dropped from analysis when participants elected to not respond to questions contributing to either education (n = 15) or income level (n = 407), resulting in approximately 4% of cases dropped, with subsequent n = 9552. None of the correlations reached significance at the 0.05 level (N = 1000). No correlations between change variables and the other variables reached the level of even a small effect size using Cohen’s  categories, regardless of their level of statistical significance. These analyses were exploratory and did not reflect a priori hypotheses.
Exercise and diet are two ways in which older adults can maintain a healthier lifestyle and help prevent illness. As predicted, our results suggest that physical activity is a health and wellness indicator that changed during the pandemic, with a decline in physical activity in adults ages 40 to 100. Similar findings confirmed a decrease in physical activity in some individuals in Italy, Canada, and Belgium. Physical activity, especially walking, decreased in undergraduate students in Italy, while sedentary behavior such as watching TV and computer use increased . In Canada, 1098 adults over 19 years old were surveyed and individuals who were relatively inactive before the pandemic were more likely to become even less active during the strictest period of lockdown, whereas those who were relatively active before the pandemic were more likely to increase activity during lockdown . Furthermore, inactive individuals who spent more time active outdoors had lower anxiety than individuals who spent less time being active outdoors . Largely contrary to our results and those from Italy and Canada, adults in Belgium primarily increased their exercise level, but sedentary behaviors also increased and exercised decreased in some groups, especially those over the age of 55 years old .
A decline in physical activity could impact overall health of older adults, including their risk of severe complications from COVID-19. Older adults that participated in our survey had, on average, more than two of the 20 pre-existing health conditions we included on our survey. We recognized that many older adults are at risk of severe COVID-19 because of pre-existing health conditions; however, we noted that while physical activity decreased among many in our sample most were able to maintain some normalcy with respect to physical activity. New Zealand researchers showed similar finding in that many of the participants surveyed during March through May 2020 continued their physical activity routine .
Physical inactivity has been associated with reduced heart health, which increases the likelihood of sudden cardiac death, an increase in skeletal muscle decline, and a decrease in cognition . In older adults, exercise reduces frailty (reduced capacity to reach physiological homeostasis) and sarcopenia (muscle atrophy, loss of muscle strengths and power); these conditions have negative outcomes following hospital discharges in older adults . The World Health Organization and the United States Department of Health and Human Services [43, 44] recommend 150 min of moderate physical activity per week or 75 min of vigorous physical activity per week, while adding at least 2 days of muscle-strengthening exercises [6, 43,44,45]. Several authors suggested that some major public health initiatives in response to the pandemic — including “lockdowns” and social distancing protocols—have created personal, social, and environmental barriers to the ability of older adults to engage in physical activities [46, 47].
One group of researchers have argued that the imposition of such public health measures serves as a starting point for a vicious cycle of inactivity, muscle disuse, sarcopenia, and physical inactivity among older adults . Our results support the idea that the pandemic may prevent older adults from engaging in physical activity. We found this effect regardless of minority status.
We predicted that COVID-19 would exacerbate food insecurity because many local and state policies closed businesses, including food outlets. However, our results suggested otherwise, as participants reported a high level of food security. In fact, food security was somewhat increased among minority participants. We were puzzled by this finding as we predicted more food insecurity for older adults and minorities especially after the onset of the pandemic. Prior to COVID-19 many older adults (especially adults over 60) received meals through a variety of ways, including social services such as “meals on wheels” and “home meal delivery.” Perhaps food security increased because government-sponsored agencies increased meal delivery to this group after the onset of the pandemic. For example, Healthy New York and Seabury Home Meal Delivery services supported by the DC Department of Aging and Community Living ensured that older adults, especially those who were homebound, continued to receive healthy meals [48, 49]. Moreover, adults over 60 years and older in most urban cities have access to social services that provided meals and adults 40 to 59 years may have access to food from local food pantries. Organizations such as Feeding America have delivered an estimated 4.2 billion meals to people in the United States from March through October 2020 .
Quality-of-life (physical and mental health)
Participants reported between two (2) and three (3) days in the prior month in which their physical and/or mental health was not good before the pandemic and this did not change during the pandemic. So, overall quality-of-life for participants remained relatively stable, indicating an underlying resilience in this population. Resilience is defined as the process of adapting well in the face of adversity, trauma, tragedy, threats, or significant source of threats . The answers of older adults, regardless of minority status, suggests quality living and an ability to adapt to circumstances during the COVID-19 pandemic crisis, which demonstrates high level of resilience, especially since their physical activity was reduced .
Adequate nutrition during the pandemic has an added benefit of boosting the immune system and improving resistance to malnutrition in older adults. We predicted that COVID-19 would lead to less nutritious food choices in older adults. In older adults, malnutrition and undernutrition facilitate the onset of sarcopenia, which is particularly problematic in individuals with health conditions such as cancer, heart disease, or chronic infection . Nutritional screening for malnutrition has been recommended as a part of routine clinical care [53, 54]. Additionally, it has been recommended that older adults consume a high protein diet at each meal to protect the skeletal muscles from wasting, but especially in the presence of acute or chronic illnesses [53,54,55]. Our results showed that older adults continued to consume the same amounts of fruits, vegetables, and proteins before and since the onset of COVID-19. This was unexpected given that access to nutritious food may have been challenging for some during the pandemic. While our current study showed no differences in consumptions patterns before and since the pandemic, we cannot conclude whether a sufficiently nutritious diet is being consumed. Research supports that older adults need a diet high in fruits and vegetables with adequate proportions of protein to increase resistance to non-communicable diseases .
Food security findings in ethnic and minority participants
We previously noted the unexpected finding that food security increased among the minority population, when we predicted a decline in food security. We believed that many minority participants would be considered essential workers, living in densely-populated cities with limited access to fresh produce, and so would rely on unhealthy food choices. Researchers had reported poor nutrition increased during the early phases of the pandemic, leading to a pronounced impact on minorities with a disproportionate burden of chronic diseases such as hypertension, diabetes, and asthma [57, 58]. We also recognize that minorities, especially African Americans, have a higher burden of chronic diseases and have been shown to have a higher death rate from COVID-19 than any other ethnic and minority group . In fact, it has been reported that African Americans had a 3.4 times higher mortality rate than non-Hispanic Whites .
Our results may run counter to other studies that show a decline in food security among minorities because of the size of our sample, which is much larger than many studies, and was collected at a different timeframe from other studies. Early research on COVID-19 focused on March through June 2020 when lockdowns were the most restrictive in many states in the United States. Since we collected data in August and September 2020, the rates of COVID-19 were lower in the United States and restrictions eased, providing participants more mobility. Many minority respondents who were working, may have had access to food and those who were not working may have had access to soup kitchens and food pantries.
Additionally, in states like New York, there was a major push to increase enrollment in the Supplemental Nutrition Assistant Program (formerly known as “Food Stamps”, especially among older adults, and it is possible that other states across these regions made similar efforts . In fact, the USDA initiated the SNAP online pilot, to which New York was one of the early adopters, that allowed SNAP benefits to be used online . We suspect that many states-initiated safety nets like these to assure that many citizens were able to have enough healthy food during the pandemic. We also considered the possibility that since our data collection was later in the year, that local jurisdictions were the beneficiaries of learned lessons of what worked and what did not and were able to adjust implementation of their safety nets for their citizens more efficiently. We believe that because many older adults were homebound, it is possible that large proportion reconnected to cooking their own meals and/or sharing cooked meals with others. We suspect that food insecurity was less of an issue as spending on grocery took precedent over other types of spending such entertainment or traveling, which in many ways left citizens with the ability to save more money that was perhaps used to purchase healthy food. Lastly, while the survey aim was to target a representative sample of older adults across the four US census regions, it is possible that the respondents to this survey were more middle-income individuals and may have been in a better economic position to endure the COVID-19 storm.
There is a growing body of research on the plight of older adults in the wake of COVID-19 and how it affects health conditions, physical activity, food security, quality-of-life, and nutrition. Our aim was to sample a large population of adults 40 years and older in the four U.S. census regions and to target urban cities and populations that were at high risk for suffering from severe COVID-19 complications. Populations we considered high risk include minorities, less educated, lower socio-economic status, older, and those with underlying health conditions. For example, members of minoritized groups have been reported to be at greater risk for contracting COVID-19 and experience worse health outcomes or greater rates of death than Whites, which aligns with our understanding of health disparities and health inequities when minorities are not able to access adequate and quality health care [59, 62]. Hypertension, diabetes, asthma, and other chronic diseases are prevalent in Black and Hispanic populations, resulting in an elevated risk factor for COVID-19. Blacks and Hispanics are disproportionately represented as essential workers without the luxury of working from home . Many Blacks and Hispanics are more likely to live in densely populated housing, perhaps placing them at increased risk for transmission of the virus. Therefore, we intentionally targeted urban cities since minorities are likely to make up a greater percentage of the population in these areas, and thus would be represented in our study.
Limitations and implications for practice
One limitation to our study was that despite our efforts to target minoritized individuals, Whites were most likely to respond to the survey. We report this as a limitation given our aims, but our sampling closely aligns with the demographics in the United States . A second limitation was that the survey was offered online. It is possible that there was a technology bias that skewed results toward those who could afford and/or access a computer. The survey could be completed on a smart phone, which we anticipated would have mitigated some of the technology bias in our sampling, but this technology is also not ubiquitous. A third limitation was that onset and effects of COVID-19 were not similar throughout the country, nor were the responses by local and state governments. Our survey gives a snapshot of what conditions were like during the first peak of the pandemic in the U.S., but conditions became worse. A fourth limitation was that the reliability of the physical activity scale and DST were lower than desired, so a suggestion for future research would be to create a tool with greater reliability.
It is concerning that physical activity declined because this helps maintain physical and mental health and is also an important time to socialize for many older adults. In many ways our data indicate that the older adult population in U.S. cities may be more resilient than expected during the pandemic. However, the pandemic could have negative impacts that we did not detect, either due to the survey instrument or the timing of our survey.
Our recommendation for future research should look more closely at the impacts of COVID-19 on high-risk groups, including minorities. For example, an analysis of the minority population, separated by regions of the U.S., in relation to physical activity, nutritional status related to food intake, and quality-of-life indicators based on differential age categories is warranted. Given the evolving nature of the pandemic and the high risk of individuals we studied, health and well-being of older adults should continue to be monitored so impacts can be mitigated.
We recommend developing of interventions that target minority older adults and increase awareness of the benefits of physical activity on physical and mental well-being in times of crisis that are especially beneficial to increase resilience in this population. There has been some recent research that highlights the benefits and barriers of physical activity and exercises in older adults . We know that increasing physical activity improves health outcomes, lowers the burden of chronic diseases, and improves the overall quality-of-life for all people to include people in racial and ethnic minority groups. Further, community engagement of ethnic racial minority groups must be embedded in any public health response that seeks to decrease the disparate health treatment suffered by minorities in the current health care system .
Availability of data and materials
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
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This research project was funded by the University of the District of Columbia Agricultural Experiment Station with funding from the Hatch Multi-State Research Capacity funding program (NE 1939) from the USDA National Institute of Food and Agriculture. The funders had no role in the design of the study and collection, analysis, and interpretation of data or in writing the manuscript.
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This research was approved by the Institutional Review Board at the University of the District of Columbia (IRB#138067–4).
All methods were carried out in accordance with relevant guidelines and regulations.
Informed consent was obtained from all participants, no participant under 18 participated in this study.
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Harrison, E., Monroe-Lord, L., Carson, A.D. et al. COVID-19 pandemic-related changes in wellness behavior among older Americans. BMC Public Health 21, 755 (2021). https://doi.org/10.1186/s12889-021-10825-6
- Food security
- Physical activity
- Senior citizens

domain: medical


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Foxconn To Sign R Deals With China’s Guizhou Province
Foxconn Technology Group, the world’s biggest electronics component maker, said on Thursday it will sign agreements with China’s Guizhou province to research and develop big data technology and nanotechnology. Foxconn, the major supplier of Apple Inc’s iPhones, has had similar projects in cooperation with Tsinghua University and Peking University, according to a company statement. The flagship unit of Foxconn is Hon Hai Precision.
“Foxconn To Sign R Deals With China’s Guizhou Province” is categorized as “science and technology”. This video was licensed from Grab Networks. For additional video content, click the “video” tab at the top of this page.
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domain: news


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A printing press gets “up to color” by printing sheets and throwing them away until they’re right. Trash/treasure: in Italy the photographer was with kept these “makereadies” for each of his projects and bound them up into his own kind of alternative book afterwards. Purple where green should be…smudges…missing colors…wrinkles.
This scrambles the fetishization of the “final product.” Keeping the remnants is a part of being open about your work. Put another way, the work is all just a series of remnants.
Visual Editions is selling some extra sheets from their Tree of Codes project.

domain: artistic


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One of the first signs of a good relationship is clear communication. In a romance, both lovers feel like that they can express themselves without the need for answers. A healthy relationship is built upon mutual esteem and a great ability to talk clearly. A wholesome relationship enables each partner to express their very own feelings and interests devoid of fear of verdict or critique. A strong romantic relationship also permits partners to have time besides each other. The cabability to express demands without censoring each other is crucial designed for building a long-term partnership.
Some other early sign of a great relationship is actually a positive frame of mind. When the a couple communicate well, they can see how every other’s feelings are currently being expressed. If they are compatible, they shall be happier along. A wholesome relationship is known as a priority meant for both lovers and requires consistent communication. Several can make in the differences in the personality and goals. A person’s personality style can result a marriage and affect a person’s frame of mind.
A good marriage is the one that has each of the ingredients to become healthy romance. For example , somebody who is emotionally stable should be able to communicate with each other conveniently and honestly. In addition , they will promote information unhampered and share thoughts with the various other. They will also be able to understand every other’s feelings. This will help these people resolve any kind of conflicts and create a much better bond. The signs of a great relationship are frequently the same meant for both lovers. They are both happy to communicate with each other and to be honest.
A proper relationship even offers a strong sense of trust and conversation. It also seems natural to express concerns. That woman of dominican republic would not use unaggressive aggressive behavior. It is additionally not afraid of confrontation, which can improve the romantic relationship and add to the chances of a successful relationship. When a few is in a proper relationship, they don’t avoid confronting each other. In addition, they make an effort to spend precious time apart. Signs and symptoms of a good marriage are mentioned in a frequent basis.
A very good relationship is usually one where both companions are relaxed being themselves. When two people are comfortable with one another, they feel at ease and don’t make an effort to impress each other. In addition , the right partner does not try to win over the various other partner. They are wide open and don’t coveted by each other’s success. They make their spouse happy and comfortable in their romantic relationships. A healthy partner never pushes things. For example , the other person will not have to impress the other person to be treasured.
The signs of an excellent relationship are numerous. Those who are within a good romantic relationship will not concern the other’s intentions. That may also be easy for these to read every single other’s ambiance. It is also essential that they esteem each other’s differences. In the event they understand each other’s needs, they will be able to esteem each other peoples feelings. Within a good romance, there are zero secrets regarding the two associates.

domain: psychology


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On Monday, Shares of Fitbit Inc (NYSE:FIT), subtract -1.00% and closed at $13.90 in the last trading session. The last trading range of the stock ranges between $13.76 and $14.19. The company’s Market capitalization is $2.97 Billion with the total Outstanding Shares of 222.15 million. During the 52-week trading session the minimum price at which share price traded, registered at $11.65 and reached to max level of $41.97. Fitbit (FIT), the global leader in the connected health and fitness market, recently declared the launch of the Step It Up! Challenge with special guest U.S. Surgeon General Vivek Murthy – a two-week step challenge that encourages people of all ages, abilities and physical fitness levels to take steps toward a healthier lifestyle. The Challenge is designed to get communities across America moving more, using the power of friendly competition as motivation. People can sign up starting October 5, 2016 at www.StepItUpUSA.org using their Fitbit tracker or the Fitbit app to have their steps automatically count toward the challenge, or can sign in with a Google or Facebook account and manually input their steps or distance travelled throughout the challenge. Participants can compete in teams with friends, family, or co-workers, in addition to with some of the country’s leading athletes, fitness professionals and Fitbit Ambassadors. The challenge will run from October 13-26.
By issuing the Step It Up! Challenge, Fitbit is taking action to encourage physical activity, which has been linked to assisting combat high rates of chronic conditions, such as obesity, diabetes and cancer.1 According to the World Health Organization, more than one in three adults worldwide is overweight2, and cardiovascular disease is the leading global cause of death3. Robust scientific evidence shows that physical activity is critical for both preventing and treating many of the chronic conditions we face recently, and walking is one simple, yet impactful way people can improve their fitness level.4,5
EnteroMedics Inc (NASDAQ:ETRM), dropped -5.35% and closed at $0.115 in the last trading session. The last trading range of the stock ranges between $0.11 and $0.12. The company’s Market capitalization is $7.49 million with the total Outstanding Shares of 69.70 million. During the 52-week trading session the minimum price at which share price traded, registered at $0.11 and reached to max level of $4.95. EnteroMedics Inc. (ETRM), the developer of medical devices using neuroblocking technology to treat obesity, metabolic diseases and other gastrointestinal disorders, recently highlighted the Company’s recent achievements in a letter to shareholders, ahead of the Company’s anticipated special meeting of shareholders to be held October 19, 2016.


There are a lot of perks to being alive today. You can access whatever information you’re seeking instantaneously, from practically anywhere. You can have essentially any product delivered to your door within 24 hours of thinking of it. You can use extremely advanced technology for an affordable price tag. And you can share everything — articles, your thoughts, your location, and even your latest purchase — with you friends and family with the touch of a button. All of this would have seemed insane a mere 30 years ago. Sometimes it does feel like we’re living in a sci-fi movie from the ’80s.
But…the ’80s had a few things going for them that wouldn’t be so bad nowadays. Namely, cheaper things! Of course, inflation does factor into the price increases we have seen throughout the years, but it can not explain the jump in every cost that we incur. Here are a few things that were a little easier to buy in the good ol’ days.
For less than $1, you could mail four letters in 1985. At that time, the price of a single first-class stamp was $0.22. Considering what happens when you drop a letter in a mailbox (i.e.- it travels across the country and lands on the doorstep of the person to whom you’re writing), that is pretty incredible. That being said, the cost of a stamp is less today than it would be if we account for inflation. That $0.22 should have the same buying power as $0.52 today. Instead, we shell out a cool $0.50 to mail a letter in 2018. So even though it might seem like a lot, it’s less than it actually could/should be.
A half gallon cost $1.09 in the ’80s. It’s crazy to think that anything healthy could actually be that cheap. The good news is that with inflation, that same half gallon should cost $2.58 by today’s standards, but we only pay about $1.96 per a half gallon in 2018. Keep in mind that this price is associated with regular milk. These days many people opt for organic or added DHA Omega-3, which definitely hike up the cost.
Fulfilling the American dream by buying a home is not as easy as it once was. In the ’80s (1985 to be exact), the average price of a new home was $96,200. While interest rates were probably much higher then than they are now, getting a new house for under $100,000 is a steal. With inflation, that same amount would be $226,000 in today’s dollars. Unfortunately, the average cost of a home is much higher in reality. Today, it costs $369,900 for new digs.
My favorite line from Young MC’s “Bust a Move” was always, “Your movie’s showin’, so you’re goin’, could care less about the five you’re blowin’.” Yes, there was a time when $5 could get you into a movie. In fact, in the mid-’80s, the average cost of a ticket was only $3.55. Inflation would put that at $8.40 in 2018, but unfortunately, that’s not the case. The current average price of a movie ticket is $9.18. If you live, however, in or near a big city, you’re probably paying much more. Where I live, just outside of NYC, we pay $12.50. And if you actually live in NYC? It’s $19.99, baby. Ouch.
There was a time when a part-time job, along with some summer job cash, could cover much of the cost of a college education. In 1988, the average annual tuition at a non-profit college was $15,160. So for about $60k, you could graduate with a degree from a decent university. Today, you are looking at $34,740 — at the very least. Many liberal arts colleges cost much more. With inflation, that price in 1988 should be $32,698 today.


Overview for Voltage Reference
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Additional feature capabilities such as low-Iq shutdown enable pin, noise-reduction/TRIM pin, and dual-output to achieve lower power consumption and higher precision.
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text:
Statement of the European Regional Office of WFTU about Leroy Merlin in Italy
The European Regional Office of WFTU express its support and solidarity with USB Italy and the struggles for the defense of workers employed in Leroy Merlin.
The large French multinational Leroy Merlin uses the method of outsourcing for the recruitment of employees in the warehouse of the logistic pole of Castel San Giovanni in the province of Piacenza in Italy by “cooperatives" companies operating as real intermediaries.
The cooperatives that provide manpower to Leroy Merlin do not guarantee the respect of the contract and the minimum rights -layoffs are daily and the replacement is very high, just workers try to raise the head - but they change continuously name and fiscal code to escape the labour inspectors in order to continue undisturbed to violate the rules governing wages, regular contributions, and the protection of health in plants.
The workers, the majority of them migrant workers, suffer the exploitation and subtracting of their wages and rights, while the companies make huge profits.
Behind the discounts and the low price of the goods displayed on the shelves of its shops hides the exploitation and slavery of thousands of workers who work day and night to ensure the handling and transport of the products.
Capital and multinationals are using anti-peoples policies to attack workers’ rights and to attack the workers movement.
We condemn these policies and we demand that multinationals such as Leroy Merlin to immediately stop any relationship with the system of cooperatives, hire their own employees, apply the contract of reference without discounts, they pay taxes and contributions in the countries that host them.
It is obvious that under these conditions the resistance of the working people and solidarity is the most decisive factor for the defense of workers’ rights against the multinational policies.

domain: sociology


Infrared instruments effective in troublshooting HVAC/R systems in summer heat
Mississauga, ON – With the summer heat upon us, HVAC/R systems should be tuned-up to run at maximum efficiency to avoid wasting energy, prevent system downtime, and reduce expensive emergency maintenance. An efficient way to start is to...
Mississauga, ON – With the summer heat upon us, HVAC/R systems should be tuned-up to run at maximum efficiency to avoid wasting energy, prevent system downtime, and reduce expensive emergency maintenance. An efficient way to start is to make a quick visual inspection of the system with a visual infrared (IR) thermometer to identify potential issues that need further investigation.
One such example is the Fluke VT02 Visual IR Thermometer, a troubleshooting camera with an infrared heat map, combines the convenience of a single-spot IR thermometer with the visual insight of an infrared camera. The thermal heat map quickly detects the exact location of potential problem areas and context on the findings.
Troubleshooting HVAC/R systems is much faster with this instrument than with using an infrared thermometer, as it instantly detects problems using a blended thermal heat map and digital images. It displays and saves images as full visual, full infrared, or in three blended modes (25%, 50%, and 75%). Markers pinpoint hot and cold spots, indicating the hottest temperature with a red box and the coldest with a blue box. A temperature reading is provided at the centre point. Images are saved to a micro-SD card, eliminating the need to write down single or multiple measurements.
The VT02 operates does not need to be focussed, expanding the user base from senior to junior technicians. Images can be imported into SmartView analysis and reporting software, included with the instrument, to produce professional reports that document problems detected or repairs made for management and customer review.
For more information about the Visual IR Thermometer, visit: www.fluke.com/VT02.


Abbott “Blocky” Lopez earned entry into the Madden Ultimate League as the lowest ranked of 16 competitors in Madden 18 Championship Series points. With a chip on his shoulder, he’s seemingly embraced the underdog narrative, a-la the Super Bowl LII champion Philadelphia Eagles.
“My record and stats show that I’ve been playing really well, so I’m someone to look out for,” Blocky said when asked what he’d say to anyone who might be underestimating his ability in this tournament.
From Underdog to No. 1 Seed
Rising to the challenge and lack of fanfare, Blocky finished the regular season as the No. 1 seed in the Elite Conference, with a 7-3 record and ranked top-five in total offense, passing offense, rush defense, and turnover differential.
“I had a close game against pretty much everybody during the season, whether I won or lost,” he said with confidence. “It definitely was grueling. Every game was a tough game, a close game,” he elaborated. “It really comes down to how you respond, whether you win or lose, how you’re able to go on to the next game."
Blocky’s season consisted of a series of win and loss streaks. Following a strong four-game win streak to start, he lost three straight, then won out his final three games.
“You start to get confidence, you start playing good and start rolling,” he said of the ups and downs. “If you lose a couple in a row, all of a sudden you start thinking about the playoffs and how many wins you need, and it can put a lot of pressure on you.”
The most pressure, perhaps, came during Blocky’s Elite Conference Divisional playoff victory in overtime against Michael “Skimbo” Skimbo this past weekend. The two competitors have brewed a bit of a rivalry over the last few months. Skimbo, one of the most recognizable names in the competitive Madden community, is the only competitor in history to have won two Madden Championship Series Major belts and is the reigning Madden 17 MCS champion.
The history between the two started when Blocky faced Skimbo in the Madden 18 Club Championship series at the end of January. Skimbo won rather easily by a score of 24-10, ending Blocky’s hopes of advancing to the final rounds of the tournament. But after the contest, Skimbo admitted that Blocky was no pushover, and that he put more into preparing for Blocky than he had for any other opponent. “I prepared for Blocky like I never prepared for anyone, ever. For three months, I focused on Blocky,” Skimbo told reporter Adrienne Lawrernce after the game. That’s some high praise for a competitor tagged with the underdog moniker.
Beating the Best
Blocky and Skimbo met again during the MUL regular season, and Skimbo won, but by a much closer, 13-9 margin. So, when Blocky defeated his adversary to advance to the MUL Conference Championship, it was a major mental hurdle cleared. “That was a very big win for me against Skimbo. Getting over that hump and showing I’m able to perform on the big stage and in the big game,” the 21-year-old said. It was so big that Blocky couldn’t help but show a bit of emotion near the end of the contest, something he’s not known to do.
“I don’t want to let my emotions run high and get away from my game plan. So, that’s really the main reason why I stay focused after big plays.” Seriously, the man almost never flinches while he’s got a controller in his hand. “Occasionally I’ll show some emotion, like when I know that’s probably the game, a really big game-changing play.” Smile Blocky, it won’t hurt.
Now, Blocky is preparing for his Elite Conference Championship game against Shay “Young Kiv” Kivlen Saturday, the winner advancing to the 2018 Madden Bowl. Young Kiv defeated Blocky 24-20 in their only regular season meeting. “Kiv only beat me by like three or four points, and it came down to the last play. It really came down to a couple plays, so I was all right with the loss. You gotta move forward.”
It’s no secret that Young Kiv scored more touchdowns than any other competitor during the regular season. But Blocky, staying true to form, hasn’t flinched yet. “I’m going to put in the work, I’m going to prepare, I’m going to put in a lot of time to get ready for Kiv. And when it comes to gameday, I’m gonna be ready.”
With a $500K prize pool, the Madden Ultimate League playoff atmosphere has a high level of intensity. But one thing that stood out to me when talking with Blocky is that for a 21-year-old, he has an extremely realistic and mature view of it all. “We’re all doing what we love to do. We all play Madden. We all like playing video games. We all like football. At the end of the day, we’re just playing a game.”
Video games are supposed to be fun. Isn’t that why we’re all here?
–Matt Franciscovich (Follow Matt on Twitter @MattFranchise)
What is Madden Ultimate Team (MUT) mode in Madden NFL 18? Dig in here for more information on how to build your own ultimate Madden lineup. Customize your MUT team and support your favorite Madden Ultimate League competitors with the Gameday Competitors Program.


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George Whitman, longtime owner of the beloved Shakespeare and Company, died in Paris last week.
Remy de la Mauviniere/STF/AP
Owner of legendary Parisian bookshop Shakespeare & Company George Whitman died last week in the apartment he owned above his Paris bookstore. Whitman was 98. His English-language bookstore has been open for almost 60 years and was a favorite of Allen Ginsberg, William S. Burroughs, and scores of others.
Whitman was born in America and spent his childhood in Salem, Mass., later attending Boston University. He settled in Paris after serving in World War II and started selling books soon after, calling his store Le Mistral, but the name was soon changed to Shakespeare & Company. There had been another famous bookstore in Paris with the name, opened by American ex-pat Sylvia Beach, but Beach’s store closed while the Nazis occupied Paris. There has been debate over how and why Whitman named his store Shakespeare & Company, but historian Clive Hart recently told The New York Times that he had witnessed Beach saying publicly that she was giving Whitman the name. Whitman named his daughter, who now runs the store, Sylvia Beach Whitman.


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Amway UK had released their earning statement on November 2nd.
Needless to say, it's beyond pathetic.
Out of 14,000 folks or so, we have:
1). about 10,000 earning an average 47 Euros (about 60 bucks) a month -- before expenses.
2). about 3,000 earning an average of 139 Euros a month -- before expenses.
3). 36 folks earning about 2000 (2076) Euros a month -- again, before expenses.
Even if all those 36 were really successful -- if it was all pure profit, not including time spent, fuel, inventory bought for "personal consumption", what have you -- that's a success rate of, er, about 0.3%. And that's using the best case scenario.
What an opportunity!

domain: economics


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Buckeye Union High School student's T-shirt sparks 'Black Lives Matter' walkout
Ten students walked out of class Monday morning at Buckeye Union High School, protesting after the school last week banned a sophomore girl from wearing a Black Lives Matter T-shirt.
"Stand up, fight back," the students said as they left the school.
Mariah Havard and nine others were greeted outside by representatives of several civil-rights organizations who spoke in support of the students' action.
Havard decided to make a statement last week by wearing the T-shirt for the school's picture day — school officials had told her she couldn't wear the shirt again, and a vice principal made her change into a white shirt, she said.
"We're not trying to start a race war. We're trying to end one," Buckeye student Genesis Santoyo, a friend of Havard, said. Santoyo has younger brothers, she said, and didn't want them to have to experience "such injustice."
Santoyo said she asked Havard for the shirt and also wore it to school.
The issues started Aug. 19, when 15-year-old Havard said she was confronted about the shirt by another student who told her, "Black lives don't matter," and "That shirt is meaningless."
Havard was caught off guard by the comments, she said, but responded with an explanation of what the shirt meant to her. According to Havard, the student reported their conversation to school officials, who then told Havard she would not be permitted to wear the shirt again.
But she wore the shirt again on picture day, anyway, to make a point, she said. A vice principal gave her a white shirt to wear instead, Havard said.
Later that week, on Friday, Havard was asked to take off her sweatshirt by a male administrator to check whether or not she was wearing the Black Lives Matter T-shirt underneath.
"This quasi strip search was in direct violation of the 4th Amendment of the Constitution of the United States. The statement, 'Black Lives Matter,' is only controversial if a person thinks black lives do not matter," according to a statement by Black Lives Matter Phoenix. "Havard and her classmates have the right to exercise free speech."
Havard posted a message on Facebook expressing her disappointment about what happened. She said she was shocked by the "racist" responses to the post online.
The students' parents also were there Monday to stand behind their children's actions.
Several expressed disappointment that their children were growing up in an environment similar to the one they had faced years ago.
Havard's mother, Roxanne Havard, embraced Mariah with a tight hug before sharing her thoughts.
"When they wear their shirts that say Black Lives Matter, they're just telling you that their lives matter, too," Roxanne Havard said.
"They have made death threats to the students here on Snapchat, Facebook, social media," Roxanne Havard said. "The students that have made these threats have not had any consequences."
Black Lives Matter Phoenix said in a statement that representatives had reached out Friday to discuss the situation with Buckeye Union Principal Tawn Argeris and Eric Godfrey, the Buckeye Union School District superintendent.
Godfrey released a statement Monday saying, "The district is working with staff, local leaders, and Black Lives Matter representatives to develop a plan to turn the incident involving the Black Lives Matter T-shirt from a negative situation into a positive learning experience. This is an excellent opportunity to teach tolerance, understanding, and acceptance for the diverse learners that make up BUHSD.
"This will be a process and not happen overnight. It will take the support of all involved and from the communities we serve. BUHSD is committed to the success of all students."
At the Monday protest, Iisha Graves, who is running for the District 13 seat in the state House of Representatives, said she was proud of the students for standing up for what they believed.
Black Lives Matter Phoenix, NAACP and ACLU representatives encouraged students to stand up for their rights and to carry themselves intelligently and in a non-violent manner.
Shortly after noon, the students returned to class.


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The Lotus is an exquisite flower that symbolizes purity, faithfulness and spiritual awakening. The flower lifts itself from the dirt and mud of its surrounding and rises above the surface to bloom with remarkable beauty.
The back of each Lotus flower is adorned with a single dragonfly symbolizing change and change in the perspective of self realization. The Lotus Flower charms are approximately 1/2 inch (1.3 cm) in size.
The earrings dangle approximately 1 1/2 inch (3.8 cm) from the ear on sterling silver ear wires.
The handcrafted Lotus flower charms that are dangling from these earrings are created using Precious Metal Clay fine silver. Fine silver consists of a minimum of 999 silver; considered to be pure silver.
Currently I have the number of pieces of this item listed in the quantity section available for immediate shipment. If you would like to order additional pieces of this item, just let me know and I will create a custom order for you.
If you would like a matching Lotus Flower Necklace, click on the link listed below to find one in the shop.
Free US shipping, discounted International shipping and Stacie gift box included.
For quantity discounts and wholesale pricing, please see the shop announcement or policies.
To find out more information about Stacie Jewelry, visit my website at www.staciejewelry.net


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Frisco Holiday Poinsetta Plush Squeaky Dog Toy, 3 pack
Frequently Bought Together
About This Item
- Flower set includes squeakers to amp up the day’s activities.
- Comes with three holiday flower plush toys.
- Each toy has plush stuffing for long-lasting play sessions.
- The perfectly sized toy for x-small and small size dog breeds.
- Crinkle paper is included to add an extra oomph of fun.
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Compare Similar Items
|Toy Feature||Squeaky, Crinkle||Squeaky, Crinkle, Stuffing-Free||Squeaky||Squeaky, Crinkle||Squeaky, Crinkle|
|Material||Polyester, Synthetic Fabric||Polyester, Synthetic Fabric||Polyester, Synthetic Fabric||Polyester, Synthetic Fabric||Polyester, Synthetic Fabric|
|Breed Size||Extra Small Breeds, Small Breeds||Small Breeds, Medium Breeds, Large Breeds||Small Breeds, Medium Breeds||Extra Small Breeds||Medium Breeds|
|Toy Type||Plush Toys||Plush Toys||Plush Toys||Plush Toys||Plush Toys|
Questions & Answers
ReviewsWrite a Review
2 Customer Reviews
Love these toys!
These are the best toys. It crinkles and has two squeakers in each toy. Not that big on chewing so these should last a while.
Wonderful for Bella
I love the two squeaker and she is not chewing them up. She plays with them all the time, when she does not get a squeaker to chew.

domain: pet


Two time WWE hall of famer and six time World Heavyweight Champion Booker T Huffman opened up about his memories from the show Charmed with Tyler Treese of ComingSoon.net. During his conversation, Booker T mentioned one actress who was quite charmed by his skills.
Booker T discussed his legendary wrestling career, acting appearances and the Vegas debut of his Reality of Wrestling promotion. He also went into what Alyssa Milano told him about his acting ability.
“I remember what she told me after we finished shooting. Alyssa Milano told me, ‘You really have great timing, and you could do this if you wanted to.’ And I was so taken aback by that. I was like, wow, man, someone like Alyssa Milano is telling me I could act if I really put myself into it. You know, if I really threw myself into it. So I was like, wow, for her to give me that little bit of nudge of courage, man. It was really, really awesome. That’s what I remember most about that whole thing.”
Alyssa Milano has always been a fan favorite from the show Charmed in addition to being a passionate activist and book author. Milano was recently arrested during a voting rights protest outside the White House. The Sorry not Sorry author also met with an accident earlier this year.
The Episode that Booker T appeared on was titled “Wrestling with Demons” and was the twelfth episode of the third season of Charmed. In the episode, Booker T played a wrestler named “Thunder”.
Do you think Booker T should take more acting roles? What is your favorite Episode from Charmed? Let us know in the comments below.


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It was so cool to take in such a huge amount of Japanese culture on my recent trip to Japan. You may have read a number of my recent posts regarding the trip, what we ate, what we saw and where we travelled to. But this was another highlight, especially being able to view such a stunning piece of Japanese architecture when we visited Kinkaku-Ji, the Buddhist Temple of the Golden Pavilion in Kyoto. The top two tiers are coated in gold leaf, and against the greenery and natural environment, it was a fantastic building to spot. We walked around the beautiful gardens there before heading over to Nijo Castle to see yet more beautiful gardens, and the former home of the Tokugawa Shoguns. For anyone heading to Kyoto, both of these trips should be on your ‘to-do’ list!
Following the stunning heritage-site sightseeing, we made our way over to the Gion District, to keep our eyes peeled and cameras ready to spot the beautifully decorated Geisha ladies. Whilst I did spot a young, and training Geiko, we were too early to see any of the full-time Geisha’s which was a slight disappoint, yet apparently its best to spot them between 5-6pm, when they head out for dinner. This makes it sound as though they are some sort of bird of prey, or nocturnal animal that only comes out at night, yet their makeup and embellishments is an amazing sight to see, and I was all for capturing Japanese culture. But alas, we lucked out, but you might be more lucky!
And, if you want to visit Japan as I did, then have a look at the Contiki Japan Unrivalled trip right here. You won’t regret it. I would highly recommend this trip to anyone who needs to tick Japan off of their Bucket List. You’ll see everything you’d hope to see!
Anyone lusting over a Japan trip? Have a watch of my vlog right below!
Some of these items may have been sent to me for review. Please see my disclaimer for more information


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TOWIE is back with a bunch of new cast members but fans have already branded them ‘kids’.
Everyone’s favourite Essex reality TV show is back on our screens tonight (Sunday) and viewers have been treated to their first look at the fresh cast.
But it seems some fans aren’t too impressed as they’ve already dubbed the newcomers ‘kids’.
Most of the core TOWIE cast are in their mid to late 20s but many of the new cast appear much younger.
Becca tweeted: “Sorry but these new boys are like high school kids”, while viewer Danielle said: “Why are there kids on TOWIE?”
Fan Tanya posted: “Omg can’t even deal with some of @OnlyWayIsEssex Newbies, a load of kids. Bring back the older cast.”
Another viewer Sarah commented: “Who bought the kids in?’ while Mike quipped: “Think it’s time for TOWIE to end now like, these new members are actually kids.”
One fan called Lioness asked: "Is this now CBeebies?" and JH joked: "Towie has turned into sleepover club, these kids look like they should still be in school."
The criticism continued with Rebecca asking: "Didn't realise Towie was recruiting kids" and Emily predicting: "All these underage kids aren't gonna last long on #TOWIE."
Another added: "Did Towie do auditions at the local senior school, bare kids looking like they're getting prepped for prom."
Lucy said: "Can somebody please tell me what has happened to #TOWIE it's horrendous. Why are there kids on there?"
Sarah asked: "Who brought the kids in?" while Georgina didn't mince her words and simply said: "Get those kids off of Towie."
Even some celebrities joined in with the teasing with reality TV star Charlote Crosby tweeting: "Why is the whole new cast of Towie 16 years old? Where did the producers hold the auditions? Essex College."
Former Towie star Mario Falcone added: "The Towie producers forget the majority of people that watch have watched from the start. They have been on this journey with the cast, related to our experiences, felt the lows, enjoyed the highs and grown up with us. New kids aren’t relatable. Should’ve started a new show."
The raft of new cast mates comes as TOWIE producers axed eight stars from the last series. The eight axed members are Myles Barnett, Kady McDermott, Chloe Lewis, Chris and Jon Clark, Dean Ralph, Jordan Wright and Adam Oukhellou.
To fill that gap, they’ve recruited at least eight new Essex cast members - Chloe Brockett, Chloe Ross, Ella Rae Wise, Kelsey Stratford, Joey Turner, Jayden Beales, Harry Lee and Tom McDonell.
So far, the new boys have been seen larking about in a changing room, teasing each other about who waxes their bums and what kind of girls they go for.
TOWIE Facebook group
Want all the TOWIE gossip? Follow our Facebook group here.
Make sure you stay up-to-date with all the latest news and secrets from TOWIE - the original and the best reality TV show.
We’ll bring you the stories as they happen, interviews and loads of exclusive photos from the filming locations around Essex. Don’t miss out.
Their future storylines remain to be seen.
TOWIE is back on ITVBe at 9pm each Sunday.
To receive one WhatsApp message a day with the main headlines, as well as breaking news alerts, text NEWS to 07557 893797. Then add the number to your phone contacts book as 'Essex Live'.
Your phone number won't be shared with other members of the group.


PVC waterstops are designed to provide an integral sealing system for movement and construction joints in cast in-situ concrete.
With over 120 years of experience and a highly trained team, we can provide you with the best possible guidance on choosing the right PVC waterstops.
PVC Waterstop is a bulb profile of varying lengths extruded from high-quality PVC that eliminates water from travelling through a cast-in concrete joint.
PVC waterstops require more planning than swellable waterstops as they are integral waterstops. They are placed into the body of both faces of the concrete joint and need to be placed before any concrete is poured.
PVC waterstops can be used in both construction and movement joints depending of the profile selected.
No, they are not, as they do not rely on swellable that can be affected by environmental conditions. There are also PVC waterstops manufactured from chemically resistant materials that can be used in highly aggressive environments.


Brunette postponed the registration of applicants for majority deputation and proportional representation until January 5, the date on which the term will begin and not from tomorrow as planned in the call presented on December 23.
The National Elections Commission endorsed the modification of the dates, which would start from this MondayHowever, it postponed the start of the registry for a week due to the evolution of the health emergency due to covid-19, as well as so that applicants have “a longer period for planning their arrival in Mexico City (headquarters of the registries) and gather the documents that allow them to register properly ”.
Through an official letter signed by Mario Delgado and Citlalli Hernández, it was reported that the adjustment of the dates “will allow the proper development of the internal process stages in a spaced and orderly manner, respecting the legal deadlines for their relief, in order to comply with the applicable regulations and protect the political rights of the militancy as well as the health of the participants themselves, collaborators and, in general, people involved in the process”.
With this modification, applicants with a relative majority must register between January 5 and 9, while those with proportional representation They must do it from January 12 to 16 at Deportivo Reynosa, located in the Azcapotzalco mayor’s office.
On December 23, Morena published the call for the registration of its applicants. Those deputies seeking re-election may do so, as long as in their districts are the best positioned, which will be measured by surveys. In the case of the multi-member list, Morena will repeat the raffle method to select them.


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If you’re looking to help yourself or someone you love struggling with substance abuse in Cairo, IL, Rehabs.com offers access to comprehensive online database of luxury centers, as well as a wealth of other choices. We can help you in locating drug and alcohol abuse care programs for a variety of addictions. Search for a top rated rehabilitation center in Cairo now, and take the first step on the path to healthy living.
This place was perfect. It was beautiful also with a gorgeous Japanese garden to help them find peace. The staff was amazing. They held family weekends for learning about rehab.
Quick intake and good coordination of care, 12 step approach, good coordination of care. Does not take a holistic approach.
Take insurance and self pay. Don't take medicaid. Not state funded. Compassionate staff. Look at what's best for the patient's safety and care. Staff love what they do. Do what they can to help people move past their addiction and provide them with the tools and support.

domain: health


The new MOD 1100/2000t spreader beam, the latest addition to Modulift’s modular range of DNV type approved spreader beams, has been used in its very first lift in Dover in the UK.
The successful first lift was carried out by new owner Safe Lifting Europe for its customer Bonn & Mees Floating Cranes.
The new spreader beam has a 33 metre span. “Part of the project to supply this ‘beast’ of a beam, required Modulift’s compressive test bed to be extended to 33 metres and increased in capacity to 2300t which was quite a project in itself,” said John Baker, commercial director for Modulift.
The spreader beam was transported using two trucks from Safe Lifting Europe’s yard to Bonn & Mees Floating Cranes in Rotterdam. Bonn & Mees Floating Cranes then used two of its largest floating sheerlegs to lift and store the spreader beam before it was shipped to Dover to lift two parts of a bridge.
As part of the lifting configuration, two additional Modulift MOD 400 spreader beams had to be used. The assembly of the MOD 1100/2000 took the team at Safe Lifting Europe one full working day using an electric torque wrench, enabling them to work at a much faster pace.
“It was incredible to see the new MOD 1100/2000t spreader beam up in the air for the first time,” said Giovani Vroegop, technical commercial manager for Safe Lifting Europe.
“The sheer size of the beam can only be really appreciated when you’re up close. It really is huge,” he said.


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A nice park overlooking Lake Brophy and North Union Lake. The park has a fully accessible playground. a fire pit, dock, overlook benches, primitive trails for hiking & mountain biking, public beach and direct access to the Central Lakes Trail. In the winter, enjoy a groomed sledding hill, fat tire biking and cross country ski trails.
1900 Brophy Park Rd NW, Alexandria, MN

domain: geography


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A heartwarming Herefordshire marquee wedding was one of the first of our 2018 wedding season, and the first at Flanesford Priory. 2018 will be our second season looking after exclusive weddings at Flanesford Priory. Our beautiful marquee is nestled within the grounds of the ancient buildings. Flanesford sits just beneath Goodrich Castle and a stones throw from the River Wye.
What better way to kickstart this year’s season that with this absolute beauty. Firstly, fabulous striking colour from the simple use of richly coloured table clothes. This reflects popular dark colour choices seen in interior design. This is a trend we believe we’re going to see more of for 2019. Dark blazer blue table clothes were used on the long top table and round tables in the marquee. Therefore the ivory roof and wall linings provided the perfect blank canvas for the colour on the table.
Herefordshire Marquee Wedding
Decoration on the table was simple and stylish. Silver candelabra and cut glass candle holders added a vintage touch to the table settings. Just white flowers and green foliage was used in arrangements. Our black and white dancefloor looked stunning in the marquee, and helped set off the art deco styling the bride and groom and chosen. Finally, the couple also chose some fabulous peacock detail napkins, which tied all the theming together.
We’ve got plenty more Herefordshire marquee wedding at Flanesford Priory to come. Please keep your eyes peeled on our Instagram account to see all the fabulous images we’ll be capturing. What a fabulous Summer season it’s turning out to be.
Finally, for more wedding inspiration have a look at our wonderfully varied galleries. And of course of you’d like to get in touch, just give is a ring in the office or complete our enquiry form. Tell us a bit about your event and we can create a bespoke marquee just for you.