Heterogeneity, State Dependence and Health

This paper investigates the evolution of health over the life-cycle using the Panel Study of Income Dynamics. We allow for two sources of persistence: unobserved heterogeneity and state dependence. The former is modeled by discrete “types.” Estimation indicates that there are at least four types suggesting that there is a large degree of heterogeneity governing health dynamics. We find that the degree of state dependence is near unity for over half of the population. The implications of these findings are twofold. First, health inequalities in adulthood have antecedents in childhood. Second, policies that improve health care and its delivery may be an effective means of mitigating the gradient.Health, Dynamic Panel Data Models, Gradient

Cognitive Behavioral Therapy for Veterans Experiencing Insomnia: A Systematic Review

In this systematic literature review, research regarding veterans experiencing insomnia and the utilization of Cognitive Behavioral Therapy for Insomnia as an effective treatment modality were synthesized. Using the sociology research database SocINDEX; nine studies examining the effectiveness of Cognitive Behavioral Therapy as a treatment option for insomnia and insomnia related symptoms met criteria for the review. The Behavioral Model of Insomnia was used as the conceptual framework for this review. This framework was utilized to explore Cognitive Behavioral Therapy as an effective means of treating veterans experiencing insomnia. Studies included in this systematic review produced these findings: improvements in sleep quality, sleep efficiency, sleep onset latency, total sleep time, a reduction in depressive and insomnia symptoms, increased normalization of sleep, and a reduction in dysfunctional beliefs about sleep. This study contributes to the growing body of literature supporting Cognitive Behavioral Therapy for Insomnia as an evidenced based treatment option for veterans experiencing insomnia through a dissemination of the findings, strengths, limitations, and implications for future research

Cognitive Behavioral Therapy for Veterans Experiencing Insomnia: A Systematic Review

In this systematic literature review, research regarding veterans experiencing insomnia and the utilization of Cognitive Behavioral Therapy for Insomnia as an effective treatment modality were synthesized. Using the sociology research database SocINDEX; nine studies examining the effectiveness of Cognitive Behavioral Therapy as a treatment option for insomnia and insomnia related symptoms met criteria for the review. The Behavioral Model of Insomnia was used as the conceptual framework for this review. This framework was utilized to explore Cognitive Behavioral Therapy as an effective means of treating veterans experiencing insomnia. Studies included in this systematic review produced these findings: improvements in sleep quality, sleep efficiency, sleep onset latency, total sleep time, a reduction in depressive and insomnia symptoms, increased normalization of sleep, and a reduction in dysfunctional beliefs about sleep. This study contributes to the growing body of literature supporting Cognitive Behavioral Therapy for Insomnia as an evidenced based treatment option for veterans experiencing insomnia through a dissemination of the findings, strengths, limitations, and implications for future research

Exploring the links between HIV/AIDS, social capital, and development

This paper attempts to quantify the impact of the HIV/AIDS epidemic on social capital with cross-country data. Using data from the World Values Survey, the authors estimate reduced-form regressions of the main determinants of social capital controlling for HIV prevalence, institutional quality, social distance, and economic indicators. The results obtained indicate that HIV prevalence affects social capital negatively. The empirical estimates suggest that a one standard deviation increase in HIV prevalence will lead to a decline of at least 1 percent in trust, controlling for other determinants of social capital. Moving from a country with a relatively low level of HIV prevalence, such as Estonia, to a country with a relatively high level, such as Uganda, there is a more than 11 percentpoint decline in social capital. These results are robust in a number of dimensions and highlight the empirical importance of an additional mechanism through which HIV/AIDS hinders the development process.Population Policies,Social Capital,HIV AIDS,Disease Control&Prevention,Inequality

Stress reactivity in individuals with Non-REM Parasomnias, insomnia and good sleep

To date, there is little research into either stress reactivity or the specificity of psychological characteristics in particular forms of sleep disorder. NREM parasomnias are a relatively un-studied group of sleep disorders. The purpose of this study was to gain greater insight into how people with NREM parasomnias respond to ‘threat’ and to life situations. In particular, the aim was to investigate how their responses to a psychological stressor compared to individuals with insomnia and to good sleepers by measuring autonomic arousal, as well as subjective appraisals of stress. Baseline levels of autonomic arousal were intended to provide insight into daytime arousal levels at the trait level. Participants (N = 38) were recruited from the general population and attended the University of Glasgow Sleep Centre to take part. Autonomic arousal was measured via continuous electrocardiogram (ECG) recordings of heart rate (HR) and cardiac vagal tone (CVT) whilst participants took part in baseline, stressor (a difficult mathematical task) and recovery phases. In general, group differences were not found, however this may be partly due to the small sample size and corresponding lack of power to detect differences. The results indicated that the NREM group reacted to stress in a similar way to good sleepers. In general, it was the insomnia group but not the NREM group whose data differed from good sleepers. However, both the NREM parasomnia and Insomnia groups exhibited a relatively higher (though not statistically significant) resting baseline HR compared to the good sleeper group, suggesting a higher level of underlying sympathetic arousal. The findings of this type of study have potentially important implications for the development of treatment programmes for NREM parasomnias. However, further work needs to be done before any conclusions can be drawn. The study was intended as an exploratory study and the preliminary findings indicate that further exploration is warranted

Internet searches for medical symptoms before seeking information on 12-step addiction treatment programs: A web-search log analysis

© 2019 George Nitzburg, Ingmar Weber, Elad Yom-Tov. Background: Brief intervention is a critical method for identifying patients with problematic substance use in primary care settings and for motivating them to consider treatment options. However, despite considerable evidence of delay discounting in patients with substance use disorders, most brief advice by physicians focuses on the long-term negative medical consequences, which may not be the best way to motivate patients to seek treatment information. Objective: Identification of the specific symptoms that most motivate individuals to seek treatment information may offer insights for further improving brief interventions. To this end, we used anonymized internet search engine data to investigate which medical conditions and symptoms preceded searches for 12-step meeting locators and general 12-step information. Methods: We extracted all queries made by people in the United States on the Bing search engine from November 2016 to July 2017. These queries were filtered for those who mentioned seeking Alcoholics Anonymous (AA) or Narcotics Anonymous (NA); in addition, queries that contained a medical symptom or condition or a synonym thereof were analyzed. We identified medical symptoms and conditions that predicted searches for seeking treatment at different time lags. Specifically, symptom queries were first determined to be significantly predictive of subsequent 12-step queries if the probability of querying a medical symptom by those who later sought information about the 12-step program exceeded the probability of that same query being made by a comparison group of all other Bing users in the United States. Second, we examined symptom queries preceding queries on the 12-step program at time lags of 0-7 days, 7-14 days, and 14-30 days, where the probability of asking about a medical symptom was greater in the 30-day time window preceding 12-step program information-seeking as compared to all previous times that the symptom was queried. Results: In our sample of 11,784 persons, we found 10 medical symptoms that predicted AA information seeking and 9 symptoms that predicted NA information seeking. Of these symptoms, a substantial number could be categorized as nonsevere in nature. Moreover, when medical symptom persistence was examined across a 1-month time period, a substantial number of nonsevere, yet persistent, symptoms were identified. Conclusions: Our results suggest that many common or nonsevere medical symptoms and conditions motivate subsequent interest in AA and NA programs. In addition to highlighting severe long-term consequences, brief interventions could be restructured to highlight how increasing substance misuse can worsen discomfort from common medical symptoms in the short term, as well as how these worsening symptoms could exacerbate social embarrassment or decrease physical attractiveness

EXAMINING A HIGH-IMPACT, FIRST-SEMESTER SEMINAR CLASS ON ONLINE UNDERGRADUATE STUDENT SELF-REGULATION, SELF-DIRECTION, ONLINE LEARNING SELF-EFFICACY, AND PERSISTENCE

EXAMINING A HIGH-IMPACT, FIRST-SEMESTER SEMINAR CLASS ON ONLINE UNDERGRADUATE STUDENT SELF-REGULATION, SELF-DIRECTION, ONLINE LEARNING SELF-EFFICACY, AND PERSISTENC

Sleep across the psychosis continuum and its relationship to paranoid thinking

Background: The present thesis sought to explore the relationship between sleep and paranoia, and investigate what factors mediate this relationship. The research was conducted at different levels, and in different groups including healthy members of the general population, people with a diagnosis of psychosis and clinicians. Method: in chapter 3, a cross-sectional study was conducted online to examine the relationships between sleep and paranoia in a non-clinical sample. Following this, chapter 4 outlines a systematic review that aimed to further understand how sleep has been investigated in clinical samples of people with psychosis. Next, chapter 5 examined the relationship between sleep disturbance and paranoia in a clinical sample using novel experience sampling methodologies. Finally, chapter 6 explored clinician perceptions of sleep problems in people with psychosis. Results: chapter 3 found evidence for a mediation model whereby sleep predicted paranoia, and this relationship was mediated by negative emotions, alexithymia and perceptual anomalies. Chapter 4 revealed that there is a range of methodologies used to assess and measure sleep and identified areas of bias. Chapter 5 found no relationship between sleep and paranoia in a clinical sample of people with psychosis. Finally, chapter 6 found that clinicians are fully aware of the range and types of sleep problems in people with psychosis but lack the training and skills to treat sleep problems. Discussion: Overall, the relationship between sleep and paranoia is inconsistent. Sleep disturbances are common and should be treated in people with psychosis. More work is required to develop effective intervention strategies to address the range and type of sleep disturbances found in people with psychosis

Herpes zoster risk and vaccination in inflammatory bowel disease patients

Patients with inflammatory bowel disease, particularly those on systemic immunosuppression, have been shown to be at increased risk of herpes zoster infection. Herpes zoster (also known as shingles) is a condition resulting from reactivation of varicella zoster virus (VZV), which causes chickenpox. VZV reactivation is thought to be due to impairment of cell-mediated immunity. Some immunosuppressive agents have been shown to be associated with higher risk for herpes zoster reactivation than others. Until recently, the only vaccine for herpes zoster was a live-attenuated vaccine, which is contraindicated in most immunosuppressed IBD patients due to their immunosuppressive therapy. Recently, an inactivated subunit vaccine has been developed and investigated for use in immunocompetent adults, as well as select groups of immunocompromised individuals. This novel vaccine has not yet been studied in IBD patients but holds promise for use in this population. The proposed study is a single-center prospective pilot study comparing immunogenicity and safety of the inactivated herpes zoster vaccine in patients with IBD (ulcerative colitis or Crohn’s disease) treated with high-level combination immunosuppression (both anti-TNF biologics and immunomodulators) to those not on systemic immunosuppressive therapy (5-aminosalicylates or no treatment). Investigators will compare cell-mediated responses between groups using an intracellular cytokine staining assay with flow cytometry assessed prior to vaccination and at four time points up to 12 months after completion of the immunization sequence. Adverse effects will also be monitored. This study will help to identify whether the novel herpes zoster vaccine is immunogenic and safe for use in IBD patients and whether these parameters are significantly impacted by intensity of immunosuppressive treatment. An additional goal is to provide preliminary data with which to develop future studies of vaccine immunogenicity and efficacy in this target population