Information Sources in Relation to Information Quality, Information-seeking, and Uncertainty in the Context of Healthcare Reform

This exploratory study examines information-seeking about the 2010 Patient Protection and Affordable Care Act (i.e. healthcare reform) in relation to the potential barriers of uncertainty,uncertainty discrepancy, and low health self-efficacy. Adult United States participants completed an anonymous online survey about their perceptions and understanding of healthcare reform. Results confirmed recent literature, suggesting a complex relationship between information-seeking and uncertainty. Specifically, for this sample, significant positive relationships were observed between information-seeking about healthcare reform and uncertainty, uncertainty discrepancy, health self-efficacy. Further, uncertainty discrepancy was the potential barrier that accounted for the most variance in predicting information-seeking.Implications of these findings for improving public understanding of healthcare reform are discussed.https://digitalcommons.chapman.edu/communication_books/1011/thumbnail.jp

“Some Days Are Much Holier Than Others”: Relational Uncertainty and Partner Influence in Christian Dating Couples\u27 Sexual Intimacy Negotiation

When intrafaith couples\u27 religion strictly prohibits premarital sexual intercourse, negotiating sexual intimacy can become a multilayered process of identity negotiation that compounds the difficulty of sexual communication. Through the lens of relational turbulence theory, this study explored how devout Christian couples negotiate sexual intimacy by reanalyzing qualitative interview data the first author collected in 2017 from 16 self-identified Christians (8 heterosexual couples). Seven themes revealed how relational uncertainty, partner interference, and partner facilitation manifested in the context of sexual intimacy negotiation. Themes of relational uncertainty experience and prevention included assumption of shared values, relationship talk, and sexual behaviors as an uncertainty catalyst. Partner facilitation and interference emerged as themes of sexual escalation and de-escalation including snowball effect, pinpointing underlying motivations for boundary violations, gatekeeping sexual temptation, and drawing from shared values of sacrifice and prayer. These interpretive findings advance the literature on relational turbulence theory and provide Christian dating couples with practical advice for how to negotiate sexual intimacy in committed premarital relationships

Introduction to the Special Issue: Relationships in the Time of COVID-19

This introduction describes the background for the special issue entitled “Relationships in the Time of COVID-19: Examining the Effects of the Global Pandemic on Personal Relationships.” It also examines reasons for conducting interdisciplinary research on COVID-19 and personal relationships, and previews first articles published in the special issue

Romantic Partner Interference and Psychological Reactance in the Context of Caregiving for an Aging Family Member

Negotiating romantic relational dynamics is inherent to family caregiving situations, which continue to be on the rise in the United States. However, despite evidence that family caregiving duties are linked to a variety of negative relational outcomes, limited research examines communication processes that contribute to or alleviate the burden of caregiver duties on romantic relationships. Guided by psychological reactance theory (PRT), this study examined the link between romantic partner interference with family caregiving duties and the reactance process, as well as directness of communication about irritation as a type of freedom restoration behavior associated with reactance. Adults caring for aging family members recruited from MTurk (N = 187) completed an online survey as part of a larger study of romantic partner communication surrounding family caregiving. Results using PROCESS serial mediation indicated that greater partner interference was related to heightened perceptions of freedom threat, which was positively associated with the experience of reactance, which in turn was associated with communication about irritation. However, the association between reactance and directness of communication about irritation was negative, the opposite direction of what was hypothesized. Implications for PRT and interventions with caregivers and their romantic partners are discussed

Disclosures about important life events on Facebook: Relationship with stress and quality of life

a b s t r a c t The current study examined the relationship between general perceived levels of stress, quality of life, social networking usage, and disclosing important life events on Facebook in order to better understand the complex relationship between online disclosure and individual well-being. An online survey was completed by adult Facebook users aged 18-70. Results indicate that the more time spent on and the more social network memberships, the higher stress and lower quality of life; Facebook-specific usage was unrelated to either well-being variable. Together, these findings suggest that the current increase in social media variety and usage may be detrimental to user well-being. Users who shared important, bad health news on Facebook had higher stress and lower quality of life than those who did not, with no significant differences for sharing good health news. The more that users did not share important news on Facebook for self-protection and friend unresponsiveness reasons, the greater their stress. The self-protection reason was also negatively related to quality of life. These inconsistent findings can likely be partially explained by the nature of the information that is shared. These findings are discussed in light of disclosure and relationship patterns on social networks

Silent progression in disease activity-free relapsing multiple sclerosis.

ObjectiveRates of worsening and evolution to secondary progressive multiple sclerosis (MS) may be substantially lower in actively treated patients compared to natural history studies from the pretreatment era. Nonetheless, in our recently reported prospective cohort, more than half of patients with relapsing MS accumulated significant new disability by the 10th year of follow-up. Notably, "no evidence of disease activity" at 2 years did not predict long-term stability. Here, we determined to what extent clinical relapses and radiographic evidence of disease activity contribute to long-term disability accumulation.MethodsDisability progression was defined as an increase in Expanded Disability Status Scale (EDSS) of 1.5, 1.0, or 0.5 (or greater) from baseline EDSS = 0, 1.0-5.0, and 5.5 or higher, respectively, assessed from baseline to year 5 (±1 year) and sustained to year 10 (±1 year). Longitudinal analysis of relative brain volume loss used a linear mixed model with sex, age, disease duration, and HLA-DRB1*15:01 as covariates.ResultsRelapses were associated with a transient increase in disability over 1-year intervals (p = 0.012) but not with confirmed disability progression (p = 0.551). Relative brain volume declined at a greater rate among individuals with disability progression compared to those who remained stable (p < 0.05).InterpretationLong-term worsening is common in relapsing MS patients, is largely independent of relapse activity, and is associated with accelerated brain atrophy. We propose the term silent progression to describe the insidious disability that accrues in many patients who satisfy traditional criteria for relapsing-remitting MS. Ann Neurol 2019;85:653-666

Meta-analysis of genome-wide association studies from the CHARGE consortium identifies common variants associated with carotid intima media thickness and plaque

Carotid intima media thickness (cIMT) and plaque determined by ultrasonography are established measures of subclinical atherosclerosis that each predicts future cardiovascular disease events. We conducted a meta-analysis of genome-wide association data in 31,211 participants of European ancestry from nine large studies in the setting of the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium. We then sought additional evidence to support our findings among 11,273 individuals using data from seven additional studies. In the combined meta-analysis, we identified three genomic regions associated with common carotid intima media thickness and two different regions associated with the presence of carotid plaque (P < 5 × 10 -8). The associated SNPs mapped in or near genes related to cellular signaling, lipid metabolism and blood pressure homeostasis, and two of the regions were associated with coronary artery disease (P < 0.006) in the Coronary Artery Disease Genome-Wide Replication and Meta-Analysis (CARDIoGRAM) consortium. Our findings may provide new insight into pathways leading to subclinical atherosclerosis and subsequent cardiovascular events

Common coding variant in SERPINA1 increases the risk for large artery stroke

Large artery atherosclerotic stroke (LAS) shows substantial heritability not explained by previous genome-wide association studies. Here, we explore the role of coding variation in LAS by analyzing variants on the HumanExome BeadChip in a total of 3,127 cases and 9,778 controls from Europe, Australia, and South Asia. We report on a nonsynonymous single-nucleotide variant in serpin family A member 1 (SERPINA1) encoding alpha-1 antitrypsin [AAT; p.V213A; P = 5.99E-9, odds ratio (OR) = 1.22] and confirm histone deacetylase 9 (HDAC9) as a major risk gene for LAS with an association in the 3?-UTR (rs2023938; P = 7.76E-7, OR = 1.28). Using quantitative microscale thermophoresis, we show that M1 (A213) exhibits an almost twofold lower dissociation constant with its primary target human neutrophil elastase (NE) in lipoprotein-containing plasma, but not in lipid-free plasma. Hydrogen/deuterium exchange combined with mass spectrometry further revealed a significant difference in the global flexibility of the two variants. The observed stronger interaction with lipoproteins in plasma and reduced global flexibility of the Val-213 variant most likely improve its local availability and reduce the extent of proteolytic inactivation by other proteases in atherosclerotic plaques. Our results indicate that the interplay between AAT, NE, and lipoprotein particles is modulated by the gate region around position 213 in AAT, far away from the unaltered reactive center loop (357-360). Collectively, our findings point to a functionally relevant balance between lipoproteins, proteases, and AAT in atherosclerosis

Spinal Cord Atrophy Predicts Progressive Disease in Relapsing Multiple Sclerosis

Objective A major challenge in multiple sclerosis (MS) research is the understanding of silent progression and Progressive MS. Using a novel method to accurately capture upper cervical cord area from legacy brain MRI scans we aimed to study the role of spinal cord and brain atrophy for silent progression and conversion to secondary progressive disease (SPMS). Methods From a single-center observational study, all RRMS (n = 360) and SPMS (n = 47) patients and 80 matched controls were evaluated. RRMS patient subsets who converted to SPMS (n = 54) or silently progressed (n = 159), respectively, during the 12-year observation period were compared to clinically matched RRMS patients remaining RRMS (n = 54) or stable (n = 147), respectively. From brain MRI, we assessed the value of brain and spinal cord measures to predict silent progression and SPMS conversion. Results Patients who developed SPMS showed faster cord atrophy rates (-2.19%/yr) at least 4 years before conversion compared to their RRMS matches (-0.88%/yr, p &lt; 0.001). Spinal cord atrophy rates decelerated after conversion (-1.63%/yr, p = 0.010) towards those of SPMS patients from study entry (-1.04%). Each 1% faster spinal cord atrophy rate was associated with 69% (p &lt; 0.0001) and 53% (p &lt; 0.0001) shorter time to silent progression and SPMS conversion, respectively. Interpretation Silent progression and conversion to secondary progressive disease are predominantly related to cervical cord atrophy. This atrophy is often present from the earliest disease stages and predicts the speed of silent progression and conversion to Progressive MS. Diagnosis of SPMS is rather a late recognition of this neurodegenerative process than a distinct disease phase. ANN NEUROL 202