The Responsiveness of Migration to Labor Market Conditions

This dissertation explores how migration responds to economic conditions, particularly differences in responsiveness for various segments of the population. After a brief introduction and motivation of my work in Chapter One, Chapter Two estimates the responsiveness of households’ interstate migration to origin state labor market conditions and surrounding state labor market conditions. Each percentage point increase in origin state unemployment insurance claims leads to a 3.2 percent increase in household’s propensity to migrate interstate and each percentage point increase in the unemployment insurance claims rate of surrounding states reduces interstate migration propensity by 5.2 percent. I then examine how this responsiveness varies by demographics and how it has changed over time. I determine that the responsiveness of migration to labor market conditions is weaker for several groups at high poverty risk, including less educated, non-employed and rural households and households with children present. I also show that between the early 1980s and mid 1990s labor market conditions became a smaller factor in household migration decisions, but since then labor market conditions have gained in importance. While Chapter Two examines short-run migration responsiveness, Chapter Three explores the size of the long-run outflow (or inflow) of skilled labor occurring in local areas in response to economic conditions, amenities and other area characteristics. I estimate the extent of this brain gain and brain drain within localities in the United States between the early 1990s and late 2000s, describing both absolute changes (percentage growth in the stock of educated individuals) and relative changes (growth in the share of educated individuals). For each of three measures of brain gain estimated, I show substantially more positive flows of educated individuals towards local areas with strong initial economic conditions. I also show that non-metropolitan areas are more likely to experience all three measures of brain drain. I present evidence that nonmetropolitan areas’ inability to attract and retain educated individuals stems primarily from labor market disparities including the urban-rural wage differential

Using Information to Manage Uncertainty During Organ Transplantation

People living with a chronic illness can experience uncertainty about their physical conditions, identities, and relationships. One way individuals cope with this uncertainty is through managing information related to their illness. We conducted in-depth interviews with 38 pretransplant and posttransplant patients and analyzed the transcripts using grounded theory techniques. Participants reported that they managed their uncertainty related to transplantation by seeking and avoiding specific information and by strategically handling personal and social information. Participants also described a number of challenges associated with their information use. We discuss the theoretical implications of these findings for literature on information management, uncertainty in illness, and organ transplantation. In addition, we highlight practical implications for medical professionals as well as transplant patients and their loved ones, and we suggest that future research might usefully address what role uncertainty appraisal plays for people coping with chronic illness.</jats:p

The Message Design Logics of Responses to HIV Disclosures

This article uses the theory of message design logics to investigate the relative sophistication of responses to disclosure of HIV status. In Study 1, 548 college students imagined a sibling revealing an HIV-positive diagnosis. Their responses to the HIV disclosures were coded as expressive (n= 174), conventional (n= 298), or rhetorical (n= 66). Type of message produced was associated with gender and HIV aversion. In Study 2, 459 individuals living with HIV rated response messages that were taken verbatim from Study 1. Expressive messages were rated lowest in quality, and rhetorical messages were rated highest. The discussion focuses on the utility of message design logics for understanding responses to HIV disclosures and the implications for message design logics

Interactive acquisition and sharing: Understanding the dynamics of HIV/AIDS information networks

HIV/AIDS information is an important resource for people affected by the disease, particularly information that they obtain from other people. Although existing studies reveal that people with HIV/AIDS (PHAs) rely extensively on personal relationships for HIV/AIDS information, they explain little about how this happens as a social process. To investigate how PHAs and their friends/family members acquire and share network-mediated HIV/AIDS information, semistructured, in-depth interviews were conducted in three rural regions of Canada. Interviews were carried out with 114 PHAs, their friends/family members, and health care and service providers. A network solicitation and chain-referral recruitment procedure was used to delineate HIV/AIDS information networks for participants. Interview data were analyzed qualitatively and compared to Haythornthwaite's ( 1996 ) concepts of network-mediated information processes and Talja and Hansen's ( 2006 ) collaborative information behavior framework. Findings revealed that participants obtained HIV/AIDS information from their networks through five interactive processes: joint seeking, tag-team seeking, exposure, opportunity, and legitimation. The results of this study advance information behavior theory by pointing to the interactive character of information behavior and introducing new concepts to describe everyday life collaborative information behavior. This research also demonstrates the extensive interplay between health information exchange and the sharing of emotional support. The insights emanating from this study suggest that health information practice might benefit from a focus on program strategies such as building information network capacity, developing collaborative information retrieval systems and relationship-building, in addition to the more traditional library-related concerns of reference encounters, collections, and institutional Web sites.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/64304/1/21151_ftp.pd

The resting human brain and motor learning.

Functionally related brain networks are engaged even in the absence of an overt behavior. The role of this resting state activity, evident as low-frequency fluctuations of BOLD (see [1] for review, [2-4]) or electrical [5, 6] signals, is unclear. Two major proposals are that resting state activity supports introspective thought or supports responses to future events [7]. An alternative perspective is that the resting brain actively and selectively processes previous experiences [8]. Here we show that motor learning can modulate subsequent activity within resting networks. BOLD signal was recorded during rest periods before and after an 11 min visuomotor training session. Motor learning but not motor performance modulated a fronto-parietal resting state network (RSN). Along with the fronto-parietal network, a cerebellar network not previously reported as an RSN was also specifically altered by learning. Both of these networks are engaged during learning of similar visuomotor tasks [9-22]. Thus, we provide the first description of the modulation of specific RSNs by prior learning--but not by prior performance--revealing a novel connection between the neuroplastic mechanisms of learning and resting state activity. Our approach may provide a powerful tool for exploration of the systems involved in memory consolidation

Practice Makes Imperfect: Restorative Effects of Sleep on Motor Learning

Emerging evidence suggests that sleep plays a key role in procedural learning, particularly in the continued development of motor skill learning following initial acquisition. We argue that a detailed examination of the time course of performance across sleep on the finger-tapping task, established as the paradigm for studying the effect of sleep on motor learning, will help distinguish a restorative role of sleep in motor skill learning from a proactive one. Healthy subjects rehearsed for 12 trials and, following a night of sleep, were tested. Early training rapidly improved speed as well as accuracy on pre-sleep training. Additional rehearsal caused a marked slow-down in further improvement or partial reversal in performance to observed levels below theoretical upper limits derived on the basis of early pre-sleep rehearsal. This decrement in learning efficacy does not occur always, but if and only if it does, overnight sleep has an effect in fully or partly restoring the efficacy and actual performance to the optimal theoretically achieveable level. Our findings re-interpret the sleep-dependent memory enhancement in motor learning reported in the literature as a restoration of fatigued circuitry specialized for the skill. In providing restitution to the fatigued brain, sleep eliminates the rehearsal-induced synaptic fatigue of the circuitry specialized for the task and restores the benefit of early pre-sleep rehearsal. The present findings lend support to the notion that latent sleep-dependent enhancement of performance is a behavioral expression of the brain's restitution in sleep

Expanding Rural Opioid Addictions Treatment: An Inter-institutional, Inter-professional Telehealth Case Study Simulation

Purpose: To determine if inter-institutional collaboration, using telehealth technology, inter-professional education techniques, and case study methodology is a feasible way to teach health professions students how to appropriately address opioid addictions, especially in rural populations with limited health care access. Study subjects: Ten health professions students from four Virginia universities participated. Professions represented included medicine, nursing, physical therapy, social work, nutrition, and psychology at the graduate and undergraduate levels. Methods: Inter-professional faculty from four Virginia universities developed an opioid addiction simulation case study using a standardized patient. Students from different regions engaged in a facilitated patient interview and care planning via secure virtual meeting platform. Faculty observation and feedback, student feedback, and inter-professional education assessments were used to assess this pilot study. Findings: Inter-institutional faculty collaboration and telehealth technology was successfully employed to convene multiple health professions students from different sites; simulation case study methodology using a standardized patient was effective and compelling; students effectively utilized interprofessional competencies and skills to develop a comprehensive and holistic care plan for opioid addiction treatment. Conclusions: Telehealth technology, inter-professional education, and simulation case study methodology can be successfully used to teach health professions students how to collaborate to address the opioid crisis, especially in resource-limited rural areas. Implications: Many resources are necessary to successfully treat opioid addictions. By using telehealth technology combined with inter-professional concepts and skills, resources can be shared between institutions and professions to successfully treat patients with opioid addictions in resource-limited areas

Managing uncertainty in advanced liver disease:a qualitative, multiperspective, serial interview study

OBJECTIVE: To understand the experiences and support needs of people with advanced liver disease and those of their lay and professional carers to inform improvements in the supportive and palliative care of this rapidly growing but currently neglected patient group. DESIGN: Multiperspective, serial interviews. We conducted up to three qualitative in-depth interviews with each patient and lay carer over 12 months and single interviews with case-linked healthcare professionals. Data were analysed using grounded theory techniques. PARTICIPANTS: Patients with advanced liver disease of diverse aetiologies recruited from an inpatient hepatology ward, and their lay carers and case-linked healthcare professionals nominated by the patients. SETTING: Primary and secondary care in South-East Scotland. RESULTS: 37 participants (15 patients, 11 lay and 11 professional carers) completed 51 individual and 13 joint patient-carer interviews. Nine patients died during the study. Uncertainty dominated experiences throughout the course of the illness, across patients’ considerable physical, psychological, social and existential needs and affected patients, lay carers and professionals. This related to the nature of the condition, the unpredictability of physical deterioration and prognosis, poor communication and information-sharing, and complexities of care. The pervasive uncertainty also shaped patients’ and lay carers’ strategies for coping and impeded care planning. While patients’ acute medical care was usually well coordinated, their ongoing care lacked structure and focus. CONCLUSIONS: Living, dying and caring in advanced liver disease is dominated by pervasive, enduring and universally shared uncertainty. In the face of high levels of multidimensional patient distress, professionals must acknowledge this uncertainty in constructive ways that value its contribution to the person's coping approach. Pervasive uncertainty makes anticipatory care planning in advanced liver disease challenging, but planning ‘just in case’ is vital to ensure that patients receive timely and appropriate supportive and palliative care alongside effective management of this unpredictable illness

Retrograde Interference in Perceptual Learning of a Peripheral Hyperacuity Task

Consolidation, a process that stabilizes memory trace after initial acquisition, has been studied for over a century. A number of studies have shown that a skill or memory must be consolidated after acquisition so that it becomes resistant to interference from new information. Previous research found that training on a peripheral 3-dot hyperacuity task could retrogradely interfere with earlier training on the same task but with a mirrored stimulus configuration. However, a recent study failed to replicate this finding. Here we address the controversy by replicating both patterns of results, however, under different experimental settings. We find that retrograde interference occurs when eye-movements are tightly controlled, using a gaze-contingent display, where the peripheral stimuli were only presented when subjects maintained fixation. On the other hand, no retrograde interference was found in a group of subjects who performed the task without this fixation control. Our results provide a plausible explanation of why divergent results were found for retrograde interference in perceptual learning on the 3-dot hyperacuity task and confirm that retrograde interference can occur in this type of low-level perceptual learning. Furthermore, our results demonstrate the importance of eye-movement controls in studies of perceptual learning in the peripheral visual field