A Foundation for Health Reform: Findings of a 50 State Survey 2009

Surveys state actions on Medicaid and Children's Health Insurance Plans and analyzes advances and setbacks in expanding coverage for low-income children and parents as well as disparities between the two groups. Discusses legislative and economic factors

A Systematic Review on the Relationship Between Attachment Styles and Chronic Pain

Chronic pain (CP), a leading cause of disability, is associated with addiction, physical and psychosocial impairment and tremendous financial burden. Childhood experiences contribute to the genesis of different attachment styles. Attachment theory offers a useful framework for the conceptualization of CP, with different attachment styles impacting the experience and clinical manifestations of CP. This systematic review aims to evaluate the relationship between attachment styles and CP, to investigate which attachment styles pose the greatest risk for CP, to examine how CP is expressed in the context of different attachment styles, and to gain insight regarding the treatment approach to CP. This systematic review utilized a quantitative approach and included 29 studies relating to the relationship between attachment styles and CP. The studies yielded results indicating that an insecure attachment style is more prevalent among those suffering from CP when compared with healthy subjects. Attachment insecurity was noted to be a predisposing factor with respect to various dimensions of the CP experience. A secure attachment style served as a protective factor vis-a-vis the genesis and clinical manifestations of CP. The studies highlighted the necessity of an attachment-based, customized treatment approach for CP patients with varying attachment styles. Future research should inform healthcare providers about vulnerable populations, early intervention strategies and efficacious treatment modalities

Mate Choice Patterns in Social and Non-Social Decision-Making Domains

Thesis (Ph.D.) - Indiana University, Department of Psychological and Brain Sciences and the Cognitive Science Program, 2019Humans are a fundamentally social species, and an individual may have social ties of many flavors. One social domain, mate or romantic partner choice, has been thoroughly examined, but others remain relatively understudied. How do our choice patterns vary between different social domains? In this work, I argue that although choice constraints vary between social domains (e.g. a collaborator, spouse, friend, mentor, or dodgeball teammate), the fundamental patterns of choice are ultimately similar. In this dissertation, I present studies of three different choice areas. First, I compare the search for non-social resources such as food (i.e. Optimal Foraging Theory; OFT) with that for a romantic partner to produce a theory-driven framework for mate choice as a foraging problem. Mate foragers demonstrated sensitivity to search costs as predicted by OFT, where those searching longest for their first marriage (but not cohabitations) had a decreased risk of relationship dissolution. However, periods of relationships and search also covaried in ways unexpected by OFT. Next, I tested for the presence of two common patterns in romantic partner choice: positive assortment (e.g. homophily) and the stated-revealed preference gap (inconsistency between one’s stated preferences and the actual traits of a chosen partner). I demonstrated these patterns in two social domains: academic collaborator choice and companion animal choice. I tested whether homophily was the best predictor of academic collaborations forming. I held three academic speed-networking events, a modified form of speed-dating. Pairs were assigned experimentally based on the similarity of academics’ current research and complementarity of desired vs current knowledge. These manipulations did not significantly impact collaboration rates; rather, believing a partner’s research was similar was predictive of collaboration, suggesting homophily has a nuanced role in collaboration formation. I then examined dog choice in animal shelters. Comparing the traits of a newly adopted dog to the stated preferences of their adopter, adopters perceived their dog to fulfill their stated preferences at above-chance rates. These adopter-dog pairs also exhibited weak positive assortment of personality. I summarize the implications of exapting choice mechanisms which are appropriate for one adaptive domain to novel social domains with different choice constraints

The Inter-Subject Correlation of EEG in Response to Naturalistic Stimuli

Inter-subject correlation is a measure of the similarity of the brain activity of a group of people as they respond to the same naturalistic stimulus, typically a story or video, meant to simulate a real world experience. This thesis tests the hypothesis that the correlation of the brain responses of a group of people is indicative of stimulus engagement. The rationale is that the content of the stimulus drives brain activity in a consistent manner, while internal thoughts are divergent and result in uncorrelated activity. The inter-subject correlation (ISC) of neural responses have previously been assessed with fMRI, EEG, and MEG. Here, EEG will assess ISC, thereby examining the correlation of the early responses to a stimulus. Engagement has been examined previously with self-report assessments of interest. These ratings are noisy, subject to bias, and do not measure how engagement evolves over time. In this thesis, engagement is defined as a commitment to devote a scarce resource, such as attention or time, to a stimulus. In the experiment presented here, subjects were allowed limited time with the stimuli, thus forcing them to engage with the content they determined to be most compelling. This behavioral metric strongly correlated with ISC of the EEG, thus validating it as a measure of neural engagement. Interestingly, higher ISC was also indicative of a shared perception of the passage of time across subjects. This suggests that when people are engaged with a stimulus, their perception of time is also driven by that stimulus, rather than by an internal sense of time. If people are more engaged at the time of encoding, it is likely that they will better remember their experiences. Memory was therefore assessed three weeks after subjects heard salient emotional narratives. Individuals whose EEG responses during the stories correlated more strongly with their peers had stronger memories of the events in the stories. ISC was also tested as a predictor of retention in the context of online educational videos. Again, the similarity between each subject’s brain activity and that of his or her peers corresponded with memory for factual information in a subsequent test. It is possible that people with different backgrounds do not engage with the world in similar ways, and their neural responses will therefore correlate more strongly with people who are most similar to them. To address this notion, ISC was compared across the dimensions of age and gender. In a population with ages ranging from 5 - 44 years old, ISC weakens with age and is stronger in males than it is in females. This result is consistent with the idea that age and experience are marked by an increase in the repertoire of neural representations. Adults may therefore have more variable interpretations that mediate their sensory responses to stimuli. Alternatively, if ISC is truly assessing engagement in this context, the result may demonstrate that adults are less susceptible to the influence of outside stimuli since they have more powerful internal voices that distract them. Whichever the ultimate reason for this change, the gender disparity may also be related to a developmental difference because the deviation between males and females in ISC is strongest in young ages, a period when anatomical findings show that young males are less neurally mature than young females. Although ISC is implicated in fundamental processes such as engagement, memory, and development, the neural underpinnings of this signal are unclear. The spatial distribution of the EEG signal that drives ISC appears similar on the surface of the scalp across stimuli with different narrative content, and between different stimulus modalities. The similarity of the topography of correlated activity across sensory modalities may indicate that this activity is supramodal and is therefore generated by a region that is impervious to the stimulus modality. To assess ISC’s dependence on stimulus modality and stimulus type, the modulation of ISC was compared with the fMRI BOLD responses to the same stimuli. This analysis revealed that ISC is mostly modulated by sensory regions, and that the extent of the regions involved depends on the content of the stimulus. These areas, which are largely driven by immediate processing of the stimulus at a fast timescale, are therefore implicated in higher-level behaviors such as engagement and memory

Empirical Challenges in Organizational Aesthetics Research: Towards a Sensual Methodology

Despite growing scholarly interest in aesthetic dimensions of organizational life, there is a lack of literature expressly engaging with the methodological mechanics of 'doing aesthetics research'. This article addresses that gap. It begins with an overview of the conceptual idiosyncrasies of 'aesthetics' as a facet of human existence and maps out the challenges these pose for empirical research methodology. A review of methodological approaches adopted to date in empirical studies of organizational aesthetics is then presented. The remainder of the article draws on the author's experiences and suggests methods and techniques to address both conceptual and practical challenges encountered during the execution of an organizational aesthetics research project. The article calls for a firmer focus on the aesthetic experiences of organizational members in addition to those of researchers and concludes with some suggestions as to the future of such 'sensual methodologies' </jats:p

Older Teen Attitudes Towards Birth Control Access in Pharmacies: A Qualitative Study

Objectives To examine adolescent attitudes toward accessing contraception through a new pharmacist prescribing model in the State of California. Study design In-depth telephone interviews were conducted in summer 2015 with 30 females ages 18 to 19 in California. Participants were recruited using a social media advertisement. Semi-structured interviews utilized open-ended questions to understand teens' experiences with pharmacies, experiences obtaining contraception, and views on pharmacist prescribing of contraception. Responses were transcribed and qualitatively analyzed using an independent-coder method to identify salient themes. Results Participants were ethnically diverse and primarily living in suburban areas. All participants had completed high school and many had completed one year of college. Nearly all participants were supportive of California's new law allowing pharmacist prescribing of contraception. Thematic analyses revealed that while participants were satisfied with traditional service providers and valued those relationships, they appreciated the benefit of increased access and convenience of going directly to a pharmacy. Participants expected increased access to contraception in pharmacies would lead to both personal and societal benefits. They expressed concerns regarding parental involvement, as well as confidentiality in the pharmacy environment and with insurance disclosures. Conclusion Older teens in California are very supportive of pharmacies and pharmacists as direct access points for contraception, but confidentiality concerns were noted. Policy makers and pharmacies can incorporate study findings when designing policies, services, and physical pharmacy spaces to better serve teens. Further research is warranted after pharmacies implement this new service to assess teen utilization and satisfaction as well as outcomes. Implication statement Several states recently passed legislation enabling pharmacists to prescribe contraception and other states are considering similar legislation. Older teens are interested in this additional method of contraceptive access and understanding their perspectives can help guide implementation by states and in individual pharmacies

Multisensory Integration and Autistic Traits Using Non-Sociolinguistic Information

Background: Sensory processing issues are one of the most common complaints in autism spectrum disorder (ASD). One area of sensory difficulties in ASD that has been the focus of intense research in recent years is multisensory integration (MSI), or the ability to bind auditory and visual information into a single, unified percept. While integration of social or linguistic information is consistently shown to be an area of difficulty in ASD, results are less clear with simple, non-sociolinguistic stimuli. This study aims to address this ambiguity by determining whether MSI of non-sociolinguistic sensory information is related to traits and symptomatology commonly associated with ASD. Methods: Sixty-five undergraduate students completed a behavioural audiovisual detection task and a battery of questionnaires assessing ASD-related traits and symptomatology. Multisensory enhancement (ME) was measured by comparing accuracy rates during audiovisual trials to the accuracy rate predicted by the unisensory conditions assuming independent processing: (AVacc-[Aacc+Vacc-(Aacc*Vacc)]). Results: Results revealed no relationship between ME of simple, non-sociolinguistic sensory information and autistic traits and symptomatology, with R-squared values ranging between 0.001-0.03. Discussion & Conclusion: While MSI issues are well established with sociolinguistic stimuli, these data suggest that these issues may be restricted to social or linguistic information. The lack of any relationship between ME and ASD traits spanned a range of symptoms, including repetitive behaviours, social communication, and sensory issues, suggesting MSI may be associated with autism symptomatology only when sociolinguistic information is present. Interdisciplinary Reflection: This research combines behavioural measures of sensory perception and diagnostic criteria used in clinical settings to assess ASD traits

Investigating the Anti-dyskinetic Effects of Serotonin- and Glutamate-acting Compounds, Vilazodone and Amantadine, in Hemiparkinsonian Rats

Parkinson’s disease is a progressive, neurodegenerative movement disorder caused by loss of nigrostriatal dopamine (DA) neurons. DA replacement therapy using L-3,4-dihydroxyphenylalanine (L-DOPA) improves motor functioning but often results in L-DOPA-induced dyskinesia (LID) typified by abnormal involuntary movements (AIMs). In this state of DA depletion, serotonin (5-HT) neuron hyperinnervation and glutamate overactivity are heavily implicated in LID. This study investigated the anti-dyskinetic effects of Vilazodone (VZD), a 5-HT transport blocker and partial 5-HT1a agonist, and/or Amantadine (AMAT), an NMDA glutamate antagonist. It was hypothesized that alone each would reduce LID, while co-administration at low doses would synergistically reduce LID without compromising L-DOPA efficacy. Hemiparkinsonian Sprague-Dawley rats were given L-DOPA (6mg/kg, s.c.) for 14 days to establish LID. VZD (0, 1, 2.5, 5mg/kg) and AMAT (0, 20, 40, 60mg/kg) were administered in a within-subjects counterbalanced design with L-DOPA to ascertain effective anti-LID doses (n=9). AIMs were monitored for 3 hours following injections to measure LID expression. Before examining potential treatment synergy, doses exhibiting minimal effect on AIMs scores were selected (VZD 1.0, 2.5mg/kg; AMAT 40mg/kg). The following cohort (n=8) received 6 counterbalanced treatments consisting of L-DOPA (6mg/kg) and either VZD (1, 2.5mg/kg), AMAT (40mg/kg), or both. Results revealed a significant decrease in AIMs and maintained motor performance with VZD (2.5mg/kg) compared to those receiving only L-DOPA. AMAT prolonged peak AIMs without maintaining L-DOPA motor efficacy when co-administered with VZD or L-DOPA alone. These results suggest co-administration of VZD and AMAT with L-DOPA does not synergistically reduce LID in hemiparkinsonian rats. Rather, our results suggest that AMAT may reduce the efficacy of VZD. However, our results suggest very low doses of VZD (2.5mg/kg) reduce LID severity and duration while maintaining L-DOPA efficacy.https://orb.binghamton.edu/research_days_posters_2021/1099/thumbnail.jp

Pharmacist Outlooks on Prescribing Hormonal Contraception Following Statewide Scope of Practice Expansion

In an effort to increase access to contraception, the pharmacist scope of practice is being expanded to allow prescribing. While this is being accomplished in the United States by a variety of models, legislation that allows pharmacists to prescribe hormonal contraception under a statewide protocol is the most common. This study was designed to explore the outlooks of pharmacists regarding prescribing contraception in the period following the first state legislation and prior to statewide protocol development and availability. A qualitative study of community pharmacists in California using structured phone interviews explored their opinions regarding access to contraception in pharmacies and outlooks regarding prescribing. Data were analyzed using an inductive approach to identify themes. Among the thirty participants, the majority worked in a chain pharmacy. Themes were identified in five overarching domains: Pharmacist barriers, system barriers, patient issues, safety concerns, and pharmacist role. Most were unfamiliar with the new law, yet were interested in expanding access for patient benefit despite foreseeing challenges with implementing the service in community pharmacies. Barriers will need to be addressed and requisite training disseminated widely to facilitate successful implementation and thus improve access on a broad scale. Further research following protocol implementation is needed to understand service implementation, as well as patient utilization and satisfaction

The Effects of Vilazodone, YL-0919, and Vortioxetine in L-DOPA Treated Hemiparkinsonian Rats

Parkinson\u27s Disease (PD) is a debilitating, neurodegenerative disorder characterized by motor symptoms, including bradykinesia, tremor, stiffness, and postural instability, that result from significant nigrostriatal dopamine (DA) loss. The current gold standard treatment for PD involves replacement therapy via the DA precursor L-3,4-dihydroxyphenylalanine (L-DOPA); however, 90% of patients eventually experience choreic and dystonic side effects termed L-DOPA induced dyskinesia (LID). A key driver of LID is neuroplasticity within the serotonin (5-HT) system leading to the unregulated release of L-DOPA derived DA from 5-HT terminals into the striatum. Previous work has implicated the dual action of 5-HT1A receptor agonism and 5-HT transporter (SERT) blockade as an effective therapeutic method for attenuating LID. The present study examined 3 purportedly similar pharmacological drugs, Vilazodone, YL-0919, and Vortioxetine, that act as 5-HT1A agonists and SERT blockers. Adult female Sprague-Dawley rats received unilateral injection of 6-hydroxydopamine (6-OHDA) into the medial forebrain bundle (MFB) to deplete DA neurons. Thereafter they received 2 weeks of L-DOPA treatment until they developed stable abnormal involuntary movement (AIMs) akin to LID. Rats were also assessed for motor performance with the forepaw adjusting steps (FAS) test. Results revealed that Vilazodone and Vortioxetine significantly reduced AIMs and maintained L-DOPA beneficial prokinetic effects. In contrast, YL-0919 unexpectedly had no effect on LID though it did maintain L-DOPA motor performance. Overall, these findings support pharmacological targets within the 5-HT system that reduce LID. They also provide evidence for unique features of Vilazodone and Vortioxetine, both FDA approved compounds, as potential adjunct therapeutics for LID management in PD patients.https://orb.binghamton.edu/research_days_posters_2021/1090/thumbnail.jp