State-Level and County-Level Estimates of Health Care Costs Associated with Food Insecurity.

IntroductionFood insecurity, or uncertain access to food because of limited financial resources, is associated with higher health care expenditures. However, both food insecurity prevalence and health care spending vary widely in the United States. To inform public policy, we estimated state-level and county-level health care expenditures associated with food insecurity.MethodsWe used linked 2011-2013 National Health Interview Survey/Medical Expenditure Panel Survey data (NHIS/MEPS) data to estimate average health care costs associated with food insecurity, Map the Meal Gap data to estimate state-level and county-level food insecurity prevalence (current though 2016), and Dartmouth Atlas of Health Care data to account for local variation in health care prices and intensity of use. We used targeted maximum likelihood estimation to estimate health care costs associated with food insecurity, separately for adults and children, adjusting for sociodemographic characteristics.ResultsAmong NHIS/MEPS participants, 10,054 adults and 3,871 children met inclusion criteria. Model estimates indicated that food insecure adults had annual health care expenditures that were $1,834 (95$1,073-2,595, P < .001) higher than food secure adults. For children, estimates were 80 higher, but this finding was not significant (95% CI, -$171 to$329, P = .53). The median annual health care cost associated with food insecurity was $687,041,000 (25th percentile,$239,675,000; 75th percentile, $1,140,291,000). The median annual county-level health care cost associated with food insecurity was$4,433,000 (25th percentile, $1,774,000; 75th percentile,$11,267,000). Cost variability was related primarily to food insecurity prevalence.ConclusionsHealth care expenditures associated with food insecurity vary substantially across states and counties. Food insecurity policies may be important mechanisms to contain health care expenditures

Individual differences in attributional style but not in interoceptive sensitivity, predict subjective estimates of action intention

The debate on the existence of free will is on-going. Seminal findings by Libet et al. (1983) demonstrate that subjective awareness of a voluntary urge to act (the W-judgment) occurs before action execution. Libet's paradigm requires participants to perform voluntary actions while watching a clock hand rotate. On response trials, participants make a retrospective judgment related to awareness of their urge to act.This research investigates the relationship between individual differences in performance on the Libet task and self-awareness. We examined the relationship between W-judgment, attributional style (AS; a measure of perceived control) and interoceptive sensitivity (IS; awareness of stimuli originating from one's body; e.g., heartbeats). Thirty participants completed the AS questionnaire (ASQ), a heartbeat estimation task (IS), and the Libet paradigm. The ASQ score significantly predicted performance on the Libet task, while IS did not - more negative ASQ scores indicated larger latency between W-judgment and action execution. A significant correlation was also observed between ASQ score and IS. This is the first research to report a relationship between W-judgment and AS and should inform the future use of electroencephalography (EEG) to investigate the relationship between AS, W-judgment and RP onset. Our findings raise questions surrounding the importance of one's perceived control in determining the point of conscious intention to act. Furthermore, we demonstrate possible negative implications associated with a longer period between conscious awareness and action execution. © 2014 Penton, Thierry and Davis

Optimal experience and personal growth. Flow and the consolidation of place identity

This study examined the relationship between flow experience and place identity, based on eudaimonistic identity theory (EIT) which prioritizes self-defining activities as important for an individual's identification of his/her goals, values, beliefs, and interests corresponding to one's own identity development or enhancement. This study focuses on place identity, the identity's features relating to a person's relation with her/his place. The study is also based on flow theory, according to which some salient features of an activity experience are important for happiness and well-being. Questionnaire surveys on Italian and Greek residents focused on their perceived flow and place identity in relation to their own specific local place experiences. The overall findings revealed that flow experience occurring in one's own preferred place is widely reported as resulting from a range of self-defining activities, irrespective of gender or age, and it is positively and significantly associated with one's own place identity. Such findings provide the first quantitative evidence about the link between flow experienced during meaningfully located self-defining activities and identity experienced at the place level, similarly to the corresponding personal and social levels that had been previously already empirically tested. Results are also discussed in terms of their implications for EIT's understanding and enrichment, especially by its generalization from the traditional, personal identity level up to that of place identity. More generally, this study has implications for maintaining or enhancing one's own place identity, and therefore people place relations, by means of facilitating a person's flow experience within psychologically meaningful place

Targeted prevention of common mental health disorders in university students: randomised controlled trial of a transdiagnostic trait-focused web-based intervention

Background: A large proportion of university students show symptoms of common mental disorders, such as depression, anxiety, substance use disorders and eating disorders. Novel interventions are required that target underlying factors of multiple disorders.&lt;p&gt;&lt;/p&gt; Aims: To evaluate the efficacy of a transdiagnostic trait-focused web-based intervention aimed at reducing symptoms of common mental disorders in university students.&lt;p&gt;&lt;/p&gt; Method: Students were recruited online (n = 1047, age: M = 21.8, SD = 4.2) and categorised into being at high or low risk for mental disorders based on their personality traits. Participants were allocated to a cognitive-behavioural trait-focused (n = 519) or a control intervention (n = 528) using computerised simple randomisation. Both interventions were fully automated and delivered online (trial registration: ISRCTN14342225). Participants were blinded and outcomes were self-assessed at baseline, at 6 weeks and at 12 weeks after registration. Primary outcomes were current depression and anxiety, assessed on the Patient Health Questionnaire (PHQ9) and Generalised Anxiety Disorder Scale (GAD7). Secondary outcome measures focused on alcohol use, disordered eating, and other outcomes.&lt;p&gt;&lt;/p&gt; Results: Students at high risk were successfully identified using personality indicators and reported poorer mental health. A total of 520 students completed the 6-week follow-up and 401 students completed the 12-week follow-up. Attrition was high across intervention groups, but comparable to other web-based interventions. Mixed effects analyses revealed that at 12-week follow up the trait-focused intervention reduced depression scores by 3.58 (p&#60;.001, 95%CI [5.19, 1.98]) and anxiety scores by 2.87 (p = .018, 95%CI [1.31, 4.43]) in students at high risk. In high-risk students, between group effect sizes were 0.58 (depression) and 0.42 (anxiety). In addition, self-esteem was improved. No changes were observed regarding the use of alcohol or disordered eating.&lt;p&gt;&lt;/p&gt; Conclusions This study suggests that a transdiagnostic web-based intervention for university students targeting underlying personality risk factors may be a promising way of preventing common mental disorders with a low-intensity intervention

Photo-a-day: a digital photographic practice and its impact on wellbeing

The practice of taking and sharing one photo every day for a year, has become a popular new form of photography enabled by the Internet. The purpose of this study was to investigate how people use photo-a-day to enhance their wellbeing. The data for the study were sixteen interviews with people who practised photo-a-day, analysed by thematic analysis. The analysis showed how photos offer positive affordances because of the conventions to take aesthetically pleasing images, share positive events and comment positively. A seemingly simple activity, photo-a-day creates a new layer of interest woven around daily activities, and expands social relationships. Representations of identity are complex, emerging through photos taken, rather than a premeditated profile

A neurocomputational account of how inflammation enhances sensitivity to punishments versus rewards

BACKGROUND: Inflammation rapidly impairs mood and cognition and, when severe, can appear indistinguishable from major depression. These sickness responses are characterized by an acute reorientation of motivational state; pleasurable activities are avoided, and sensitivity to negative stimuli is enhanced. However, it remains unclear how these rapid shifts in behavior are mediated within the brain. METHODS: Here, we combined computational modeling of choice behavior, experimentally induced inflammation, and functional brain imaging (functional magnetic resonance imaging) to describe these mechanisms. Using a double-blind, randomized crossover study design, 24 healthy volunteers completed a probabilistic instrumental learning task on two separate occasions, one 3 hours after typhoid vaccination and one 3 hours after saline (placebo) injection. Participants learned to select high probability reward (win £1) and avoid high probability punishment (lose £1) stimuli. An action-value learning algorithm was fit to the observed behavior, then used within functional magnetic resonance imaging analyses to identify neural coding of prediction error signals driving motivational learning. RESULTS: Inflammation acutely biased behavior, enhancing punishment compared with reward sensitivity, through distinct actions on neural representations of reward and punishment prediction errors within the ventral striatum and anterior insula. Consequently, choice options leading to potential rewards were less behaviorally attractive, and those leading to punishments were more aversive. CONCLUSIONS: Our findings demonstrate the neural mediation of a rapid, state-dependent reorientation of reward versus punishment sensitivity during inflammation. This mechanism may aid the adaptive reallocation of metabolic resources during acute sickness but might also account for

A 14-year longitudinal study of the impact of clean indoor air legislation on state smoking prevalence, USA, 1997-2010

While clean indoor air legislation at the state level is an evidence-based recommendation, only limited evidence exists regarding the impact of clean indoor air policies on state smoking prevalence. Using state smoking prevalence data from 1997 to 2010, a repeated measures observational analysis assessed the association between clean indoor air policies (i.e., workplace, restaurant, and bar) and state smoking prevalence while controlling for state cigarette taxes and year. The impacts from the number of previous years with any clean indoor air policy, the number of policies newly in effect during the current year, and the number of policies in effect the previous year were analyzed. Findings indicate a smoking prevalence predicted decrease of 0.13 percentage points (p = 0.03) for each additional year one or more clean indoor air policies were in effect, a predicted decrease of 0.12 percentage points (p = 0.09) for each policy newly in effect in the current year, and a predicted decrease of 0.22 percentage points (p = 0.01) for each policy in effect in the previous year on the subsequent year. Clean indoor air policies show measurable associations with reductions in smoking prevalence within a year of implementation above and beyond taxes and time trends. Further efforts are needed to diffuse clean indoor air policies across states and provinces that have not yet adopted such policies.ECU Open Access Fun

Reversing Threat to Safety: Incongruence of Facial Emotions and Instructed Threat Modulates Conscious Perception but Not Physiological Responding

Facial expressions inform about other peoples’ emotion and motivation and thus are central for social communication. However, the meaning of facial expressions may change depending on what we have learned about the related consequences. For instance, a smile might easily become threatening when displayed by a person who is known to be dangerous. The present study examined the malleability of emotional facial valence by means of social learning. To this end, facial expressions served as cues for verbally instructed threat-of-shock or safety (e.g., “happy faces cue shocks”). Moreover, reversal instructions tested the flexibility of threat/safety associations (e.g., “now happy faces cue safety”). Throughout the experiment, happy, neutral, and angry facial expressions were presented and auditory startle probes elicited defensive reflex activity. Results show that self-reported ratings and physiological reactions to threat/safety cues dissociate. Regarding threat and valence ratings, happy facial expressions tended to be more resistant becoming a threat cue, and angry faces remain threatening even when instructed as safety cue. For physiological response systems, however, we observed threat-potentiated startle reflex and enhanced skin conductance responses for threat compared to safety cues regardless of whether threat was cued by happy or angry faces. Thus, the incongruity of visual and verbal threat/safety information modulates conscious perception, but not the activation of physiological response systems. These results show that verbal instructions can readily overwrite the intrinsic meaning of facial emotions, with clear benefits for social communication as learning and anticipation of threat and safety readjusted to accurately track environmental changes.This research was supported by the German Research Foundation (DFG) grant to FB (BU 3255/1-1)

The ethics of digital well-being: a multidisciplinary perspective

This chapter serves as an introduction to the edited collection of the same name, which includes chapters that explore digital well-being from a range of disciplinary perspectives, including philosophy, psychology, economics, health care, and education. The purpose of this introductory chapter is to provide a short primer on the different disciplinary approaches to the study of well-being. To supplement this primer, we also invited key experts from several disciplines—philosophy, psychology, public policy, and health care—to share their thoughts on what they believe are the most important open questions and ethical issues for the multi-disciplinary study of digital well-being. We also introduce and discuss several themes that we believe will be fundamental to the ongoing study of digital well-being: digital gratitude, automated interventions, and sustainable co-well-being

A nice surprise? Predictive processing and the active pursuit of novelty

Recent work in cognitive and computational neuroscience depicts human brains as devices that minimize prediction error signals: signals that encode the difference between actual and expected sensory stimulations. This raises a series of puzzles whose common theme concerns a potential misfit between this bedrock informationtheoretic vision and familiar facts about the attractions of the unexpected. We humans often seem to actively seek out surprising events, deliberately harvesting novel and exciting streams of sensory stimulation. Conversely, we often experience some wellexpected sensations as unpleasant and to-be-avoided. In this paper, I explore several core and variant forms of this puzzle, using them to display multiple interacting elements that together deliver a satisfying solution. That solution requires us to go beyond the discussion of simple information-theoretic imperatives (such as 'minimize long-term prediction error') and to recognize the essential role of species-specific prestructuring, epistemic foraging, and cultural practices in shaping the restless, curious, novelty-seeking human mind