The Social Stratification of Environmental and Genetic Influences on Education: New Evidence Using a Register-Based Twin Sample

Baier T, Lang V. The Social Stratification of Environmental and Genetic Influences on Education: New Evidence Using a Register-Based Twin Sample. SOCIOLOGICAL SCIENCE. 2019;6:143-171.The relative importance of genes and shared environmental influences on stratification outcomes has recently received much attention in the literature. We focus on education and the gene-environmental interplay. Specifically, we investigate whether-as proposed by the Scarr-Rowe hypothesis-genetic influences are more important in advantaged families. We argue that the social stratification of family environments affects children's chances to actualize their genetic potential. We hypothesize that advantaged families provide more child-specific inputs, which enhance genetic expression, whereas the rearing environments of children in disadvantaged families are less adapted to children's individual abilities, leading to a suppression of genetic potential. We test this relationship in Germany, which represents an interesting case due to its highly selective schooling system characterized by early tracking and the broad coverage of part-time schools. We use novel data from the TwinLife panel, a population-register-based sample of twins and their families. Results of ACE-variance decompositions support the Scarr-Rowe hypothesis: Shared environmental influences on education matter only in disadvantaged families, whereas genetic influences are more important in advantaged families. Our findings support the growing literature on the importance of the gene-environmental interplay and emphasize the role of the family environment as a trigger of differential genetic expression

Poremećaji spavanja - kako dijagnosticirati i liječiti nesanicu u obiteljskoj medicini?

Poremećaji spavanja učestali su i nedovoljno prepoznat zdravstveni problem, a najčešći je nesanica. Karakterizira ju postojanje poteškoća s uspavljivanjem, održavanjem sna i/ili sklonost preranom buđenju s posljedičnim teškoćama u dnevnom funkcioniranju. Učestalost nesanice varira među ispitivanim stanovništvom različitih država, no najčešće se tumači kao simptom neke druge bolesti ili mentalnog stanja. Postaviti pravovremeno dijagnozu nesanice vrlo je bitno u svakodnevnoj praksi jer ima izravan utjecaj na svakodnevno funkcioniranje i posljedično na kvalitetu života pacijenata, a prema nekim autorima ima jednak utjecaj na kvalitetu života kao i veliki depresivni poremećaj ili kronične bolesti. Postoje različite podjele nesanica i podtipovi, no u praksi su najčešće prisutni preklapajući simptomi tih podtipova, što predstavlja veliki problem i još veći izazov u liječenju za svakog liječnika. Vrlo je korisno u svakodnevnom radu poslužiti se alatima koji nam pomažu u procjeni težine i opisu problema nesanice, kao što su dnevnik spavanja i razni upitnici. Liječenje poremećaja spavanja, uključujući liječenje nesanice, kompleksno je i sastoji se od higijene spavanja, psihoterapijskih metoda, psihofarmakoterapije i ostalih postupaka

Prevalencija i značajke nesanice među odraslima u središnjoj Istri

Aim: We sought to examine the frequency and characteristics of insomnia among adults in central Istria, as well as to analyse sociodemographic characteristics and explore whether there is an association between symptoms of insomnia and sociodemographic parameters. Methods: This research included 685 participants that visited family medicine offices (FMOs) in Central Istria from September till December 2016. Mean age of the sample was 52.73 ± 17.93 years. Participants were randomly selected and interviewed and all gave their informed consent. Participants with sleep disturbances and insomnia lasting one year prior to study enrolment were assessed using the questionnaire designed for the study; along with gathering of sociodemographic data. Results: More than half of the participants had insomnia, 30% of them each night or several times a week, mostly older participants and women. Regardless of the frequency of insomnia symptoms, all participants reported great impairment in all areas of daytime functioning. The most frequent incidence of insomnia was associated with more frequent sleep apnoea and less frequent bruxism. Frequent night awakenings and restless legs syndrome were not related to a greater incidence of insomnia. Conclusion: Insomnia is a common problem among patients treated in primary care. Family physicians are therefore in an ideal position to identify, evaluate and treat insomnia. The high prevalence of insomnia highlights the need for a more adequate recognition and treatment of this psychiatric illness.Cilj: Istražiti učestalost i obilježja problema spavanja među odraslim ispitanicima centralne Istre, analizirati sociodemografske karakteristike ispitanika i ispitati postoji li povezanost između pojedinih simptoma nesanice i sociodemografskih karakteristika ispitanika. Metode: 685 ispitanika prosječne dobi 52.73±17.93 (± standardna devijacija), posjetilo je ordinacije obiteljske medicine u centralnoj Istri, u razdoblju od rujna do prosinca 2016. Ukupno je 14% odraslih ispitanika nasumično izabrano i anketirano. Svi ispitanici su potpisali informativni pristanak. Ispitivani su anketnim upitnikom koji se odnosio na razdoblje od godine dana prije istraživanja i napravljen je posebno za ovo istraživanje; također su prikupljeni sociodemografski podaci ispitanika. Rezultati: Više od polovice ispitanika imalo je probleme spavanja, no 30% ispitanika imalo je probleme spavanja svaku noć ili nekoliko puta tjedno, a najčešće su to bili stariji ispitanici i žene. Problemi spavanja, neovisno o učestalosti, jednako su ometali svakodnevicu ispitanika. Češća pojavnost problema spavanja bila je povezana s češćom apnejom u snu i manjom učestalosti škrgutanja zubima. Češća buđenja tijekom noći i nemirnost nogu kod ispitanika nisu bili povezani s većom učestalošću problema spavanja. Zaključak: Problemi spavanja su učestali među bolesnicima liječenim u primarnoj zdravstvenoj zaštiti stoga su liječnici obiteljske medicine idealno pozicionirani za njihovo pravodobno prepoznavanje, evaluaciju i liječenje. Velika učestalost problema spavanja naglašava potrebu za daljnjim edukacijama i istraživanjima, a zdravstvenu skrb obvezuje na rano prepoznavanje i liječenje ovih problema

Facilitating Access to Health Coverage and Care by Advancing Health Insurance Literacy

Although Massachusetts currently has the highest rate of health insurance coverage in the nation, reports suggest health care consumers do not fully understand how their insurance works. Thus, the insured and uninsured populations alike need ongoing support in order to develop health insurance literacy, defined as the degree to which individuals obtain, process, and understand information about health insurance in order to make informed decisions about choosing and using their coverage, which in turn can lead to positive health outcomes. Educating consumers and giving them tools and resources are strategies that advance health insurance literacy. Since 2001, the Blue Cross Blue Shield of Massachusetts Foundation (the Foundation) has awarded over $5 million to community health centers and community-based organizations throughout Massachusetts, through its Connecting Consumers with Care (CCC) grant program, to conduct outreach, provide education and help consumers enroll in health insurance and access primary care. In 2015, the Foundation focused its CCC grant activities to improve health insurance literacy and engage consumers to utilize the health care system more effectively. Grantees have collected data on common measures, using adaptable data collection tools (e.g., brief client surveys), to assess changes in clients\u27 knowledge, confidence, and/or preparedness to better navigate complex systems of coverage and care. The poster presentation will discuss: - the importance of health insurance literacy and its relevance to improving population and community health - strategies currently used to increase health insurance literacy among diverse populations, including successes and challenges - how the impact of these strategies was measured - how assessments were designed to reflect consumers\u27 voices

Neuroprotective Effects of Bilobalide are Accompanied by a Reduction of Ischemia-Induced Glutamate Release \u3cem\u3ein vivo\u3c/em\u3e

Neuroprotective properties of bilobalide, a specific constituent of Ginkgo extracts, were tested in a mouse model of stroke. After 24 h of middle cerebral artery occlusion (MCAO), bilobalide reduced infarct areas in the core region (striatum) by 40–50% when given at 10 mg/kg 1 h prior to MCAO. Neuroprotection was also observed at lower doses, or when the drug was given 1 h past stroke induction. Sensorimotor function in mice was improved by bilobalide as shown by corner and chimney tests. When brain metabolism in situ was monitored by microdialysis, MCAO caused a rapid disappearance of extracellular glucose in the striatum which returned to baseline levels after reperfusion. Extracellular levels of glutamate were increased by more than ten-fold in striatal tissue, and by four- to fivefold in hippocampal tissue (penumbra). Bilobalide did not affect glucose levels but strongly attenuated glutamate release in both core and penumbra regions. Bilobalide was equally active when given locally via the microdialysis probe and also reduced ischemia-induced glutamate release in vitro in brain slices. We conclude that bilobalide is a strong neuroprotectant in vivo at doses that can be used therapeutically in humans. The mechanism of action evidently involves reduction of glutamate release, thereby reducing excitotoxicity

Genetic Influences on Educational Achievement in Cross-National Perspective

There is a growing interest in how social conditions moderate genetic influences on education [gene–environment interactions (GxE)]. Previous research has focused on the family, specifically parents’ social background, and has neglected the institutional environment. To assess the impact of macro-level influences, we compare genetic influences on educational achievement and their social stratification across Germany, Norway, Sweden, and the United States. We combine well-established GxE-conceptualizations with the comparative stratification literature and propose that educational systems and welfare-state regimes affect the realization of genetic potential. We analyse population-representative survey data on twins (Germany and the United States) and twin registers (Norway and Sweden), and estimate genetically sensitive variance decomposition models. Our comparative design yields three main findings. First, Germany stands out with comparatively weak genetic influences on educational achievement suggesting that early tracking limits the realization thereof. Second, in the United States genetic influences are comparatively strong and similar in size compared to the Nordic countries. Third, in Sweden genetic influences are stronger among disadvantaged families supporting the expectation that challenging and uncertain circumstances promote genetic expression. This ideosyncratic finding must be related to features of Swedish social institutions or welfare-state arrangements that are not found in otherwise similar countries

Psychomotor therapy targeting anger and aggressive behaviour in individuals with mild or borderline intellectual disabilities:A systematic review

Background: Poor anger regulation is considered a risk factor of aggression in individuals with mild or borderline intellectual disabilities. Psychomotor therapy (PMT) targets anger regulation through body- and movement-oriented interventions. This study aims to inform practitioners on efficacy and research-base of PMT in this population. Method: This systematic review evaluated nine studies which met inclusion criteria in terms of participants, intervention procedures, outcomes and certainty of evidence. Results: Seven studies revealed a substantial reduction of aggressive behaviour or anger. Certainty of evidence was rated inconclusive in most cases due to absence of experimental control. Conclusions: We can conclude that body-oriented PMT, involving progressive relaxation and meditation procedure "Soles of the Feet", is a promising approach. However, the paucity of studies and methodological limitations preclude classifying it as an evidence-based practice. This suggests stronger methodological research and research aimed at PMT's mechanisms of action (e.g., improved interoceptive awareness) is warranted.</p

Clinical relevance of lung transplantation for COVID-19 ARDS: a nationwide study

BACKGROUND: Although the number of lung transplantations (LTx) performed worldwide for COVID-19 induced acute respiratory distress syndrome (ARDS) is still low, there is general agreement that this treatment can save a subgroup of most severly ill patients with irreversible lung damage. However, the true proportion of patients eligible for LTx, the overall outcome and the impact of LTx to the pandemic are unknown. METHODS: A retrospective analysis was performed using a nationwide registry of hospitalised patients with confirmed severe acute respiratory syndrome coronavirus type 2 (SARS-Cov-2) infection admitted between January 1, 2020 and May 30, 2021 in Austria. Patients referred to one of the two Austrian LTx centers were analyzed and grouped into patients accepted and rejected for LTx. Detailed outcome analysis was performed for all patients who received a LTx for post-COVID-19 ARDS and compared to patients who underwent LTx for other indications. RESULTS: Between January 1, 2020 and May 30, 2021, 39.485 patients were hospitalised for COVID-19 in Austria. 2323 required mechanical ventilation, 183 received extra-corporeal membrane oxygenation (ECMO) support. 106 patients with severe COVID-19 ARDS were referred for LTx. Of these, 19 (18%) underwent LTx. 30-day mortality after LTx was 0% for COVID-19 ARDS transplant recipients. With a median follow-up of 134 (47–450) days, 14/19 patients are alive. CONCLUSIONS: Early referral of ECMO patients to a LTx center is pivotal in order to select patients eligible for LTx. Transplantation offers excellent midterm outcomes and should be incorporated in the treatment algorithm of post-COVID-19 ARDS