The relationships between insomnia, sleep apnoea and depression: findings from the American National Health and Nutrition Examination Survey, 2005-2008.

Objective: To determine the association between insomnia, obstructive sleep apnoea (OSA), and comorbid insomnia- OSA and depression, while controlling for relevant lifestyle and health factors, among a large population-based sample of US adults. Method: We examined a sample of 11,329 adults (≥18 years) who participated in the National Health and Nutrition Examination Survey (NHANES) during the years 2005-2008. Insomnia was classified via a combination of self-reported positive physician diagnosis and high-frequency 'trouble falling asleep', 'waking during the night', 'waking too early', and 'feeling unrested during the day'. OSA was classified as a combination of a positive response to a physician-diagnosed condition, in addition to a high frequency of self-reported nocturnal 'snoring', 'snorting/stopping breathing' and 'feeling overly sleepy during the day'. Comorbid insomnia-OSA was further assessed by combining a positive response to either insomnia (all), or sleep apnoea (all), as classified above. Depressive symptomology was assessed by the Patient Health Questionnaire-9 (PHQ-9), with scores of >9 used to indicate depression. Odds ratios (ORs) and 95% confidence intervals (CIs) for sleep disorders and depression were attained from logistic regression modelling adjusted for sex, age, poverty level, smoking status and body mass index (BMI). Results: Those who reported insomnia, OSA or comorbid insomnia-OSA symptoms reported higher rates of depression (33.6%, 22.2%, 27.1%, respectively), and consistently reported poorer physical health outcomes than those who did not report sleep disorders. After adjusting for sex, age, poverty level, smoking status and BMI (kg/m2), insomnia (OR 6.57, 95% CI 3.89-11.11), OSA (OR 5.14, 95% CI 3.14-8.41) and comorbid insomnia-OSA (OR 6.67, 95% CI 4.44-10.00) were associated with an increased likelihood of reporting depression. © The Royal Australian and New Zealand College of Psychiatrists 2014.

Higher social distress and lower psycho-social wellbeing:examining the coping capacity and health of people with hearing impairment

Abstract
Purpose: The objectives of this paper are as follows: (1) propose an explanatory model as to how hearing disability may impact on health and (2) examine the model’s utility.
Methods: Data were collected on the psycho-social wellbeing, disability and physical health of farmers (n=56) participating in an intervention to manage the social impacts of hearing disability. Two models were proposed and examined using multiple hierarchical linear regression. Model 1 used self-rated quality of life and model 2 used capacity to manage hearing and listening impairments, as dependent variables.
Results: The analyses found that physical measures of hearing impairment (audiograms) were not correlated with physical or mental health outcomes. However, in model 1, self-confidence and self-rated ability to manage hearing impairment were most closely associated with reduced quality of life (anxiety and diastolic blood pressure were positively associated with quality of life). In model 2, higher anxiety and reduced self-confidence were associated with decreasing ability to successfully manage one’s hearing impairment.
Conclusions: The findings support the explanatory model that stress is higher and wellbeing lower when the fit between the person’s coping capacity and environmental demands is poor.

Real and substantial connections : Enforcing Canadian privacy laws against American social networking companies

Any organisation that captures personal data in Canada for processing is deemed tohave a ‘real and substantial connection’ to Canada and thus fall within thejurisdiction of the Personal Information Protection and Electronic Documents Act(PIPEDA) and of the Office of the Privacy Commissioner of Canada (OPC). Whathas been the experience of enforcing Canadian privacy protection law on US-basedsocial networking services? We analyse some of the high-profile enforcement actionsby the Privacy Commissioner. We also test compliance through an analysis of theprivacy policies of the top 23 SNSs operating in Canada and through the use of accessto personal information requests. Our analysis suggests that non-compliance iswidespread, and is explained by the countervailing conceptions of jurisdictioninherent in corporate policy and technical system design.

Analysis of serious non-AIDS events among HIV-infected adults at Latin American sites

Acquired immune deficiency appears to be associated with serious non-AIDS (SNA)-defining conditions such as cardiovascular disease, liver and renal insufficiency and non-AIDS-related malignancies. We analysed the incidence of, and factors associated with, several SNA events in the LATINA retrospective cohort.

Cross-cultural examination of the structure of the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R)

This study investigated the cross-cultural factor stability and internal consistency of the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R); a measure of the quality of postoperative pain management employed internationally. We conducted exploratory factor analysis (EFA) of APS-POQ-R data from two point-prevalence studies comprising 268 and 311 surveys of Danish and Australian medical-surgical patients. Parallel analysis indicated four and three factor solutions for Danish and Australian patients respectively, which accounted for 58.1% and 52.9% of variance. Internal consistency was unsatisfactory among both Danish (Cronbach α=.54) and Australian (Cronbach α=.63) cohorts. There was a high degree of between-group similarity in item-factor loadings of variables coded as "pain experience", but not "pain management". This reflected cross-cultural differences in ratings of treatment satisfaction. For Danish patients, satisfaction was associated with the degree of pain severity and activity interference whereas for Australian patients, satisfaction was associated with their perceived ability to participate in treatment. To facilitate further cross-cultural comparison, we compared our findings to past research conducted in the U.S. and Iceland. EFA supported the construct validity of the APS-POQ-R as a measure of "pain experience", but indicated that items measuring "pain management" may vary cross-culturally. Findings highlighted the need for further validation of the APS-POQ-R internationally. PERSPECTIVE: This study revealed the APS-POQ-R as a valid measure of postoperative pain experience for Danish and Australian patients. Measures of patients' perception of pain management were not robust to group differences in treatment expectations and demonstrated cross-cultural instability. Results highlighted difficulties in establishing stable cross-cultural, cross-population subscales for the APS-POQ-R.

Benefits of education at the intensive margin: childhood academic performance and adult outcomes among American immigrants

Using the Children of the Immigrants Longitudinal Study (CILS), we examine the associationbetween education at the intensive margin and twenty pecuniary and non-pecuniary adultoutcomes among first- and second-generation American immigrant youth. Education at theintensive margin is measured by two widely used standardized math and reading test scores,national percentile rankings on these tests and cumulative grade point average (GPA) in bothmiddle and high school. Our findings provide evidence that the academic achievement ofimmigrant children in early adolescence is an accurate predictor of later life outcomes. Wealso examine a novel hypothesis that relative academic performance of immigrant children inhigh school compared to middle school, which could be an indicator of change in adolescentaspirations and motivation as well as the degree of adaptation and assimilation to the hostcountry, has an effect on their adult outcomes even after controlling for the levels ofacademic performance in middle and high school. The results suggest that an improvementin GPA from middle school to high school is associated with favorable adult outcomes.Several sensitivity tests confirm the robustness of main findings.

Brutalism, metabolism and its American parallel : encounters in Skopje and in the architecture of Georgi Konstantinovski

Abstract Massive, raw concrete structures – the likes of the Telecommunications Building (1972–81) by Janko Konstantinov; the campus of Ss. Cyril and Methodius University (1974) by Marko Musˇicˇ; the National Hydraulic Institute (1972) by Krsto Todorovski; and the Bank Complex (1970) by R. Lalovik and O. Papesˇ – have led to the production of an enduring monumental presence and helped inspire Skopje’s title as the “Brutalist capital of the world”. These works followed Kenzo Tange’s introduction of Japanese Metabolism to Skopje through his role in the 1965 United Nations sponsored reconstruction competition. The unique position of a Non-Aligned Yugoslavia staged and facilitated architectural and professional exchange during the Cold War. Each trajectory and manifestation illustrates the complex picture of international architectural exchange and local production. Skopje and its numerous Brutalist edifices is an elucidative story, because it represents a meeting point between Brutalism, Metabolism and its American parallel. This article discusses, in particular, the Skopje Archive Building (1966) and the “Goce Delcˇev” Student Dormitory (1969) – two buildings designed by the architect Georgi Konstantinovski, realised on his return from a Masters program at Yale University and employment within I. M. Pei’s New York office. Their architecture illustrates the simultaneous preoccupations of leading architects at the time in regaining a conceptual ground made explicit through a complete and apprehensible image. From this particular position, the article explores the question of ethics and aesthetics central to Banham’s outline of the “New Brutalism”.

Beyond interdependence: Economic security and Sino-American-Australian trilateralism

Chinas economic and politico-military development is placing considerable strain on the established framework of the trilateral relationship between itself, the United States, and Australia. Specifically, Chinas rise is generating security concerns that are politicizing economic relations between the three states. A more guarded approach to economic collaboration will transform trilateralism, which up to now has been characterized by the scope allowed for the discrete pursuit of security and economic relations. This will force political authorities to carefully consider their policy priorities and further strain relations between the states, as well as supporting a more cautious approach to China on the part of the United States and Australia.

Volatility dynamics in the term structure of Latin American sovereign international bonds

We examine the nature of volatility dynamics in the term structure of sovereign bonds issued in international markets by major Latin American countries. Focusing only on the U.S. dollar-denominated sovereign international bonds, this study shows the heterogeneous nature of volatility effects that affect the term structure of individual countries in Latin America. Considering the significance of the Argentine credit event in the region, we also account for any change in dynamics following the Argentine default in 2001 by subsampling the pre- and postdefault windows. We also find some evidence of liquidity-driven volatility interaction in the term structure.

How social work can contribute in the shift to personalised, recovery-oriented psycho-social disability support services

This paper presents the findings from an Australian study in which forty-one people, who self-identified as having a psycho-social disability as a result of mental health problems, spoke about their priorities for treatment, care and support within a personalised funding context. The research enabled an improved understanding of the choices about support that people with psycho-social disabilities would make if offered individualised funding packages. Participants prioritised specific supports to improve their health, financial situation, social connection, housing and personal relationships. A relationship with a support worker with a range of skills was identified as a key facilitator of these life goals, but people with psycho-social disabilities also valued opportunities to have discretionary funds to directly address the major problems they face, including stigma, discrimination and poverty. The paper argues that social workers can potentially fill a range of roles and are well placed to work in partnership with people with psycho-social disabilities. Particularly, they have skills in co-production of services, negotiation and advocacy that are required if individual funding is to be maximised for user control, social justice and personal recovery outcomes.