Sleep Quality as a Mediator of the Relationship Between Attachment Anxiety and Health Outcomes During Romantic Conflict

Attachment anxiety, or a fear of abandonment by those close to you, is an important predictor of many individual and interpersonal outcomes. Individuals high in attachment anxiety are more likely to experience physical illness due to disrupted immune functioning and deregulated stress responses. I was interested in examining potential mechanisms accounting for why individuals high in attachment anxiety are more likely to become ill. One variable that has been demonstrated to mediate the relationship between stress and health is sleep quality. As attachment anxiety is characterized by the experience of stress and worry over abandonment by romantic partners, I predicted sleep quality would mediate the relationship between attachment anxiety and health. Further, I predicted attachment anxiety would interact with romantic threat, in that individuals high in attachment anxiety who perceive threat to their relationships would have poor sleep quality (compared with individuals low in attachment anxiety and individuals high in anxiety who do not perceive threat) which would mediate the most unhealthy outcomes. I tested these hypotheses using three online diary studies. In the first two studies, participants completed a seven-night diary describing their sleep quality, health, and interaction with their partner. In Study 3, I surveyed participants once a week for eight weeks to examine longer-term health outcomes. Sleep quality did indeed mediate the relationship between attachment anxiety and various health outcomes over one week (Study 2), and showed a trend towards mediating effects over two months (Study 3). Interestingly, however, attachment anxiety did not interact with perceived romantic threat to predict health in the mediation analyses. Implications for sleep as a mediating variable are discussed, as well as the lack of attachment anxiety by romantic threat interaction.

Highbury Group Statement on Housing and Planning Bill

Briefing for members of House of Lords on Housing and Planning Bill

Housing and Planning in London under the Conservative Government: Spatial impacts, social polarisation, sustainable development and social justice

This paper will be based on my continuing research on planning and housing development in London. It will focus on the proposals in the Government’s Housing and Planning Bill, which are likely to be enacted in Spring 2016. It will review the evidence of potential spatial impacts in terms of the supply of existing affordable homes and the location and affordability of new supply. This will be related to a review of the alternative development options for London’s growth in the context of the Mayor of London’s draft 2050 Infrastructure Plan. The paper will analyse the potential impact of new Government policy and legislation on whether London’s housing requirements can be delivered in accordance with the objectives of sustainable planning and social justice, and will also consider the constraints on the ability of the new Mayor of London, to be elected in May 2016 to achieve manifesto commitments.

THE EPIDEMIOLOGY AND HEALTH ECONOMICS OF ANKLE INJURIES

The thesis focuses on a central theme of the epidemiology and health economics of ankle sprains to inform health policy and the provision of health services. It describes the burden, prognosis, resource utilization, and costs attributed to these injuries. The first manuscript systematically reviewed 34 studies on the direct and indirect costs of treating ankle and foot injuries. The overall costs per patient ranged from $2,075- $3,799 (2014 USD) for ankle sprains; $290-$20,132 for ankle fractures; and $6,345-$45,731 for foot fractures, reflecting differences in injury severity, treatment methods, and study characteristics. The second manuscript provided an epidemiological and economic profile of non-fracture ankle and foot injuries in Ontario using linked databases from the Institute for Clinical Evaluative Sciences. The incidence rate of ankle sprains was 16.9/1,000 person-years. Annually, ankle and foot injuries cost $21,685,876 (2015 CAD). The mean expenses per case were $99.98 (95% CI, $99.70-100.26) for any injury. Costs ranged from $133.78-$210.75 for ankle sprains and $1,497.12-$1,755.69 for dislocations. The third manuscript explored the impact of body mass index on recovery from medically attended grade 1 and 2 ankle sprains using the Foot and Ankle Outcome Score. Data came from a randomized controlled trial of a physiotherapy intervention in Kingston, Ontario. At six months, the odds ratio of recovery for participants with obesity was 0.60 (0.37-0.97) before adjustment and 0.74 (0.43-1.29) after adjustment compared to non-overweight participants. The fourth manuscript used trial data to examine the health-related quality of life among ankle sprain patients using the Health Utilities Index version 3 (HUI-3). The greatest improvements in scores were seen at one month post-injury (HUI-3: 0.88, 95% CI: 0.86-0.90). Individuals with grade 2 sprains had significantly lower ambulation scores than those with grade 1 sprains (0.70 vs. 0.84; p<0.05). The final manuscript used trial data to describe the financial burden (direct and indirect costs) of ankle sprains. The overall mean costs were $1,508 (SD: $1,452) at one month and increased to $2,206 (SD: $3,419) at six months. Individuals with more severe injuries at baseline had significantly higher (p<0.001) costs compared to individuals with less severe injuries, after controlling for confounders.

Architecture and health care: a place for sociology.

Sociologists of health and illness have tended to overlook the architecture and buildings used in health care. This contrasts with medical geographers who have yielded a body of work on the significance of places and spaces in the experience of health and illness. A review of sociological studies of the role of the built environment in the performance of medical practice uncovers an important vein of work, worthy of further study. Through the historically situated example of hospital architecture, this article seeks to tease out substantive and methodological issues that can inform a distinctive sociology of healthcare architecture. Contemporary healthcare buildings manifest design models developed for hotels, shopping malls and homes. These design features are congruent with neoliberal forms of subjectivity in which patients are constituted as consumers and responsibilised citizens. We conclude that an adequate sociology of healthcare architecture necessitates an appreciation of both the construction and experience of buildings, exploring the briefs and plans of their designers, and observing their everyday uses. Combining approaches and methods from the sociology of health and illness and science and technology studies offers potential for a novel research agenda that takes healthcare buildings as its substantive focus.

The association between anticholinergic medication burden and health related outcomes in the ‘oldest old’: A systematic review of the literature

Background: Increased exposure to anticholinergic medication is problematic, particularly in those aged 80 years and older.

Objective: The aim of this systematic review was to identify tools used to quantify anticholinergic medication burden and determine the most appropriate tool for use in longitudinal research, conducted in those aged 80 years and older.

Methods: A systematic literature search was conducted across six electronic databases to identify existing tools. Data extraction was conducted independently by two researchers; studies describing the development of each tool were also retrieved and relevant data extracted. An assessment of quality was completed for all studies. Tools were assessed in terms of their measurement of the association between anticholinergic medication burden and a defined set of clinical outcomes, their development and their suitability for use in longitudinal research; the latter was evaluated on the basis of criteria defined as the key attributes of an ideal anticholinergic risk tool.

Results: In total, 807 papers were retrieved, 13 studies were eligible for inclusion and eight tools were identified. Included studies were classed as ‘very good’ or ‘good’ following the quality assessment analysis; one study was unclassified. Anticholinergic medication burden as measured in studies was associated with impaired cognitive and physical function, as well as an increased frequency of falls. The Drug Burden Index (DBI) exhibited most of the key attributes of an ideal anticholinergic risk tool.

Conclusion: This review identified the DBI as the most appropriate tool for use in longitudinal research focused on older people and their exposure to anticholinergic medication burden.

SACN Carbohydrates and Health Report

The Scientific Advisory Committee on Nutrition (SACN) was asked by the Department of Health and the Food Standards Agency to examine the latest evidence on the links between consumption of carbohydrates, sugars, starch and fibre and a range of health outcomes (such as heart disease, type 2 diabetes, bowel health and tooth decay) to ensure the government’s position on consumption was up-to-date. In addition to the main report, you can read the SACN press release In its review of the evidence, SACN found that: High levels of sugar consumption are associated with a greater risk of tooth decay. The higher the proportion of sugar in the diet, the greater the risk of high energy intake. Drinking high-sugar beverages results in weight gain and increases in BMI in teenagers and children. Consuming too many high-sugar beverages increases the risk of developing type 2 diabetes. In light of these findings, SACN recommends that: Free sugars should account for no more than 5% daily dietary energy intake. The term free sugars is adopted, replacing the terms Non Milk Extrinsic Sugars (NMES) and added sugars. Free sugars are those added to food or those naturally present in honey, syrups and unsweetened fruit juices, but exclude lactose in milk and milk products. The consumption of sugar-sweetened beverages (e.g. fizzy drinks, soft drinks and squash) should be minimised by both children and adults.

SACN Carbohydrates and Health Report

Carbohydrates are a major source of energy in the diet. Classified according to their chemistry, carbohydrates can be divided into sugars (monosaccharides and disaccharides), polyols, oligosaccharides (malto-oligosaccharides and non-digestible oligosaccharides) and polysaccharides (starch and non-starch polysaccharides). However, this classification does not allow a simple translation into nutritional effects since each class of carbohydrates has overlapping physiological properties and effects on health. Carbohydrates can also be classified according to their digestion and absorption in the human small intestine. Digestible carbohydrates are absorbed and digested in the small intestine; non-digestible carbohydrates are resistant to hydrolysis in the small intestine and reach the large intestine where they are at least partially fermented by the commensal bacteria present in the colon. There is no universal definition of the term ‘dietary fibre’; broadly speaking, it refers to some or all of the constituents of non-digestible carbohydrates and may also include other quantitatively minor components (e.g.lignin) that are associated with non-digestible carbohydrates in plant cell walls.  

Vitamin D and Health

SACN reviewed the evidence on vitamin D and health to see if UK dietary recommendations, set in 1991, were still appropriate. In addition to the main report, you can read the SACN press release. In a change to previous advice, SACN is now recommending: a reference nutrient intake (RNI) of 10 micrograms of vitamin D per day, throughout the year, for everyone in the general population aged 4 years and older an RNI of 10 micrograms of vitamin D per day for pregnant and lactating women and population groups at increased risk of vitamin D deficiency a ‘safe intake’ of 8.5 to 10 micrograms per day for all infants from birth to 1 year of age a ‘safe intake’ of 10 micrograms per day for children aged 1 to 4 years The RNI and safe intakes were developed to ensure that the majority of the UK population has enough vitamin D to protect musculoskeletal health, all year round. SACN did not take account of sunlight exposure in making recommendations because of the number and complexity of factors that affect skin synthesis of vitamin D. The RNI and safe intakes refer to intake from all dietary sources: natural food sources fortified foods (including infant formula milk) supplements They also refer to average intakes over a period of time, such as a week, and take account of day-to-day variations in intake.

Exploring associations between violent discipline and aggressive behavior in children ages 4-5 in The Republic of Nicaragua: A secondary data analysis of the 2011 Demographic and Health Survey

Thesis (Master's)--University of Washington, 2016-06

Visual functioning and health-related quality of life in diabetic patients about to undergo anti-vascular endothelial growth factor treatment for sight-threatening macular edema

Purpose To examine patient-reported outcome (PRO) in a selected group of Swedish patients about to receive anti-vascular endothelial growth factor (VEGF) treatment for diabetic macular edema (DME). Material and methods In this cross-sectional study, 59 patients with diabetes mellitus, who regularly visited the outpatient eye-clinics, were included. Sociodemographic and clinical data were collected and the patients completed PRO measures before starting anti-VEGF treatment. PRO measures assessed eye-specific outcomes (NEI-VFQ-25) and generic health-related quality of life (SF-36). Results The participants consisted of 30 men and 29 women (mean age, 68.5 years); 54 (92 %) patients had type 2 diabetes; Five (9%) patients had moderate or severe visual impairment; 28 (47 %) were classified as having mild visual impairment. Some of the patients reported overall problems in their daily lives, such as with social relationships, as well as problems with impaired sight as a result of reduced distance vision. Conclusions Further studies are needed to investigate PRO factors related to low perceived general health in this patient population. It is important to increase our understanding of such underlying mechanisms to promote improvements in the quality of patient care.

Extending the capabilities of smartphone sensors for applications in interaction and health

Thesis (Ph.D.)--University of Washington, 2016-08

Iowa State University : premedical and health sciences, 2005

Includes information on Premedical and Health Sciences programs available at Iowa State University.

Agreed-upon procedures reports on twelve agreements between the Bureau of Nutrition and Health Services of the Iowa Department of Education and child care centers for the period October 1, 2014 through September 30, 2015

Agreed-upon procedures reports on twelve agreements between the Bureau of Nutrition and Health Services of the Iowa Department of Education and child care centers for the period October 1, 2014 through September 30, 2015