Amanda M. Balkhi

Sleep disturbances associated with cigarette smoking

Sleep disturbances resulting in insufficient sleep have been linked to negative physical, cognitive, and public health outcomes. Despite this, there has yet a study that examines the impact of smoking on sleep in a US based national sample. The current study sought to observe sleep disturbances associated with smoking status. Sleep disturbances in adults aged 20 years and above, from the 2005–2006 National Health and Nutrition Examination Survey, were measured among current, former, and never smokers (NS). Current smokers (CS) reported significantly less total sleep time, longer sleep onset latency, increased difficulty falling asleep, maintaining sleep, and waking up earlier than desired when compared to NS. Former smokers reported disturbances similar to NS and CS experienced poorer sleep than nonsmokers. Our study is the first to observe sleep difficulty by smoking status in a large, population-based, nationally representative sample. Recommendations for smoking cessation programs are discussed.

The diabetes online community: the importance of forum use in parents of children with type 1 diabetes

Online forums for chronic health conditions emerged as early as 30 yr ago and interest in their study has blossomed. Type 1 diabetes (T1D) forums have grown exponentially since 2005. Therefore, a comprehensive evaluation of these forums is needed. This study assesses the demographics and motivations of parents who use type 1 diabetes forums and the potential impact that forum membership (FM) has on parenting stress and hypoglycemic fear. One hundred and two parents were recruited through online T1D forums and asked to complete qualitative and quantitative measures of their experience with the T1D forums. Results of this study suggest that parents who use T1D forums mirror those who participate in clinic‐based research protocols and are primarily motivated to participate in forums to increase their diabetes knowledge and gain social support. Indeed, parents who use T1D forums report high levels of trust, social support, and perceived knowledge gained. However, FM was positively related to increased self‐reported parenting stress frequency and hypoglycemic fear behaviors. Taken together, the relationships formed within these communities may have a significant impact on the experience of these caregivers. The need for future research and potential implications for physicians, including parent debriefing, are discussed.

Telehealth interventions to reduce management complications in type 1 diabetes: A review.

Type 1 diabetes is a chronic illness with a high burden of care. While effective interventions and recommendations for diabetes care exist, the intensive nature of diabetes management makes compliance difficult. This is especially true in children and adolescents as they have unique psychosocial and diabetes needs. Despite the development of effective in-person interventions targeting improving self-management and ameliorating psychosocial difficulties there are still a number of barriers to implementing these interventions, namely time, cost, and access. Telehealth interventions allow for the dissemination of these interventions to a broader audience. Self-management and psychosocial telehealth interventions are reviewed with a special emphasis on mobile phone and internet based technology use. While efficacy has been demonstrated in a number of telehealth interventions with improved cost effectiveness over in-person interventions, many challenges remain including high participant attrition and difficulties with receiving reimbursement for services rendered. These and other challenges are discussed with recommendations for researchers and telehealth providers provided.

Paging Dr. Google: Parents’ Report of Internet Use for Type 1 Diabetes Management

Caregivers are important for effective treatment management of a child’s type 1 diabetes, as effective treatment often requires intensive care. Some parents balance this high burden of care by turning to the Internet for additional information (online health information seeking [OHIS]) and often use information found online to care for their child (1,2). This is potentially concerning as the quality and accuracy of online health information are variable (3,4); however, reliable estimates of OHIS have not been established. The current study will examine the prevalence and frequency of OHIS in type 1 diabetes caregivers. The researchers designed a brief survey for caregivers to complete while waiting for their child’s appointment at a large Southeastern pediatric diabetes specialty clinic. The survey assessed parents’ demographics and their use of online sources for diabetes information. A total of 49% …

Frequent Nonprescription Stimulant Use and Risky Behaviors in College Students: The Role of Effortful Control

Abstract Objective: The goal of this study was to (a) investigate the association between nonprescription stimulant use (NPSU) and risky behaviors, including risky sex, driving, financial behaviors, and drug use and (b) collect preliminary evidence on mechanisms that may link NPSU to risky behaviors. Participants: A sample of 555 college students was collected between August 2010 and February 2012. Methods: Students completed several self-report measures assessing their drug use history, attention-deficit and hyperactivity symptoms, temperament, and risky behaviors beyond drug use. Results: Those who reported more frequent NPSU were more likely to engage in high-risk behavior across all 4 domains studied. Further, effortful control abilities partially mediated the link between NPSU and risky behaviors. Conclusions: These results highlight the associated risks of frequent NPSU for college students as well as provide future directions for examining effortful control as a potentially important mechanism linking NPSU to other risky behaviors.

Impact of Perceived Weight Discrimination on Patient Satisfaction and Physician Trust

Fat patients may perceive weight discrimination from their physician or the support personnel with whom they interact. This in turn may harm the physician-patient relationship. Physician trust and patient satisfaction are two domains in which the effect of perceived weight discrimination can be assessed. The authors assessed whether size as measured by body mass index (BMI) is related to patient satisfaction and physician trust, and whether this relationship is mediated by perceived weight discrimination. Eighty-nine men and women of all weight classes were recruited to participate in the study. Participants completed an online survey of healthcare perceptions. The relationship between BMI and accessibility and convenience satisfaction was fully mediated by perceived weight discrimination, suggesting that measures to reduce perceived weight discrimination may be warranted in medical care settings.

Relations Between Quality of Life, Family Factors, Adherence, and Glycemic Control in Pediatric Patients With Type 1 Diabetes Mellitus

This study examined relations among diabetes-specific family factors, adherence to medical regimen, quality of life (QOL), and glycemic control in youth and adolescents with type 1 diabetes. During an endocrinologist visit, patient and parent–caregiver dyads (n = 70) completed family factors and QOL measures and participated in a structured interview to assess medical regimen compliance, and the patients glycemic control was assessed by a medical professional. Combined measures accounted for 42% of the variance in glycemic control. QOL partially mediated adherence and glycemic control. Ethnic minority status was associated with poorer glycemic control.

The progressive cascading model improves exposure delivery in trainee therapists learning exposure therapy for obsessive-compulsive disorder.

Researchers postulate that a lack of training in exposure therapy may underlie the poor dissemination that has been observed. The current study sought to provide support for the progressive cascading model (PCM), which was developed to train novice therapists in exposure-based techniques. The PCM is promising considering its scalability and financial feasibility. Forty-two trainee therapists completed a rotation at a university clinic specializing in obsessive–compulsive disorder where they were trained within the PCM. After training, therapists delivered exposure therapy in a more intense manner with fewer cautious delivery behaviors (e.g., allowing anxiety reduction strategies) and distress reduction behaviors (e.g., reassuring safety). Therapists also had fewer negative beliefs about exposure therapy and reported lower disgust sensitivity post-training. The PCM appears to be a potentially effective training model for teaching exposure-based techniques and warrants additional research. Such a model is timely considering the poor dissemination of exposure therapy and the movement toward competency-based education in graduate school.

The link between ADHD-like inattention and obsessions and compulsions during treatment of youth with OCD ☆

Attention-deficit/hyperactivity disorder (ADHD) has been found to be highly comorbid in children and adolescents with obsessive-compulsive disorder (OCD). Some have proposed, however, that obsessive anxiety may cause inattention and executive dysfunction, leading to inappropriate ADHD diagnoses in those with OCD. If this were the case, these symptoms would be expected to decrease following successful OCD treatment. The present study tested this hypothesis and evaluated whether ADHD symptoms at baseline predicted OCD treatment response. Obsessive-compulsive and ADHD symptoms were assessed in 50 youth enrolled in a randomized controlled trial investigating selective serotonin reuptake inhibitor and cognitive behavioral treatment. Repeated-measures analysis of variance (RMANOVA) revealed that ADHD symptoms at baseline do not significantly predict treatment outcome. A multivariate RMANOVA found that OCD treatment response moderated change in inattention; participants who showed greater reduction in OCD severity experienced greater reduction in ADHD-inattentive symptoms, while those with less substantial reduction in obsessions and compulsions showed less change. These findings suggest that children and adolescents with OCD and inattention may experience meaningful improvements in attention problems following OCD treatment. Thus, in many youth with OCD, inattention may be inherently tied to obsessions and compulsions. Clinicians may consider addressing OCD in treatment before targeting inattentive-type ADHD.