Interpersonal factors in insomnia: A model for integrating bed partners into cognitive behavioral therapy for insomnia

Available online 18 May 2012

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Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, Ontario, Canada M5B 2K3Received 29 September 2011. Revised 2 February 2012. Accepted 14 February 2012. Available online 18 May 2012.View full text Sleep has largely been conceptualized as an individual phenomenon, despite the fact that most adults share their bed with a partner at some time in their life. Only recently have researchers begun to examine the dyadic nature of sleep, and there is growing evidence that bed partners can play a role in the onset and maintenance of insomnia. Additionally, emerging evidence suggests that bed partners can be powerful agents of social control in terms of promoting adaptive health and sleep-related behaviors, and shared social rhythms between partners can help foster an environment that is conducive to good sleep. As such, the aim of the present article is to review the social context of the sleep environment and how best to include bed partners in insomnia treatment. Based on a synthesis of relevant literatures, a model for integrating bed partners into cognitive behavior therapy for insomnia (CBT-I) is presented and directions for future research are discussed.

prs.rt("abs_end");Insomnia; Sleep; Couple therapy; Cognitive behavioral therapy for insomnia; CBT-I; Partner-assisted

Figures and tables from this article:

Table 1. Questions to consider in conducting a clinical interview with the patient's partner.

View Within ArticleTable 2. Areas for integrating bed partner into partner-assisted version of CBT-I.

Note. Adapted from Edinger JD & Carney CE. Overcoming insomnia: A cognitive behavioral therapy approach. Therapist guide. New York, NY: Oxford University Press, USA 2008.

View Within ArticleCopyright © 2012 Elsevier Ltd. All rights reserved.

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View the original article here

Interpersonal factors in insomnia: A model for integrating bed partners into cognitive behavioral therapy for insomnia

Available online 18 May 2012

In Press, Corrected Proof — Note to users

Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, Ontario, Canada M5B 2K3Received 29 September 2011. Revised 2 February 2012. Accepted 14 February 2012. Available online 18 May 2012.View full text Sleep has largely been conceptualized as an individual phenomenon, despite the fact that most adults share their bed with a partner at some time in their life. Only recently have researchers begun to examine the dyadic nature of sleep, and there is growing evidence that bed partners can play a role in the onset and maintenance of insomnia. Additionally, emerging evidence suggests that bed partners can be powerful agents of social control in terms of promoting adaptive health and sleep-related behaviors, and shared social rhythms between partners can help foster an environment that is conducive to good sleep. As such, the aim of the present article is to review the social context of the sleep environment and how best to include bed partners in insomnia treatment. Based on a synthesis of relevant literatures, a model for integrating bed partners into cognitive behavior therapy for insomnia (CBT-I) is presented and directions for future research are discussed.

prs.rt("abs_end");Insomnia; Sleep; Couple therapy; Cognitive behavioral therapy for insomnia; CBT-I; Partner-assisted

Figures and tables from this article:

Table 1. Questions to consider in conducting a clinical interview with the patient's partner.

View Within ArticleTable 2. Areas for integrating bed partner into partner-assisted version of CBT-I.

Note. Adapted from Edinger JD & Carney CE. Overcoming insomnia: A cognitive behavioral therapy approach. Therapist guide. New York, NY: Oxford University Press, USA 2008.

View Within ArticleCopyright © 2012 Elsevier Ltd. All rights reserved.

prs.rt('data_end');

View the original article here

Prenatal Factors influence Kwashiorkor: Evidence for the Predictive Adaptation Model

AppId is over the quota AppId is over the quota

Severe acute malnutrition in childhood manifests as oedematous (kwashiorkor, marasmic kwashiorkor) and non-oedematous (marasmus) syndromes with very different prognoses. Kwashiorkor differs from marasmus in the patterns of protein, amino acid and lipid metabolism when patients are acutely ill as well as after rehabilitation to ideal weight for height. Metabolic patterns among marasmic patients define them as metabolically thrifty, while kwashiorkor patients function as metabolically profligate. Such differences might underlie syndromic presentation and prognosis. However, no fundamental explanation exists for these differences in metabolism, nor clinical pictures, given similar exposures to undernutrition. We hypothesized that different developmental trajectories underlie these clinical-metabolic phenotypes: if so this would be strong evidence in support of predictive adaptation model of developmental plasticity.

We reviewed the records of all children admitted with severe acute malnutrition to the Tropical Metabolism Research Unit Ward of the University Hospital of the West Indies, Kingston, Jamaica during 1962–1992. We used Wellcome criteria to establish the diagnoses of kwashiorkor (n = 391), marasmus (n = 383), and marasmic-kwashiorkor (n = 375). We recorded participants’ birth weights, as determined from maternal recall at the time of admission. Those who developed kwashiorkor had 333 g (95% confidence interval 217 to 449, p<0.001) higher mean birthweight than those who developed marasmus.

These data are consistent with a model suggesting that plastic mechanisms operative in utero induce potential marasmics to develop with a metabolic physiology more able to adapt to postnatal undernutrition than those of higher birthweight. Given the different mortality risks of these different syndromes, this observation is supportive of the predictive adaptive response hypothesis and is the first empirical demonstration of the advantageous effects of such a response in humans. The study has implications for understanding pathways to obesity and its cardio-metabolic co-morbidities in poor countries and for famine intervention programs.

Posted in evolutionary medicine

 

Prenatal Factors influence Kwashiorkor: Evidence for the Predictive Adaptation Model

AppId is over the quota AppId is over the quota

Severe acute malnutrition in childhood manifests as oedematous (kwashiorkor, marasmic kwashiorkor) and non-oedematous (marasmus) syndromes with very different prognoses. Kwashiorkor differs from marasmus in the patterns of protein, amino acid and lipid metabolism when patients are acutely ill as well as after rehabilitation to ideal weight for height. Metabolic patterns among marasmic patients define them as metabolically thrifty, while kwashiorkor patients function as metabolically profligate. Such differences might underlie syndromic presentation and prognosis. However, no fundamental explanation exists for these differences in metabolism, nor clinical pictures, given similar exposures to undernutrition. We hypothesized that different developmental trajectories underlie these clinical-metabolic phenotypes: if so this would be strong evidence in support of predictive adaptation model of developmental plasticity.

We reviewed the records of all children admitted with severe acute malnutrition to the Tropical Metabolism Research Unit Ward of the University Hospital of the West Indies, Kingston, Jamaica during 1962–1992. We used Wellcome criteria to establish the diagnoses of kwashiorkor (n = 391), marasmus (n = 383), and marasmic-kwashiorkor (n = 375). We recorded participants’ birth weights, as determined from maternal recall at the time of admission. Those who developed kwashiorkor had 333 g (95% confidence interval 217 to 449, p<0.001) higher mean birthweight than those who developed marasmus.

These data are consistent with a model suggesting that plastic mechanisms operative in utero induce potential marasmics to develop with a metabolic physiology more able to adapt to postnatal undernutrition than those of higher birthweight. Given the different mortality risks of these different syndromes, this observation is supportive of the predictive adaptive response hypothesis and is the first empirical demonstration of the advantageous effects of such a response in humans. The study has implications for understanding pathways to obesity and its cardio-metabolic co-morbidities in poor countries and for famine intervention programs.

Posted in evolutionary medicine

 

Tesla unveils sticker price for its Model S electric vehicle

As Americans pursue different ways to go green in 2012, some are considering buying electric vehicles. And while sales have been somewhat limited for two of the more popular electric automobiles—the Nissan Leaf and the Chevy Volt—Tesla is hoping to invigorate the market with an updated version of one of its classic electric offerings.
The carmaker recently announced that it would start selling its latest Tesla Model S sometime in 2012. While Tesla has detailed what the Model S looks like and what features it has, it's been tight-lipped about how much it will cost.
But in late December, Tesla announced how much their newest electric model will cost in 2012, a 365-day period which the company dubbed "The Year of Model S."
Model S will fetch $49,900 after tax credits
"There have been a lot of rumors about price increases lately," said George Bankenship, vice president of worldwide sales at Tesla. "I'm happy to say that all Model S pricing remains unchanged, including the basic version with the 40 [kilowatt-hour lithium] battery at the price we announced in 2009 of $49,900 after federal tax credits."
He added that the price includes standard features such as the 17-inch touch screen on the console, 19-inch wheels and a universal mobile connector that will enable motorists to power up their vehicles quickly.
Price higher for models with higher battery capacity
While the price may be costly for some, motorists who have the ability to spend more will be rewarded with improved performance. According to Cars.com, a standard 40-kWh battery will enable a Model S to travel 160 miles while traveling at an average speed of 55 miles per hour. However, Tesla will also offer models that have battery capacities of 60-kWh and 85-kWh. At the same speed of 55 mph, motorists in these cars will be able to travel 230 and 300 miles, respectively.
The increased capacity comes at a cost, though. The website reports that each increase in battery size raises the price by $10,000. Before federal tax credits, that means a 60-kWh Model S will run approximately $77,400.
But the first 1,000 Model S vehicles produced will have an even steeper asking price. Cars.com reports that these vehicles—part of Tesla's special Signature series—will run around $105,400, as they'll be equipped with a 300-mile-range battery.

When dealing with computer What is a working model of a proposed system?

How do you build a working model of an irrigation system? To build an irrigation system you will need clay,sand or soil (optional), plastic leaves,glass and other natural materials.

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