Facebook Use Predicts Declines in Subjective Well-Being in Young Adults.


Abstract

Over 500 million people interact daily with Facebook. Yet, whether Facebook use influences subjective well-being over time is unknown. We addressed this issue using experience-sampling, the most reliable method for measuring in-vivo behavior and psychological experience. We text-messaged people five times per day for two-weeks to examine how Facebook use influences the two components of subjective well-being: how people feel moment-to-moment and how satisfied they are with their lives. Our results indicate that Facebook use predicts negative shifts on both of these variables over time. The more people used Facebook at one time point, the worse they felt the next time we text-messaged them; the more they used Facebook over two-weeks, the more their life satisfaction levels declined over time. Interacting with other people “directly” did not predict these negative outcomes. They were also not moderated by the size of people’s Facebook networks, their perceived supportiveness, motivation for using Facebook, gender, loneliness, self-esteem, or depression. On the surface, Facebook provides an invaluable resource for fulfilling the basic human need for social connection. Rather than enhancing well-being, however, these findings suggest that Facebook may undermine it.

Discussion

Within a relatively short timespan, Facebook has revolutionized the way people interact. Yet, whether using Facebook predicts changes in subjective well-being over time is unknown. We addressed this issue by performing lagged analyses on experience sampled data, an approach that allowed us to take advantage of the relative timing of participants’ naturally occurring behaviors and psychological states to draw inferences about their likely causal sequence [17][18]. These analyses indicated that Facebook use predicts declines in the two components of subjective well-being: how people feel moment to moment and how satisfied they are with their lives.

Critically, we found no evidence to support two plausible alternative interpretations of these results. First, interacting with other people “directly” did not predict declines in well-being. In fact, direct social network interactions led people to feel better over time. This suggests that Facebook use may constitute a unique form of social network interaction that predicts impoverished well-being. Second, multiple types of evidence indicated that it was not the case that Facebook use led to declines in well-being because people are more likely to use Facebook when they feel bad—neither affect nor worry predicted Facebook use and Facebook use continued to predict significant declines in well-being when controlling for loneliness (which did predict increases in Facebook use and reductions in emotional well-being).

Would engaging in any solitary activity similarly predict declines in well-being? We suspect that they would not because people often derive pleasure from engaging in some solitary activities (e.g., exercising, reading). Supporting this view, a number of recent studies indicate that people’sperceptions of social isolation (i.e., how lonely they feel)—a variable that we assessed in this study, which did not influence our results—are a more powerful determinant of well-being than objectivesocial isolation [25]. A related question concerns whether engaging in any Internet activity (e.g., email, web surfing) would likewise predict well-being declines. Here too prior research suggests that it would not. A number of studies indicate that whether interacting with the Internet predicts changes in well-being depends on how you use it (i.e., what sites you visit) and who you interact with [26].

Future research

Although these findings raise numerous future research questions, four stand out as most pressing. First, do these findings generalize? We concentrated on young adults in this study because they represent a core Facebook user demographic. However, examining whether these findings generalize to additional age groups is important. Future research should also examine whether these findings generalize to other online social networks. As a recent review of the Facebook literature indicated [2] “[different online social networks] have varied histories and are associated with different patterns of use, user characteristics, and social functions (p. 205).” Therefore, it is possible that the current findings may not neatly generalize to other online social networks.

Second, what mechanisms underlie the deleterious effects of Facebook usage on well-being? Some researchers have speculated that online social networking may interfere with physical activity, which has cognitive and emotional replenishing effects [27] or trigger damaging social comparisons[8][28]. The latter idea is particularly interesting in light of the significant interaction we observed between direct social contact and Facebook use in this study—i.e., the more people interacted with other people directly, the more strongly Facebook use predicted declines in their affective well-being. If harmful social comparisons explain how Facebook use predicts declines in affective well-being, it is possible that interacting with other people directly either enhances the frequency of such comparisons or magnifies their emotional impact. Examining whether these or other mechanisms explain the relationship between Facebook usage and well-being is important both from a basic science and practical perspective.

Finally, although the analytic approach we used in this study is useful for drawing inferences about the likely causal ordering of associations between naturally occurring variables, experiments that manipulate Facebook use in daily life are needed to corroborate these findings and establish definitive causal relations. Though potentially challenging to perform—Facebook use prevalence, its centrality to young adult daily social interactions, and addictive properties may make it a difficult intervention target—such studies are important for extending this work and informing future interventions.

Caveats

Two caveats are in order before concluding. First, although we observed statistically significant associations between Facebook usage and well-being, the sizes of these effects were relatively “small.” This should not, however, undermine their practical significance [29]. Subjective well-being is a multiply determined outcome—it is unrealistic to expect any single factor to powerfully influence it. Moreover, in addition to being consequential in its own right, subjective well-being predicts an array of mental and physical health consequences. Therefore, identifying any factor that systematically influences it is important, especially when that factor is likely to accumulate over time among large numbers of people. Facebook usage would seem to fit both of these criteria.

Second, some research suggests that asking people to indicate how good or bad they feel using a single bipolar scale, as we did in this study, can obscure interesting differences regarding whether a variable leads people to feel less positive, more negative or both less positive and more negative. Future research should administer two unipolar affect questions to assess positive and negative affect separately to address this issue.

Concluding Comment

The human need for social connection is well established, as are the benefits that people derive from such connections . On the surface, Facebook provides an invaluable resource for fulfilling such needs by allowing people to instantly connect. Rather than enhancing well-being, as frequent interactions with supportive “offline” social networks powerfully do, the current findings demonstrate that interacting with Facebook may predict the opposite result for young adults—it may undermine it.

Source: PLOS one

 

 

 

 

 

Concurrent Naltrexone and Prolonged Exposure Therapy for Patients With Comorbid Alcohol Dependence and PTSDA Randomized Clinical Trial.


Importance   Alcohol dependence comorbid with posttraumatic stress disorder (PTSD) has been found to be resistant to treatment. In addition, there is a concern that prolonged exposure therapy for PTSD may exacerbate alcohol use.

Objective   To compare the efficacy of an evidence-based treatment for alcohol dependence (naltrexone) plus an evidence-based treatment for PTSD (prolonged exposure therapy), their combination, and supportive counseling.

Design, Setting, and Participants   A single-blind, randomized clinical trial of 165 participants with PTSD and alcohol dependence conducted at the University of Pennsylvania and the Philadelphia Veterans Administration. Participant enrollment began on February 8, 2001, and ended on June 25, 2009. Data collection was completed on August 12, 2010.

Interventions   Participants were randomly assigned to (1) prolonged exposure therapy plus naltrexone (100 mg/d), (2) prolonged exposure therapy plus pill placebo, (3) supportive counseling plus naltrexone (100 mg/d), or (4) supportive counseling plus pill placebo. Prolonged exposure therapy was composed of 12 weekly 90-minute sessions followed by 6 biweekly sessions. All participants received supportive counseling.

Main Outcomes and Measures   The Timeline Follow-Back Interview and the PTSD Symptom Severity Interview were used to assess the percentage of days drinking alcohol and PTSD severity, respectively, and the Penn Alcohol Craving Scale was used to assess alcohol craving. Independent evaluations occurred prior to treatment (week 0), at posttreatment (week 24), and at 6 months after treatment discontinuation (week 52).

Results   Participants in all 4 treatment groups had large reductions in the percentage of days drinking (mean change, −63.9% [95% CI, −73.6% to −54.2%] for prolonged exposure therapy plus naltrexone; −63.9% [95% CI, −73.9% to −53.8%] for prolonged exposure therapy plus placebo; −69.9% [95% CI, −78.7% to −61.2%] for supportive counseling plus naltrexone; and −61.0% [95% CI, −68.9% to −53.0%] for supportive counseling plus placebo). However, those who received naltrexone had lower percentages of days drinking than those who received placebo (mean difference, 7.93%; P = .008). There was also a reduction in PTSD symptoms in all 4 groups, but the main effect of prolonged exposure therapy was not statistically significant. Six months after the end of treatment, participants in all 4 groups had increases in percentage of days drinking. However, those in the prolonged exposure therapy plus naltrexone group had the smallest increases.

Conclusions and Relevance   In this study of patients with alcohol dependence and PTSD, naltrexone treatment resulted in a decrease in the percentage of days drinking. Prolonged exposure therapy was not associated with an exacerbation of alcohol use disorder.

Source: JAMA

Deaf Student, Denied Interpreter by Medical School, Draws Focus of Advocates.


Speaking with the parents of a sick infant, Michael Argenyi, a medical student, could not understand why the child was hospitalized. During another clinical training session, he missed most of what a patient with a broken jaw was trying to convey about his condition.

His incomprehension, Mr. Argenyi explained, was not because of a deficiency in academic understanding. Rather, he simply could not hear.

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Mr. Argenyi, 26, is legally deaf. Despite his repeated requests to use an interpreter during clinical training, administrators at the Creighton University School of Medicine in Omaha, Neb., have refused to allow it. They have contended that Mr. Argenyi, who is able to speak, communicated well enough without one and that patients could be more hesitant to share information when someone else was present. They added that doctors needed to focus on the patient (not a third party) to rely on visual clues to make a proper diagnosis.

Mr. Argenyi took a leave of absence at the end of his second year, in 2011, after suing Creighton for the right to finish his medical training with an interpreter. The case, scheduled to go to trial on Tuesday in Federal District Court in Omaha, is attracting the attention of the federal government and advocates who are concerned that it could deal a setback to continuing efforts to achieve equality for people with disabilities.

“I couldn’t understand so much of the communication in the clinic,” Mr. Argenyi wrote in an e-mail. “It was humiliating to present only half of a history because I had missed so much of what was communicated. I was embarrassed every time I would miss medicine names that I knew from classes but couldn’t understand when the patient or a colleague spoke them.”

Despite making tremendous strides over the past four decades with the passage of theRehabilitation Act and the Americans with Disabilities Act, those with disabilities remain underrepresented in higher education and in the work force. In the medical field, people who are deaf or hard of hearing remain less likely to hold high-skilled positions than those without impairments.

Universities tend to provide requested accommodations after admitting a student who they know has a disability, proponents for the deaf say. And most arrangements for the deaf are settled long before any issues reach a courtroom, said Curtis Decker, the executive director of the National Disability Rights Network, a federally financed association of legal services programs.

But, he said of Mr. Argenyi’s lawsuit, “It’s a very important case because, I think, if it’s successful it will send a very powerful message to the university community that the law does cover them and the law is clear about the accommodations that they need to provide.”

Creighton officials maintain that they have provided Mr. Argenyi with the necessary tools for him to succeed in medical school.

“Michael Argenyi is a very bright, capable young man who Creighton believes will make a good doctor,” said Scott Parrish Moore, the lead counsel for Creighton.

After being accepted to Creighton four years ago, Mr. Argenyi asked the university to provide a real-time captioning system for lectures and a cued speech interpreter. (Mr. Argenyi, who does not know sign language, can read lips. An interpreter helps by mouthing words while using hand signals to clarify sounds.) These were the same accommodations that Mr. Argenyi, who had a diagnosis of profound deafness when he was 8 months old, received for much of his schooling, from grade school through undergraduate studies at Seattle University.

Creighton provided Mr. Argenyi with just one of the aides that his audiologist had recommended — an FM system, which amplifies the sounds he hears in cochlear implants. The university also provided note takers for lectures, priority seating and audio podcasts.

Soon after classes began, Mr. Argenyi told school officials that the accommodations were inadequate and that he was missing information. He sued in federal court in Omaha in September 2009, arguing that the university was legally required to pay for and provide necessary aides.

Mr. Argenyi said he hired his own interpreter and transcription service, which cost him more than $100,000 during his two years in medical school. The breaking point, he said, came during his clinical work in his second year when Creighton refused to allow him to use an interpreter, even if he paid for it himself. The university did allow Mr. Argenyi to use interpreters during a couple of clinics while the Justice Department was trying to broker a settlement, but stopped when a deal could not be reached.

Mr. Argenyi is pursuing degrees in public health and social work at Boston University, which is providing his requested transcription services, while the lawsuit is pending.

 

Source: http://www.nytimes.com

Surgeon lied to cancer patient about removing brain tumour.


A cancer surgeon lied to a patient for two years falsely telling her he had removed her brain tumour – leaving her with an inoperable tumour.

Emmanuel Labram lied to the woman and her husband, as well as colleagues about the operation, and forged documents to pretend the cancer had been removed. He even told her GP she didn’t need any further treatment.

Labram-surgeon_2638059b

The woman, referred to as Patient A, eventually had to seek private medical care but by that stage she was told the tumour was inoperable, the Medical Practitioners Tribunal Service heard.

She is due to give evidence at the hearing about what happened when she was under Labram’s care.

Craig Sephton QC, for the General Medical Council, told the misconduct hearing: “This is a case where it is difficult to understand why Mr Labram initially told the patient and her husband that he had completely removed the lesion when he must have known that no such thing had happened.

“He then lied and lied and lied in order to cover up his initial failure and the GMC will therefore invite you to conclude that is what has happened.”

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Labram, of Maryculter, Aberdeen, faces 11 allegations relating to his conduct surrounding the patient’s treatment.

The neurosurgeon is currently able to work in the UK subject to six conditions that mean his work is monitored by his professional regulator, but could be struck off if he is found guilty of misconduct. He continued to work at the hospital for three years after the patient complained, and took early retirement in March.

The hearing was told that he not only lied to Patient A about operating on her tumour, but later claimed it had returned before changing his position again and telling her he had never known it was even there.

After the woman fell ill on holiday in November 2007, she went to her optician and was referred to the Aberdeen Royal Infirmary, the hearing was told.

An MRI scan revealed a tumour about one inch in diameter in an area in her brain and she saw Labram to discuss her options in June 2008.

She decided to go ahead with an operation and underwent surgery at the hands of Labram on September 2.

After the surgery Labram told the woman and her husband the surgery had gone well and described how he had removed the tumour – when he hadn’t done this at all. He also sent letters to her GP telling them she needed no further treatment.

Mr Sephton added: “In fact he had not excised the lesion at all, whether in its entirety or otherwise, and Mr Labram must have known he had not done so.

“The GMC does not know why Mr Labram told Mr and Mrs A the lesion had been removed but there is no doubt he did so and what he said was clearly untrue and he knew it was untrue.

“The only explanation is he was being dishonest.”

It is alleged he only removed four tiny hard pale fragments when he knew the tumour was an inch in diameter and recorded in his notes only that ‘biopsies’ had been taken.

In January 2009 Labram is alleged to have sent a forged pathology report to Patient A to hide the fact she might need treatment and two months later failed to tell her an MRI scan showed the tumour was still present.

It was only after a third scan that the neurosurgeon changed his stance but continued his string of lies. He first told her and her GP the tumour had returned, and then in May 2010 told her he didn’t know it had been present when he operated on her.

The panel heard he gave her a further forged pathology report, with the author’s signature cut and pasted in.

After the woman raised concerns with the hospital he also lied to bosses, allegedly claiming he had not wanted to cause her any further stress.

“He was given the opportunity to come clean about the lies he had told and elected to not do so,” added Mr Sephton.

The hearing continues.

Source: http://www.telegraph.co.uk

Low Diastolic BP Associated with Higher Mortality in Chronic Kidney Disease.


The association of blood pressure with mortality in chronic kidney disease seems to follow a J-shaped curve, especially with regard to diastolic pressure, according to an Annals of Internal Medicine study.
Researchers followed some 650,000 U.S. veterans with non-dialysis–dependent disease over a median of 6 years. After adjustment for such factors as age, diabetes, and cardiovascular disease, patients with blood pressure in the range of 130 to 159 mm Hg systolic and 70 to 89 diastolic had the lowest mortality risk. Even patients with “ideal” systolic blood pressure of less than 130 had increased mortality rates if their diastolic levels were under 70.
The association could be caused, the authors speculate, by lower coronary perfusion with decreased diastolic pressure. Editorialists (and the authors) emphasize the observational nature of the data, with the “attendant limitations,” and note the preponderance of male patients. “Translating these findings into practice is challenging,” they conclude.
Source: Annals of Internal Medicine article

 

Specialized Care Didn’t Affect Healthcare Use Among Confused Hospitalized EldersBut patients were happier, and their families were satisfied with their care..


 

 
Some hospitals have specialized units to care for older, cognitively impaired patients, but whether such units improve outcomes is unclear. In this randomized trial, investigators compared care in a specialized unit versus standard care (geriatric or general medical wards) in 600 patients (median age, 85) identified as “confused” on admission to a large U.K. hospital. Specialized unit staff were skilled in managing patients with delirium and dementia, and specialized care included regular psychiatrist visits, organized activities, a physical environment tailored to patients with cognitive impairment, and proactive involvement of family caregivers.

After adjusting for multiple variables, investigators found no significant differences between patients randomized to specialized care and those randomized to standard care in days spent at home during 90 days after randomization (51 and 45 days) or in median length of hospital stay (11 days in both groups). Rates of return home from the hospital, in-hospital mortality, 90-day survival, hospital readmission, and nursing home placement also were similar. However, specialized-unit patients were significantly more likely than standard-care patients to be in a positive mood (79% vs. 68%), and their family caregivers were significantly more likely to be satisfied with their care (91% vs. 83%).

COMMENT

In this trial, confused elders admitted to a specialized unit did not have superior healthcare-use outcomes or longer survival than those admitted to geriatric or general medical wards. Although patient mood and family caregivers’ satisfaction favored specialized care over standard care, the absolute differences were small. Based on these findings, justifying the costs associated with such specialized units would be difficult.

Source: NEJM

 

3 Ways to Follow Your Passion While Still Working a Full Time Job.


Choose a job you love, and you will never have to work a day in your life. ~Confucius

We have all been there – sitting in our cubicle staring into the distance, dreaming of the day when you could leave it all behind and really follow your passion.  Safe inside those four walls it sounds so nice, and just outside your grasp.  But how do you really develop the skills and income needed to leave your job, while still working at your full time job?  It’s hard to stay motivated and pursue your passion when you don’t have that much extra energy after work.

3-Ways-to-Follow-Your-Passion-While-Still-Working-a-Full-Time-Job-

Here are 3 ways you can keep nurturing your dreams and following your passion, so that when you’re ready to leave the full time job, the path is laid out before you.

1. Keep the Inspiration Alive

Whatever your dream is, make sure it stays alive and real.  Don’t let your ideas fester in your head, only to wilt away.  Feed it, give it a life of its own. Connect with your passion in real life – take classes, go to lectures, attend meetups with folks interested in similar activities.  If you’re passionate about becoming a life coach, attend a coaching seminar or workshop in your area.  If you long to become a yoga teacher, make sure you’re taking classes at a yoga school that also helps train new teachers.

Join online communities of likeminded folks, so you start building your network of people with similar ideas, dreams and passions as yourself.  Tell your old friends and new community about your dream.  It helps make it real and gives you invested stakeholders to support you on your way.

2. Connect with Other People Farther Along Your Path

You can learn from them what to expect, and what the potential pitfalls and benefits are.  It’s a fine line between connecting with people who are doing what you want to do and idolizing people who are years ahead of you.  It can be damaging to look at highly successful people and try to map your journey to theirs, because the distance is daunting.  Especially if you’re just starting out, this can cause paralysis and overwhelm.  We want to avoid that and keep you moving towards your dreams in an informed way.

Mentors are an amazing thing.  Build relationships with people that inspire you, and ask them to mentor you.  It’s a fast track for learning more about your chosen path, quickly.  Mentors can inspire you, support you, and help you understand the next steps in your journey.

3. Gain Experience

As much as possible, get your feet wet before leaving your job.  This way you will know if you really like it, or just loved the idea of it.   It’s totally fine to like an idea more than the reality of something – and it’s good to know if that’s the case before you cut ties (and loose a paycheck).  If you do love it as much as you think you do, it’ll only motivate you more to keep following your passion – and the time gaining experience will give you a solid boost when it’s time to spread you wings and fly on your own.

All of these things can be done after work or on the weekends.  Generally, the more we love something, the more reward we feel doing it, the more motivated we are to invest more time in it.  So don’t be surprised if these start out as one or two hour a week activities that end up taking most of your time! That’s a good thing, it means you’re on the right path, following your passion, making your dreams happen.

If you do follow your bliss you put yourself on a kind of track that has been there all the while, waiting for you, and the life that you ought to be living is the one you are living. Follow your bliss and don’t be afraid, and doors will open where you didn’t know they were going to be. ~Joseph Campbell

Source: http://www.purposefairy.com

Molecular Remissions in Myeloproliferative Neoplasms with Pegylated Interferon.


 

Patients who failed to achieve complete molecular response tended to have mutations in genes outside the JAK2 pathway.
Myeloproliferative neoplasms are a heterogeneous group of diseases most often represented by polycythemia vera (PV) and essential thrombocythemia (ET). Mutations in the JAK2 tyrosine kinase are observed in nearly all patients with PV and in half of those with ET. Treatment with pegylated interferon α-2a (PEG-IFN) has induced complete hematologic and molecular responses and decreased the JAK2V617F allele burden in some but not all patients.

To determine whether patients unresponsive to PEG-INF have mutations in genes lying outside the JAK2 pathway, investigators performed a follow-up of a phase II study of 83 patients (43 with PV and 39 with ET) treated with PEG-IFN (90 µg subcutaneously weekly).

The rate of complete hematologic response was 76% for PV and 77% for ET, and the median time to a complete response was 40 days (range, 3–1478 days). Complete and partial (≥50%) elimination of the JAK2 mutant allele occurred in 18% and 35% of PV patients and 17% and 33% of ET patients, respectively. Patients who failed to achieve complete molecular response tended to have mutant genes outside the JAK2 pathway (56% vs. 30%), but this difference was not significant. However, 9 of 14 who failed to achieve complete molecular response had evidence of clonal evolution of their disease based on the appearance of new genetic abnormalities, whereas none of the 9 patients who achieved complete molecular response acquired new abnormalities. The JAK2burden was higher in patients with a concomitant mutation in TET2 than in those without this mutation (67% vs. 39%; P=0.04), and patients with the TET2 variant did not have a significant decline in the JAK2 mutant allele with PEG-IFN treatment.

COMMENT

Symptomatic patients with polycythemia vera or essential thrombocythemia are usually treated with cytoreductive agents, but these drugs are unsuitable for younger patients, and responses are usually transient. However, if patients can tolerate pegylated interferon α-2a, remission is often sustained. Refractory patients usually have several genetic mutants, and clonal evolution frequently occurs during treatment. The development of new agents targeting mutant genes outside the JAK2pathway should increase the response rate in patients with these myeloproliferative neoplasms.

Source: NEJM

Soda Linked to Aggression, Attention Problems, and Social Withdrawal in Young Children.


Soda has already been blamed for making kids obese. New research blames the sugary drinks for behavioral problems in children too.

Analyzing data from 2,929 families, researchers linked soda consumption to aggression, attention problems and social withdrawal in 5-year-olds. They published their findings in the Journal of Pediatrics on Friday.

Although earlier studies have shown an association between soft-drink consumption and aggression in teens, none had investigated whether a similar relationship existed in younger children.

To that end, Columbia University epidemiologist Shakira Suglia and her colleagues examined data from the Fragile Families and Child Wellbeing Study, which followed 2,929 mother-child pairs in 20 large U.S. cities from the time the children were born. The study, run by Columbia and Princeton University, collected information through surveys the mothers completed periodically over several years.

In one survey, mothers answered questions about behavior problems in their children. They also reported how much soda their kids drank on a typical day.

Suglia and her colleagues found that even at the young age of 5, 43% of the kids consumed at least one serving of soda per day, and 4% drank four servings or more.

The more soda kids drank, the more likely their mothers were to report that the kids had problems with aggression, withdrawal and staying focused on a task. For instance, children who downed four or more servings of soda per day were more than twice as likely to destroy others’ belongings, get into fights and physically attack people, compared with kids who didn’t drink soda at all.

Source: RealFarmacy.com