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This study examined the relationship between a diagnosis of cancer and the likelihood of having any out-of-pocket costs (OOPC) and medical debt, and the amounts of OOPC and medical debt, at the household level. We used the 2013 Panel Study of Income Dynamics, a continuous, representative panel survey that collects demographic, economic, and social data in the United States. The analytic sample included head of households and their spouse (if married), 18–64 years old. Two-part models were used. The first part consisted of logistic regression models and the second part consisted of generalized linear models with logarithmic link and a gamma distribution. Logistic regression results showed odds of 2.13 (CI: 1.27, 3.57, p &lt, 0.01) for any OOPC and odds of 1.55 (CI: 0.93, 2.58, p &lt, 0.1) for any medical debt for households in which either the head or spouse (if married) reported a diagnosis of cancer compared to those that did not report a diagnosis of cancer. Likewise, results from the second part of the model for households with a positive amount of OOPC showed an exponentiated coefficient of 1.73 (CI: 1.33, 2.25, p &lt, 0.01) for households in which either the head or spouse (if married) reported a diagnosis of cancer compared to households without a diagnosis of cancer. This study shows that a diagnosis of cancer places a financial burden on families, particularly with all types of debt, in the United States even after controlling for differences between households with a diagnosis of cancer and those without a diagnosis of cancer.

This paper examines the relationship between self-reported health status and medical debt outcomes using data from the 2013 Panel Study of Income Dynamics. There were two outcomes of interest: (a) the likelihood of having any medical debt, which included 4,227 households and (b) the amount of medical debt (medical debt > 0), which included 631 households. The results from the multivariate models showed that fair/poor health status increased the likelihood of having any medical debt by 73% and was associated with an increase in the amount of medical debt among those with medical debt by about 77% (p < .001) compared to those who reported better health. Poor health status appears to impose a financial burden on some households.

There is a scarcity of research establishing a relationship between mental illness and the U.S. military service members who participate in the field of military humanitarian assistance/disaster relief (HA/DR). One of the few studies in this area showed that participation in military HA/DR was not associated with depressive symptoms, however, the study was limited by sample size. This study examined (1) the relationship between participation in military HA/DR and mental health symptoms and military stress and (2) the relationship between HA/DR and mental health treatment and therapy.Data from the 2011 Health Related Behaviors Survey was used. The analytic sample consisted of U.S. military service members who participated in HA/DR (the Haiti earthquake and Deepwater Horizon oil spill in the Gulf) (n = 573) compared to those who participated in non-HA/DR deployments from 2007 to 2011 (n = 986). Multivariate models were used to examine the relationship between the independent variables and dependent variables while controlling for a set of variables that may confound the relationship between the two.The logistic regression model found that participating in HA/DR deployments decreased the likelihood of service members reporting post-traumatic stress disorder (PTSD) symptoms by 3% (p0.1) and depressive symptoms by 1% (p0.05). Furthermore, participation decreased the likelihood of having a prescription for antidepressants during and/or 3 months after deployment by 1% (p0.05). Additional results showed that junior enlisted and senior enlisted members were more likely to report symptoms of PTSD than senior officers (p0.05). Marines were more likely to seek treatment and therapy for depression than U.S. Coastguard members (p0.1).Results showed that participation in HA/DR was associated with significant reductions in PTSD symptoms, depressive symptoms, and the use of antidepressants by service members. Further research needs to understand the mechanism of these associations for better planning and implementation of HA/DR and delivery of care to service members who participate in these missions.

This study used data from the Military Health System Data Repository to examine the association between mild traumatic brain injuries (mTBI) and work functioning such as work duty limitations, hospital emergency room visits and inpatient admissions for active-duty service members (ADSMs). Further, this study assessed the role that common symptoms of mTBI play in work functioning. Multivariate results showed that having a mTBI diagnosis is not a major factor that results in being “released with work duty limitations”. However, findings from these regression models also showed that the interaction of mTBI with cognitive and linguistic symptoms resulted in odds of 3.63 (CI: 1.40–9.36, p &lt, 0.01) for being “released with work duty limitations” and odds of 4.98 (CI: 1.16–21.39, p &lt, 0.05) for having any emergency department visits compared to those with no diagnosis of mTBI and none of these symptoms. Additionally, the interaction of mTBI with sleep disturbance and chronic pain showed odds of 2.72 (CI: 1.31–5.65, p &lt, 0.01) and odds of 11.56 (CI: 2.65–50.44, p &lt, 0.01) for being “released with work duty limitations” compared to those with no diagnosis of TBI and none of these symptoms, respectively. Further research is needed to investigate the association between mTBI and duration of time off work to provide a comprehensive understanding of the effect of mTBI on work functioning in the Military Health System.

Threat induces a state of sustained anxiety that can disrupt cognitive processing, and, reciprocally, cognitive processing can modulate an anxiety response to threat. These effects depend on the level of cognitive engagement, which itself varies as a function of task difficulty. In adults, we recently showed that induced anxiety impaired working memory accuracy at low and medium but not high load. Conversely, increasing the task load reduced the physiological correlates of anxiety (anxiety-potentiated startle). The present work examines such threat-cognition interactions as a function of age. We expected threat to more strongly impact working memory in younger individuals by virtue of putatively restricted cognitive resources and weaker emotion regulation. This was tested by examining the influence of age on the interaction of anxiety and working memory in 25 adolescents (10 to 17 years) and 25 adults (22 to 46 years). Working memory load was manipulated using a verbal n-back task. Anxiety was induced using the threat of an aversive loud scream and measured via eyeblink startle. Findings revealed that, in both age groups, accuracy was lower during threat than safe conditions at low and medium but not high load, and reaction times were faster during threat than safe conditions at high load but did not differ at other loads. Additionally, anxiety-potentiated startle was greater during low and medium than high load. Thus, the interactions of anxiety with working memory appear similar in adolescents and adults. Whether these similarities reflect common neural mechanisms would need to be assessed using functional neuroimaging.

Background There is limited knowledge on the impact of education on veterans' health in the United States. This study specifically examines the relationship between the education benefits from the G.I. Bill and veterans' health. Methods This study used data from the 2010 National Survey of Veterans. The subjects for this study were 5,052 veterans who were eligible to receive G.I. Bill benefits, representing a total of about 12.7 million non-institutionalized veterans in the United States in 2010. The dependent variables included self-reported health status and smoking behavior. The key independent variable was whether veterans used the education benefits from the G.I. Bill compared with those who were eligible but did not use them. Findings Results from multivariate regression analyses showed that those who used the education benefits from the G.I. Bill were 4% less likely to report fair/poor health (p < 0.01) and 3% less likely to report any smoking (p < 0.05) compared with those who did not use the education benefits. Additional analyses showed that using the education benefits to attend college decreased the probability of being in fair/poor health by 4% (p < 0.10) and being a smoker by 4% (p < 0.05) compared with those who did not attend college but used their benefits for non-college attainment such as business, technical, or vocational schools. More importantly, a larger association was found between the use of the education benefits from the G.I. Bill to obtain a college degree and fair/poor health (7%, p < 0.05) and smoking behavior (9%, p < 0.01) compared with those who attended college but did not obtain a college degree. Discussion This study shows that providing opportunities for service members to complete their education also has important health benefits.

This study examines the influence of trait anxiety on working memory (WM) in safety and threat. Interactions between experimentally induced anxiety and WM performance (on different cognitive loads) have been reported in healthy, nonanxious subjects. Differences in trait anxiety may moderate these interactions. Accordingly, these interactions may be potentiated by high trait anxiety (HTA), or show a resilient pattern that protects cognitive performance. HTA and low trait anxiety (LTA) were defined by a median split of scores on the trait component of the state-trait anxiety inventory. Sustained anxiety was evoked by a probabilistic exposure to an aversive scream, and was measured by eyeblink startle and self-report. WM was tested using an n-back task (1-, 2-, and 3-back). Results revealed that, as expected, the HTA group reported greater anxiety during the task. However, trait anxiety did not impact the modulation of WM performance by induced anxiety. Notably, HTA influenced anxiety-potentiated startle (startle during threat minus startle during safe; APS) differently as a function of memory load. Accordingly, APS decreased with increasing WM load, but HTA antagonized this reduction. The HTA group showed no impairment on the 3-back WM task despite a higher APS. The amplified APS could be associated with the increase in effort-related cognitive arousal. Furthermore, this third replication of the interaction of induced anxiety by load on WM performance testifies to the robustness of the unique interplay between anxiety and WM.

A workflow is presented that integrates gene expression data, proteomic data, and literature-based manual curation to construct multicellular, tissue-specific models of human brain energy metabolism that recapitulate metabolic interactions between astrocytes and various neuron types. Three analyses are applied for gene identification, analysis of omics data, and analysis of physiological states. First, we identify glutamate decarboxylase as a target that may contribute to cell-type and regional specificity in Alzheimer’s disease. Second, the decreased metabolic rate seen in affected brain regions in Alzheimer’s disease is consistent with a suppression of central metabolic gene expression in histopathologically normal neurons. Third, we identify pathways in cholinergic neurons that couple mitochondrial metabolism and cytosolic acetylcholine production, and subsequently find that cholinergic neurotransmission accounts for ∼3% of brain neurotransmission. Constraint-based modeling can thus contribute to the study and analysis of multicellular metabolic processes in human tissues, and provide detailed mechanistic insight into high-throughput data analysis.