Functioning of Adolescents With Symptoms of Disturbed Sleep

The objective of the study was to examine the association between disturbed sleep and the functioning of adolescents, in particular cumulative effects on functioning across multiple life domains. Data from a large, school-based survey (n = 5,423) were used to examine the association between eight indicators of psychological, interpersonal, and somatic functioning and symptoms of insomnia and hypersomnia among adolescents. The strongest correlates of insomnia were disturbed mood (OR = 5.9), fatigue (OR = 7.4), and suicidal ideation (OR = 3.4). The same pattern held for hypersomnia, although the associations were not as strong for fatigue (OR = 6.8), mood disturbance (OR = 3.5), and suicide ideation (OR = 2.8). Youths who experienced both insomnia and hypersomnia had greater odds of psychological, interpersonal, and somatic dysfunction than youths who had experienced only one sleep disturbance. Cumulative effects of sleep problems were pronounced, with 27.6% of those with hypersomnia, 41.7% of those with insomnia, and 59.2% of those with both sleep problems reporting three or more types of dysfunction. The results suggest that adolescents experiencing disturbed sleep also experience a range of deficits in functioning. Further, youths with disturbed sleep are more likely to manifest multiple deficits in functioning. From the available evidence, however, it is not possible to specify what the causal pathways are. What are needed are cohort studies designed to examine the association of disturbed sleep and functional impairment among adolescents prospectively.     

Watching the Race: Where You Sit Affects What You See

States do seem to compete in making welfare policy. This competition,however, does not drive states inexorably toward a race to thebottom. Instead, this competition is a political rivalry ofthe kind that leads to unpredictable and unstable outcomes.This rivalry entails interstate learning and results in adaptation,but it stems from its political utility in appealing to votersand gaining personal recognition in the political arena     

Convergence in the Dutch Health Insurance: Possibilities and Obstacles in a European Perspective

Convergence in Dutch Health Insurance presents possibilities and obstacles considered from a European perspective. The idea is to converge the two existing systems of social and private health insurance. Private health insurers will be obliged to offer a minimum level of health insurance cover based on community rating. In this article consequences of the EC Treaty are in focus. Extensive convergence can be legally allowed in the interests of the common good. The European Court of Justice plays a decisive role in deciding whether convergence is approved according to the rules of the EC Treaty.     

Street Foods: Traditional Microenterprise in a Modernizing World

Action-research projects focused on poor women both collect information and design interventions to improve their livelihood. This approach is illustrated by studying street food vendors in Iloilo, Philippines. Findings document the importance of street foods as a source of income and of food. Interventions to improve both safe food handling and income were proposed and tested in Iloilo and Manila; a revisit after a decade shows their long-term impact on the vendors. Overall, this and six other studies comprising the street food project influenced policy changes by municipal, national, and international agencies and organizations. The conclusions challenge theoretical assumptions held by economists concerning the informal sector and by feminists regarding the family.