Medicaid expansion and the mental health of college students.

Reported mental health problems have risen dramatically among US college students over time, as has treatment for these problems. We examine the effect of state-level Medicaid expansion following the 2014 implementation of the Affordable Care Act on the diagnosis of mental health conditions, psychotropic prescription drug use, and the mental health status of a national sample of college students. We find that students from disadvantaged backgrounds are more likely to report being on public insurance after 2014 in expansion states relative to non-expansion states, while more advantaged students do not see this increase. Both diagnosis of common mental health conditions and psychotropic drug use increase following expansion for disadvantaged students relative to advantaged ones, which translates into an elimination of the pre-expansion gap in these outcomes by family background in expansion states. However, in contrast to some recent work on Medicaid expansion and mental health, we do not find that these changes are associated with improvements in self-reported mental health status. We also do not find that Medicaid expansion has affected risky health behaviors or academic outcomes.

Demonstration of acceleration of relativistic electrons at a dielectric microstructure using femtosecond laser pulses.

Acceleration of electrons using laser-driven dielectric microstructures is a promising technology for the miniaturization of particle accelerators. Achieving the desired GV m-1 accelerating gradients is possible only with laser pulse durations shorter than ∼1 ps. In this Letter, we present, to the best of our knowledge, the first demonstration of acceleration of relativistic electrons at a dielectric microstructure driven by femtosecond duration laser pulses. Using this technique, an electron accelerating gradient of 690±100 MV m-1 was measured-a record for dielectric laser accelerators.

Allosteric Signaling in PDZ Energetic Networks: Embedding Error Analysis.

Allosteric signaling in proteins has been known for some half a century, yet how the signal traverses the protein remains an active area of research. Recently, the importance of electrostatics to achieve long-range signaling has become increasingly appreciated. Our laboratory has been working on developing network approaches to capture such interactions. In this study, we turn our attention to the well-studied allosteric model protein, PDZ. We study the allosteric dynamics on a per-residue basis in key constructs involving the PDZ domain, its allosteric effector, and its peptide ligand. We utilize molecular dynamics trajectories to create the networks for the constructs to explore the allosteric effect by plotting the heat kernel results onto axes defined by principal components. We introduce a new metric to quantitate the volume sampled by a residue in the latent space. We relate our findings to PDZ and the greater field of allostery.

Variable Regions of p53 Isoforms Allosterically Hard Code DNA Interaction.

Allosteric regulation of protein activity pervades biology as the "second secret of life." We have been examining the allosteric regulation and mutant reactivation of the tumor suppressor protein p53. We have found that generalizing the definition of allosteric effector to include entire proteins and expanding the meaning of binding site to include the interface of a transcription factor with its DNA to be useful in understanding the modulation of protein activity. Here, we cast the variable regions of p53 isoforms as allosteric regulators of p53 interactions with its consensus DNA. We implemented molecular dynamics simulations and our lab's new techniques of molecular dynamics (MD) sectors and MD-Markov state models to investigate the effects of nine naturally occurring splice variant isoforms of p53. We find that all of the isoforms differ from wild type in their dynamic properties and how they interact with the DNA. We consider the implications of these findings on allostery and cancer treatment.

Forward-Thinking Teens: The Effects of College Costs on Adolescent Risky Behavior.

This paper analyzes the effect of college costs on teenagers' engagement in risky behaviors before they are old enough to attend college. Individuals with brighter prospects for future schooling attainment may engage in less drug and alcohol use and risky sexual activity because they have more to lose if such behaviors have harmful effects in their lives. If teens correctly predict that higher college costs make future college enrollment less likely, then adolescents facing different expected costs may choose different levels of risky behavior. I find that lower college costs in teenagers' states of residence raise their subjective expectations regarding college attendance and deter teenage substance use and sexual partnership. Specifically, a $1,000 reduction in tuition and fees at two-year colleges in a youth's state of residence (roughly a 50% difference at the mean) is associated with a decline in the number of sexual partners the youth had in the past year (by 26%), the number of days in the past month the youth smoked (by 14%), and the number of days in the past month the youth used marijuana (by 23%). These findings suggest that the often-studied correlation between schooling and health habits emerges in adolescence because teenagers with brighter college prospects curb their risky behavior in accordance with their expectations. The results also imply that policies that improve teenagers' educational prospects may be effective tools for reducing youthful involvement in such behaviors.

GEOGRAPHICAL ACCESS TO RECREATIONAL MARIJUANA.

We investigate whether adult marijuana use in Washington responds to increased local access as measured by drive time to the nearest legal marijuana retailer as well as measures of retail density. Using survey data from the Behavioral Risk Factor Surveillance System, we find that as retailers open closer to where they live, more individuals use marijuana and more frequently. These effects are concentrated among young adults (ages 18-26), women, and rural residents. Controlling for distance to the nearest retailer, we find that whether retail density affects marijuana use depends on how it is measured.

Young People Seeking Help Online for Mental Health: Cross-Sectional Survey Study.

BACKGROUND: Young people are particularly vulnerable to experiencing mental health difficulties, but very few seek treatment or help during this time. Online help-seeking may offer an additional domain where young people can seek aid for mental health difficulties, yet our current understanding of how young people seek help online is limited. OBJECTIVE: This was an exploratory study which aimed to investigate the online help-seeking behaviors and preferences of young people. METHODS: This study made use of an anonymous online survey. Young people aged 18-25, living in Ireland, were recruited through social media ads on Twitter and Facebook and participated in the survey. RESULTS: A total of 1308 respondents completed the survey. Many of the respondents (80.66%; 1055/1308) indicated that they would use their mobile phone to look online for help for a personal or emotional concern. When looking for help online, 82.57% (1080/1308) of participants made use of an Internet search, while 57.03% (746/1308) made use of a health website. When asked about their satisfaction with these resources, 36.94% (399/1080) indicated that they were satisfied or very satisfied with an Internet search while 49.33% (368/746) indicated that they were satisfied or very satisfied with a health website. When asked about credibility, health websites were found to be the most trustworthy, with 39.45% (516/1308) indicating that they found them to be trustworthy or very trustworthy. Most of the respondents (82.95%; 1085/1308) indicated that a health service logo was an important indicator of credibility, as was an endorsement by schools and colleges (54.97%; 719/1308). Important facilitators of online help-seeking included the anonymity and confidentiality offered by the Internet, with 80% (1046/1308) of the sample indicating that it influenced their decision a lot or quite a lot. A noted barrier was being uncertain whether information on an online resource was reliable, with 55.96% (732/1308) of the respondents indicating that this influenced their decision a lot or quite a lot. CONCLUSIONS: Findings from this survey suggest that young people are engaging with web-based mental health resources to assist them with their mental health concerns. However, levels of satisfaction with the available resources vary. Young people are engaging in strategies to assign credibility to web-based resources, however, uncertainty around their reliability is a significant barrier to online help-seeking.

Recreational marijuana legalization and college student use: Early evidence.

We analyze marijuana use by college undergraduates before and after legalization of recreational marijuana. Using survey data from the National College Health Assessment, we show that students at Washington State University experienced a significant increase in marijuana use after legalization. This increase is larger than would be predicted by national trends. The change is strongest among females, Black students, and Hispanic students. The increase for underage students is as much as for legal-age students. We find no corresponding changes in the consumption of tobacco, alcohol, or other drugs.

Employer-sponsored health insurance and the gender wage gap.

During prime working years, women have higher expected healthcare expenses than men. However, employees' insurance rates are not gender-rated in the employer-sponsored health insurance (ESI) market. Thus, women may experience lower wages in equilibrium from employers who offer health insurance to their employees. We show that female employees suffer a larger wage gap relative to men when they hold ESI: our results suggest this accounts for roughly 10% of the overall gender wage gap. For a full-time worker, this pay gap due to ESI is on the order of the expected difference in healthcare expenses between women and men.

The effects of merit-based financial aid on drinking in college.

We study the effect of state-level merit aid programs (such as Georgia's HOPE scholarship) on alcohol consumption among college students. Such programs have the potential to affect drinking through a combination of channels--such as raising students' disposable income and increasing the incentive to maintain a high GPA--that could theoretically raise or lower alcohol use. We find that the presence of a merit-aid program in one's state generally leads to an overall increase in (heavy) drinking. This effect is concentrated among men, students with lower parental education, older students, and students with high college GPA's. Our findings are robust to several alternative empirical specifications including event-study analyses by year of program adoption. Furthermore, no difference in high-school drinking is observed for students attending college in states with merit-aid programs.

The incidence of the healthcare costs of smoking.

Smokers earn less than non-smokers, but much is still unknown about the source(s) of the smoker's wage gap. We build on the work of Bhattacharya and Bundorf (2009), who provide evidence that obese workers receive lower wages on account of their higher expected healthcare costs. Similarly, we find that smokers who hold employer-sponsored health insurance (ESI) receive significantly lower wages than their non-smoking peers, while smokers who are not insured through their employer endure no such wage penalty. Our results have two implications: first, the incidence of smokers' elevated medical costs appears to be borne by smokers themselves in the form of lower wages. Second, differences in healthcare costs between smokers and non-smokers are a significant source of the smoker's wage gap.

High-harmonic inverse-free-electron-laser interaction at 800 nm.

We present the first direct observation of a higher-order inverse-free-electron-laser (IFEL) interaction. Interaction at the fourth, fifth, and sixth harmonics is observed from an IFEL operating at 800 nm. The harmonic spacing, relative harmonic strength, and transverse beam overlap of the interaction are all in good agreement with tracking simulations.