Geography of Southeast Asia

Mark is a significant part of any record or understanding between two gatherings. Just manually written marks are legitimate for authoritative reports. The advanced world is presently doing part of recommendations and understandings through PCs and web. So as to use in the online reports, technologists has built up another mark strategy called computerized signature. This paper analyzes the innovation, legitimacy and dependability of computerized marks Introduction Digital mark is an electronic mark which is utilized to distinguish the legitimacy of a document.With the assistance of advanced mark one can confirm that the message he got is unique and unaltered. It's not possible for anyone to dismiss the parenthood of a message on the off chance that it is marked carefully. Advanced mark is a procedure which includes an encryption and decoding of information. The individual who sends the message will scramble the message which can be unscramble just by the recipient. â€Å"A computer ized mark is a â€Å"stamp† places on the information which is interesting to someone, and is hard to forge.In expansion, the mark guarantees that any progressions made to the information that has been marked can't go undetected. † (David Youd) Digital marks 3 Digital mark †Technology â€Å"After making a record, utilizing exceptional programming one can acquire a message hash (scientific outline) of the message. At that point utilizing a private key acquired from an open private key position, the message is been hashed. This encoded hash is the computerized mark of the message.The beneficiary of the message makes a hash of the got message to guarantee the legitimacy of the message. He will at that point utilize the open key gave by the sender to unscramble the message hash. On the off chance that the hashes coordinated, at that point the got message is legitimate. † (Digital mark) Legality of Digital mark Many nations like, US, European Union, and Australia have affirmed computerized marks legitimately simply like other transcribed mark archives. The greater part of the internet business exercises are utilizing computerized marks to verify the documants.â€Å"Stimulated by the advancement of the American Bar Association Digital Signature Guidelines, electronic mark enactment started with the Utah Digital Signature Act, which was established in 1995 and concentrated exclusively on issues raised by cryptography-based advanced marks. Before long, enactment was presented in a few other states† (Thomas J. Smedinghoff and Ruth Hill Bro) Digital marks 4 Issues and worries of computerized marks Like the greater part of the other secure archives have endured by the interruption of programmers, advanced mark innovation is likewise under the consistent dangers from the e-frauds.â€Å"How do you confirm the real assent and authority of an individual identifying with these new electronically-marked exchanges, or realize that the electronic mark wasn't taken from a PC by some inside or outside substance? † (Lauren Weinstein) Conclusion Digital marks are widely utilized in online business exercises. It is lawfully endorsed in numerous nations simply like the manually written marks. Like a large portion of the other secure records in web, the computerized marks are likewise under danger from interlopers or programmers.

Rubber and Alternatives essays

Elastic and Alternatives expositions A forebearer to the elastic business has been in presence since 1876 when an Englishman, Henry Wickham, came back to England from Brazil with elastic tree seeds he had accumulated for germination. In any case, societys utilization of elastic originates before that presence by very nearly 3500 years. The MesoAmericans were known to have utilized the latex delivered by the elastic tree for an assortment of purposes, including the creation of elastic balls that they would use for games and amusement. As of now, obviously, the elastic business makes a wide assortment of items for which elastic is fused. The elastic business not just keeps on utilizing the latex created by the elastic plant to deliver such items, however it has additionally had the option to add polymer mixes to improve that creation. The utilization of polymer mixes is a viable strategy for changing the exhibition of polymer materials and is generally utilized in designing plastics, elastic and fiber materials (Chiu, Tsai, 2006, p. 89). Adding polymers to the elastic gives a much progressively strong item and upgrades the ease of use of characteristic elastic (NR) when contrasted with the polybutadiene characterization of elastic (BR). Regular elastic is delegated elastic that is gotten from characteristic fixings, while polybutadiene elastic is named containing added substances to upgrade certain characteristics. Chius investigation of the contrasts between the two arrangements of elastic gives proof that Natural rubber...has certain favorable circumstances, for example, adaptability however a similar report shows that a portion of its properties miss the mark in specific applications, for example, oil opposition, air porousness, ozone obstruction, pressure set and warm maturing obstruction (Chiu, p. 89). BR can be named one of various engineered rubbers. There are various reasons why the elastic business has thought that it was important to build up these options in contrast to utilizing regular elastic. Those re... <!

Diabetes and Nutrition Free Essays

Diabetes mellitus is a nonstop issue of sugar and lipid digestion in which blood levels of glucose and lipids are raised. This anomalous digestion results from an overall absence of insulin, either too little insulin is emitted or the insulin that is discharged isn't viable. What's more, diabetes is related with incessant foundational entanglements, which, after some time, can influence the retina, kidneys, nerves, and cardiovascular framework. We will compose a custom paper test on Diabetes and Nutrition or on the other hand any comparable point just for you Request Now The most widely recognized orders of diabetes mellitus incorporate sort I, or insulin-subordinate, diabetes mellitus (IDDM); type II, non-insulin-subordinate diabetes mellitus (NIDDM); and gestational diabetes (GD). How it is Developed The issues of diabetes start in an organ situated behind the stomach about the length of a human hand called the pancreas. The pancreas is fundamental for both processing food and managing vitality. It is the guideline of vitality for the body that is significant in the advancement of diabetes. The pancreas produces hormones that process food. These hormones manage the utilization of glucose, a basic sugar, which is utilized for the greater part of the exercises in our bodies. The pancreas directs vitality in an assortment of practices in which people connect, for example, exercise and development, reacting to injury and stress, and diseases. The pancreas emanates three unique kinds of hormones. Insulin is the principal hormone that is created when glucose ascends in the blood. Insulin for the most part ascends in the wake of eating a dinner, and abundance glucose that isn't utilized is animated by insulin to be put away in muscles and fat cells with the goal that vitality can be utilized later. The liver likewise stores abundance glucose as a sugar called glycogen. The second kind of pancreatic hormone is glucagon. Glucagon separates glycogen put away in the liver with the goal that it very well may be utilized as vitality when blood glucose supplies are down. The third sort of pancreatic hormone is called somatostatin, thought to be significant in managing both insulin and glucagon. At the point when diabetes creates, this decent control framework doesn't work appropriately. The glucose in the circulatory system increments, and the cells can't use it. The individual creates hyperglycemia (overabundance glucose in the blood). This can be distinguished by estimating the glucose in the blood from a blood test, or if the glucose is sufficiently raised, it tends to be identified in the pee as overflow. This kind of circumstance happens when there isn't sufficient insulin to allow the cells to use the glucose, or there is opposition in all probability at the cell level to the nearness of insulin. The two cases produce diabetes. Indications of Diabetes A portion of the indications of Diabetes Mellitus are expanded thirst, expanded pee, weight reduction despite the fact that the individual is eating more, weariness, sickness, and heaving, skin contaminations, vaginitis, obscured vision, bladder diseases, and weakness in men and discontinuance of menses in ladies. One extreme side effect of diabetes is diabetic ketoacidosis. This side effect now and then creates somewhat sweet-smelling breath that is brought about by CH3)2CO, a metabolic side-effect, when the body is compelled to consume unsaturated fats instead of glucose. This procedure turns out to be increasingly more poisonous to the body as it proceeds; the individual may create diabetic unconsciousness and bite the dust. Ketoacidosis happens when people are either not getting enough insulin or the insulin isn't satisfactory to permit cells of the body to use the glucose. Impacts of Diabetes Diabetes has two sorts of long haul impacts. One sort is related with vein contribution. Harm to the enormous vessels puts the diabetic at more serious danger of stroke, cardiovascular failure, and gangrene of the feet. At the point when little veins are harmed, eyes, kidneys, and nerves become harmed. The other long haul impact is nerve harm as a rule in the feet, yet in addition once in a while in the hands. This nerve harm is called diabetic neuropathy. This harm may create an agonizing consuming uproar with loss of sensation after some time, making the body part progressively subject to injury and disease. Foot ulcers and gangrene can create, with further harm in the limits. In men, diabetic neuropathy may cause erectile weakness. Nourishment for Diabetes Counsel with a dietitian acquainted with kids and with type 2 diabetes is significant for all patients. The dietitian ought to evaluate the healthful status and practices of the patient and afterward counsel them to give a feast plan which, in any event at first, doesn't go astray in a significant route from their standard eating rehearses. Changes made steadily, through resulting arrangements and meetings, much of the time accomplish consistence more effectively than does radical and fast change. People giving directing must be clear about the distinctions in the administration of patients with type 1 and type 2 diabetes. Since stoutness is a common finding in type 2 diabetes and caloric limitation brings about improved glycemic control and insulin affectability, unobtrusive caloric limitation and weight reduction or upkeep are significant objectives: so is adjustment of the dyslipidemia, which much of the time goes with the metabolic condition or IRS. As a rule, calories from dietary fat ought not surpass 30% of vitality admission, and calories from soaked fat ought not surpass 10%. An exertion is additionally made to constrain cholesterol in the eating regimen to 300 mg/day, and 200 mg/day if hypercholesterolemia is available. Monounsaturated fats can be expanded to up to 15-20% of all out calories and may effectsly affect triglycerides and high-thickness lipoprotein (HDL). Protein should represent 15-20% of all out calories. The rest of calories is comprised of sugar. Dietary guidance for individuals with diabetes has changed over ongoing years. Old routine guidelines requested that all staples were gauged and their vitality content determined by standard tables. Everything was relegated a particular worth, and patients were required truly to gauge every constituent of each feast. This style of numerical measurement has now been loose with the acknowledgment that it is difficult to evaluate each factor in what is currently considered as a way of life malady, and that, a long way from helping patients, the methodology was itself a significant reason for trouble that obstructed consistence. The attention presently is on instruction, incorporating clinical counsel inside the patient’s existing way of life instead of endeavoring to override it. What wellbeing experts signify is that since the goal is to ‘live an ordinary life’ patients ought not become over-fixated and not be barred from uncommon event nourishments, for example, at weddings and birthday celebrations. A treat for patients, in any case, is frequently the customary, ongoing tonic that they use as a concentration in their everyday lives. It is enticing to imagine that for diabetics it is on the grounds that specific nourishments ought to be wiped out that they are wanted. In any case, many express that sweet nourishments, for example, candy parlors and cakes, were viewed as close to home rewards even before analysis. These exceptional nourishments are characterized not exclusively by their pleasantness, yet in mix with their place in people’s eats less as additional items: but rather fulfilling hunger giving erotic delight at specific occasions in every day schedules. This prize measurement is completely joined into the rhythms of their lives, providing markers between times of work, for example, early in the day breaks or evening snacks. That it is decisively these which are prohibited is deciphered as conviction certifying; treats consistently were viewed as offenses from work, and the clinical exhortation got from the diabetes just affirms their status. At the point when squeezed, patients concede that they know the counsel doesn't generally approve ordinary offenses. However, leaving the message adequately unchallenged serves to exonerate them ethically. In the early years after the revelation of the illness, there was sugar limitation, at that point an expansion in starches and decrease in fat admission. Presently the American Diabetes Association prescribes 10% to 20% protein in the eating regimen yet no particular restrictions on sugars and fats. An individualized dietary arrangement is suggested, remembering incidental guilty pleasures for limited quantities of sucrose. The impacts of medications on glucose must be given genuine thought in the administration of diabetes in light of the fact that various drugs generally utilized for older folks influence glucose in antagonistic manners. The likelihood of creating diabetes increments in the event that somebody eats numerous nourishments that have a high glycemic list score-food sources that rapidly increment glucose levels, for instance pop, dessert, and chocolate cake. Consequently it shouldn’t be astounding that eating in the contrary way, that is, eating nourishments that don’t rapidly increment glucose levels-high-fiber nourishments, for example, beans, entire wheat bread, and oranges-may help standardize glucose levels and control diabetes. Late discoveries demonstrate that individuals who eat bunches of fiber are less inclined to have put on weight or to have strange insulin levels 10 years after the fact. So eating bunches of fiber may assist with forestalling or control diabetes. Individuals who see themselves as for the most part ready to achieve their objectives are generally effective at controlling what they eat in order to live sensibly well with diabetes. End Most of patients neglect to keep inside the ideal scope of glucose levels, and in spite of the fact that prescription can without much of a stretch be modified, the eating routine is the main thing to go under examination. Along these lines, food, the methods for progress quickly comes to serve additionally as a methods for representing blame and disappointment. Its double capacity is valuable along these lines to both expert and patient, since it gives a typical site on which both can center, refining the immense scope of conceivable way of life factors into clear components that can be followed up on. Reference Hiser, Elizabeth N. (2002). The

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purchase custom UNK paper Theoretical It is of foremost significance, to spare your work in any product application. It great to prepare yourself to spare work frequently in light of the fact that a PC or server may crash and it can't tell you that it will do as such. Information reinforcement is of foremost significance. Crucial records are incidentally erased constantly. Basic information can get degenerate. Cataclysmic events may demolish your office. Sponsored with a solid reinforcement and recuperation plan, you can improve from any of these. Without one, you are left with nothing, however a bombed framework and lost information. Shutting a File, Exit Files or Applications Shutting a document After you spare the document appropriately, you can either pick to close the record and leave the application window open. Shutting a record from the enu chooses File, at that point Close or the X button on the upper right corner of the window. Leaving the Application You can decide to leave the application as well. Leaving the application, from the menu select File, at that point Exit or use X button at the upper right of the title bar of the window (eHow, 2009). Reinforcement, File Synchronization, Restore Point, and Recovery Disk Reinforcement Reinforcement, is replicating of documents, to a second medium for example a diskette, compressed drive, or tape as a security measure on the off chance that the primary medium falls flat. You can back up records either utilizing working framework orders, and particular reason reinforcement utilities. Pack information to spare space and cost (Radiant correspondences, 2011). Document Synchronization Document Synchronization, is the procedure to guarantee envelopes put away in at least two separate areas, contain the equivalent refreshed records. On the off chance that you erase, update, or include a document from one area, the synchronization procedure will erase, update, or include a similar record at the other area. Reestablish Point Reestablish point, is fundamentally a past condition of a working framework, before you experienced an extreme framework issue. It is essentially in a PC hard drive. Recuperation Disk Recuperation circle is a media containing a reinforcement of the first processing plant arrangement, or supported state of a PC as designed by a unique PC producer or an end-client (Radiant correspondences, 2011). Purchase custom UNK exposition

Disorders and Diseases of the Thyroid Research Paper

Clutters and Diseases of the Thyroid - Research Paper Example Presentation In proof based practice, simply after the issue is comprehended and looked into can clinical experts express a present best technique for treatment. In this sort of clinical practice, clinical experts depend on bleeding edge explore results to settle on treatment choices, as opposed to on the more seasoned strategy for accepting that convention and authority constantly held the correct responses for a patient. The best patient consideration is perceived to be a mix of the ebb and flow substantial clinical research, a professional's own encounter and instruction, and the circumstance of an individual patient (Fineout-Overholt, Stillwell, Williamson, Cox, and Robbins, 2010). Applied to the zone of thyroid brokenness, proof based and best practice rules could mean perceiving the impact of a particular patient's way of life on their body's wellbeing so as to differentiate between straightforward corpulence and a discouraged thyroid, for instance, and staying aware of the mos t present writing on which kinds of thyroid hormones are viewed as best (Maas, 2007). Since by certain appraisals, as much as five percent of the general female populace and more than twenty-five percent of the whole populace beyond seventy five years old experiences some type of thyroid sickness, it is indispensably significant that the clinical network comprehend these issues as they identify with thyroid brokenness (Maas, 2007; Mulryan, 2010). A few sorts of thyroid brokenness bring about the over-creation of metabolic hormones. This over-creation brings about a condition known as hyperthyroidism (Mulryan, 2010). Hyperthyroidism is most regularly found in ladies until the age of sixty-five or seventy-five, so, all in all, as in found in thyroid ailment no matter how you look at it, the occurrence extraordinarily increments and turns out to be similarly likely between the genders (Gutierrez, 2008). As would be normal from an organ whose intention is to manage the body's digestion, hyperthyroidism prompts a seriously expanded basal metabolic rate. The overactive thyroid can create as much as five to multiple times the typical measure of thyroid hormones and can bring about a heap of unfavorable consequences for the remainder of the body. This expansion in discharge is accomplished through an expansion in the size and an accessible cell framework of the thyroid organ, such huge numbers of more cells can live inside the organ, just as through an expansion in the emission of the hormone by the individual thyroid cells (Hall, 2011). By and large, this condition is incited by an immediate disease inside or harm to the thyroid organ itself, however it can likewise happen once in a while as an auxiliary issue when there is a brokenness in the pituitary or nerve center organs (McCance, Huether, Brashers, and Rore, 2010). The most widely recognized illnesses that lead to either the essential or optional brokenness of the organs are auto-safe ailments, while a few reas ons for reversible essential harm to the thyroid itself are an iodine insufficiency in the eating regimen or viral disease of the thyroid (Mulryan, 2010).â

Identity vs. Role Confusion in Eriksons Theory

Identity vs. Role Confusion in Eriksons Theory Theories Psychosocial Psychology Print Identity vs. Role Confusion in Psychosocial Stage 5 By Kendra Cherry facebook twitter Kendra Cherry, MS, is an author, educational consultant, and speaker focused on helping students learn about psychology. Learn about our editorial policy Kendra Cherry Reviewed by Reviewed by Amy Morin, LCSW on July 01, 2019 facebook twitter instagram Amy Morin, LCSW, is a psychotherapist, author of the bestselling book 13 Things Mentally Strong People Dont Do, and a highly sought-after speaker. Learn about our Wellness Board Amy Morin, LCSW Updated on December 07, 2019 Psychosocial Development Overview Trust vs. Mistrust Autonomy vs. Shame and Doubt Initiative vs. Guilt Industry vs. Inferiority Identity vs. Confusion Intimacy vs. Isolation Generativity vs. Stagnation Integrity vs. Despair Identity versus confusion is the fifth stage of ego according to psychologist  Erik Eriksons theory of psychosocial development. This stage occurs during adolescence between the ages of approximately 12 and 18. During this stage, adolescents explore their independence and develop a sense of self. Verywell / Nusha Ashjaee According to Erikson,  people progress through a series of stages as they grow and change throughout life. During each stage, people face a developmental conflict that must be resolved to successfully develop the primary virtue of that stage. He was  interested in how social interaction and relationships affect  development and growth. Overview Psychosocial Conflict: Identity Versus ConfusionMajor Question: Who am I?Basic Virtue: FidelityImportant Event(s): Social Relationships What Is Ego Identity? One of the main elements of Eriksons psychosocial stage theory is the development of  ego identity. It is the conscious sense of self that we develop through social interaction, which is  constantly changing due to new experiences and information we acquire in our daily interactions with others.   During the identity versus confusion stage, the conflict is centered on developing a personal identity. Successfully completing this stage leads to a strong sense of self that will remain throughout life. As they transition from childhood to adulthood, teens may begin to feel confused or insecure about themselves and how they fit into society. As they seek to establish a sense of self, teens may experiment with different roles, activities, and behaviors. According to Erikson, this is important to the process of forming a strong identity and developing a sense of direction in life. Development During the Adolescent Years Teen behavior often seems unpredictable and impulsive, but all of this is part of the process of finding a sense of personal identity. Parents and family members continue to exert an influence on how teens feel about themselves, but outside forces also become particularly important during this time. Friends, social groups, schoolmates, societal trends, and even popular culture all play a role in shaping and forming an identity. Those who receive proper encouragement and reinforcement through personal exploration will emerge from this stage with a strong sense of self and a feeling of independence and control. Those who remain unsure of their beliefs and desires will remain insecure and confused about themselves and the future. Resolving the crisis at this stage of development involves committing to a particular identity. This might involve committing to a career path, deciding what social groups to associate with and even developing a sense of personal style. Those who are successful develop fidelity, a psychological virtue characterized by the ability to relate to others and form genuine relationships.?? This ability plays an important role in the upcoming stage known as intimacy versus isolation. So, what happens to those who do not end up successfully forming an identity at this point in development? Kids who are not allowed to explore and test out different identities might be left with what Erikson referred to as role confusion. These individuals are not sure who they are or what they like. They tend to drift from one job or relationship to another, never really sure what they want to do with their lives. Instead of feeling a sense of personal cohesiveness, they are left feeling disappointed and confused about their place in life.

Longitudinal Course and Impact of Insomnia Symptoms - 1100 Words

Longitudinal Course and Impact of Insomnia Symptoms in Adolescents with and without Chronic Pai (Research Paper Sample) Content: Article Summary: Longitudinal Course and Impact of InsomniaSymptoms in Adolescents with and without Chronic PainNameUniversityProfessorDate of Submission Article Summary: Longitudinal Course and Impact of InsomniaSymptoms in Adolescents with and without Chronic PainIntroductionIn the article in question, the researchers were seeking to evaluate insomnia symptoms in adolescents who experienced chronic pains and those without such pain. The researchers further sought to establish the associated psychological and behavioural risk factor of insomnia, as an indicator of quality of life through a certain time period ADDIN CSL_CITATION { "citationItems" : [ { "id" : "ITEM-1", "itemData" : { "abstract" : "This study aimed to 1) examine trajectories of insomnia symptoms in adolescents with chronic pain compared to their healthy peers; 2) evaluate psychological and behavioral risk factors for longitudinal insomnia symptoms; and 3) evaluate insomnia as a predictor of quality of life, activity limitations, and healthcare utilization over 12 months. Participants included 61 adolescents with chronic pain and 60 youths without chronic pain (12\u201318 years; 72% female). Questionnaires were completed at enrollment, 6 months, and 12 months and assessed pain intensity, insomnia symptoms, sleep hygiene, presleep arousal, depression, pubertal status, activity limitations, quality of life, and healthcare utilization. Insomnia symptoms persisted for both groups and remained higher at all time points for youths with chronic pain. Generalized estimating equations modeling identified 3 risk factors for longitudinal insomnia symptoms: having chronic pain, poorer sleep hygiene, and higher depressive symptoms. Insomnia symptoms also predicted poorer quality of life over time and were associated with more frequent healthcare utilization. Findings suggest that sleep problems are persistent and associated with negative impact for youths with chronic pain. Treatment of ins omnia symptoms in youths with chronic pain may lead to improvements in quality of life and reductions in healthcare costs. Perspective: Insomnia symptoms are persistent over a 12-month period and are associated with negative impact for youths with chronic pain. These findings suggest that treatment of insomnia symptoms in youths with chronic pain may lead to improvements in quality of life and reductions in healthcare costs.", "author" : [ { "dropping-particle" : "", "family" : "Palermo", "given" : "Tonya M.", "non-dropping-particle" : "", "parse-names" : false, "suffix" : "" }, { "dropping-particle" : "", "family" : "Law", "given" : "Emily", "non-dropping-particle" : "", "parse-names" : false, "suffix" : "" }, { "dropping-particle" : "", "family" : "Churchill", "given" : "Shervin S.", "non-dropping-particle" : "", "parse-names" : false, "suffix" : "" }, { "dropping-particle" : "", "family" : "Walker", "given" : "Amy", "non-dropping-particle" : "", "parse-names" : false, "suffix" : "" } ], "container-title" : "The Journal of Pain", "id" : "ITEM-1", "issue" : "11", "issued" : { "date-parts" : [ [ "2012" ] ] }, "page" : "1099-1106", "title" : "Longitudinal Course and Impact of Insomnia Symptoms in Adolescents With and Without Chronic Pain", "type" : "article-journal", "volume" : "13" }, "uris" : [ "/documents/?uuid=35b0225d-1915-4abc-b391-1c8316d85324" ] } ], "mendeley" : { "previouslyFormattedCitation" : "(Palermo, Law, Churchill, Walker, 2012)" }, "properties" : { "noteIndex" : 0 }, "schema" : "https://github.com/citation-style-language/schema/raw/master/csl-citation.json" }(Palermo et al., 2012). The hypothesis pointed towards chronic pain resulting in insomnia among the many adolescents who experienced these pains. A comorbid association between chronic pains and insomnia was also believed to be fundamental in determining the quality of life for the individuals suffering from the condition.Previous research indicated a close association between chronic pa in the occurrence of insomnia among youths. The researcher believed there could be a comorbid association which resulted in adverse behavioural and psychological effects upon the individuals suffering from the condition ADDIN CSL_CITATION { "citationItems" : [ { "id" : "ITEM-1", "itemData" : { "abstract" : "This study aimed to 1) examine trajectories of insomnia symptoms in adolescents with chronic pain compared to their healthy peers; 2) evaluate psychological and behavioral risk factors for longitudinal insomnia symptoms; and 3) evaluate insomnia as a predictor of quality of life, activity limitations, and healthcare utilization over 12 months. Participants included 61 adolescents with chronic pain and 60 youths without chronic pain (12\u201318 years; 72% female). Questionnaires were completed at enrollment, 6 months, and 12 months and assessed pain intensity, insomnia symptoms, sleep hygiene, presleep arousal, depression, pubertal status, activity limitations, quality of life, a nd healthcare utilization. Insomnia symptoms persisted for both groups and remained higher at all time points for youths with chronic pain. Generalized estimating equations modeling identified 3 risk factors for longitudinal insomnia symptoms: having chronic pain, poorer sleep hygiene, and higher depressive symptoms. Insomnia symptoms also predicted poorer quality of life over time and were associated with more frequent healthcare utilization. Findings suggest that sleep problems are persistent and associated with negative impact for youths with chronic pain. Treatment of insomnia symptoms in youths with chronic pain may lead to improvements in quality of life and reductions in healthcare costs. Perspective: Insomnia symptoms are persistent over a 12-month period and are associated with negative impact for youths with chronic pain. These findings suggest that treatment of insomnia symptoms in youths with chronic pain may lead to improvements in quality of life and reductions in heal thcare costs.", "author" : [ { "dropping-particle" : "", "family" : "Palermo", "given" : "Tonya M.", "non-dropping-particle" : "", "parse-names" : false, "suffix" : "" }, { "dropping-particle" : "", "family" : "Law", "given" : "Emily", "non-dropping-particle" : "", "parse-names" : false, "suffix" : "" }, { "dropping-particle" : "", "family" : "Churchill", "given" : "Shervin S.", "non-dropping-particle" : "", "parse-names" : false, "suffix" : "" }, { "dropping-particle" : "", "family" : "Walker", "given" : "Amy", "non-dropping-particle" : "", "parse-names" : false, "suffix" : "" } ], "container-title" : "The Journal of Pain", "id" : "ITEM-1", "issue" : "11", "issued" : { "date-parts" : [ [ "2012" ] ] }, "page" : "1099-1106", "title" : "Longitudinal Course and Impact of Insomnia Symptoms in Adolescents With and Without Chronic Pain", "type" : "article-journal", "volume" : "13" }, "uris" : [ "/documents/?uuid=35b0225d-1915-4abc-b391-1c8316d85324" ] } ], "mendeley" : { "previouslyFormat tedCitation" : "(Palermo et al., 2012)" }, "properties" : { "noteIndex" : 0 }, "schema" : "https://github.com/citation-style-language/schema/raw/master/csl-citation.json" }(Palermo et al., 2012). Depression as a symptom has been utilised in predicting occurrence of insomnia among adolescents. This psychological factor can be observed through the behaviours displayed by individuals suffering from insomnia. Other factors that have been associated with the development of sleeping problems include moods, sleeping habits and behaviours with regard to adolescents. Most of the other research focused on the behavioural and psychological factors, which were associated with the presence of insomnia among adolescents.ParticipantsThe participants in the context of this research included individuals who had been diagnosed with chronic pains and other adolescents without such problems. The participants with chronic pains were recruited from a paediatric clinic at an academic medical centre in t he Northwest. The recruitment was either done through written letters to the participants, or through one on one contact with the participants at the clinic. Inclusion included people aged between 12-18, with constant pain for the last three months and who could understand English fluently ADDIN CSL_CITATION { "citationItems" : [ { "id" : "ITEM-1", "itemData" : { "abstract" : "This study aimed to 1) examine trajectories of insomnia symptoms in adolescents with chronic pain compared to their healthy peers; 2) evaluate psychological and behavioral risk factors for longitudinal insomnia symptoms; and 3) evaluate insomnia as a predictor of quality of life, activity limitations, and healthcare utilization over 12 months. Participants included 61 adolescents with chronic pain and 60 youths without chronic pain (12\u201318 years; 72% female). Questionnaires were completed at enrollment, 6 months, and 12 months and assessed pain intensity, insomnia symptoms, sleep hygiene, presleep arousal , depression, pubertal status, activity limitations, quality of life, and healthcare utilization. Insomnia symptoms persisted for both groups and remained higher at all time points for youths with chronic pain. Generalized estimating equations modeling identified 3 risk factors for longitudinal insomnia symptoms: having chronic pain, poorer sleep hygiene, and higher depressive symptoms. Insomnia symptoms also predicted poorer quality of life over time and were associated with more frequent healthcare utilization. Findings suggest that sleep problems are persistent and associated with negative impact for youths with chronic pain. Treatment of insomnia symptoms in youths with chronic pain may lead to improvements in quality of life and reductions in healthcare costs. Perspective: Insomnia symptoms are persistent over a 12-month period and are associated with negative impact for youths with chronic pain. These findings suggest that treatment of insomnia symptoms in youths with chro...